Escaping the Indoor Health Crisis With Dr. John La Puma

0:03Thank you for joining us for episode 562 of Live Happy Now. This week, we're celebrating the International Day of Happiness, and one way to do that is by getting out in nature. I'm your host, Paula Felps, and today I'm talking with Dr. John La Puma, a two-time New York Times bestselling author, board-certified internist, and professionally trained chef who pioneered culinary medicine. With his new book, Indoor Epidemic, John is teaching us how spending so much time inside affects our physical and mental health, and he offers simple evidence-based practices we all can implement to improve our well-being.

0:42Let's have a listen. John, thank you so much for joining me on Live Happy Now. Paula, pleasure to be here. I was really excited to discover your book because biophilia and the power of nature is something that I don't think we can talk enough about. And a lot of times it slips out of our conversations, we just don't think about it. So to give us a little bit of backstory, can you talk about how you started connecting indoor living with chronic disease and mental health? My own journey is that of a traditional physician who has done some non-traditional things inside of the lines of medicine. So I trained in internal medicine, I did a fellowship in medical ethics at the University of Chicago.

1:26I taught there for a while and went into practice and moved to California and continued that after I'd gone to cooking school for a year and taught cooking in a cooking school and worked in a great restaurant. So I felt a little more like I needed to bring what I learned about food and nutrition in cooking school and in a restaurant into medical practice, which helped to result in a field called culinary medicine, which I taught the first medical school course in with my colleague and friend, Mike Roizen at the Cleveland Clinic. And after that, having such interesting experiences, bringing culinary medicine into medicine and feeling its importance to people about using food as medicine in addition to medication, and in some cases instead of it, but largely in addition, I felt like I needed to know more about where the food came from, what was really nutritious about how it had been grown.

2:25So I found an abandoned nursery in Santa Barbara, where I live, and rehabbed it into an organic farm and regenerative farm and used it as a laboratory to try to figure out how nature and growing things affected the body and brain as well. Kind of an extension of an initiation to culinary medicine. In that process, found that what I had put together from medical practice, which was that where people spend their time is probably the most underappreciated and important factor that we're just not asking, that the environment turns out to influence so much of our medical, not just condition, but our mental health.

3:17And so that is where I have wound up. The idea that the environment determines much of our behavior, which is not new to anybody who's struggled with eating or obesity or almost any other kind of what can be an addiction, but it is new to the idea and science of longevity. And that's where I'm focusing in indoor epidemic. And I mean, you and I could spend another couple hours talking about how food as medicine can change us and change our mental health. And can you talk about, as you learned all this, all the components came together for the basis of the indoor epidemic? Well, working on the farm and having hundreds, maybe thousands of people over by now.

4:03and doing medical research, reading 2 ,200 peer-reviewed studies about how light and air and soil and environment changed mental health and physical health. I found that indoor life, which of course I've had and we all have a need for cognitive performance and for work, actually turns out to be a biological emergency. We are not getting the 93 % of us don't spend more than 7 % of our time outside. We're 93 % indoors, 7 % outdoors. So 93 % of the week, we're inside. And our bodies just didn't evolve to handle that. So as a consequence, most of us, nearly all of us, are missing a big biological signal in the morning of morning light, which activates your cortisol, which tells your hormones to get ready to work, including serotonin, a chief happiness hormone, and sets your melatonin for the evening so that you can begin to fall asleep that evening.

5:18Without that big morning wake up of at least 10 ,000 lux within an hour of awakening, your body is kind of wired but tired and you go through the day with brain fog and feeling not yourself. And unless we have that morning stimulus and unless we have the dusk setting of the sun with some kind of signal to the brain to tell you that you're powering down and that it can rest, we not only underperform, but we shorten our telomeres, which of course are the ends of the chromosomes that indicate aging, which normally fray and shorten as the cell divides. But we accelerate that fraying and that shortening so much so that it impacts our longevity by at least five years.

6:12And people don't think of that being there's no way that they're going to equate like I'm not getting sunlight. I'm going to die earlier. You know, they're not. No, nor do we think about light and air as nutrients like protein is a nutrient or carbohydrate is a nutrient or magnesium is a micronutrient. But we need to because light sets not just our mood, but our metabolism, because it helps establish our circadian rhythm, because that allows about 50 % of our genes, which are under circadian control, to work optimally. Indoor life, biologic emergency is that we're confined. And the toxins inside not just disrupt our circadian rhythm because we don't get outside, But the toxins themselves are responsible for chronic inflammation, which is at the bottom of many chronic diseases, heart disease, diabetes, many brain diseases as well.

7:11Can we talk a little bit? I want to touch on that for a moment because we talk about the toxins of being inside. And we do not talk enough about indoor air quality, about the things that are being emitted from our electronics, the off-gassing from the furniture, from our clothing, from all the building materials around us. Can you talk about just how toxic it can be to stay inside? Well, I think you've just summarized it beautifully. And the interesting thing is that you can reverse that by getting fresh air in. Most outdoor air is better quality than most indoor air by far. And as our buildings have gotten tighter and more confined and more air and light and waterproof, the CO2 builds up and that can actually hinder mental performance.

8:03Over a thousand parts per million of CO2, and you can get a CO2 meter to measure this, and some companies do because they're concerned about cognitive performance. Over a thousand parts per million of CO2 in a room drops cognitive performance by 15 percent and even more at higher levels. And so you upgrade the room's IQ as well as the room's health by opening a window. And interestingly, also, if you can reduce that chronic inflammation by using green exercise, and these are the ways, these are very specific, intentional ways that we can use the 7 % of time that we're already spending outdoors.

8:45And the good news is that we only need to repurpose about two hours of this. in a week, optimally even five hours in a week, as long as it's specific intentional time. Most time we spend outdoors now is incidental. You know, we walk to the coffee shop where we take the trash out or we walk in a parking lot to our car, which is fine. But it's not using outdoors as a mental health tool. It's not using the outdoors as a medical tool. And most people don't realize that the happiness that you yourself focus on and have successfully for so many years is not just I choose to be happy or I want to be happy.

9:31It's actually a biological result of your environment. And when you change your environment to use natural forces to help your biology work, then your mood changes and the happiness becomes easier. Getting outdoors with specific intentional time, doing things like green exercise, doing things like morning light, doing things like looking at the dusk, doing things like appreciating the sky and the ground, maybe with gardening, which 70 million Americans are fans of, which has important implications for your microbiome to protect your skin and your internal microbiome to change your metabolism. So it can make the hormones that give you a regular metabolism.

10:19And gardeners themselves have half a percent lower hemoglobin A1c than non-gardeners, which is about the same as an initial dose of metformin. So using specific intentional time, repurposing some of that 7 % can dramatically improve your physical health and your mental health. But we have to understand happiness as a biological result, not a personal failing or even a personal choice. It's a result of what your environment is telling you, the information that light and air is giving your body and brain. We'll be right back with more of Live Happy Now.

11:08And now let's hear more from Dr. John LaPuma. You give us some very specific approaches, prescriptions, if you will, for embracing intentional exercise, how we can use it. Let's talk a little bit about how that looks because you even start with the way that we wake up in the morning. And I love that part. Can we start with that about how we need to be waking up in the morning? I think we need to be waking up gently. I think it's a kind of... Very few of us do. There are very few of us do. 40 % of us go to sleep with a lamp or a TV on. And that monitor has implications for your brain and your heart.

11:54If you go to sleep with a lamp or a TV on, you might not know that bright light, that white and blue light from an LED monitor tells your brain it's still time to work. Just like when your phone is in your hand, your brain thinks it's time to work. And it's very difficult to turn off and just use your parasympathetic nervous system and your senses, which is how we experience nature, when your phone is in your hand, because you're looking at it. And that time at night where we go to sleep with the light on or the TV on, right, light between 1230 in the morning and six in the morning means that you have a 50 % greater chance of a heart attack and 56 % chance greater of heart failure than if you don't have bright light during that time.

12:46Wow. And it's about 30 % for stroke and atrial fibrillation. This is the result of a huge study from the UK Biobank show over 90 ,000 people over 9.4 years tracing light sensing. It came out in JAMA end of last 2025. And it's very important and really hasn't been recognized as such with light being a risk factor for heart disease. But when you wake up in the morning, you actually want that full spectrum bright light that's outside. If you wake up when it's dark and you have to get up at 5 a.m. for your job or for any other reason, then you ought to have a bright light meter, a 10 ,000 lux satellite.

13:35But you should also try to get outside and have a double anchor because you get other wavelengths of light that tell your brain it's time to wake up, tell your gut it's time to make serotonin, tell your brain and pineal gland to make melatonin that evening. And you should avoid blue light at least 30 minutes, but optimally an hour before bedtime. And blue light comes from any monitor. And that's because it suppresses your melatonin by 80%. So it's much harder to get to sleep and much harder to experience deep sleep. Now, deep sleep, as you know, is the slow wave sleep that occurs at the beginning of sleep and the first couple of cycles.

14:19And deep sleep, you only get if you have this morning boost of morning light for 10 or 15 minutes within 60 minutes of waking. So the receptors in your retina can receive that light. And deep sleep is essential because it's the time that you make bone. It's a big surge of growth hormone. So women who are concerned about osteoporosis ought to really essentially, as part of their osteoporosis treatment, have morning light. A lot of people I know sleep with their phone beside the bed. The notifications go off that sometimes they'll wake up and check them. Yeah, that's a biological killer. Yeah, what's that doing to us?

15:06Well, it is just what I've said, that that bright light, especially if it's between 1230 and 6 in the morning, has really significant cardiovascular implications. So greater risk for heart events. And secondly, it doesn't allow your brain to rest. It doesn't allow you to go to sleep properly because your brain is getting different signals. with bright light and you don't need very much of it, your brain goes, oh, I don't have to sleep. Let's work. And that's great for 8 a.m. It's not great for 11 p.m. Try to park your phone in another room. And when you get up in the morning and to get this morning light, look through a screen.

15:52Don't look through a window because the window actually filters out much of the light that the sun is giving you, even though it doesn't seem it. And even though it doesn't look as bright outside than it looks like it is inside, it actually is. You just can't detect the wavelengths as well. How do we integrate this outdoor blessing into our morning routine when it's so busy? It is so busy. And a lot of people have their time mapped out kind of minute by minute before they have to get out the door or before they have to get somebody else out the door. And women actually are prime in this because many women don't experience outdoor time without responsibility, without having to do something.

16:37So the first is to align your biological rhythm at night. I think it's easiest to do this if you're not being overstimulated at night with screens before bed and that you don't go to sleep with a lamp or a TV on because it will give your brain the wrong signals. signals. The second is that a few minutes earlier is all that it takes. Getting up 15 minutes earlier is all that it takes to make the rest of the morning more productive and to handle these responsibilities in a way that is not as burdensome. They don't seem as frantic. The third is to enlist your partner or somebody else as a buddy, as an accomplice in this, where you're doing it together.

17:22You're meeting somebody else. When I'm in New York next month in March, we're going to do a Central Park morning light event where we're going to have everybody come out at sunrise and watch the sun for 15 minutes and then go up about our day. And it's such an important biological signal that you really can't afford to miss it. And once you understand that, and once you start integrating that into your day, then you can kind of make space for other ways to intentionally be outside. Can you talk about what some of those practices are that we can use to get that intentional green exercise? You know, being outdoors and exercising is at least 20 % more efficient than being indoors and doing the same exercise because your perceived exertion when you're outdoors is about 20 % less.

18:18So you can be doing the same exercise outdoors than you do indoors and it will feel about 20 % less burdensome or energy zapping if it does feel that way. And the reason for that is that when you're outdoors, your attention is drawn. It's not demanded like it is on your phone. Like, I got notifications, I got to do something with this. When you're outside and exercise, you have other things to draw your attention. Scientists call this soft fascination, where the way a leaf moves or fractals in a pattern or the feeling of the air or even the phytoncides, which are aromatic chemicals that are released by trees, all impact how you are outside.

19:09And that efficiency translates to less perceived exertion. Green exercise is simply exercising outside in or among or near trees. And it's been shown that people who live within 500 meters of dense vegetation have dramatically fewer antidepressant prescriptions than those who do not. Trees themselves seem to, and being near trees themselves, appear to reduce not just rumination in your prefrontal cortex. And it's been shown by MRI tests that a 90-minute walk near or among trees has dramatic reduction in rumination and activity in your prefrontal cortex versus an urban walk, probably because of this soft fascination idea, possibly because of the fight inside documentation where specific chemicals from the trees which communicate to each other using these chemicals have an immune effect on a person's body as well.

20:14Those have been well-documented to increase natural killer cell counts, which are the white cells that you have in your body that kill cancer cells and infection cells, infectious cells. So being outside also near trees also reduces chronic inflammation, measuring C-reactive protein, which is what we use as a general marker of inflammation in the body. of up to 22%, simply being near trees or walking near greenery of up to 500 meters, living within that time, or even walking within that distance, or even walking near those trees for 20 to 30 minutes, three times a week. And that lowers cortisol levels by an average of 21 % below what your diurnal variation is.

21:05So there are many direct now scientifically shown benefits that have simply not been put together in this way to improve not just telomere shortening, but also chronic inflammation and specific medical conditions that work in addition to medication that I think we have simply missed as ways of improving anxiety and depression, heart disease, diabetes, myopia. You know, Paula, you actually have more control than you thought. 80 % of heart disease is preventable. 50 % of all depression and anxiety is preventable. 40 % of most cancers, which are environmentally related, is preventable. And I think we need to take advantage of this idea that this isn't a vibe, you know, it's a protocol.

21:59There's strong science behind this kind of findings. And in the book, there are hundreds of ways to do this. and we've discovered some of them. John, that is terrific. I'm so excited to share this book with our listeners. We're going to tell them how to find you, how to find the book. We're going to give them that free download of your nature resources. So thank you so much for sitting down with me today talking about this. And, you know, I look forward to seeing where this goes. Well, thanks so much. I look forward to it too.

22:55Thank you. 20th, and we'd love to have you join us. Be sure to visit our Live Happy social media pages on Facebook and Instagram and tell us how you're sharing happiness, as well as seeing how other Live Happy listeners are observing this special day. That is all we have time for today. We'll meet you back here again next week for an all new episode. And until then, this is Paula Phelps, reminding you to make every day a happy one.

23:28Thank you.