What Extreme Environments Teach Us About Human Performance | Dr Jack Kreindler

0:00The very crux of what I've been interested in, medicine and physiology for all this time. And why not try and work out, okay, there seems to be a cluster of advantages over there. It happens to be in women or it happens to be in this particular type of population or it happens to be in these people with these genes or those genes. And that helps us understand what should we be doing when someone's in intensive care who's losing loads of weight and we need to feed them in the right way. They're in an extreme setting as well. They're in a hyper endurance, long, long haul of going, of getting out of hospital.

0:35You know, their South Pole victory is getting back home. So that's what we do is we look at people in extremes. That's certainly not conventional medicine, which is waiting for a disease usually and then trying to fix it with something. It's looking at how people behave and survive and thrive or fail in extremes, seeing what are the core components of success or failure, and then saying, well, how do we add that to your and my life? And what medicine practices, maybe not today, but over the next 10, 20 years, what should we be doing in medicine to get more survivors and to get better outcomes?

1:17Was there anything fascinating that came from that, apart from kind of women were better at the long term endurance and men better at the short term? I mean, for me, that is thinking about the XX chromosome versus the women have. And is that because we're in our mitochondria? It might be fibroblast growth factor 21. It might be a lot of different things. Is there anything that surprised you out? Is there anything that you saw that was quite interesting? So what I found most intriguing was, despite us sticking all sorts of gizmos and gadgets on everyone, like continuous glucose monitors, watches, people looked like flashing Christmas trees.

1:57Literally, they had like in the dark, which there isn't any dark, obviously, at the South Pole in summer, because it's 124-hour daylight. But if you were to put someone in the dark, they'd look like a Christmas tree, blinking and glowing. With all of that sensor data, what was the most surprising thing to me? It was the daily journals of how people felt about themselves and about their interaction, communication and feeling of support. That showed for me the greatest signal of whether a person was going to have a good day or not, or was going to, yeah, overall have less physiological wear and tear by the end of the trip.

2:46It wasn't about the physiology. It was about the recognition of your own load. We talked about cadence, about knowing when to pause, but it's not just understanding that for yourself. It's also the ability to be able to spot that in others and to be able to express that you're observing that in others and offering to share load. so the ability to communicate speak uh understand where you are understand where your teammates are and to load balance between yourselves as a tribe seem to be the the number one key performance indicator as opposed to anything particularly genetic or physiological and that was a really big surprise for me and so is that the fact that women were being were able to communicate maybe more freely.

3:40I mean, did you read their journals? Every single one. Wow. Yeah. And they were semantically scored and this kind of thing. Now, we haven't actually published anything on that yet. We've done more of the physiological hard data publications on that. But it is pretty clear that, okay, maybe this is just anecdote, but usually we regard men on trips, certainly inexperienced people on expeditions who have male physiology, as being quite content if the person next to them isn't doing quite as well. It's almost like, yeah. Status. Yeah, I'm better than you. Watch me as I'm going up this hill without being out of breath and whistling an Eric Clapton song or something.

4:35And that's a kind of a male trait. And losing that and constantly being aware of the load balancing that is needed in the group is a skill that needs to be. I think it seems to come more naturally to female hyper endurance athletes and participants in things like trans Antarctic crossings than it does in men. And I don't know if that's nature or nurture. We've done we haven't done enough study on that so far. But I don't know. most people would anecdotally probably say the same, that men have a kind of, they're more okay with a testosterone driven, let's go forward and power on than those with female physiology tend to be more aware of the subtle signs of what's going on in others.

5:42Maybe that's also to do with being able to pick up subtle signs in children about being well or unwell yeah maybe this is early days but it's fascinating a big trait of empathy as well hopefully well it's a very big trait of empathy but i think like you know naturally the women become the caregivers right and so you naturally are always i think women normally put themselves at the bottom of a list and they normally put everyone else above them and that's actually why you know i think there's a crisis where women feel so unsupported because they're trying to do everything and they're the line at the bottom, which is a big analogy of put your own oxygen mask on before you put anyone else's on, right?

6:18Yeah. And that feels like that's kind of come out in that study quite a lot. It's certainly being indicated that if you want to have a really successful round the world yacht crew or Antarctic crossing crew, make it mixed for sure. A bunch of dudes may not be your best pick. um so yeah that that's uh that seems to be the that seems to be the uh the way things are the way things are looking but we've it's very very early days but in answer to your question of what was the most surprising thing it wasn't the physiology per se it was more the psychology you know that's what i'm interested in you know that's like you when we met we met at odyssey I can't remember where it was, the Abbey, just outside France.

7:09It was beautiful. And I, you know, hosted a talk around the optimization culture and actually why, you know, the mindset piece is actually the one of the most important when it comes to this. And actually our thoughts have the power to change our physiology, right? Changes our behavior. It's kind of like the central node to everything. It is. Yeah, it's not the peptide that you poke in. It's not the supplement that you swallow. So it's not the brand new NAD infusion that's just come out with some extra chemical. It really is what's going on up here and what goes on between people. The verbalization.

7:48So let's talk about the enhanced games because I touched upon this so briefly with Dr. Karan, who was on the podcast before. But I found this interesting. So I read your article on the enhanced games. Now, if anyone doesn't know what the Enhanced Games is, May the 24th, 2026, the Enhanced Games launched in Vegas, which is basically athletes competing on legal performance enhanced drugs to win big prize money. Supported by a range of billionaires. Love it or hate it. Interesting. Interesting. Interesting to look. So before we dismantle it, I want you to give me your strongest possible argument in favor of the Enhanced Games.

8:30Data. Okay. The reality is that whether we like it or not, it doesn't matter how many bans you're going to put on people, how many fines you're going to give people, how many gold medals you're going to withdraw. People are going to take performance enhancing drugs in elite sport, period. And the big pro for accepting that and saying, look, it's going to happen is a little bit like intravenous heroin addicts being allowed to get needles from the health service. it's kind of saying look you're gonna do it but let's at least let's get you to do it in a way that we can have some form of visibility on it and maybe even learn right that is the biggest single thing is is not being so patronizing to believe that by saying this is banned that people are not going to say it's just not going to happen so learn the data that you could get from studying people over time and actually seeing, is there a performance enhancement?

9:48And I'll say what I think is the most interesting type of performance enhancement because it's slightly adjunct to what the games we're trying to do. And what are the harms? And really building up a registry is important. It's too small to develop a really good registry. That's the challenge. And actually, God knows if the data were really collected or offered were really what was going on. But what is fascinating to me is not whether somebody can get their personal best at the age of 45, or, as we probably pretty well failed to do in the enhanced games, win any new world records. That was what was really interesting, like the guy who thought it was going to beat Usain Bolt, and he didn't.

10:33I didn't miserably, miserably did. There was only one. It was the swimmer. There was swimmer, but they were wearing, they were, they were wearing a, uh, a swimsuit that was invented by Poseidon himself. Um, but they're still arguing that, right? Yeah, it's a performance enhancing swimsuit. I actually did some calculations on it and it gave more of a performance in advance. Many gold medals, many more gold medals would be won in normal games if people were wearing those suits. But the point is not about winning a gold medal now. What is really intriguing to me is, is any of this going to help us still be skiing when we're 90?

11:18That's more important. For me, give a person a million dollars if they beat their personal best 10 years after their personal best. that to me is intriguing because it's about maintaining the ability to still be strong fit, fast, balanced, coordinated and hopefully independent yeah, that is really intriguing people should get gold medals for still being able to do what they did 20 years after normal nature taking its course said, no way, stop there. We don't want you to be an alpha anymore. We don't want you to be as strong. It's time to make way for the next generation. The gerodemographic situation that we've got in the world needs people to be fit, mobile, strong, have coordination, balance, and all of the good musculoskeletal and neuromuscular things that we need into our 80s now, not into our 60s anymore.

12:24And that to me is a huge opportunity.