The Living Proof Challenge: Simon Hill’s 12-Week Protocol To Optimize Your Health, Fitness & Longevity

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39:13Let's move on to truth number two. Blood pressure, which actually is the number one risk factor for cardiovascular disease, believe it or not. And more than, I think, 50 % of adults in this country have hypertension, stage one or stage two, which is a systolic blood pressure over 130. So ideal blood pressure, we're sitting at 120 over 80. And what those numbers just very briefly mean is the systolic blood pressure, the top number is measuring the pressure in your arteries as your heart is contracting. And then the heart relaxes so that it can receive blood. And as it's relaxing, you're measuring the pressure in the arteries.

40:04That's the diastolic blood pressure. For every 20 millimeters of mercury that systolic blood pressure goes above 120, you double your risk of having a stroke, ischemic heart disease, or other types of vascular disease. That's a shocking statement. I feel like blood pressure was something that the generation above me paid a lot of attention to. And then for some reason, we don't pay enough attention to it now. I don't hear a lot of people talking about it. When's the last time you had your blood pressure? Oh, it's been a long time. Like, yeah, you go to the pharmacy and you see the cuff like by there, and there's old people taking it, but it never occurs to me to do it.

40:49I don't think of it as being such a powerful indicator of risk or health. So what you just shared is like, wow, that's in terms of like the biggest things that can move the needle, that certainly sounds like something that we should be prioritizing better than maybe we are. And there's a study that came out recently comparing at home measurements of blood pressure versus in office. and at home measurements are more predictive of cardiovascular disease and there could be a few reasons that explain that it could be the the white coat effect sometimes people go into get their blood pressure measured and it just reads high simply because anxious they're anxious it could be because that it's not being carried out properly in the clinic you should be resting for five minutes your legs shouldn't be crossed your arm or cuff should be at the level of your heart all of these things make a big difference.

41:48But I'm of the view and what I recommend, and it sets you back about$40, is to get an Omron at-home blood pressure cuff. I have no affiliation with that company. I just know that they make very reliable devices that accurately measure blood pressure. And you can get that for a wrist cuff or the upper arm cuff. And these are automatic machines. You can get manual blood pressure equipment, but they're a little harder to use if you're not experienced with them. So my - And they're accurate enough? Like I always wonder like the sort of over the counter type measurement devices that you can find at your typical pharmacy.

42:30Like are these legitimate? These are accurate enough in that you can monitor over time. And if you see changes, whether that be significant drops or significant increases, then that's a reason to go in and see your physician and get a manual test done. But yeah, I certainly, I recommend, I think I agree with you. It's one of these things that, I think the last time I did it was a year ago. I recently bought one of these cuffs and I saw, there's companies now working on watches and other ways of giving you kind of real time blood pressure, which I think is where the future is. All right, so APOB, that's gonna be part of the blood work that you get done either with InsideTracker or however you wanna do that.

43:23Blood pressure, you can test on your own at home, more accurate anyway. What's next? Next is VO2max. So, VO2 max is really a measure of our cardio respiratory fitness. How much oxygen can we utilize per milliliter, per minute, per kilogram of body weight? We use oxygen, of course, to produce ATP, to produce energy. And the higher our cardiorespiratory fitness, the higher our VO2 max. And when we go out and look at a population of, let's say, 50 or 60-year-olds, there's a couple of studies now that have looked at this and stratify people based on their VO2 max, their cardiorespiratory fitness, and you can put people into buckets, low, below average, average, above average, elite, for example, and you can then monitor these people and the two studies I'm thinking of monitored for between 7 and 10 years and you look at the risk of dying during that period.

44:45compared to people that have low cardiorespiratory fitness, a low VO2 max. People in the elite category are five times less likely to die during that follow-up period. We're not asking everyone to be elite athletes here. What I find incredibly promising and empowering is that just going from low to average will half your risk of death and cardiovascular disease. And researchers have looked at what it would take to do that, to get from low to average. And you'd be shocked, it's in line with what the recommendations are to do 150 minutes a week of moderate intensity exercise. In those studies, tracking people's VO2 max and evaluating the association, with longevity or disease prevention, I have to wonder about confounding variables because if somebody has a superior or optimal VO2 max, they're probably practicing a whole battery of other healthy lifestyle habits within the construct of their life.

46:04So how do you isolate VO2 max in relationship to longevity and disease prevention outside of the influence of those other habits? This is the same problem that really any observational study has. How do you get a clear view of the variable of interest to see what the effect of that is on the outcome that you're looking at, in this case mortality or premature death? And what researchers use is called a multivariate analysis. So they have a statistical model which accounts for differences between those different groups, low, below average, average. There probably is differences in smoking incidents.

46:51There's probably differences in alcohol consumption, BMI. All of these things can get factored into that model. Now, I will say one of the things I've pushed back on these studies previously on is that there doesn't seem to be any adjustment for diet quality. And as you rightly pointed out, people with a high VO2 max. They're paying attention to what they're eating. They're probably eating a healthier diet. So can we say that the five times lower risk of premature death is purely based on the VO2 max? Probably not. There's some residual confounding in there and there's some other attributes of their life that are influencing that.

47:35But I think there's enough signal to say that it matters. Mm-hmm, mm-hmm. VO2 max was something I had previously thought in my youth was a genetic predisposition. There are certain people who are born with a crazy VO2 max, they end up becoming these amazing elite athletes. But in truth, VO2 max is malleable. Through lifestyle changes, you can influence and increase your VO2 max. So, this is to disabuse anybody who's like walking around with that myth in their head. And there's some, I think I understand where that's come from because there's great debate. If you speak to endurance athletes and coaches that have been in the space for a long time, they'll talk about case studies where people have increased their VO2 max by 40 or 50 percent.

48:25And then you read the literature and quite often they'll say, you can probably increase VO2 max by about 10 percent. but we have to appreciate that often in these studies where you're looking at shifting vo2 max there's a time limit it might be a six-week intervention or an eight-week intervention and usually it's isolating specific modalities so it'll be comparing a high intensity protocol with a moderate it's not comparing you know or looking at multi-modal interventions and then looking over the long term. So, I think that's where you see that discrepancy between the research and what people in the endurance community perhaps have seen.

49:07Obviously, we could do a three-hour podcast on VO2max alone and the interventions that are going to move the needle in terms of improving it and drill down on all the various training protocols and philosophies behind them. That is not this podcast. Suffice it to say, VO2max is an important lever in terms of overall wellbeing and longevity and disease prevention. This is one of the 10 truths. We're gonna try to move the needle over this 12 week period through these interventions, but you gotta test. How does one test for their VO2 max? That in and of itself has spawned a thousand Reddit threads about how to figure this out.

49:52So in the most simplistic terms, Obviously blood pressure, we know how to test that. ApoB, we're gonna get a blood test. How is somebody gonna figure out what their VO2 max is? There's a bunch of different ways. Is it the direct way where you go into a lab and you're connected to a machine and you're either on a treadmill or on a bike? That's going to be the most accurate way to determine your VO2 max. Proper lactate test, lactate threshold test. and I did one of those recently with DexaFit who we've actually partnered with here as well. So within the PDF, people can find some information out about them.

50:34So you can go in and you can do it that way. But I wanted to make this challenge as accessible as possible for everyone and not everyone's going to go in and do a VO2 max treadmill test. Although if you have access to one of those labs and you can afford it, I would highly suggest it. I mean, I was doing this super regularly when I was training for all of these races. And it's quite revealing in terms of where you think you are with your fitness versus where you actually are. And some of the findings I think you'll discover are quite counterintuitive because it is extremely precise. If you can't do that, go ahead.

51:15Sorry, I interrupted you. I went on my own tangent there. I'm telling you not to do it. I'm all doing it myself. So I know we're keeping this on, we're on the highway. We're on the super highway here, Simon. We're chugging along, we're doing good. Keep it going. How do we do this? How do we do the VO2 test at home, man? Come on. You've set a precedent. Tangents are completely acceptable. So you can do a beep or a shuttle test. This has been done in studies where they've looked at, did you ever do a beep test or a shuttle test? No, what is that? but I know that's part of this whole thing. I have no idea what that is.

51:52I just like run slow really far. All this running back and forth and all the high intensity stuff. This is a new world to me. There's a lot of people listening right now that are having flashbacks and are thinking on, the beep test was the thing at school that you tried to get out of. So you're running back and forth in the gym, picking up the erasure. You set up two cones, 20 meters apart, which is give or take I think it's 65 foot right and there's a beep and you're running to the beep you have to get between the two cones before the beep and that beep gets progressively quicker and quicker and quicker and quicker so the amount of time now that you can rest at each end is getting shorter and shorter until you get to a point where you're sprinting from one to the other and ultimately if you miss one beep you have the opportunity to make it back to the other end and you can stay in the game but if you miss two beeps you fall short you're out and at that point you will have a rating like level nine shuttle three and we have a table so this is one of the other assets that people will get with the challenge that tells you with with a very the correlation coefficient between this shuttle test and vo2 max is 0.92 so it's a pretty strong correlation.

53:30So, it tells you with a fairly high level of confidence what your VO2 max is. And from there, then you can put that VO2 max straight into the calculator. And I assume in the materials for the challenge, you have details about the beep interval and all of that. Is there an app on your phone? How do you do this at home? He just handed me a piece of paper so the protocol is completely laid out we we mentioned the app there's there's various apps you can download they're free i recommend connecting the app up to some type of speaker so it's loud enough so that you can hear it and it's as simple as just following the beep and And at each stage, the app tells you level one, shuttle one, level one, shuttle two.

54:27And so that when you eventually get to your limit, you've been listening, you know what level and shuttle you're up to. Exactly. Okay. I love it. So it's basically a test of failure, which is the same as what you would do in a lab on a treadmill or on a stationary bike. Right, but you can do it on a basketball court, any flat surface. And you don't even need a heart rate monitor? is heart rate part of this? It's just you're at your level. Wherever you reach failure, that's gonna dictate where you're at. And then that gets calculated in terms of your age. And what else? Like does your body weight factor into that or just age and gender?

55:04Age and gender. So you just need a flat, hard or firm surface, your runners, joggers, and the app. There's many that you can find that are free to pace you. That's all you need. I love it. Simple. When am I gonna do this? Let's do it together. You're gonna laugh. I've rubbed a few people into doing it and we recently ran a couple of those retreats in Bali. This is not, this will not be like my specialty. Let's do it and let's. You should get a chuckle out of this. Let's upload that to Instagram. Cool, all right. ApoB we've talked about, blood pressure we've talked about, VO2 max. Anything that remains to be shared about VO2 max before we move along here?

55:50I think that's sufficient. Let's keep moving. Cool. What's next? Next are the 10 truths which speak to metabolic health. And there's four of these. So, triglycerides, waist circumference to height ratio, fasting blood glucose, and HbA1c. So, three of those are things that you'll get on a blood test and the other one you'll measure with a tape measure. All of these give insight into your metabolic health. What is metabolic health? Because it can be a somewhat abstruse or I guess ambiguous term. It's a buzzword. A lot of people are using it, but I'm not sure it's clearly defined. The way that I see it is there's two key critical components of this and both are addressed in the challenge.

56:48One is that we are storing energy, particularly fat, in the right place. And we can delve into that if you want. And the second is that we are able to efficiently convert chemical energy, so the energy in our food, into mechanical energy, which requires healthy mitochondria. These are the two key aspects of metabolic health. And metabolic health you can think about as a spectrum. it's not that you go from healthy to type 2 diabetes there's a there's a large spectrum and i spoke to inigo san milan about this in in our episode and he he really emphasized the point you know you don't have pre-diabetes you know you don't have type 2 diabetes but if you're not moving your body as it's made to be moved you will have mitochondrial decay it's happening underneath the hood.

57:55So there's a spectrum. And when we begin to, particularly when we begin to store fat in the wrong place, we start to see elevations in triglycerides, we see elevations in fasting glucose, we see an increase in waist circumference to high ratio. Okay, so basically what we wanna do is get our bodies in a place where we are efficiently metabolizing nutrients. Our bodies are regulated in terms of how we're storing fat in the right place. I guess that means the difference between visceral fat versus subcutaneous fat or fat as an energy source. And for fat that is an energy source, that or those foods or those nutrients are being properly converted into energy.

58:51somebody who is metabolically dysregulated has some level of dysfunction with one of these two systems. Or perhaps both in many cases. And so you might say, well, what determines whether you're storing fat in the right place or the wrong place? And to that, I would say, to prevent us going into a deep dive, listen to the episode I did with Roy Taylor, who is the domain-specific expert on visceral fat, ectopic fat, and type 2 diabetes. But in short, each of us have what he describes as a personal fat threshold. And a personal fat threshold essentially speaks to our capability to store fat subcutaneously.

59:42There's essentially three different places we can store fat. subcutaneously, which just means under the skin, which is the more safe place to store fat. It's more benign. It doesn't seem to have these deleterious effects on metabolic health. That's where we want fat if we're storing it. Then there's visceral fat, which is between organs, and there's ectopic fat inside organs, particularly the liver and in the pancreas. it seems that our personal fat threshold how much fat we can store in the subcutaneous adipose tissue compartment is largely determined by genes and that's actually why the bmi chart for asians is different to caucasians because genetically they're predisposed to visceral fat at a lower body mass.

1:00:39So, our personal fat thresholds are all a little bit different. And that's why you can look at two different people. You can have two people in front of you who have the same body fat percentage, but one of them has type 2 diabetes and the other doesn't. Where they're storing their fat differs. And once you exceed your personal fat threshold, what happens is the body has to store that energy somewhere and it begins to store initially that fat in the liver. And as a liver, you're increasing the amount of fat that's in the liver, the liver becomes insulin resistant. And this is non-alcoholic fatty liver disease.

1:01:26Right. And one of the really key tasks of the liver and insulin at the side of the liver is insulin actually acts to slow down glucose being released from the liver into the blood. So when you become insulin resistant at the liver, you start to see elevations in blood glucose. and you'll also see elevations in insulin as well because the pancreas initially which produces insulin will try and compensate for that. It will say, hey, let's just produce more insulin and try and get this glucose level down and for a while people might be able to maintain normal glucose levels but their body will be producing a lot of insulin to do that.

1:02:17over time if the person remains in an energy surplus so um you know roy taylor refers to this as energy toxicity and they continue to build up fat in the liver eventually there's so much fat being poured out of the liver because it can't be stored there has to go somewhere else so it goes into circulation into vldls which are apob containing lipoproteins so you get elevations in apob and the body has to make a decision where where are we going to send these the fat subcutaneous fat store the subcutaneous adipose tissue site is full it's not the liver is full the liver is full now it starts to go into the pancreas and as it goes into the pancreas you start to lose the function of the beta cells which produce insulin and this is when you start to see a reduction in insulin production over time as the pancreas is really fighting an uphill battle and becomes more and more worn out and you get elevations of fasting blood glucose elevations of hba1c which are two of of those four truths that I mentioned that speak to metabolic health.

1:03:39The point being here is that people say to me, well, how do I know if I'm under my personal fat threshold? These markers, HbA1c, fasting glucose, waist circumference to height ratio, and triglycerides offer you a window into that. So explain that specifically one by one. Okay. So triglycerides, I just mentioned there that as you're getting increased fat lipid production within the liver and it's building up with fat, the body has to do something with that. So it packages those triglycerides up into these lipoproteins called VLDL and pushes them into circulation. That's why you get at the elevation.

1:04:26So when you get the blood test, you are getting a calculation of the volume of those VLDLs, is that what you said? In your blood and that's the triglyceride metric. They're a triglyceride rich lipoprotein. Okay. Waist circumference to height ratio. We know that waist circumference is a much better measure than BMI if we're thinking about fat distribution and we want to understand where someone's holding that fat. So when you're above your personal fat threshold, or I should say when your waist circumference is increased, it is a sign that you have visceral fat and that you're storing fat around the abdomen, which is not where we want it.

1:05:21fasting glucose as I mentioned. So, when you become insulin resistant in the liver and when the pancreas begins to get worn out, your glucose levels are rising. Your body's having great difficulty shutting off glucose production at the liver. And HbA1c, which is just another measure of blood glucose, but it's looking at an average over a three month window. So, all of those together paint this picture. So, when somebody gets results for these four metrics, they then do what? Like this gets plugged into the calculator and you get a score from that. Is there one of these that's more important than the other?

1:06:04Are they all informed in the context of each other? Like, how do you make sense of these? If you, let's say two of them are elevated, the other ones aren't. I guess though, if you're truly metabolically dysregulated, they're all gonna be out of range, right? Yeah, they usually go hand in hand. And I think it's important to measure each of them because there can be some scenarios where you may have an elevation in fasting glucose, but not in triglycerides. But measuring all four of these is a comprehensive way of understanding what your risk is of these metabolic conditions, pre-diabetes, type 2 diabetes, non-alcoholic fatty liver disease, et cetera.

1:06:56And if you have exceeded your personal fat threshold, it seems that if someone is considered overweight or obese, typically they need to lose about 10 to 15 kilograms of body mass in order to see these things normalized. but it is possible rich to have to develop type 2 diabetes and be of normal bmi one in six people that have type 2 diabetes have a normal bmi and roy taylor just published a paper looking at this specific population. And he was able to show that, again, if these people lost weight, they didn't need to lose as much weight. So, they didn't need to lose 10 or 15 kilograms. They were a lower body weight to begin with.

1:07:53On average, if they lost around seven or eight kilograms, these markers would normalize, which was indicative and they did scanning of showing that you're getting fat out of the pancreas and the liver. And I guess that's a more direct way of answering your question. These four biomarkers are essentially telling us if you're storing fat in the wrong place. And so we wanna normalize them and then we know that you do not have excessive fat, ectopic fat, fat within these organs. What is the understanding or the current science in terms of metabolic health and mortality. So if somebody is significantly metabolically dysregulated, how does that correlate in terms of mortality?

1:08:48Do we know the answer to that or? Yeah, we do. I mean, we have data looking at metabolic syndrome or type two diabetes, for example. If you have type two diabetes, you have double the risk of cardiovascular disease mortality, the number one cause of death. So we know that poor metabolic health is driving most of the chronic disease health burden that we're seeing today. It's driving a lot of cardiovascular disease. It's driving type 2 diabetes, non-alcoholic fatty liver disease, and probably a significant chunk of dementia as well.

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1:11:05so the next category would be the um the truths that fall under musculoskeletal health yes all So there's two things we're asking people to measure here, and that is grip strength and bone mineral. We know that as we age, there are age-related changes to skeletal muscle and also to our bone. And this is important for a few reasons. One is that strength of our muscles and our ability to produce force and also the strength of our bones affects our risk of falls and fractures. Fractures are not a leading cause of death, but if you have one, there's a very high mortality rate. I think it's 25%. If you fracture your hip, there's a 25 % mortality rate in the first year and 80 % within the three to four years after that hip fracture, if you're aged 65 or older.

1:12:13Because of the domino effect. that occurs as a result of that fracture. Right, and if we want to prevent falls, then, or fractures I should say, then that really boils down to two things. We wanna prevent someone from falling in the first place, and if they do fall, we want them to have strong bones so they don't fracture. So we can get a very good understanding as to what someone's sort of global total body strength looks like with a grip strength test. This seems to be quite indicative of overall body strength. It's not that grip strength itself is magical and is the kind of longevity hack. We're not going to ask people to go away and do wrist curls necessarily.

1:13:03But grip strength is highly predictive of mortality. It's highly predictive of cardiovascular disease. We know that for every five kilogram reduction in grip strength, you have a 16 % increased risk of premature death. And that's strength and we can go as deep as you want, but that is dictated by a number of factors. It's not just muscle mass. There is strength independent of muscle mass as well. and a lot of that is to do with the chemical and the neural signals that go from the brain to the muscle and the kind of motor units is what they called which is the nerves innovating into the muscle tissue.

1:13:55We see from the age of about 40, you start to lose 2-3 % of strength on a yearly basis which is you know that's a considerable amount of strength to be losing yeah and it accelerates the older you get yeah it accelerates the older we get but we have to remember that this is looking at populations that are mostly sedentary so we shouldn't assume that that is just the way it is and these are the age-related changes that are going to occur to our muscle because we know with certain interventions, for example, that you can actually increase the number of those motor units. You can increase the size of the muscle.

1:14:45So, there are things that you can do to at least attenuate that loss in strength as you age. A couple thoughts. You mentioned the difference between muscle mass and actual strength. In other words, it's not just about putting bulk on your body. It's about your body's ability to recruit the muscle fibers that you have and to do that efficiently. Those are two different things. And that recruitment can be trained, of course, as can bulk. And grip strength, correct me if I'm wrong, this came up in the podcast that I did with Peter Attia. It's not that you're going to train grip strength. It's that grip strength is a proxy or a way of getting a sense of what somebody's overall strength is.

1:15:37Because if you have strong grip strength, you're probably doing lots of things or whatever that are just making you strong and robust. Right, a byproduct of the way that you're living. Yeah. So how do we test for grip strength? We use a dynamometer, which is a 20 or$30. You can just hang from a bar and like, you know, count to however long it takes until you have to let go. Yeah, that is a test that's been done, but probably measures grip endurance more than strength. So the dynamometer allows you to look at absolute strength. And it's what's used in these studies where they're looking at grip strength as a predictor of mortality.

1:16:17They're using a dynamometer to measure someone's grip strength. And where do you get one? How do you use it? How expensive is this thing? $20 or$30. I mean, like a lot of things in life, you can go out and you can indulge and spend$300. I don't think you need to do that. In the challenge, we have a link to one that has been used in studies is about$30 that you can order on Amazon. on and the protocol to measure your grip strength is very simple. We outline those four or five steps. You do your left side and your right side and you repeat it three times and you take an average and then you plug that into the calculator.

1:17:03And what gets factored in there again is Asian sex and you get a score for that. Exactly. Okay. Grip strength, what was the other one? Bone mineral density. So bone mineral density is measured with a DEXA scan. We know that for every one standard deviation below the average bone mineral density of a 30-year-old, so every one standard deviation below, which is like a 10 % reduction in bone mineral density, you have a doubling of your risk of fracture. The DEXA scan measures your what's called a T-score. So you get this number that is exactly that. It's measuring you against the average bone mineral density of a healthy 30-year old adult.

1:18:02And so if your score is zero, that is the average for a 30-year-old adult. If you're minus one, well you're 10 % lower. And from minus one to minus 2.5 is called osteopenia. So this is the stage before someone is diagnosed with osteoporosis, which is from minus 2.5 and down on the retreat set we just ran because we had everyone measure these 10 truths before they came it was you and drew harrisburg who were hosting this retreat in bali and you put all of your campers like through a version of this challenge yeah yeah we i mean we deep dived this entire challenge we had 90 minute lectures on the cardiovascular system and then on metabolic and then on psychological wellbeing, all the things and all the 10 truths and what we're measuring and then all of the interventions.

1:19:05But what was really surprising to three of the guests who were all postmenopausal women. Now postmenopausal women are the highest risk category for osteopenia and osteoporosis. And three of these women who had never done a DEXA scan for the first time, were told that they had osteoporosis. And that's important information to know because it can affect the choices you make with your lifestyle. Where are you going to focus your attention on from an exercise point of view, for example? What parts of your diet do you want to focus on a little bit more? Is there pharmacotherapy that's important? it.

1:19:56So, you know, measuring these things, they have real world consequences, I guess, is the point that I'm trying to make here. And a lot of us are floating along through life with really no idea what's happening underneath the hood. Yeah, yeah. I'm one of those people, I think. I've always thought bone mineral density or things like osteoporosis, these are issues that predominantly concern women more than men, perhaps I'm incorrect in that assumption. I don't know why I even think that or where that came from. And secondarily, that this is something that would be very unusual to be concerned about until maybe you're in your mid fifties in terms of testing and evaluating.

1:20:43So that's a two part question. So part one, you're right. It is more common to see osteoporosis in women, particularly post-menopausal women. There are some other conditions, some pre-menopausal conditions where you can see osteoporosis, particularly in athletes who are restricting energy. Now, why is that the case? The simple answer is it's probably driven by hormones. So in that post-menopausal phase, and I did a two or three hour episode with Dr. Suzanne Davis on menopause where we spoke at length about this. But in that post-menopausal phase, estrogen kind of goes off a cliff. Yeah, I just had Lisa Moscone in here.

1:21:29We did a couple hours on that. And one of the key roles of estrogen is when we load our bone. So the two best ways to load bone to stimulate it to grow stronger is weight-bearing exercise where there's some type of ground reaction force that is greater than what we would be subjected to just in everyday life. So let's say we walk around every day. Just walking more is not going to increase our bone mineral density, but skipping or hopping or jogging, these types of things where you increase that ground reaction force can stimulate the body to lay down more bone. but hormones are very important for that process and estrogen in particular sort of acts as the signal between the force is recognized by estrogen it stimulates estrogen which then stimulates these cells called osteoblasts to produce more bone and so if you have less estrogen around, then you're getting less bang for your buck when it comes to the stimulus of jogging or skipping resulting in that adaptation that you're looking for.

1:22:49But there still is some adaptation. There still is some. And I mean, that's why I mentioned though pharmacotherapy because depending on someone's context, for example, estrogen therapy, it's not indicated for everyone. It's contraindicated for some people, but for others, it can be indicated and can be very helpful for things like osteoporosis. Interesting. And for men, is there a point at which there's no return or is this something where interventions can always lead to improvements? I'm just imagining somebody who gets their bone mineral density evaluated, realizes they're way off the mark, obviously, then you have to worry about fractures, right?

1:23:39So when you're talking about load-bearing exercises, that suddenly becomes a precarious kind of prospect, right? You have to be safe about this, but also engage in it so that you can get that stimulus and try to regenerate some of that density. And I think this is why you're starting to see these bone health clinics being set up. I'm not sure if you've seen any of them. I haven't seen that. That's a thing. Yeah, it's a thing. And you can go in and do very specific training to increase your bone mineral density under the supervision. Because as you say, there will be a large percentage of the population with low bone mineral density that also, quite frankly, don't have very good balance.

1:24:22And getting them to do some of these exercises could be dangerous. So I think if you do a DEXA and you have osteoporosis or osteopenia, then that's a time with a physician and hopefully with an exercise physiologist, if you can access one, you create a really robust plan for you. Jogging and skipping is not going to be for everyone. It's going to depend on someone's baseline health and their risk of having a fracture. So I want people to kind of do this safely. But yes, the body can adapt. there's some beautiful studies looking at 80 and 90 year old subjects. And even at 80 or 90, you can build muscle and you can increase bone mineral density.

1:25:08So, it's not as though it gets too late for the body to adapt to a stimulus. It still will, but you need to do that safely. Is the only way to get an accurate sense of your bone mineral density is to undergo a DEXA scan? Is there any other way of testing this? I'm just imagining not everybody's gonna have access to this kind of technology. How does that work? If somebody does wanna get a DEXA scan, how do they even go about figuring that out? There's some other technology, but that doesn't really speak to the accessibility part of your question. So like there's another scanning device called the Echo, which is becoming popular, but the DEXA scan is by far the marker that is used in clinical research to look at risk of fracture.

1:26:06So we know it's a robust. If you measure your T-score, we know that that is a robust marker that can be used along with other risk factors. So we're going a little bit into the weeds here, but if you were in a clinical setting and you had a DEXA scan and you were speaking with your physician and you were trying to work out what's your 10-year risk of a fracture, they have a calculator and they can consider your history of smoking and alcohol and whether you have osteoporosis in your family and all those sorts of things get factored in as well. But certainly, this is probably the least accessible of the 10 truths to measure.

1:26:46I'm aware of that. But I think it's something that everyone should do but particularly post-menopausal women and i say everyone because you made a point before about um you know what happens if you measure your bone mineral density at 50 60 and it's low is there still enough time to to change that i think we need to think about our bones like a savings account in a bank and so if we can build that saving up early in life then we're less likely to run into issues later in life. So I'm speaking to the young person here now who's 20 or 30 or in their 40s. I'm not even gonna think about this for another 30 years.

1:27:33Yeah, and I'm saying you should approach this as your savings account. So the interventions that are in the challenge that have been included in there to promote bone mineral density should be things that you should try and integrate into your regime in advance. On top of all of this, if you do get a DEXA scan, you're getting a window into not just your bone mineral density, but a whole number of things, your visceral fat. Like there's a lot of data that you can extract from that experience. Yeah, so and visceral fat, I thought about putting that into these truths that we're measuring, but I feel like it's adequately covered with triglycerides and fasting glucose and HbA1c.

1:28:22I spoke to that earlier. I had my visceral fat measured recently. Yeah. You say with a twinkle in your eye. Yeah, I can brag about it. Well, I feel like I can brag about it because I got so much shit on YouTube and on Instagram for at least a couple of years where proponents of an animal-based or carnival-style diet were nagging me to get a DEXA scan, saying that maybe I'm fit and strong on the outside, but with that high-carbohydrate diet, I probably have a lot of visceral fat being built up. So I was pleasantly surprised to see that my visceral fat was almost zero. Have you made a little video, clapback video about that?

1:29:15I haven't posted anything that is directed towards that crowd. I did put some stories up on my Instagram with the results, but yeah, maybe I should think about that. Interesting. If somebody wants to get a DEXA scan, how do they even go about figuring out where to go and what does that cost and what does that entail? I went to DEXA Fit in Boston, but DEXA Fit are all around the United States. And in most countries now, there are studios set up to measure, to do a DEXA scan and a VO2 max often are in the same place. So, DEXA fit, do both. So, if you wanted to do a treadmill VO2 max test and a DEXA, you're wanting to go all out with measuring your 10 truths accurately.

1:30:07The premium plan. Yeah. Then you would go to an organization like DEXA fit or if you're in another country, something that's equivalent. We have a partnership with DexaFit so that if people doing this challenge who are based in the United States want to use them, they can get some saving on either the Dexa Scan or VO2 Max or both if they choose to do both. But in terms of what it costs, I probably should know that. I think it's between$200 or$300. Oh, I would have thought it would have been more. I think it's more if you do both. I think that's the cost just for the Dexa Scan. but don't quote me on that.

1:30:47Interesting. Yeah, but there'll be a link to the DexaFit situation in the materials for the challenge, right? So whatever savings or discount is going to be made available, people can figure that out there. Exactly. Okay. Have we covered this system, the musculo, why do I have so much trouble? Musculoskeletal. I have trouble saying that word, musculoskeletal system. I get made fun of for saying musculoskeletal because in this country, skeletal. I know, I've given you a long rope with some of your pronunciations because I'm trying to keep it on the rails, dude. Can we move on to psychological and emotional wellbeing?

1:31:33Any final thoughts on what we just covered before we go to the next thing? I think we covered that pretty comprehensively. the two truths that we're measuring to get a window into your musculoskeletal health are your grip strength and your bone mineral density. Okay. So now we move into this weird, you know, kind of ephemeral area. Like I can understand testing for APO-B and grip strength and all this sort of thing. How are you going to create an accurate way to evaluate somebody's psychological or emotional well-being to get a baseline before introducing interventions. This was the hardest of all 10 truths to find a tool that can accurately measure that and encompass all of the various aspects of emotional health, psychological well-being, whether that be self-esteem or purpose or optimism, relationships.

1:32:37You can't just blow into a tube and have a number. I wish. So, I had to dig pretty deep here and consulted a number of different people in psychology and psychiatrists and came across a tool called the Flourishing Scale, which was produced by a psychologist. He went by the name Dr. Happiness, actually. and this is the most robust clinically validated tool that I could find it's not the only one that can act as a relatively simple way to get a gauge on your psychological well-being psychological resources and strengths there's eight questions on this flourishing scale and for each of those eight questions i have it in front of me i can read out a couple of a couple of them so you can kind of get a better feel for it for each of the eight questions you either strongly agree agree slightly agree all the way up to strongly disagree

1:33:49and i'll read all eight i lead a purposeful and meaningful life my social relationships are supportive and rewarding i am engaged and interested in my daily activities i actively contribute to the happiness and well-being of others so being of service debatable i am competent and capable in the activities that are important to me i am a good person and live a good life everybody thinks they're a good person I am optimistic about my future. People respect me. That's a good one. And so, that's the tool that we've used to kind of assess this and the maximum score you can get is 56 if you score eight on, sorry, seven on all eight questions.

1:34:50Because each one of these is you score at one to five? one to seven and there's eight questions so maximum score is is uh 56 and you know why these questions why relationships self-esteem purpose optimism service well there's a whole lot of research that underpins that you know we could we could speak of a number of of different studies the the one that maybe people are familiar with is the harvard study of adult development which looked at a group of students from Harvard and tracked them for 80 years and they were interested in what were the greatest predictors of happiness and longevity and more than than money or fame and money was important actually but up to after a certain level of about$75 ,000 income.

1:35:47That might be a little higher today. Yeah, probably. But up to a certain level after that, it wasn't a great predictor. Above all of those and also above traditional risk factors like LDL, cholesterol, and even smoking, the quality of their relationships were the greatest predictor of their happiness and their longevity. And Robert Waldinger, who is the director of that study, He's very famous for a quote where he says, loneliness kills. And that is often mistaken for solitude being deleterious, but I don't actually think that's the case. There's some research looking at how much time you spend by yourself versus with others.

1:36:40And certainly spending time by yourself can be healthy appears to be healthy but if people are spending more than 75 % of their time by themselves they're significantly they're they're significantly more likely to experience loneliness so these are you know some of the I guess some of the science that has informed the decision to use a scale like this that's you know measuring some of these questions are related to relationships there's other questions in here that are related to service and there's some incredible research looking at the differences between giving or getting and looking at the differences in how our brain is activated and you know you see when when someone is is giving something the reward center of the brain.

1:37:38It lights up in both of those contexts. But also the stress level of the brain goes down. Oh, interesting. I didn't know about that piece. And so there's this really interesting MRI research that's shown that, which is then corroborated by population level research where you look at large populations of people and you use different questions to determine how frequently someone is of service to others around them. And you see that people who are of service to others are less likely to die during the follow-up period. And on the flip side, you see that people that are highly stressed have much higher risk of premature death.

1:38:34But the interesting thing is people that are highly stressed that are of service do not have increased risk of mortality. Oh, wow. So, there's - That's an interesting ripple. So, there's something about giving and being of service to others that seems to attenuate stress. And I don't think it's been fully elucidated exactly what's happening there, but there would be a physiological explanation and there are researchers debating as to whether that's sort of mediated through inflammation or other physiological processes. But point being that being of service seems to be incredibly important when it comes to our psychological resilience, well-being.

1:39:25And so that's something that's evaluated within the flourishing scale and that's why it was included in that scale. specifically and then in our 12 week challenge, we have a few things in there that hopefully inspire people. Yeah, I'm interested in what the interventions are here or what the exercises are here. But let me just say, first of all, I commend you in tackling a soft science, as a hard science guy, like you try to wrap your brain around, like how do I make sense of this very unwieldy world where data points are sort of less mission critical, than insights and kind of general ideas about where you should place your attention and your focus.

1:40:12All of this is of course true and vetted through the social sciences and the hard sciences that overlaps or intersects quite nicely with what we know about the blue zones and the centenarians, as well as the work that Chip Conley is doing with his modern wisdoms, modern elder academy and his focus on the relationship between longevity and kind of human connection in that regard. And then the surgeon general who has made loneliness, his mission to ameliorate, like these are very real things that we're grappling with. And I think it's cool that you wove this in as one of the four key systems, because with your background, I could easily just say, We just have to focus on diet and nutrition and maybe brain health, what else can we throw in there?

1:41:02Strength, et cetera. But this is key. And I think it's important to point out that you can have an absolutely pristine, perfect diet and you can adhere to your fitness routine with extraordinary consistency. But if you're a narcissist or you're self-obsessed or you're just an asshole or you isolate from other human beings and you never consider the thoughts or emotions of other people, not only does that make you just a giant douchebag, it's really not doing a lot for your longevity, right? So even if you are selfish in that regard, it is in your interest to figure out a way to give of yourself for others.

1:41:47And do you wanna live a long life or do you wanna live a good life? Because for me, the difference there is that living a good life requires emotional health, it requires you to be happy with the things that you're doing in that time that you're alive. So it was an important pillar, an important inclusion within those four systems, emotional well-being and you can't deny the science. You know, there's a reason that the quality of our relationships are the number one predictor of longevity because those relationships affect our physical body. So, yeah, I'm glad that we included it. All right. Well, we're like an hour and 40 minutes into this and now we have our baseline, right?

1:42:43We're good. We're on track for a five-hour podcast. That's a joke, son. Okay. Okay, so on the template of test, intervention, retest, we have our test results. We have a baseline for where we're at. Now we're into the intervention phase of this. And obviously we can't address every single aspect of this. So how do you help us understand what this 12-week challenge will involve before the retest at the conclusion of those 12 weeks? Okay, so let's start very high level. There are 12 different lifestyle habits and these are split across nutrition, exercise, sleep and emotional well-being. Each week there are focuses for nutrition, for exercise, for sleep and emotional well-being.

1:43:38and we start off in week one relatively gently. And then over the course of the 12 weeks, we're building on what we're putting into practice and we're making it more and more challenging such that at week 12, we arrive at a point where the evidence suggests you will have significantly shifted your longevity score, those 10 truths. So then you can do your retest and you can see proof that this program has worked and has shifted your health in a favorable direction. Do you need perfect adherence to achieve this? You do not need perfect adherence. In fact, I would encourage people to not be so hard on themselves.

1:44:29I don't expect a 100 % adherence. we've factored that in to what we're recommending. Now we're going to provide coaching and emails and reminders along the way to kind of help encourage and improve adherence. But even if you were to adhere to this 70 or 80%, you're going to get improvements in your health. so for example some of the the lifestyle habits that we've included from a nutrition perspective we we want people to optimize their protein intake we think that's important for a variety of reasons now the the total amount of protein that you consume has a direct effect on your strength. It affects bone mineral density, but also where that protein is coming from affects your cardiometabolic health risk factors.

1:45:29So we're providing people with a target for total protein intake, but then we're also recommending that they're getting at least a certain amount of that from plant protein. And we have a whole guide on protein so that people can see what are the really good sources of plant protein on a per calorie basis. And so if they're not familiar with that, they can make some decisions more easily. We have a lifestyle habit built around fats. So we're encouraging people to cook with olive or avocado oil instead of butter or tallow or coconut or palm oil. Does it include recipes or just general guidelines?

1:46:19So we have both. The guidelines are general. In the weekly learnings, people will get some recipes. So for example, in week one, the theme of that week is built around protein. So each week, there is a different theme that we're educating on. And in that week, we have a short video that we want people to watch. I've interviewed Stuart Phillips, Don Lehman, Chris Gardner, Volta Longo, all these guys with slightly different research backgrounds, different individual or personal diets themselves who all have really important things to say about protein. So we've pulled some of that information together for people to listen to.

1:47:08Just finding the specific pieces that relate to the theme or the subject matter that you're trying to address and organizing that in a way that is helpful to the person. And then that week they do get recipes. So they get a high protein plant-based recipe PDF, which has sort of 15 or 20 different recipe ideas in there. How much of a time commitment is this whole thing? A lot of this is set and forget. the exercise component is the most time consuming. How much time? A day per week? Well, we're wanting people to by week 12 be doing 150 minutes of zone two slash three training per week. So we would call zone two, three moderate intensity.

1:47:59Somewhere in the ballpark of say 60 to 80 % max heart rate. So that's 150 minutes a week, two and a half hours. We want people to be working up to a four-by-four-minute hit interval per week with a warm-up and a cool-down. That's another 30 minutes. So you're at three hours of training from a cardiovascular exercise point of view across a week. And then on top of that, resistance training by week 12, we want people doing at least twice per week. And those sessions are to be 45 to 60 minutes. So let's just say that you're doing 60 minute sessions. It's five hours of exercise a week. That's the most time consuming part of this program, which is less than an hour a day if you drag that over a seven day week.

1:48:58Talk a little bit about the sleep piece. So sleep, we focused on two aspects. There are so many things that we could include into this challenge. Yeah, well, it just gets infinitely more and more complicated. I've had conversations with domain experts in a lot of these areas. You've had more than I have. And if anybody who's listening to this or watching it wants to drill down deep on VO2 max or sleep or protein or whatever, just like go to the proof and get into Simon's archive because I'm sure that you're gonna find what you want and people are gonna talk for hours about this stuff. We're trying to like canvas it and get to just the meat on the bones here.

1:49:46Yeah, exactly. So you can go and find a whole two hour episode on fermented foods if you want. Only two hours? Yeah, that was one of the shorter ones. we're getting people to focus on sleep duration. So how long are you in bed for? So the research is pretty clear that seven to eight hours of sleep per night is associated with lower total mortality, premature death. Now, if you're in bed for eight hours, you probably get seven hours sleep. I'm not sure if you've ever looked on your whoop. Oh yeah, it's like, oh, cause I used to just think, oh, I went to bed at this time and I woke up at this time.

1:50:29The whoop, you realize like, oh, time in bed is not necessarily an indicator of how much time you slept, nor is it an indicator certainly of the restorative phases of sleep that are most important. So we're recommending that people are in bed for eight hours per night. Now, I think you've had Satchin Panda on. No, I haven't actually. You haven't had him on, okay. but you've had episodes on where you've discussed circadian rhythms and circadian biology and everyone's experienced chronic jet lag fly across the other side of the world to Byron Bay where I live and you're going to feel pretty lousy until you adjust to that new time zone what people may be a little less aware of is that that's a very sort of acute form of chronic of circadian disruption but you can have more of a chronic insidious circadian disruption which is occurring whilst you're staying in the same time zone because of the way that you're living and so So circadian biology, in short, we have these natural fluctuations of hormones and things like our heart rate and our blood pressure.

1:51:52They change throughout the day and they really just change in order to prepare us for what we're about to do. So in the morning, things are changing to get us ready for being active and get us ready for digesting food. Later in the evening, various physiological processes are changing based on these circadian rhythms to get us ready for rest and rejuvenation and renewal overnight. These circadian rhythms are primarily affected by two external cues in our environment. There's two things that can really throw them out of whack. One is light exposure. so if we're sitting up late at night in very very very bright lights it's let's say it's 9 p.m our body and it's dark outside our body we might be sitting in la but our body thinks we're in sydney so we can cause some dysregulation of our circadian rhythms and then that affects the release of melatonin, which has an effect on your sleep, for example.

1:53:02We can also dramatically affect these circadian rhythms through the timing in which we eat. That's the other really important signal here. So within this challenge, we have two different habits that speak to nurturing our circadian rhythms. One is light exposure. We want people in the morning to get outside, get at least 10 minutes of natural light exposure in the first couple of hours of waking up. That's important. That sets your clock. This is the Huberman protocol around morning sunlight. And then at nighttime, as the sun's going down, ideally you don't have to turn all the lights off in the house, but it will be helpful if you dim the lights down and if you're using screens you can adjust the the brightness on those and put them into night mode and then with regards to the timing of our food there's some really interesting research that has come out of Courtney Peterson's lab I interviewed her looking at how efficiently is our body utilizing nutrients at different times of the day and it seems that particularly at night time a couple hours a couple of hours before we go to bed we have changes in hormones that make things like glucose glucose metabolism much less effective how it makes sense our body is getting ready to go to sleep not to digest food and convert it into energy.

1:54:48The ideal kind of eating window, and some people have described this as a circadian biology eating window or circadian fasting. I don't think it's really a crazy fast, is you're in bed for eight hours a night. That's what we said just before. and when you wake up not eating for one or two hours upon waking and before you go to bed not eating for one or two hours before you go to bed before you go to bed now if you let's say you you do that as two hours so you you're in bed for eight you don't eat for the first two hours of waking up and then before you go to bed you're not eating in the two hours leading up to bed automatically that means your eating window is at 12 hours the average person's eating window in america is 15 to 16 hours so pretty much rolling out of bed having a bite of a donut and hitting all the way up to going to sleep again the reason why all of this is important is that we know that this chronic circadian disruption significantly increases risk of metabolic diseases, significantly increases risk of obesity, of cardiovascular disease.

1:56:11So there are repercussions if we're living in a way where our circadian rhythms are disrupted. And it's not just the long-term. If you're experiencing chronic circadian disruption, you're likely to feel more brain fog, more fatigue, less lower energy or lethargy on a daily basis. So just getting some routine in place where we're in bed for eight hours, which thinking about light exposure and then we're eating at a regular time, trying to avoid eating too close to waking up or going to bed can make a very big difference. This is like my Mount Everest because I get so hungry at night, man. It's very difficult for me to not eat in the two hours before I go to sleep.

1:57:03Like that is my Achilles heel. So if I accomplish nothing other than figuring out how to master that as a result of doing this challenge, that would be a huge win for me. Have you played around with the types of food that you're eating? Yeah. And when I was wearing a continuous glucose monitor, is very evident like when I would eat like right before going to bed, how it would wreak havoc on me. And I wake up in the middle of the night and stuff like that. And my blood glucose regulation is super dysregulated as a result of that. Like I know I shouldn't do it. And this is a habit that's been very difficult for me to break.

1:57:48I haven't seen this formally studied, so I can't speak to an intervention, but I have a hypothesis here and I'm not sure whether you've tried this, but I'd be interested to see what happens if you have a slightly lower carbohydrate dinner and higher fat. And I suspect because that will be slower to digest and metabolize that you might feel fuller for longer. It's a weird satiety thing and I don't know if it's just mental or emotional, But if I don't feel full when I get into bed, like I feel like agitated, I feel like I need to, there's something emotional or physiological about how you kind of relax when you've just eaten, like your anxiety and your stress level lowers.

1:58:42And for some reason, if I'm going to bed and I'm hungry, like it becomes very difficult for me to fall asleep. I get that. You might need a bigger plate at dinner. I eat plenty, trust me, dude. Anyway, I don't wanna get too sidetracked on that, but I think that's really important and that's great. And if you wanna be more rigorous about your sleep tracking, there's always like a whoop or something like that that you can get that, listen, I never take this thing off and it's really been helpful in keeping me on track. Not so much for the day to day, but more for the trends and just understanding the types of behaviors and habits that influence things like HRV and the amount of REM or deep sleep that I'm getting every night and how that impacts resting heart rate, stress, like all those sorts of things.

1:59:32Like just, it's just information that arms you with the data points to kind of solve the arithmetic of what works for you and what's leading you astray. Yeah, I love the sleep data. And, you know, I agree. I've been able to identify a few different kinds of patterns. I've noticed if I'm working really late, then my restorative deep sleep is much lower. Probably going to bed thinking about all the things I need to do. And then if you correlated that with where your stress levels are and how long it takes them to go down as you go to sleep, because if you haven't reduced those before going to bed, you're gonna have a less restful evening of sleep.

2:00:19Yeah, my recovery today was 86%. That's pretty good. I was happy with that. Yeah, right on. All right, what else do we need to know? I think we have a good idea of in a general sense of the type of interventions and protocols that are gonna be served up as a result of this challenge. And then of course, at the tail end of this, you're gonna retest all of this stuff. but what else do you wanna share generally about the challenge itself? I mean, there's so much in here. We have an emphasis on fermented foods based on evidence out of Justin Sonnenberg's lab and Chris Gardner's work. We have this information and recommendations on both moderate and high intensity cardiovascular training.

2:01:10Both of those are important, they're different stimuli. And I see exercise as very much like a poly pill. A poly pill, some people might be familiar with that. You can package up like a lipid-lowering drug and a blood pressure-lowering drug and a blood glucose-lowering drug all into one thing and take that as a pharmaceutical drug. Exercise is similar in that you have all of these different types of exercise, moderate intensity, cardio, high intensity, resistance training, and they are providing different stimuli, really important stimuli to get different systems in the body to adapt. So we have a guide in there for resistance training, for that moderate intensity cardiovascular training, for high intensity interval training.

2:01:59Again, we start off gentle and we progress it over the 12 weeks. And then there are, as I mentioned before, there are some lifestyle habits and things that we're wanting people to do that we think will shift the needle on emotional health. And so I'll give one example of this. Tom Gilovich is a psychologist who did some fascinating research looking at regret at the end of someone's life. What is it that accounts for the most regret? and he was looking at is it actions that they've taken throughout their life or is it inaction his results were really really insightful and a little bit surprising so 76 percent of the regret was through inaction.

2:03:06it was through things that people wish they did that they didn't do now importantly he was able to identify through different questions you know each of us have kind of he describes this as our actual self that's who we are today who we think we are and then we have our ought self our all self is who we ought to be from society expectations what society kind of wants us to to be or um conform to and then we have our ideal self and our ideal self is who we truly want to grow into the 76 of the regret was explained 76 of the time by inaction towards the ideal self so it was and they had they have all these beautiful quotes from people it was simple things rich it was people who wanted to pick up that musical instrument but never did they wanted to write poetry but never did they wanted to grow a garden at home for their family but never did and digging a little bit deeper, they were able to see that the main reason why people didn't take these actions was fear.

2:04:36A lot of the time it was fear of what people around them would think or that they weren't going to be able to do it. Yeah, the pressure to conform to the odd self, moving the actual self towards the odd rather than the ideal self. and the delta between the actual self and the ideal self or the aspirational self is a direct correlate to the extent to which someone experiences regret on their deathbed, right? And we get caught up in that fear and those social expectations, we internalize them and then we move further and further away from the things that authentically bring us happiness. Yeah, like I do this myself.

2:05:17I used to play the guitar when I was 15, 16, and from when I was 10 up to 15, 16, and then I remember getting to an age where I started to focus on, you know, whether I was good enough and what other people thought of me while I was, you know, playing music, and it no longer was fun and I gave it up. And I think, you know, for the last five or ten years, I've said to myself, gosh, it would be good to pick that guitar back up, but I haven't. And if I'm being completely honest, a lot of that is fear of am I going to be good enough? Is this going to be embarrassing? And the interesting thing is that we're all doing that.

2:06:02So, I'm sitting here thinking about what everyone else is going to be thinking of me. And so, I'm not doing something. And that's what everyone else is doing. Sure. But the good news, Simon, is that there's a 12-week program. that's gonna correct this for you. Exactly, so my challenge is, I'm gonna have to come back on here and play the guitar at some stage and make a fool of myself, but have fun. That's good, well, there we go. That's enough to whet the appetite, right? Well, we are gonna do that. We're gonna do some follow-up check-in podcasts. You're gonna do a whole bunch of like IG lives after February 1st.

2:06:42I'm gonna be in Australia on my sabbatical during the first two weeks of February. So maybe you and I can get together and share some stuff or see where we're at while we're in the midst of all of this. Should we go for a surf in Byron? Yeah, that's the embarrassing thing for me. Did Ben Gordon tell you about me? Did I tell you that story? And I just, oh God, anyway, I'm not gonna indulge people with that. But I actually am committed to getting better at surfing. That's a big intention for me when I go back to Australia. And that requires just consistently doing it. Like, it's not that I don't know how to do it, it's that I never do it, you know?

2:07:21And I enjoy it when I have some level of fluidity with it, but I never invest the time to do it. So that's one of my, that's like one of my big things for that period of time, which happens to segue, you know, completely overlap with this challenge period. Yeah, Ben's the guy to help you do that. Yeah, I know, I know. No, he's like, I gotta make amends for the last, and whatever. Well, he did take you to the most crowded break. He took me out and I was like, listen, like I'm a super, like I'm not a great surfer. Like let's just go where there's nobody there. And he's like, sure. And we went to this break and the break was flat.

2:07:57So he's like, don't worry, we'll go to the main beach. We'll just stay on the outside or whatever. Sure enough, there's a million people out there and I'm all up in my head about not getting in anyone's way. So of course I manifest that very experience and I drop in on a wave and I accidentally, there's a guy in my blind spot and I, you know, without meaning to kind of cut him off and our boards collide, I go under and then the fin just like slices my hand wide open. You know, like, and it was literally like, it was exactly what I told Ben I was trying to avoid. You called it in. That I created, yeah, for myself.

2:08:30Yeah, he took you to the past. So if anyone is familiar with that, that's a crazy chaotic. Shout out to Ben, I love you. and we'll be going surfing soon. But anyway, I think this is a good place to kind of bring this to a conclusion, but I do have a couple quick questions. First of which is, what is the role of supplements in all of this? When we have a conversation around longevity and health span, that conversation tends to get sort of hijacked by all of these new molecules that are being studied, NAD, NMN, NAD, like all that kind of stuff, right? Rapamycin, what's going on there? This challenge is designed to look at the biggest levers with the most heft.

2:09:16And while there's interesting science going on at the pointy edge of longevity, what's most important are these big levers, right? So with that kind of preface, like do supplements fit into this? How does that work? When somebody gets their blood work done and they realize maybe they have a deficiency here and there, or does this account for that? My approach with supplements is I look at it from two angles. One is I think supplementing with a particular essential nutrient to fill a gap is always a good idea if you can't adjust your diet in a way to account for that. And the second is to take a supplement that can help optimize you for particular performance goals, outcomes.

2:10:10We've spoken about that previously when we, I think in the first or second episode we did together where we spoke a lot about creatine and protein. And to your point about NMN and rapamycin and metformin, some of these are supplements, some of these are pharmaceuticals, I think that space is super interesting, but I think it's speculative. whereas the challenge is not speculative in the sense that we do know what markers matter in terms of predicting our health and we do have science-based interventions that we know improve them. So this whole challenge was built upon that framework, less speculation, more concrete science, maybe not as exciting to some corners of the internet.

2:10:57From a supplement point of view, So within the PDF, there's a supplement protocol recommendation. And some of these depend on the way that someone's eating. For example, I recommend a DHA, EPA, algae slash fish oil, depending on someone's preference, if they're not consuming fatty fish. And actually, Rich, I went and looked at how much fatty fish you would need to consume to get enough DHA and EPA in terms of what's optimal. And I had a whole episode with Philip Calder on this, who's the expert or one of the domain-specific experts researching omega-3s and 6s. To get one gram of DHA and EPA a day, which is not a crazy high amount, is what I recommend because I think that's where the evidence is lined with, you would need to be having three to four servings of fatty fish a week.

2:12:00A very, very small percentage of the population would be doing that. And if everyone was doing that, quite frankly, it would not be sustainable. So in short, there are recommendations for supplements like that. It's not going to apply to everyone. It will depend on their diet. Omega-3s, a multivitamin, there's a prebiotic supplement which i think can be a good idea if someone is increasing plant diversity and having difficulty with that it's coming from a diet that's been heavily restricted creatine and protein so it's not a crazy long laundry list of of supplements it's just a handful or so for people to consider and for each of those there's a recommended brand there's a recommended dosage and then some links for people to get some savings right what if somebody's blood work comes back and it's way out of range like they realize like those women who realized they were osteoporotic that they're in a dire state is there some you know kind of guidance around when it might be appropriate to call your doctor and explore the options that are available to you if somebody realizes they're like really in the red or in a crisis state on an important blood marker.

2:13:23Yeah, I think this is a great point. I think if anything is wildly out of range, then you should be having a discussion with your physician. it might be that some people require pharmaceutical interventions i also want people to sit down with their physician if they have type 2 diabetes if they have cardiovascular disease if they have metabolic syndrome and they're currently taking medications and the reason for that is that these interventions are very effective and you want your physician or primary care provider to know that you're changing the way that you're living because that could affect the dose of various pharmaceutical compounds that you have and they may need to be titrated along the way so another um i guess indicator of success of this challenge is not just shifting these into an optimal range but i would say for many people is reducing the dosage of some of the medications that they're taking as well yeah somebody's on blood pressure medication, they're on statins, they're on a battery of whatever.

2:14:38Obviously, that complicates the protocols, I would imagine, in some regard. How does all that play into somebody's day-to-day program? I think most of, if not all of the 12 lifestyle habits, someone with type 2 diabetes could do. but I want their physician to be aware that they're doing it. And the primary concern that I have there is not whether they can do these things, it's how it's going to affect their physiology and therefore how that will affect the medications that they're likely taking. So when you did this retreat with Drew, you sort of proofed this or tested out some of this, but it wasn't a 12-week retreat.

2:15:26So I'd imagine you had some kind of compressed, reduced version of this? So we still have people going through now. So you kind of initiated it there and you stayed in touch with those people? Yeah, and we were, I guess one of the benefits of a retreat versus the challenge is, you can work on an individual basis a little bit more with regards to the specific interventions that they should focus on based on those 10 truths, gives you a little bit more flexibility there. but otherwise we took them through essentially this same kind of protocol and that was only in October. So people are sort of six or eight weeks into that process.

2:16:11Now I've had a lot of emails from our guests who have already done blood tests. They couldn't wait 12 weeks there to go. And this is the thing that it doesn't take 12 weeks to change all of these biomarkers. Some of these change on different sort of time courses like bone mineral density takes a lot longer than ApoB. You can reduce your ApoB in many instances within a week of changing your diet. In the long run, what we're hoping to do, and I see this very much as kind of version 1.0. Each year, I wanna be reviewing the calculator, the 10 truths, looking at new evidence that's emerging. Do we need to tweak things in there in terms of how we're scoring it?

2:17:05And then over time, accumulating data from people that are going through the challenge so we can see the typical outcomes. And then that way, you can, before someone decides to sign up to this and commit to 12 weeks, so you can kind of understand what benefits are up for grabs. I'm trying to put myself in the shoes of the contrarian who's watching this or listening to this and thinking, do I really need to do all this? Because when I look at the Blue Zones folks and what Dan Buettner has to say, these people lived 100 and beyond. They're all fit and seemingly doing great. And they don't worry about any of this shit.

2:17:50They're not counting their calories. They're not doing beep tests or shuttle tests. They're not checking their email. They're not worried about how many plants they're eating every day. They're living their lives and they're rocking it out. So can I just get like blue zones adjacent and call it a day, Simon? I think you can if you're prepared to move to Okinawa or perhaps a certain part of Costa Rica. But short of changing your environment to their environment. Unfortunately, I think we have to be intentional. The environment that we live in is very different to their environment. And I think I've heard Dan Putner argue this before.

2:18:33It's not willpower that separates us. Centenarians in blue zones aren't born with crazy amounts of willpower. They just live in an environment that's conducive. They have an environment that's conducive to those choices. Yeah, and I think the best way to kind of visualize this is to think of the difference between a maze and a labyrinth. You know, a labyrinth is kind of designed for you to find your way. You don't have to make choices along the way. There's only one path and eventually you'll get to the middle. in fact some of these labyrinths are designed to be you know useful for the purpose of mindfulness or meditation that's the point of them whereas a maze is really designed for you to get lost and so a blue zone is more like a labyrinth the environment is set up for them to succeed they don't have to be intentional they can just walk through that environment and they're going to be very likely to enjoy good health and get to the center of that labyrinth find their way out of it whereas in western countries where we're exposed to a different food environment food marketing is different we have a different way of living that results in a more sedentary lifestyle it's more like a maze designed for us to get lost so the challenge and you know the information that i put out on my show and all the information that you put out on your show with with guests with a health and wellness sort of background i see those as you know acting as a voice so that as people are walking through the maze you get to a point where you have to go left or right yeah don't go that way so it's a little whisper you know and and so you know with that coming back to where we started this conversation in that maze giving people more confidence empowering them so that they you know they feel confident that the the energy and the time that they're putting into certain things is going to pay off there is going to be a return on investment and I think we're super lucky I'm incredibly grateful for all of this science that we have that allows us it informs this so we can come at this in an environment that let's face it it is designed for us to fail we live in a maze but we do have information that allows us to be intentional so that we can still enjoy good health despite the environment.

2:21:33Well, I think it's a laudable thing that you've created. And I think that what's great about it is that amidst the acrimonious discourse that you find online and on social media around diet tribalism, most of those arguments take place on the margins of what we know and don't yet know and overlook the pillars upon which we agree upon and truly understand to be most potent and important in terms of, as we said at the outset of this, moving the needle on the biggest things that impact our health and our wellbeing. So we can argue about, I don't know, you name it, seed oils, whatever, But we know that most people die of heart attacks, heart disease, right?

2:22:32And what are the interventions that we fully understand are going to put us in a position to avoid those pitfalls and focusing on that seems to be, you know, the responsible choice here. And then down the line through the various, you know, 10 truths that we talked about. I love it. I like that it is all inclusive and that it isn't contingent upon your affiliation with any particular dietary tribe per se. And it's easy to understand, easy to adopt. And it is like placing a labyrinth on top of this maze to create a structure and a foundation and an environment where somebody is whispering so you don't make that wrong left turn.

2:23:19And you can kind of get on board with these habits, which are not, you're not asking that much. It's not a super heavy lift. It's very gentle. And I think it provides people with a warm introduction and welcome into a new way of being in relationship with themselves and their daily habits. So I commend you, I'm excited to do it. Well, thank you for, I mean, you played a big role in pushing me, I guess, to kind of pull all this together. And I wanna reiterate, I'm just a synthesizer of this information. The, I've been so grateful for all of the guests that I've had the privilege of being able to sit down with.

2:24:00How many episodes have you done? It's coming up to 300. I've been doing this for six years now. I started actually in Venice, that Airbnb where you came over the other night, that's where this started. Oh, that was the original OG Airbnb, wow. Full circle. but I'm so grateful for not only the conversations that I've had but the relationships that I've been able to build with different academic scientists domain specific experts that's allowed me to have ongoing emails and phone calls and to really lean on on people to help decipher all this and make sense of it and then be able to translate and communicate it to to my community and other communities to me.

2:24:47I'm just very grateful for that. And obviously, to people like Drew Harrisburg that have played a huge role in sort of building out this challenge as well. Yeah. Well, I think it's the evolution of this medium. Like you had so many conversations, but they're long and it's a lot. And if you're somebody who's new to this world, you can't ask somebody to go listen to 300 episodes of your podcast. how do you synthesize that information, deliver it in a package that's organized around a protocol or a series of protocols, a program, if you will, that's doable and that's what you've done. And I think they've done a great job.

2:25:30I mean, this is like not an easy task, especially when you can get caught up in the weeds and go down these rabbit holes, like it's an endless black hole or whatever, because it's hard. Like nutrition science, man, it gets super complicated. We wanna be reductionist about it and make it binary or black or white. And it's not quite that way. And for somebody who appreciates and understands like the complexity and the level of nuance to be able to still nonetheless plant your flag here, here, here, here's what's important. I'm sure that was arduous for you. That was hard, but I've had to lean on a number of soundboards, I guess, in my life, people that can give me honest feedback.

2:26:10to pull me out of the weeds and say, simplify that. That doesn't make sense. But as you say, you can't point people to 300 episodes. So I feel, I guess proud is the word that comes to mind that now when someone says, and this happens all the time, just tell me what to do. I can just say, well, go to theproof.com forward slash. Finally, you have an answer. Yeah. And start there. There it is. So we are going to kick this thing off February 1st. That gives you a full month to get your blood work done and do all the testing to create your baseline. In the meantime, everybody needs to go to theproof.com slash livingproof.

2:26:59You'll be able to download the PDF, enter your email, get on the email list. Again, this is all zero cost, no cost to you. Obviously you have to pay for your blood work or whatever that's on you. but the program itself is free, which that's another fantastic aspect of this. And Simon is gonna be, once February 1st starts, Simon's gonna be doing IG lives. You're gonna be sharing a lot of stuff, making videos. I'm gonna be in Australia for part of it. So maybe we'll do a check-in podcast, something like that, or do create some content around this. And I'm excited, man, thanks. Thanks for pushing me to do this after our last three hour deep time.

2:27:38Yeah, well, maybe we'll figure out what to do with that. But you're gonna be spending more time in LA next year, right? I am. I think I'm doing five or six months from February. All right, so plenty of time for you to pop in. Like, I think if we even just looked at that and did separate episodes on all of those things, we could create something a little bit more concrete and helpful to people. So more to come. Thanks, Rich. Excellent, brother. Check out Simon's podcast, of course, as well, The Proof. And I have his book sitting right here, The Proof is in the Plants. All kinds of recipes, science, nutrition, info, all the good stuff.

2:28:14And love you, buddy. Thank you for sharing and to be continued. Love you, man. Thanks. Peace. Plants. Proof.

2:28:28That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guest, including links and resources related to everything discussed today, visit the episode page at richroll.com, where you can find the entire podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change, and The Plant Power Way, as well as the Plant Power Meal Planner at meals.richroll.com. If you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify, and on YouTube, and leave a review and or comment.

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2:29:51Portraits by Davey Greenberg, graphic and social media assets courtesy of Daniel Solis. Thank you, Georgia Whaley, for copywriting and website management. And of course, our theme music was created by Tyler Pyatt, Trapper Pyatt and Harry Mathis. Appreciate the love, love the support. See you back here soon. Peace. Plants.

2:30:33Thank you.