What's the deal with declining sperm counts?

9:37Emily Oster:When you listen to podcasts about AI and tech and the future of humanity, the hosts always act like they know what they're talking about and they are experts at everything. Here at the Nick, Dick, and Paul show, we're not afraid to make mistakes.

9:50Perry Wilson:What Coogler did that I think was so unique...

9:53Emily Oster:Who's he?

9:53Perry Wilson:He's the writer-director.

9:55Emily Oster:Who do you think he is? I don't know. You mean, like, the president? You think Canada has a president? You think China has a president? The La Cruzette. God, I love that thing. I use it all the time. I wrap it in a blanket and sing to it at night.

10:13Perry Wilson:It's like the old Polish saying, not my monkeys, not my circus. Yep. It was a good one. I like that saying.

10:19Emily Oster:It is an actual Polish saying. It is an actual Polish saying. Better version of play stupid games, win stupid prizes. Yes. Which, by the way, wasn't Taylor Swift who said that for the first time. I actually, I thought it was. I got that wrong. Listen to the Nick, Dick, and Paul show on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

10:37Perry Wilson:It's the new me. And it's the old them. Everybody's on their journey. And your journey's different to theirs. This Woman's History Month, the podcast, If You Knew Better with Amber Grimes, spotlights women who turn missteps into momentum and lessons into power. I think coming out of where I came from, I'm from the Bronx. I think I grew up really poor. I didn't know that then because I very much used my creativity to romanticize life. And I'm like, my mom did a really good job of like, you step back and you're like, whoa, we, I don't know how we made it. So a lot of my life was like built out of like survival to get to the next place.

11:13Perry Wilson:Like my drive, my like tunnel vision of like, I got to be better. I got to achieve this was off the strengths of like, I want to make a better life for us. If You Knew Better brings real talk from women who've lived it, unpacking career pivots, relationship lessons, and the mindset shifts that changed everything. Listen to If You Knew Better with Amber Grimes on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi, everyone. I'm Cheryl Strayed, author of Wild and Tiny Beautiful Things. I'm excited to share that I have a new podcast called Mind Over Mountain. In each episode, I interview athletes, adventurers, and adrenaline seekers to discuss the inner landscapes and life experiences that informed and inspired their extraordinary feats.

11:58Perry Wilson:I also bring a bit of advice into the mix so we, too, can better understand how to face our own seemingly insurmountable challenges.

12:07Emily Oster:Do you know what I'm going to do? I'm going to pull out what you already have inside. We're coming into this world fighting for our lives. All I'm going to do is pull out what you already got inside.

12:14Perry Wilson:We're there to support and celebrate each other. And that's not like a your story versus my story. You're going to walk up and over that dang mountain. You're not just going to put your mind over it. Yep, yep, exactly. And if I can't walk up and over it, I'm going to go through it. Listen to Mind Over Mountain every Thursday on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

12:40Perry Wilson:All right, Perry. So last week, RFK Jr., the Secretary of Health and Human Services, claimed that a ketogenic diet could cure schizophrenia. He said, the quote is, a doctor at Harvard had cured schizophrenia using the keto diet, which is a high-fat, low-carbohydrate diet, and also claimed that there were studies showing that people lose their bipolar diagnosis by changing their diet. So how much of this is rooted in fact as opposed to just in nothing?

13:11Emily Oster:So this is really typical of RFK's style, which is like there is a kernel of fact in here that then gets just like expounded to a hundredfold higher, which is fine if you're maybe an influencer on TikTok, but is not great if you're the Secretary of Health and Human Services. So ketogenic diets and what they're talking about here is not like I'm keto, like I, you know, I try to avoid carbs. A medical ketogenic diet is really hard to do. Like it's it's you have special foods and stuff. You are in the state of ketosis. And we do use it to prevent seizures in people who have refractory epilepsy that no drugs work.

13:51Emily Oster:So it does affect the brain. There was a small study which showed a ketogenic diet had modest effects on schizophrenia symptoms in a subset of people with schizophrenia. The author of that study was asked about RFK Jr.'s quote and said themselves, no, this is not a cure. I mean, it's clearly not. It's interesting. but this is just you know it it speaks to this thing that keeps happening where it's like your medical problems are kind of your fault there's always this subtext that's like oh well if you only ate a better diet maybe you wouldn't have schizophrenia and it's just it's really like disabling to people with this kind of condition.

14:33Perry Wilson:I think the other piece for me here was this this sort of taking of what should be the first step in a kind of research program and deciding that we're done, right? The process of science, I mean, you know this as a researcher, like the process of science is like, okay, we do an experiment with like two people and we see, huh, like maybe there's something interesting there and maybe there is something interesting here, but then you sort of expand it out and think about what would be feasible. Could it work on a larger scale? How big are the effects? And this is kind of taking that first step and being like, oh, we're done.

15:09Perry Wilson:We fixed it. Like, just eat a lot of bacon. Yeah, absolutely. And that's not the solution.

15:15Emily Oster:Absolutely. And the history of these interventions across all of medicine is typically that something that works in a small group or in lab animals or something that's kind of interesting doesn't scale up. Like, it doesn't work. The literature is littered with failed interventions like this. So irresponsible to say, but let's move on. Emily, did you see this article in the New York Times reporting that there has been an increase in refusals of the vitamin K shot after birth? So what is going on with vitamin K now?

15:49Perry Wilson:So it's worth saying why we might give kids a vitamin K shot right after birth, which is that it prevents bleeding. So infants who do not have a vitamin K shot are at a much higher risk for later bleeding, which can be fatal. And so there are really good reasons to give infants a vitamin K shot immediately after birth. It has been done for many decades. It's extremely safe. But in our current vaccine hesitancy environment, this shot, like many others, has become sort of part of the kind of we're afraid of shots thing. and more parents are refusing it, which of course is very dangerous for their infants.

16:32Emily Oster:But not a vaccine, right? I mean, just let's be clear.

16:34Perry Wilson:It's not a vaccine. It's a vitamin shot. Exactly. And that's what's, I mean, that's sort of amazing because people are thinking, okay, this is like a vaccine. No, it's a vitamin shot. It's a vitamin. And yet - Right. We like vitamins. We like vitamins. I mean, what's so interesting is, of course, the same space, they love vitamins that are useless. This is a vitamin that's very helpful. And yet, you know, people are refusing. And I think it's just an example of where some of this vaccine hesitancy has spilled over even into things that are not vaccines and in this case have no side effects and have very clear, obvious benefits.

17:12Emily Oster:Right. There's obviously an element of mistrust of medicine here that's taking place. There's also this movement towards kind of, you know, a more natural experience, right? Like we didn't, you know, our ancestors didn't give their kids vitamin K shots. But I will point out, as I often do, that things were really way worse in the good old days. So prior to 1900, infant mortality was 25 % in the United States. So that's death before age one, one out of every four kids. Death before age five was about 50%. So that is not something we want to go back to. And the thing that has changed infant mortality rates so dramatically are interventions like this, kind of straightforward, dumb interventions like, oh, babies are deficient in vitamin K and they have hemorrhage in their brain and let's give them vitamin K.

18:00Yeah.

18:01Perry Wilson:So please, if you're having an infant, get the vitamin K shot. Okay. So let's turn to a, I would say, arguably more important topic than schizophrenia and infants, which is ski jumping. Yeah. So it's the Olympics. I love the Olympics. I like the endurance sports, but I also like ski jumping. And there is a report of some mechanical doping in ski jumping, which is working like the following.

18:28Emily Oster:Oh, I know where you're going with this.

18:30Perry Wilson:Apparently in ski jumping, you want your suit to be very big because if your suit was like really loose, it would be like a sail. So when before you ski jump, they take a scan of you in your suit to make sure that the suit is not too far from your body. so there's a report it is admittedly from a german tabloid that some male ski jumpers are injecting their penis with acid so their penis will grow and then the 3d scanner will make it seem like they're filling up the suit more and so they'll be able to have a bigger suit but then the penis goes back down before the ski jumping so they get the sail like effect i just want to know will this work increase your penis size and would it have other uses beyond ski jumping that we should be considering?

19:13Emily Oster:I saw this article too. And yeah, real hard for me to read, I have to say. I think they really dropped the - Because you feel like you missed out on some opportunities. Yeah. I could have been a champion ski jumper. I'll let you draw your own conclusions. But no, I mean, they missed the opportunity to call this inflate gate, first of all, which is just journalistic malpractice. I think if these ski jumpers have the balls to inject their penis, you know, more power to them. Just to answer the medical side of this, hyaluronic acid, which is what they're talking about injecting it like, yes, it does swell tissues.

19:54Emily Oster:I mean, so yes, it will make something bigger transiently. It then gets absorbed by the body. There's some bodybuilders who have been accused of doing this in their pecs and stuff to make them more swollen. This is a bad idea. You do not want an infection in your penis or around your penis. It doesn't turn out well. If you want to never sleep again, Google Fournier's gangrene. Please don't. You will see what can happen if you do something like this. So just fly through the air with your regular penis, please.

20:29Perry Wilson:I think that's a good place to stop with our health news. But after the break, we'll come back and ask, what's the deal with declining sperm counts?

20:40Perry Wilson:What if mind control is real? If you could control the behavior of anybody around you, what kind of life would you have? Can you hypnotically persuade someone to buy a car? When you look at your car, you're going to become overwhelmed with such good feelings. Can you hypnotize someone into sleeping with you?

20:56Emily Oster:I gave her some suggestions to be sexually aroused.

20:59Perry Wilson:Can you get someone to join your cult? NLP was used on me to access my subconscious. NLP, aka Neuro Linguistic Programming, is a blend of hypnosis, linguistics, and psychology. Fans say it's like finally getting a user manual for your brain.

21:16Emily Oster:It's about engineering consciousness.

21:18Perry Wilson:Mind Games is the story of NLP. It's crazy cast of disciples and the fake doctor who invented it at a New Age commune and sold it to guys in suits. He stood trial for murder and got acquitted. The biggest mind game of all? NLP might actually work. This is wild. Listen to Mind Games on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

21:43Emily Oster:When you listen to podcasts about AI and tech and the future of humanity, the hosts always act like they know what they're talking about and they are experts at everything. Here at the Nick, Dick, and Pohl show, we're not afraid to make mistakes. What Coogler did that I think was so unique Who is he?

21:59Perry Wilson:He's the writer-director

22:01Emily Oster:Who do you think he is? I don't know You mean, like, the president? You think Canada has a president You think China has a president The La Cruzette God, I love that thing I use it all the time I wrap it in a blanket and sing to it at night

22:19Perry Wilson:It's like the old Polish saying Not my monkeys, not my circus Yep It was a good one I like that saying. It is an actual Polish saying. It is an actual Polish saying.

22:28Emily Oster:Better version of play stupid games, win stupid prizes. Yes. Which, by the way, wasn't Taylor Swift who said that for the first time. I actually, I thought it was. I got that wrong. Listen to the Nick, Dick, and Paul show on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

22:43Perry Wilson:It's the new me. And it's the old them. Everybody's on their journey. And your journey's different to theirs. This Woman's History Month, the podcast, If You Knew Better with Amber Grimes, spotlights women who turn missteps into momentum and lessons into power. I think coming out of where I came from, I'm from the Bronx. I think I grew up really poor. I didn't know that then because I very much use my creativity to romanticize life. And I'm like, my mom did a really good job of like, you step back and you're like, whoa, we, I don't know how we made it. So a lot of my life was like built out of like survival to get to the next place.

23:19Perry Wilson:Like my drive, my like tunnel vision of like, I got to be better. I got to achieve this was off the strengths of like, I want to make a better life for us. If You Knew Better brings real talk from women who've lived it. Unpacking career pivots, relationship lessons, and the mindset shifts that changed everything. Listen to If You Knew Better with Amber Grimes on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi, everyone. I'm Cheryl Strayed, author of Wild and Tiny Beautiful Things. I'm excited to share that I have a new podcast called Mind Over Mountain. In each episode, I interview athletes, adventurers, and adrenaline seekers to discuss the inner landscapes and life experiences that informed and inspired their extraordinary feats.

24:04Perry Wilson:I also bring a bit of advice into the mix so we, too can better understand how to face our own seemingly insurmountable challenges.

24:13Emily Oster:Do you know what I'm going to do? I'm going to pull out what you already have inside. We're coming into this world fighting for our lives. All I'm going to do is pull out what you already got inside.

24:21Perry Wilson:We're there to support and celebrate each other. And that's not like a your story versus my story. You're going to walk up and over that dang mountain. You're not just going to put your mind over it. Yep. Yep. Exactly. And if I can't walk up and over it, I'm going to go through it. Listen to Mind Over Mountain every Thursday on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

24:46Perry Wilson:Okay, Perry. So if your social media feed is like mine, you are probably hearing a lot about declining sperm counts in a very panicked way. So one of the things I keep hearing is like, if we are going in this direction by 2035, no one will have any sperm. And I keep thinking about this graphic novel that my husband liked called Why the Last Man, which is about a world in which there's just one guy who has sperm and all the ladies are like chasing him. Did you read?

25:16Emily Oster:It's classic wish fulfillment graphic novel.

25:19Perry Wilson:Exactly. So I want to talk about whether this concern about our declining sperm is a real concern or just a kind of imaginary panic sperm problem like many other things. So we're going to talk about that today, but before we get into it, I think we should make sure everybody understands what sperm are, where they come from, and how we would know how many we have and how many should you have. Give me Dr. 101 on sperm.

25:49Emily Oster:Okay. All right. Medical school 101 on sperm. Here we go. So sperm are the male unit of fertilization. A sperm carries half of your genetic information. The egg has the other half. You combine and you make a baby. Most people know this. Sperm are produced in the testes, and it's not a simple process. There are stem cells in the testes that go through multiple cycles of generation. There's multiple sort of stages of evolution of sperm in the testes, like some kind of sexual Pokemon. It takes about 90 days, between 80 and 100, to go from that stem cell to a fully functional sperm that is ready to go, so to speak.

26:32Emily Oster:Testes are busy little guys. They are producing 200 to 300 300 million sperm cells a day. That's a lot. That being said, only half are viable in your typical man. So you produce anything at that rate, you're going to get some flaws. So only half are going to be good enough to sort of make it all the way out. And that's where we get into sperm counts.

26:56Perry Wilson:Can I ask, when you make sperm that are not used, obviously, if you're making 300 million sperm a day, is that right?

27:05Emily Oster:A day, yeah. They got to go somewhere, right?

27:06Perry Wilson:Okay, they got to go somewhere. Like what happens? Are you peeing them out? Do they get eaten? What happens?

27:12Emily Oster:They kind of get eaten. They just get reabsorbed. So they don't have an unlimited lifespan. They'll just kind of die. And like any dead cell in your body, once a cell dies and breaks down, these big white blood cells called macrophages, which are just like big cells that are specialized in eating dead stuff, come in. They live in the testes and they eat them up and they dissolve them and all the nutrients and stuff go back into your body. So they just get recycled basically. Yeah. No big deal. All right.

27:39Perry Wilson:No big deal. So you have these sperms. Some of them are good. Some of them are not good. When we say that we have good sperm, and I think this is relevant for talking about declining sperm counts, because really what we mean is a decline in viable sperm. What are the things you need for a sperm to be capable of fertilization, which is its primary measure of quality?

27:59Emily Oster:Yeah. I mean, it's a lot more than just sheer numbers, I think, as you're alluding to, right? So there's all this social media talk about sperm counts and declining sperm counts. That's only one parameter in about 10 that urologists, for example, will look at to tell you what your sperm quality is. So yes, you need a certain number. We'll get into what kind of normal numbers are in just a second, but they have to be able to move. Sperm swims. So they have to be motile. They have to move around. You can see that under a microscope. They have to have a sort of standard morphology, that tadpole-ish thing that you look at.

28:32Emily Oster:Some sperm have two heads, some sperm have two or three tails, and those are not going to be efficient at getting into an egg. They have to contain the nuclear payload of half of your genetic material. If they don't, you're not going to get a viable embryo. So they have a lot to do, and it's a numbers game, basically. In the end, It's a pretty difficult trek for a sperm to make it all the way to an egg. It's a hostile environment for very good reason. The weak are weeded out on this trek to the egg. We were all traumatized as young children by watching Look Who's Talking, where we saw graphic depictions of sperm competing with each other to get to the egg.

29:19Emily Oster:But that's how biology is supposed to work. But sperm count is certainly one part of all of this.

29:25Perry Wilson:And I also think when we talk, when people talk about declining sperm counts, I think they mean both counts, but they also often mean some of these other things. So a decline in sperm that are, a decline in the number of sperm, a decline in the number of sperm with the right morphology, with the right motility. So sort of sperm that have the right shape, that can swim, that can get to the egg. That's what we're focused on. That's what we're worried about. Right.

29:50Emily Oster:Now, when it comes to count, though, because it's always nice to put like a simple number on things, there's essentially two counts that get talked about in different studies. One is actually the sperm concentration, which is the count per milliliter of fluid, basically. So how much per milliliter? And then one is the total count. So if you take all the milliliters in a particular sample, how many sperm are in there? Most researchers are focusing more on that concentration, the count per milliliter, as a better proxy of overall sperm health. And just to give you some numbers, most men will have, you know, who are healthy and fertile, have numbers in the sort of 60 to 120 million range per milliliter.

30:35Emily Oster:The WHO defines any sperm count above 16 million per milliliter as normal. They used to say 20. That's been reduced. And Emily, you're going to tell me in a second why or if that's for real. But most people are actually quite a bit above that minimum threshold. Nevertheless, lots of panic about declines in the count over time. So Emily, you tell me, what's the deal with this? What does the data show? And is it for real?

31:05Perry Wilson:I think what's most interesting to me here is why this is so hard to answer. So if you sort of think about what you would like to be able to see, to have a measure of sperm counts over time, really we would like to sort of take every person with testicles when they are 18, bring them in, have them jack off into a cup, measure their sperm. And then we could have if we had that starting in like 1920, you know, we could really get a very good sense of how sperm has changed over time because you'd have a random sample or you have everybody, even just a random sample. I would take a random sample.

31:41Emily Oster:Yeah. Yes. As any good economist would. I will point out that the time of abstinence is an important factor in sperm count. So you would need these 18-year-olds to hold off on any sort of ejaculation for five days, which I think is really the hurdle that people aren't discussing. But go ahead. That's the ideal.

32:04Perry Wilson:My study is going to totally take care of that. I have different ideas. But at any rate, Whether I would be able to do that or not, we have not. And so most of our numbers about sperm counts come from selected populations without very good controls. So often we'll see data from infertile men. Well, that's not very helpful as a metric over time for a bunch of different reasons. Sure. So we're kind of working with a lot of pretty incomplete data, which is why I think the results are quite varied. So I would say if you look at meta-analyses where they bring together a lot of different studies of sperm counts over time in a global context, mostly those suggest some moderate decline in sperm counts over time.

32:55Perry Wilson:I think the sort of most recent data maybe is a little more reassuring and suggests maybe it hasn't declined very much. But I guess my read of the evidence, I'm curious if you read it differently, is it does seem like there's some decline, but it's probably not as extreme as you would take away from some of the hyperactive claims on the internet.

33:17Emily Oster:Yeah, the sort of catastrophizing of the sperm count. Yeah. I mean, one nice meta-analysis actually broke down this issue you're referring to, which is like selection bias for men who are having fertility problems, right, or couples that are having fertility problems. So overall, this study found that the average sperm count in men, sperm concentration in men from 1973 to 2018 went from 100 million to about 50 million. And that's like, okay, all right. So that's, you know, half. That's pretty scary.

33:52Perry Wilson:That's a solid decline. It's a real decline. That's a very good big decline.

33:55Emily Oster:But when they restricted to the studies that only included fertile men, so, you know, know, sperm counts for other reasons, the decline was from 77 million to 72 million, which is like really not that much. Now, maybe there's more infertile men, right? Like it doesn't necessarily mean that this is just total hokum, but you got to think through it a little bit more in a little bit more detail, right? Yeah.

34:21Perry Wilson:And I think that that, you know, you're citing sort of one particular study and I think one that got a lot of attention, but there are other meta-analyses with sort of similar approaches that do more adjustment for, say, what area you're in or some of these fertility metrics, which don't actually see sort of significant or see much, much smaller declines. So, you know, I love data so much. I love numbers and data. And in a case like this, I think what's so hard is because the data is imperfect, it matters very much what choices you are making about exactly who you're looking at, exactly how you're looking at it, exactly what you're adjusting for.

35:04Perry Wilson:And so it's not that surprising that the literature can kind of find everything from there's no change at all to like, you know, the sperm counts down by half. And if we keep going on this trend, you know, we're all doomed forever.

35:19Emily Oster:Well, I'm going to force you to put your nickel down here. You've read a lot about this. I've read a lot about this. Yes, data is a little bit, you know, wishy-washy here and there, but like, Heart of hearts, do you think there's a decline in sperm counts overall, over time?

35:32Perry Wilson:I do. I mean, my read is that there's been a modest decline in sperm counts over the past 50 years. What about you?

35:40Emily Oster:I think that's probably right. That was the vibe I'm getting to. Yeah.

35:43Perry Wilson:I think that there's enough data that points in that direction. That's an interesting thing about how we sort of look at data. You kind of read enough of this, and you read it, and you read it, and you sort of get a picture. It's a little hard to put your finger on. It's not that I'm saying, like, I looked at this one study. It's that when you look at all of it together and kind of evaluate basically with the background of being a person who thinks a lot about evidence, you kind of come out with something. So, yeah, for me, modest decline. All right. So a very reasonable follow-up question, if we both think there's been some modest decline, is it relevant, right?

36:17Perry Wilson:So we talked about like the WHO has got a threshold of, you know, 16 or 20. We talk about numbers like 75 million per semen unit. You really only need one. You only need one, Harry. So I guess the question is, is this clinically relevant? Is this the reason we're talking about a fertility decline in the entire world?

36:44Emily Oster:Does that matter? A lot to unpack on this, but I'll start off by saying absolutely not. This is not the reason for a fertility decline across the world. There are many more important factors in that, including deliberate choices by people who are doing real family planning, and of course, economic conditions that might influence those choices and many other things. So let's just put that aside. Let's talk physiology. We actually have pretty good data from in vitro fertilization studies to know how many sperm it typically takes to fertilize an egg. And yes, it only takes one, but as I said, they're running a gauntlet to get there.

37:25Emily Oster:It's very hard. And what these studies show is sort of a diminishing returns as sperm count increases. So at the very low end, yes, there's less fertility, right? We're talking less than 20 million per milliliter. There's less fertility there. But once you start getting over that threshold, it really flattens out. There's like not much of a change in pregnancy rates, fertility rates, once you get kind of into the normal range, which of course leads me to the question, like, why are people so obsessed about this? Like, why is it that your social media feed, like God, like I, God forbid, searched sperm counts once and now it's just, it was a huge mistake.

38:11Emily Oster:I need like a, I need a burner account just for this podcast. You know, why the obsession? And I don't want to like armchair psychologist this, but like, is this just a manly thing? Is this totally like just like a tech bro? Like, yeah.

38:26Perry Wilson:Yeah. I, for, for me, I mean, this is like a very interesting question. I think really a question about psychology, but I think that it is a signal of your manhood that you have a lot of sperm. Like sperm is like a, like, it's a thing you could measure. And I think particularly for people who like to measure stuff, you know, like I like to feel like you like to measure HRV, you like to measure your, you know, this hormone and that hormone. And like, you want to measure your sperm count because you want to have the best, you want to have the best sperm, but, but just like to have it, you know, not, not to do anything with it, just to have it around.

39:00Perry Wilson:for having and for telling people what it is. Yeah.

39:04Emily Oster:It's like an online IQ test. Exactly. Or like joining Mensa.

39:10Perry Wilson:So what about testosterone? Is testosterone and sperm count the same? Are they correlated? What do we see in that?

39:18Emily Oster:Yeah. I've seen a lot of people say like, oh, sperm count is this proxy for like everything about male health, including testosterone. Not true, actually. True with a tiny caveat. So testosterone levels are correlated with sperm counts in the first three months of life. So apparently for babies age zero to three months, the testosterone level there is important for proper testicular development, but that's it. Now, you will see studies that show that men who have very low sperm counts, like less than 20 million, are more likely to have low testosterone. So when you have sperm counts that are low enough to cause a fertility issue, you are also more likely to have low testosterone, those things can be related.

40:01Emily Oster:But in the normal range of sperm count, there is no correlation between testosterone and sperm count. So a sperm count of 40 million versus 80 million, those testosterone levels have no effect on that. And so if you're using sperm count as a readout of your testosterone, it's a bad readout, or maybe it's only a readout of when you were a tiny baby. If you want to know what your testosterone level is, you can measure your testosterone. test for that.

40:26Perry Wilson:One question that I want to come back to about what you said. So we talked about the fertility environment being hostile to sperm. What do you mean? Like the vagina eats the sperm in a negative way?

40:42Emily Oster:I mean, kind of. The big issue is acidity. So the vagina, the fallopian tube, these whole areas are quite acid. I think the pH, I'd have to check, but it's like 4.5 or something like that, which is certainly toxic to sperm. The semen that they come with is basic. So there's a little acid-based reaction there. Like when you do the baking soda and vinegar, it's less dramatic than that, fortunately. But that's the primary reason. And as I said, it's for a good reason because you want to kind of select for the sperm that is most motile, most robust, because that's probably the one that has the best genetic material inside.

41:30Perry Wilson:Yeah. So you're really using, you're basically using the hostility as an evolutionary mechanism to kind of find the good sperm. Men are just producing just a billion, you know, so many of these, and we're kind of have a million different ways that we're trying to get, sort them out, as opposed to taking more time to produce good ones in the first place, which doesn't seem to be the approach that we've taken. You got it.

41:50Emily Oster:So let's go through now. Okay, so we're going to take it on a little bit of faith, but some data that sperm counts really are declining. We both think that this is happening. And of course, then the next question is why. And even before we get to some of the like really rigorous studies on this, I think we need to address just a handful of the things that I have heard on social media about this. Um, let me start with a clip from the Huberman podcast about this issue. You might have heard that carrying your phone in your pocket can reduce your testosterone levels and sperm count. And guess what?

42:28Emily Oster:That is true. The data contained within this meta-analyses and other meta-analyses clearly point out that it can reduce sperm count and maybe testosterone levels significantly, but certainly sperm count and motility significantly. It reduces sperm quality. So should you avoid putting your phone in your pocket? Certainly your front pocket, I would suggest yes, right? If you are somebody who is seeking to conceive. Emily, before I get your response to that, I just want to say that that was one of the most epic eye rolls I have ever seen. Your opinion?

43:02Perry Wilson:I do not think we have good evidence that cell phones reduce sperm counts. You know, we have a little bit of like confounded evidence that people who talk on the phone more maybe have lower sperm counts, but of course that's not a piece of causal evidence. There's this idea you often hear about, like when you have your cell phone in your pocket, it reduces your sperm count. But again, we sort of look at the better evidence on that where they know where people are carrying their phones and so on. You just don't see any impact on sperm count. There's also no reason to think that your cell phone waves would impact your sperm.

43:36Perry Wilson:There's no reason for that.

43:37Emily Oster:Yeah. Yeah. There's no biologic plausibility. No biologic plausibility. always talk about, right? You want at the very least the sort of floor, the table stakes are, there has to be like a reason to believe this would be true. And then you need to look for evidence that actually is true. And I agree. I don't know why, but this is all over the place. I actually saw a clip of a woman responding to this Huberman clip and it was like reacting to the Huberman clip. And I was like, oh, this is going to be one of my people who's going to be like, what the hell is he talking about? And it was a woman being like, good job, Andrew Huberman.

44:13Emily Oster:And also don't put your cell phone in a fanny pack if you're a woman, because that can affect your eggs. And I'm like, oh man, like now we can't even use fanny packs.

44:22Perry Wilson:And they were coming back. I mean, I think that this is an example where people are pulling causality of time trends, where it's sort of easy to say, oh, look, you know, we think sperm counts have gone down over time. Cell phones have gone up over time. And so, you know, those two things move together. of course, many things have gone up over time, not just cell phones. And so the idea that two trends have moved in the same direction is not a way that we generate causality ever. Yeah. Terrible, terrible way to do causality.

44:49Emily Oster:My nickel down here that the actual reason for declining sperm counts is the rise in political violence.

44:58Emily Oster:What about, okay, what about laptops on laps? Because, okay, Here, we got some biologic plausibility. Laptops are warm. You know, the reason that the testes are outside of the body is because sperm development is inhibited at 98.6 degrees at body temperature. They have to be slightly cooler than that. I saw a nice study looking at like the measured scrotal temperatures. This is in a lab. So measuring scrotal temperatures of people with a laptop on their lap. and it found about two and a half to three degrees Celsius higher with the laptop on their lap. And like, okay, so more biologically plausible.

45:39Emily Oster:What do you think about laptops?

45:41Perry Wilson:Yeah. So I think it actually is pretty, I want to put a pin on the heat thing because actually one of the things that does reliably impede sperm production is having your testicles be very hot. And there are other things more important than laptops for that, like very tight underwear. So like heat is an important consideration here. The laptop explanation, my guess is it's like it is biologically plausible. My guess is it's not very important just in terms of total magnitude part partly because I don't actually think people have their laptops on their laps like that much. And those effect sizes are not that big.

46:22Perry Wilson:And I would be surprised if this explained much of a time trend. But I would say like from an individual standpoint, if you are worried about your sperm count, if you're trying to get pregnant, if you're worried about your fertility, you're thinking about your sperm count and you're carrying your laptop on your lap all the time, maybe don't do that. Put it on a table. Yeah. All right. So we got we're going to carry our cell phone, but we're not going to put our laptop. What about pesticides, toxins? Okay.

46:50Emily Oster:Toxins. So, you know, this is interesting because toxins is such a huge term. It's such a huge umbrella and it can range from everything from like, yeah, the stuff we spare in crops to like automobile exhaust and particulate matter. And depending on who you ask, like corn syrup, like all this stuff. And so it's so difficult to pin down exactly what's happening. I will say that there is some interesting data in pesticides. I'm not quite ready to like poo-poo this entirely. So the one that people will have probably heard of most is called atrazine. And the reason you see a lot about this is because this was the pesticide that in like a lab animal or like in a frog embryo study, like was able to change the gender of the frogs, right?

47:48Emily Oster:This is like the pesticides are turning frogs gay type of thing. So like a lot of hype, I think a lot of misunderstanding of what these studies actually looked at. But some of these pesticides do have hormonal activity, like can be hormonally disruptive, changing levels of estrogen and testosterone in animals, at least, and potentially humans. There was a small-ish case control study looking at infertility. So I'm moving away from sperm counts here. I'm just talking about infertility. 50 men who were infertile, 50 men who weren't infertile, where the levels of pesticides were measured in their blood.

48:31Emily Oster:And there was a signal that the men who were infertile were more likely to have higher levels of pesticides in their blood. Now, like, does that mean it's the pesticides? Does it mean they tend to eat foods that contain more pesticides or like they don't wash their foods off with pesticides? We have no idea. But in contrast to cell phones, which always feels like a little like wishy-washy woo science to me, you know, pesticides are chemicals. They kill bugs. They may do something to us. Right.

49:00Perry Wilson:So let me just say, I hear you on the biological plausibility. I find the study you just described to be ridiculous. It is a kind of study I hate called a case control study. And in a study like this, I'm sorry, I'm going to nerd out for people. But what we're doing is we're sort of taking people who have some condition and then in this case infertility and then finding some other people who don't have the condition and then asking them or looking at, you know, different exposures, look different at different features of these people. And the problem with a study like that is twofold. One, there are many other potential differences across people.

49:37Perry Wilson:So, you know, it's definitely not randomized. And if you look at those two groups, they're going to be different on all kinds of other things, not just pesticides. And so we're potentially confusing correlation between pesticide exposure and infertility with causality. No reason to think it's causal. The second thing is in that particular kind of study, you also have a problem because you're selecting the people totally differently. And so that makes your kind of correlation problem worse. So I hear you on the biological plausibility. I think case control studies are so deeply stupid. It's like one of my just total pet peeves that anyone ever uses them.

50:17Sorry.

50:18Emily Oster:I'm quickly going to search my Google Scholar record for all case control studies that I may or may not have engaged in. I run randomized trials, Emily.

50:30Perry Wilson:Totally. That's the gold standard, and it probably doesn't show this. Okay. So, I mean, look, it's very difficult with something like toxins. I think in the end, it's going to be very difficult to say, well, it's not tox - because that means kind of anything. But I would be surprised.

50:45Emily Oster:It also perpetuates the sort of like decline of civilization narrative that I think goes along with the sperm count decline. Right. It's like there's this weird overlap almost from, you know, like everything is getting worse. Right. The sperm counts are going down and the pesticides are going up. And, you know, of course, the data.

51:03Perry Wilson:Frogs are gay. Frogs are gay everywhere.

51:07Emily Oster:So I think we are definitely in that sort of time period, and it's going to be hard to disabuse people of any notions like that.

51:15Perry Wilson:All right. So what about – last thing I think we hear about is soy. Oh, man. So is soy bad for your sperm?

51:21Emily Oster:So if your sperm count is like the true measure of your masculinity, then the opposite of that is how much soy you drink. Soy, totally. Okay. 100%. So the reason people even talk about this, the soy boy phenomenon, right? The reason people even talk about this is because soy, like many plants, contains chemicals which are called phytoestrogens, which just means plant estrogens, something like that. These are chemical compounds that have a similar chemical structure to human estrogen. And in some extraordinary cases, in very high doses, can mimic some of the effects of human estrogen. You can see I'm qualifying this quite a lot.

52:11Emily Oster:That's it, right? That's all that's based on is there's a little molecule in soy and lots of other plants, by the way, that looks, if you squint, kind of like the same chemical structure as estrogen. There is no good data to suggest that soy intake has any effect on sperm count whatsoever. Really, none. In fact, there's quite good data that shows that it has no effect whatsoever. There's even, Emily, randomized trial data where they took men and randomized them to have like a high soy diet versus not a high soy diet and measured their sperm counts. And there

52:52Perry Wilson:So it's not any of these things. I think we should talk about what it is. Yeah. Potentially, like what might be responsible for this change. And to do that, we basically like for something to explain this trend, it needs to both impact sperm count and be trending over time. And I actually think those are like a sort of both pretty important. So there are some things that do affect your sperm count but are not trending over time. And then things that are trending over time, which we've talked about many, that don't affect sperm size. You kind of need something to intersect to matter there.

53:30Emily Oster:Yeah.

53:31Perry Wilson:So what is it?

53:32Emily Oster:Well, all right. Let me go for low-hanging fruit. You mentioned earlier one when we were talking about laptops that heat is a major consideration here. So talk to me about heat. What's going on there? Yes.

53:45Perry Wilson:I think heat is very important because it is one of the pieces here where when I talk to people about sort of infertility and about male factor infertility is actually something not everybody thinks about and is potentially quite important. So as we mentioned, your testicles need to be slightly cooler than body temperature in order to efficiently produce sperm, which means if they're very hot, either because you're making them hot with some external source, like a sauna or a hot tub frequently, or if they're too close to your body, that can reduce sperm count. And actually, like one of my favorite studies of this is one in which researchers took men and they gave them these like super tight underwear.

54:28Perry Wilson:So, you know, they had them wear super tight underwear all the time for several months. And you can actually see this for science and you can actually see the sperm count go to zero. So their sperm count, their sort of like effective sperm count basically goes to zero and then it comes back up after they take off the underwear. So, you know, this is a great system for birth control that I think we're under utilizing. Um, but also it really illustrates like this actually potentially quite, uh, quite important. And so this can apply, you know, to again, tight underwear, not clinically study tight, but just in general, uh, tighter underwear may lower your sperm count.

55:06Perry Wilson:Uh, people who are doing like a lot of like cycling, you know, not like I ride my bike to work, you know, every day kind of cycling, but like you're in the cycling Peloton wearing the tight bike shorts on your bike for nine hours a day. That's not going to be good. It's not going to be good for your sperm. So heat is a, I think actually heat is a big factor. I don't think it is likely that it is a factor that explains much of the trend over time, because I'm not sure why people's testicles would be hotter now than they were.

55:35Emily Oster:This isn't a global warming argument that you're making.

55:37Perry Wilson:It's not a global warming argument. This is just like, this is an individual actionable thing. And I will say there's two other kind of individual actionable things, which I also don't think are anything about the trends, which are heavy alcohol consumption and smoking. So both consumption of alcohol at a very high rate and cigarette smoking definitely affect sperm counts and sperm quality. But those two things have both declined over time globally. so unlikely to explain trends in sperm counts, even if they are potentially important changes for some individual looking to improve their sperm. So we got to look for something else.

56:13Emily Oster:So we need to look for something that affects sperm count and has been rising since the 70s.

56:19Perry Wilson:And what do you think it is?

56:22Emily Oster:I will tell you, as I was digging into the medical literature, scientific literature on this, thinking that there would be more controversy just based on what I saw on social media, I was like, oh, there are 8 million studies that show that higher BMI is associated with lower sperm count. Obesity is clearly a major factor in sperm counts. It was not subtle. It wasn't one of those situations where it's like, oh, well, this study says this and this study says that. It was a consistent finding. Did you find the same thing, Em? Why isn't this just the obvious answer?

56:57Perry Wilson:I found exactly the same thing. I actually would take it one step further, which is you can see both the impacts of obesity on sperm counts, and you can see on the flip side with weight loss, particularly with GLP-1s, you can actually see men who go on a GLP-1 sperm parameters improve, sperm counts improve, sperm mobility improves as a result, presumably, of weight loss. And so this, to me, this jumped out very obviously as a clear explanation, something we know has trended up over time, something that's very clearly associated with sperm counts. And it kind of left me, as I'm often in these situations, being like, okay, given that the decline in sperm count is not very big, this probably explains almost all of what we have seen.

57:42Perry Wilson:So when we go into these like cell phones and this and that and soy and all this other stuff, there's like an obvious explanation staring you in the face that almost certainly explains like 95 % of anything that we're seeing. Yeah. It ended up being kind of, it was like a little more.

57:57Emily Oster:Right, right, right. It's anticlimactic. And maybe that's why you don't see it on social media as much as you should, because, you know, it's more interesting to say, oh, it's this thing you haven't thought of, right? Like you didn't realize that fluorescent lights are, you know, talking to your spermatocytes in some weird way.

58:15Perry Wilson:Yeah. I also think people are looking for solutions, if you sort of, if this is something you're worried about, you're looking for a solution, potentially it's sort of interesting or different or like, you know, and things get clicks. The solution that's like people, you know, obesity is a metabolic issue that we should be addressing in our health choices. That is something people have been hearing for all kinds of reasons, not just for this reason. And so just, this is like yet another reason. It's just like, that's boring. Like just another, another like shamey, well, you lose weight. It's like, yeah, I hear that.

58:47Perry Wilson:We hear that all the time. We all know that already. So we talked before about biological plausibility. In this explanation about obesity, is this a biologically plausible explanation and why?

58:59Emily Oster:It is definitely biologically plausible, although like all things, it's complicated. So fat is a hormonally active organ. So the more body fat there is, the more levels of certain hormones, including estrogen-like hormones, even in men, get generated by fat tissue. And so there's this sort of endocrine phenomenon that will happen with overweight and obesity that could affect sperm production. But that has not been totally well elucidated. There may well be other reasons, whether it's glucose metabolism and things like that, which might be important for keeping sperm alive longer and stuff like that.

59:40Emily Oster:Whether it's vascular, You know, there needs to be adequate blood flow and things. That all remains to be seen. But we talk, Emily, a lot about correlation versus causation. We kind of throw that out. But just to get metaphysical for a second, I think the way I define this for, like, my students, people say, oh, you know, A causes B. That's important to know. The reason we care if A causes B or if A is just associated with B is because if A causes B, then changing A changes B. And that's where the rubber meets the road in terms of health, right? And so what you pointed out was like, if obesity, overweight causes low sperm counts, then changing your weight will increase your sperm counts.

1:00:25Emily Oster:And that is the level of evidence we have from the GLP-1 trials. So that's like, you know, I'm sure a philosopher would take issue with that particular definition of causality, but as a doctor, like that's all I care about. Like, can I change this and make you better? Yes. Great.

1:00:40Perry Wilson:Yeah. Yeah. I think when we think about causality as economists also, we're actually much more focused on the idea of if I change this, will this other thing change as opposed to exactly why. Right. So I sort of asked you about, like, what is the mechanism for this? But in practice, you know, one of the things we get out of that GLP-1 evidence is if we change this, then sperm count would change. And that's the behaviorally relevant thing. It is interesting to think about, well, why? You know, what would be the mechanism there? Partly because it might suggest, you know, variations on the behavior change, or it just might help us understand people better.

1:01:15Perry Wilson:But causality is really about if I change X, would Y change? And that is very different from when we talk about correlation and we just see like these two things are moving together, which could be because X causes Y, it could be because of Y causes X, it could be because some other thing Z causes X and causes Y. and that's not super helpful. That's not super helpful for a decision.

1:01:37Emily Oster:So I want to drill down now. We've talked about the population. We've talked about millions of people and the average sperm count and stuff like that. We've said how a lowest sperm count at the very low end can impact fertility, but beyond the very low end doesn't seem to matter too much. But let's take an individual. I would probably argue if a patient came to me and said, my sperm count is 60 million. I'd like to get it up to 100 million. I think my answer would be, why? You're not having fertility issues. Sperm count doesn't correlate with how strong you are, how fast you can run a mile, how good you are in bed.

1:02:16Emily Oster:None of these things correlate. Nevertheless, people seem to care. So what is your set of recommendations for let's do that thing where you say, oh, get your sperm count up for some reason? Yeah.

1:02:28Perry Wilson:So first of all, I think there are a set of people who would care if you are trying to get pregnant. And maybe not to go from 60 to 100, but I actually think we're probably in some sets of populations under testing people's sperm. I think when couples go to try to get pregnant, they often like women will do a fertility workup. I usually think it's a lot of value in men doing some fertility workup to begin with, partly because this is movable in ways I will say. So if you come and you do a sperm workup and you find your sperm count is, you know, 20 million, there may well be things you can do to raise it, which would be, and that's because it's not too complicated.

1:03:01Perry Wilson:You know, don't drink heavily. So if you're doing a lot of binge drinking, try to cut down. If you are smoking a lot of tobacco or cannabis, try to cut down or quit altogether. If you are doing a lot of activities that keep your testicles very hot, like regular sauna, the most common thing would be people doing like regular sauna or hot tub usage, try to take a break from doing those. And the fourth one is, you know, if people are struggling with obesity, I think a GLP-1 is worth thinking about in that situation. But again, I would recommend these things for someone who was trying to use their sperm for pregnancy, right?

1:03:41Perry Wilson:If you said, I'm hoping to use my sperm pretty soon to, you know, get into somebody's egg, that's kind of when you want to be thinking about this. You shouldn't, this isn't just like, you know, for fun. I mean, it could, but like, it's not, it's not important if you're not using it.

1:03:57Emily Oster:Just to drive that point home, and I'm going to geek out a little bit here now and talk about this thing called the coefficient of variation. When you measure something, there's a question you have to ask, which is if I measure this again at some time in the future, will I get the same result? And how much that changes from one measurement to another can be statistically defined as this thing called the coefficient of variation. A typical lab test like you might get in the hospital, like your hemoglobin test, has a coefficient of variation of about 4%, which means that if I measure you today and I measure you tomorrow, on average, it'll be about 4 % different.

1:04:35Emily Oster:It kind of bounces around just a little bit. No big deal. There are few tests with a higher coefficient of variation than sperm count. It's about 50%. So I just want people to be on the individual level, right? So if you measure me today and even all like taking care of all the variables, right? Like remaining abstinent for five days, whatever. 50 % difference on average between test and retest. So everyone needs to keep in mind when they see those people on social media who are like, my sperm count was 40 million. And then I like, you know, ate quinoa for eight meals a day. And then it went up to 70 million.

1:05:11Emily Oster:Like that's within the range of expected variability. So the decline of sperm count is a population-wide phenomenon. Like it can be real on a population. For an individual, it's actually recommended in fertility testing that men get tested multiple times because of this issue, because there's so much variability. And certainly if you're just using it as like, I want to put this on my Tinder bio or whatever, well, you should test a bunch of times and take the average. change.

1:05:39Perry Wilson:It's like retaking the SAB because they only count the highest one. So just keep testing and testing until you get a number that you like, put that shit in your Tinder bio and then you're done. That's it. Good luck with that. All right, Perry, what's your one thing on sperm?

1:05:54Emily Oster:Here's my one thing. Here's my hot take. There's no reason to care about your sperm count if you're not trying to get someone pregnant. Full stop.

1:06:01Perry Wilson:My one thing is keep your balls cool.

1:06:05Emily Oster:Keep it cool. Keep it cool. That's it for Sperm Counts. We'll get to your listener questions after the break.

1:06:34Emily Oster:sexually aroused.

1:06:35Perry Wilson:Can you get someone to join your cult? NLP was used on me to access my subconscious. NLP, aka Neuro Linguistic Programming, is a blend of hypnosis, linguistics, and psychology. Fans say it's like finally getting a user manual for your brain.

1:06:52Emily Oster:It's about engineering consciousness.

1:06:53Perry Wilson:Mind Games is the story of NLP, its crazy cast of disciples, and the fake doctor who invented it at a New Age commune and sold it to guys in suits. He stood trial for murder and got acquitted. The biggest mind game of all? NLP might actually work. This is wild. Listen to Mind Games on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

1:07:18Emily Oster:When you listen to podcasts about AI and tech and the future of humanity, the hosts always act like they know what they're talking about and they are experts at everything. Here at the Nick, Dick and Paul show, we're not afraid to make mistakes. What Coogler did that I think was so unique

1:07:35Perry Wilson:he's the writer-director.

1:07:36Emily Oster:Who do you think he is? I don't know. You mean the president? You think Canada has a president, you think China has a president, the La Cruzette. God, I love that thing. I use it all the time. I wrap it in a blanket and sing to it at night.

1:07:55Perry Wilson:It's like the old Polish saying, not my monkeys, not my circus. Yep. It was a good one. I like that saying.

1:08:01Emily Oster:It is an actual Polish saying. It is an actual Polish saying. Better version of play stupid games, win stupid prizes. Yes. Which, by the way, wasn't Taylor Swift who said that for the first time. I actually, I thought it was. I got that wrong. Listen to the Nick, Dick, and Paul show on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

1:08:19Perry Wilson:It's the new me and it's the old them. Everybody's on their journey. And your journey's different to theirs. This Woman's History Month, the podcast, If You Knew Better with Amber Grimes, spotlights women who turn missteps into momentum and lessons into power. I think coming out of where I came from, I'm from the Bronx. I think I grew up really poor. I didn't know that then because I very much used my creativity to romanticize life. And I'm like, my mom did a really good job of like, you step back and you're like, whoa, we, I don't know how we made it. So a lot of my life was like built out of like survival to get to the next place.

1:08:55Perry Wilson:Like my drive, my like tunnel vision of like, I got to be better. I got to achieve this was off the strengths of like, I want to make a better life for us. If You Knew Better brings real talk from women who've lived it, unpacking career pivots, relationship lessons, and the mindset shifts that changed everything. Listen to If You Knew Better with Amber Grimes on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi, everyone. I'm Cheryl Strayed, author of Wild and Tiny Beautiful Things. I'm excited to share that I have a new podcast called Mind Over Mountain. In each episode, I interview athletes, adventurers, and adrenaline seekers to discuss the inner landscapes and life experiences that informed and inspired their extraordinary feats.

1:09:40Perry Wilson:I also bring a bit of advice into the mix so we, too can better understand how to face our own seemingly insurmountable challenges.

1:09:49Emily Oster:Do you know what I'm going to do? I'm going to pull out what you already have inside. We're coming into this world fighting for our lives. All I'm going to do is pull out what you already got inside.

1:09:57Perry Wilson:We're there to support and celebrate each other. And that's not like a your story versus my story. You're going to walk up and over that dang mountain. You're not just going to put your mind over it. Yep, yep, exactly. And if I can't walk up and over it, I'm going to go through it. Listen to Mind Over Mountain every Thursday on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

1:10:21Emily Oster:We've got a great question here from Anna in Columbus, Ohio.

1:10:25Perry Wilson:Hi, Emily and Perry. I'm excited for this podcast, and I have a fun question for you. Is there anything health-related that you do that isn't supported by data, but you just do it out of habit or for juju like the rest of us? Thank you.

1:10:39Emily Oster:I do have a belief that blueberries are way healthier than people think they are. And I have never looked it up. And they just taste healthy to me. But maybe I'm right. Maybe if we do a dig into that, it does have data to support it.

1:10:55Perry Wilson:Like healthier than other fruits?

1:10:58Emily Oster:They're the healthiest tasting food.

1:11:02Perry Wilson:That's so weird.

1:11:05Emily Oster:All right.

1:11:05Perry Wilson:Can't you just say you like blueberries?

1:11:07Emily Oster:I don't, I mean, I like other things more than blueberries, but I, they, the taste of health to me is a somewhat tart blueberry, I think. But I have no data that support that they're particularly healthy.

1:11:20Perry Wilson:Wow. I cannot think of a single, this is so, I feel like such a jerk. I can't, I do all kinds of weird stuff, but I feel that all of it could be supported by data. Yeah.

1:11:33Emily Oster:That's the problem with this question is that you probably can find you like you could find data to support anything. Like I can find you a study that shows the blueberries reduce the risk of cancer. Right. Like totally.

1:11:44Perry Wilson:Oh, I'll tell you what I do. I hold a very strong superstition about I am extremely neurotic about which shoes I wear at which times for when I run. And I have like very strong feelings like this is a shoe that you have to use when you're running easy. This is a shoe when you use for this kind of run. This is a shoe. And some of them are literally the same shoes, but like one of them is an older version. Like I've run on them more. So they've gotten like downgraded to like the medium long run from the, and I think that if you open the cabinets in my family room where I keep the shoes, you would be disturbed.

1:12:18Emily Oster:Okay. We will be sure to post a picture of Emily's weird shoe closet. Stick with us next week when we will ask what's the deal with peptides.

1:12:28Perry Wilson:wellness actually is produced in association with iheart media our senior producer is tamar avishai our executive producer is jennifer bassett our theme music is by eric deutsch and our content is for educational purposes only if you like the show help other people find us

1:12:44Emily Oster:leave a rating and review on apple podcasts or your podcatcher of choice and help us spread the word about the show don't give the tiktokers all the power and don't forget we want to hear from you. Head over to wellnessactually.fm and leave us a question for our mailbag or suggest a topic for a future show.

1:13:01Perry Wilson:We'll let the influencers have the last word.

1:13:04Emily Oster:Sperm counts have dropped more than 50 % in the last 50 years. If this keeps up, natural conception is going to be as rare as a Cleveland Browns Super Bowl parade. Your grandkids might need a lab just to exist.

1:13:29Emily Oster:Peace to the planet. Charlamagne Tha God here. And listen, we are back.

1:13:33Perry Wilson:The Black Effect Podcast Festival is back in Atlanta on April 25th at Pullman Yard. And the full lineup is nuts. We got the Grits and Eggs podcast. Deontay Kyle and Big Ice Cup Cat. We got Club 520 with Jeff Teague and the gang. Don't call me white, girl. Mona will be there. Keep it positive, sweetie, with Crystal Renee. We got Reality with the King with Carlos King. And yes, Drink Champ will be in the building. Plus, you know, we're going to have a lot of guests. So you need to join us. And we got the Black Effect Marketplace, the picture podcast and everything you expect from the Black Effect Podcast Festival.

1:14:08Perry Wilson:Tickets are on sale right now. Go get yours at blackeffect.com slash podcast festival. Don't play yourself, OK? Pull up.

1:14:19Emily Oster:What if mind control is real?

1:14:21Perry Wilson:If you could control the behavior of anybody around you, what kind of life would you have?

1:14:24Emily Oster:Can you hypnotically persuade someone to buy a car?

1:14:27Perry Wilson:When you look at your car, you're going to become overwhelmed with such good feelings.

1:14:32Emily Oster:Can you hypnotize someone into sleeping with you? I gave her some suggestions to be sexually aroused. Can you get someone to join your cult? NLP was used on me to access my subconscious. Mind Games, a new podcast exploring NLP, a.k.a. neurolinguistic programming. Is it a self-help miracle, a shady hypnosis scam, or both? Listen to Mind Games on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

1:14:59Perry Wilson:Hi, everyone. I'm Cheryl Strayed, author of Wild and Tiny Beautiful Things. I'm excited to share that I have a new podcast called Mind Over Mountain. In each episode, I interview athletes, adventurers, and adrenaline seekers to discuss the inner landscapes that informed and inspired their extraordinary feats. so we too can better understand how to face our own seemingly insurmountable challenges. Listen to Mind Over Mountain every Thursday on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I'm Miles Turner. And I'm Brianna Stewart. And our podcast, Game Recognized Game, has never been done before.

1:15:36Perry Wilson:Two active players giving you a real look at our lives and what we actually think, on and off the court. Nothing's off limits. We talk tanking. I might get in trouble for this answer, but I think it's definitely happening in the WBA. We talk about our mistakes, too. They pulled me to the side and was like, hey, man, we got a call last night, man. You can't be rolling around the city like this the night before games. Check out Game Recognized Game with Stewie and Miles on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.