In this episode, I chat with Dr. Peter Wojciechowski about his swim from Maui to Lanai and back, and why he thinks women are better at swimming than men at it. We also talk about his new book, "Swim Like A Girl: How to Swim Like a Woman in the 21st Century" and why women should be able to swim faster than men in order to break the world record for the longest distance a woman has ever swum in a single day. And, of course, we talk a lot about Bigfoot. If you don t know who Bigfoot is, then you re in for a treat! Thanks to Peter for coming on the show, and for being willing to share his story with us. I hope you enjoy this episode and that it makes you think about how amazing it is to be a swimmer, and that you re not alone in your ability to swim like a man. You can find out more about your ad choices at anchor.fm/TheSwimSwimLife and use the hashtag on the socials and if you like what you hear about this podcast, tag . and we ll send you a review! in the comments section below! Timestamps: 1:00 - What is Bigfoot? 2:30 - Why women can swim better than men? 3:20 - What makes a woman better than a man? 4:40 - How can swim faster? 5: Why women are a better at it? 6: what makes a man better at a woman at swimming? 7: What makes women better at that other people? 8: What are you better at something? 9:00 10:20 11:40 What is a woman s job? 12:30 13:30 | What are the benefits of being a woman? 15:00 | What does a man s job better than another woman s role? 16:00 // 15:40 | What do you need to do to swim better? 17:50 18:00 / 16: What s a good swimmer? 19:10 21:50 | What is the difference between a woman can do better than someone else? 22:50 / 15:30 / 20:00 +16:00 Is there a better swimmer s job description?
00:00:51.000I read a book in January of 2004 about this woman named Penny Dean who still to this day holds the record for the fastest crossing of the Catalina Channel.
00:01:01.000So swimming from Catalina Island to San Pedro or to...
00:01:31.000Penny Dean had a stroke rate of 90 strokes per minute, which, I mean, that might not mean anything to someone who doesn't swim, but, like, to have a hand hit the water every, you know, two-thirds of a second is a remarkable cadence.
00:01:45.000Yeah, I can't hold a cadence of that for 100 yards.
00:02:55.000You're in a Speedo and a single latex cap and that's it.
00:02:59.000And so I think women's hips, because they're going to have more fat on their hips, it corrects one of the big buoyancy issues that we have in swimming.
00:03:18.000And if you think about the importance of aerodynamics in most of the things that we think about, whether it be archery or race car driving or cycling, in water it's that much more important because the density of water is thousands of times greater than air.
00:03:33.000So swimming is just 100% about avoiding drag.
00:03:40.000I just have been fascinated forever with people that are capable of pushing their brain to do things that other people just don't think are possible, like a Bigfoot 200 race or any of those things.
00:03:54.000But the swim one is particularly crazy because you can't stop.
00:03:59.000If you're running an ultramarathon and you just want to sit down for a couple minutes and just take a break, you can do that.
00:04:05.000But if you're swimming, There's not a damn thing you can do.
00:04:09.000You could tread water is about as good as it gets.
00:04:11.000But you can't touch the boat or the kayak or it's an immediate disqualification.
00:04:23.000So you heard about this woman doing it, and that's what...
00:04:26.000I read this book, and I was like, I really want to do this.
00:04:28.000At the time, I was actually in my residency in Baltimore, and I was like, you know, I really want to do this, and I'm going to have to learn how to swim to do it.
00:04:36.000So I started taking swimming lessons, and then...
00:04:40.000I mean, to make a very long story short, basically by about the summer of 2005, I entered my first swim race, which was a two-mile swim race in Lake Reston, Virginia.
00:08:10.000And it's like, you don't know if you can do it and blah, blah, blah, blah.
00:08:13.000Well, if six hours later, you're now crawling out of the water feeling like you've done this amazing thing, that that's emotional acceleration.
00:08:25.000I mean, I've never experienced that, but I was explaining the other day to a friend of mine about this camping trip that we went on in Montana when it was like nine degrees outside.
00:09:46.000The Maui channel is a 10-mile channel, so round-trip is 20. The bigger question is time in the water because you rarely get to swim these in a straight line.
00:09:57.000I wanted to go Maui, Lanai, Molokai, Maui to do the triangle.
00:10:01.000And that would have been 30 miles as a crow flies.
00:10:04.000But we just, you know, boat captain wasn't willing to do it at night because of the tiger sharks.
00:10:09.000And during the daytime, we couldn't physiologically figure out how one could suffer against the wind because the wind gets so brutal in the middle of the day.
00:10:19.000So even the one that I did, which was just the there and back, I ended up swimming for 12 hours because on the first way crossing where there was no wind, it took me four hours.
00:10:32.000And then it took eight hours to get back because I was swimming like the hypotenuse of a triangle, right?
00:11:30.000Including the winter, you know, like, you know, even in San Diego where I live it's still, you know, 55 degrees in the water and you're gonna spend three four hours a day in the water Freezing, you know, it's just so I was like, you know, I just don't have the the drive to spend 25 hours a week swimming Yeah,
00:11:49.000what was the what was going on in San Diego when that guy got bit in half by a shark a couple years back they were training for something and Yeah, it's funny you remember that.
00:11:58.000That was May of 2008. I remember that like it was yesterday.
00:12:02.000So at the time, I lived in San Francisco.
00:12:04.000And this is actually just before I swam the Maui thing.
00:12:07.000Now that I think about it, that was 10 years ago.
00:12:08.000I swam the Maui thing in June of 06, June of 08. So I'm doing all my training in a swimming pool up in San Francisco because I don't want to acclimate to very cold water.
00:12:31.000And just by bad luck, I came down a few days after that guy was killed.
00:12:36.000Now, this was a guy, I didn't know him, but he was a triathlete training with a triathlon group that they would go out and swim every morning.
00:12:43.000And I know the beach exactly where it happened, in Solana Beach.
00:12:46.000And unfortunately, like most people who get attacked by great whites, they have a very...
00:13:18.000The problem is – so in this case, the shark had bit him and cut through his femoral arteries and veins and the saltwater prevents you from having any hemostasis.
00:13:30.000So that's generally how folks perish when they're bit by great whites.
00:13:33.000Trevor Burrus How did they get him out of the water?
00:13:36.000A bunch of other swimmers came to his rescue, and luckily that commotion prevents the sharks from wanting to come back.
00:13:42.000So three days later, I go out and I'm swimming at that beach because I swam from my training swim was La Jolla up to Solana Beach and back.
00:13:52.000And I got to tell you, like, three days after a guy dies where you're swimming, it was about one of the most mentally challenging training swims to be like...
00:14:06.000Like, the water at that part of the beach is so murky, you know, and you're only a couple hundred yards offshore that, like, you can barely see your hands when you're swimming.
00:14:16.000And so you're just thinking, is this the day?
00:14:38.000Yeah, what we are in comparison to what they are, it's just you're throwing yourself into the world of a super predator.
00:14:46.000And to know that one just jacked a person just a few days before and you're out there swimming around.
00:14:52.000Yeah, although I will say this, you know, when it's all said and done, all of the close encounters I've had, probably the scariest moment I've ever had in the water was doing a swim from Santa Rosa to Santa Barbara.
00:15:02.000So Santa Rosa Island, which is the second furthest north channel island, you've got San Miguel, Santa Rosa, Santa Cruz, and Anacapa represent the top four channel islands.
00:18:57.000Off of Catalina, I know it's one of the best shark fishing places in the world.
00:19:03.000I have a friend of mine who told me that if you think about wild places on Earth that are just overrun with predators and terrifying predator-prey activity, Catalina Island is one of the top spots in the world.
00:19:17.000I was like, what are you talking about?
00:19:18.000He's like, I'm telling you, man, the shark fishing off Catalina Island is fucking insane.
00:19:24.000And then I watched a television show, just, you know, synchronicity, a couple days later.
00:19:29.000And it was these guys shark fishing off of Catalina.
00:19:38.000Yeah, and it's actually, my recollection, because we swam around Catalina once as well, the back side is way more aggressive than the front side.
00:19:47.000The side that faces the Pacific rather than faces Los Angeles?
00:20:13.000I'd swum to it, I'd swum from it, I'd swum around it, I'd done another thing, and I'd never stepped foot on it except at the beginning or end of a swim until five years ago I went there for a vacation.
00:20:23.000Like, I actually just went to Avalon for, you know, three days.
00:20:27.000I'm like, it's not a place I could live.
00:21:21.000They just decided that they were an invasive species, regardless of how valuable they might have been to people that wanted to go there and eat them.
00:21:28.000You know, they just decided, just for the ecosystem alone.
00:21:32.000And there's no predators there, and they weren't going to...
00:21:34.000Turn the fucking island to Wild Kingdom and bring wolves or something in there.
00:23:28.000And, you know, this is after taking a full two days to get out there.
00:23:31.000I mean, this place is really hard to get to because the water is brutal and you're not in a huge boat.
00:23:35.000And, yeah, you're looking at, like, 1,000-pound elephant seals that are just, like, licking their chops, looking at you trying to get in the water.
00:23:48.000No, I think they're aggressive as hell.
00:23:50.000Did you see that video of the little girl that's sitting on a dock and a seal jumps up and grabs her in the ass and pulls her into the water?
00:25:36.000Hunting for mountain goats on the weekends because there's so many people hiking and going.
00:25:43.000They don't want people killing these mountain goats in front of them because people freak out.
00:25:47.000Even though they have decided that they have to control the population and kill a certain number of them.
00:25:54.000But so many people go out there that these things aren't scared of people.
00:26:00.000So it's created this really weird situation where if you are hunting them, You're almost hunting something that's domesticated.
00:26:10.000People feed him Cheetos, so much so that a friend of mine was talking about it, that he was up there with his daughter, his daughter opened up a bag of Cheetos and the goat walked right to, a wild goat lives out in the fucking woods, walked right up to his daughter and they were laughing,
00:26:26.000she opened up the bag of Cheetos and put it, and he stuffed his head in the bag of Cheetos, he knew what to do.
00:26:33.000And this guy who was talking about this is a hunter.
00:26:36.000And he's like, this fucking goat has, like, Cheeto dust all over its face.
00:28:57.000It's this weird animal that lives mostly in Central and South America, and it has a northern range that extends into Arizona, all the way up into Mesa, I think.
00:29:08.000It gets into the areas where it gets cold.
00:29:10.000But Arizona, I think, is the only state in the U.S. that has it.
00:29:15.000But it's this weird looking monkey raccoon thing that is so domesticated that we gave it some grapes.
00:29:28.000I mean, look at that weird little thing.
00:29:29.000It came and sat, we had like a little patio area in the hotel room, and it came and sat down with us, and so calm that it sat and went underneath one of the chairs and took a nap after we gave it some grapes.
00:30:38.000I mean, I was talking to a friend of mine about this the other day, actually, and he was saying that there's probably only, like, in our neighborhood, there's probably only, like, two mountain lions left.
00:30:46.000And the coyotes just – they've exploded.
00:31:27.000It jumps to the top of the six-foot fence, almost like it's under different gravity rules than us, and touches the top of the fence, and then boom, it's on the top of the chicken coop.
00:33:22.000And the way they were able to eradicate wolves is...
00:33:25.000They would kill the alpha, and then they would take an animal like a horse, they would shoot it, and then they would fill it up with strychnine.
00:33:33.000And so then they would rub the alpha, the body of the alpha, all over this carcass of the horse, and then the other wolves would come and smell that the alpha had been there, and then they would eat the horse and die.
00:33:46.000And so they were able to do this and essentially use this method, plus shooting them and things like that, to eradicate them from the West because of ranchers and cattle farmers.
00:33:56.000They've never been able to do that with coyotes.
00:33:58.000When you shoot a coyote, if they do roll call, like when you hear them howling, if one of them is missing, it sends the females, it sends some sort of a signal where their bodies produce more pups.
00:34:11.000So if one's missing, instead of having like three pups, you'll have six.
00:34:16.000So you make more coyotes when you kill them, and they extend their range.
00:34:19.000When you persecute them, they just extend their range.
00:35:04.000He's only a year old, too, but he's just curious.
00:35:08.000It's very weird living in proximity with all these things because where I live, we have a lot of hawks, a lot of owls, a lot of coyotes, and occasionally a mountain lion.
00:35:18.000I saw a bobcat once, which is pretty interesting.
00:36:23.000So I met Jocko through one of my really close friends, a guy named Kirk Parsley, who's also a Navy SEAL, a former SEAL. And Kirk said, hey, you got to meet my friend Jocko.
00:36:36.000Basically, it's just like, you just got to meet Jocko.
00:37:17.000Luckily, I had enough credit in the bank with Tim.
00:37:20.000I've been successful on enough sight unseen recommendations, but I think the Jocko one was the best one ever because he called me while Jocko was still there and he's like, Yeah, that was pretty intense.
00:37:32.000Yeah, I sent him an email after that podcast.
00:37:34.000I'm like, that's one of the best podcasts I've ever heard in my life.
00:38:21.000Yeah, I met him a long time ago when he was training with Dean Lister, and Dean was fighting in the UFC. I remember meeting him, and I'm like, what's that guy's deal?
00:38:32.000There's certain dudes that have got a whole lot of shit going on behind their eyes.
00:38:36.000You're like, okay, that guy's seen some stuff, you know?
00:38:40.000Yeah, I'll tell you a funny Jocko story.
00:38:42.000I guess I can tell this story in public.
00:38:47.000So, Jocko was in New York just after his book came out and I was like, look, I want to introduce you to some of my buddies who run hedge funds here because a lot of what Jocko does is he and his partner, they consult with guys like this doing leadership stuff.
00:39:03.000And so we went up to the offices of one of my friends who has this very famous hedge fund and his office is like on the 50th floor on Park and it's looking, it's like a beautiful view down Park.
00:39:13.000And we're just sitting there in his office just shooting this shit and I forget how it came up but somehow we were just talking about like how good is a sniper?
00:39:45.000Maybe it was when he was SEAL Team 2. In fact, I think Jocko said, he goes, you know, yeah, Chris was a part of my team for more of his kills than any of his other kills.
00:39:55.000And so then we were like, what sets him apart?
00:39:59.000I mean, obviously, any Navy SEAL sniper has got to be amazing.
00:40:05.000And he said, okay, let me show you what it was.
00:40:08.000So he said – so he walked us over to the window and he goes, okay, you see that guy in that hat over there like about a mile down the – you could basically see it because it was like a pink hat or something.
00:40:20.000If you're a sniper, you've got to be able to lay down, not move, and put your eye up against this thing and look out at him.
00:40:28.000And if you ever take your eye off that, you're going to lose the sight.
00:40:33.000So you've got to be able to stay in that position and not move and do that.
00:40:36.000And I forget what the number was, but Jaco said, the average Navy SEAL sniper can stay in that position without moving, eye glued to the sight for X number of minutes.
00:41:20.000Because just sharpshooting, just being able to shoot something at a distance, and long-distance shooting is a big sport in terms of target shooting.
00:41:30.000I mean, there's guys that are out there, they're shooting 1,500 yards and doing it competitively.
00:42:00.000Getting the reticle set on the target, pulling that, and without movement, the outliers are the people who can do that.
00:42:09.000And you've got to think, like, when you break down physical movements, right, like, you watch a gymnastics routine in the Olympics, like, holy shit, and it flips, and they land, and they stick, and it's incredible.
00:42:21.000But now break it down to just the movement of your trigger finger.
00:42:29.000I'm sure you've shot guns, but it's hard to, like, if you shoot pistols and you have dummy rounds, you know, like a lot of people, they mix in dummy rounds so that they find out they're jerking the trigger.
00:42:41.000And when you see, like I was watching a video with Tim Kennedy, and Tim Kennedy was shooting at the range, and he's pulling, bang, bang, bang, and it goes click, and he goes, woo, look at that trigger control!
00:43:01.000But you've got to fucking practice forever just to be able to do that, just to not anticipate the recoil of the gun and yank and move and twitch and just controlling the mind.
00:43:13.000I mean, it's a fascinating thing to me that just pulling this one finger, you would think fucking anybody could do that.
00:43:30.000Let's get you a rifle, because I could teach you how to shoot a rifle.
00:43:34.000We could sight in your rifle, go to the range, we'll sight it in 100 yards, get you a good, accurate rifle, and then all you have to do is kind of keep it together.
00:43:43.000A rifle, we get into 100 yards of a wild pig, you're going to be able to kill this thing, 100%.
00:43:49.000You got years before you're going to be able to shoot that thing with a bow.
00:44:00.000She said, of all the things you do, she's like, archery seems to be the only one where even if you don't have a good day, you're still happy.
00:44:08.000Like, if I'm on the racetrack and I'm driving a race car or if I'm, you know, swimming or whatever and I just have a bad day, like, I don't – I'm just not firing on all cylinders.
00:44:17.000Like, it, you know, it just kind of pisses me off.
00:44:20.000There's something about archery where even if I'm not having a good day, like – Maybe it's an extension of what you're talking about with the trigger finger.
00:44:27.000So for me, I got into archery because of Tim.
00:44:35.000The thing that he told me that immediately made me be like, I want to do this, was just anything that requires that much perfection just seems great.
00:44:42.000And he was like, yeah, you don't take a shot unless you can kill the animal.
00:45:13.000And so I think of archery for me as almost like a meditation.
00:45:18.000I'm talking in the way Sam Harris would talk about consciousness and the way you are so hyper-aware of what you're doing that, yes, you can daydream and your mind can wander, but if you actually start to imagine the sensations of every part of archery,
00:45:34.000in many ways it feels like meditating.
00:45:36.000So I think that's why I'm just like...
00:45:39.000I never really thought about it with shooting a rifle because I don't have much experience with guns, but I'm guessing it's very similar.
00:45:47.000But as you said, the difference between the good and the great in that is less obvious.
00:45:54.000Yeah, I think offhand, shooting a rifle and shooting a bow, I bet I'm just as accurate at 60 yards as the average person is.
00:46:07.000Not a sniper, but the average person with a rifle.
00:46:22.000You have to make sure that everything's locked in and your structure is correct.
00:46:27.000But I agree with you that I think it's some sort of a meditation.
00:46:31.000I also think there's something to hitting a target that is...
00:46:36.000In our DNA that's connected to hunting, that's connected to survival, that's connected to the thousands of years that people threw arrows and fucking...
00:49:59.000I want to talk with you about some training and some nutrition to get ready for this because it's going to be kind of an extreme whole deal.
00:51:21.000Yeah, I was reading something about the goose problem, about how the goose population has exploded because of farmlands, and that they literally don't know what to do with the certain population of different kinds of geese that are flying into this country from Canada.
00:53:02.000Yeah, but that is what they call them, so it's actually a common phrase, because I've had friends that say it might be the most delicious meat in the world.
00:53:10.000I mean, it tastes like a wagyu ribeye, and it's flying around, and you can shoot, like, fucking 10 a day.
00:54:33.000I split my time between New York and California.
00:54:35.000When I'm in New York, it's absolutely one meal a day, no ifs, ands, or buts, because the schedule is such that I'm seeing patients in the morning and afternoon, and I don't want to do...
00:56:22.000I mean, I've been doing crazy shit for 10 years, nutritional-wise.
00:56:26.000Like, I spent three years in ketosis, where it was actually one day I was in ketosis for three years.
00:56:33.000Lots of fasting, but I think intermittent fasting or time-restricted feeding, probably at least five years.
00:56:40.000And for people listening, what are the benefits of that?
00:56:44.000Well, I mean, if we're going to get really technical, we have to be clear that I think a lot of the benefits are overstated.
00:56:49.000And a lot of the benefits are things that we've only studied in animals.
00:56:52.000So there's a guy named Sachin Panda at the Salk Institute in San Diego, who's, I think, one of the world's experts on time-restricted feeding.
00:57:01.000For example, a 16-hour fast in a mouse produces unbelievable results.
00:57:06.000If you take a group of certain types of mice or strains of rats or other rodents and you, in a 24-hour period, deprive them of any nutrient for 16 hours but then for 8 hours let them eat whatever the hell they want, they can't gain weight.
00:57:19.000So – and the reason we think is that it – once you give a long enough period of time when the animal can ramp up its – like the enzymes in the liver that are responsible for fat oxidation, I mean they just basically become fat – I hate that term,
00:57:37.000But that's – they basically just become unbelievably efficient at metabolizing fat.
00:57:40.000So – We have to be careful, though, when we extrapolate that because you and I have a very different metabolism than a mouse.
00:57:48.000Like, a 16-hour fast to a mouse is much longer than it is to us.
00:57:52.000So I don't know if those benefits would extend.
00:57:55.000Also, it's not entirely clear that time-restricted feeding will produce the longevity benefit that we see in other sort of fasting or fasting-mimicking types of diets.
00:58:05.000So for me, what it comes down to is, I mean, Honestly, it's just an easier way.
00:58:11.000It gives me a much more liberty with what I eat during my feeding window.
00:58:14.000I don't have to be nearly as restrictive when I'm feeding if I have that period off, just in terms of my physiologic response.
00:58:22.000Secondly, there's a convenience thing.
00:59:04.000And I don't even remember what that feels like anymore, which is not to say I feel great all the time, but I definitely don't have that vacillating energy level.
00:59:12.000Yeah, I've said that to people when I eliminated most carbs from my diet.
00:59:16.000You know, and I have a friend of mine who talked to his trainer about that.
01:01:24.000It's crazy that there's so many folks out there that are living their life that don't even understand that this is a process they're going through.
01:01:31.000They just think this is eating and exercise.
01:01:48.000Your body will change and that that just that concept the people that sounds like horseshit It sounds like what are you saying?
01:01:56.000You you're what are you offering some miracle cure you know, I'm saying You will change the dimension of life that you operate in it would change because you won't be the same person You won't like who you are is dependent upon a lot of things But one of them is how much energy you have how you feel whether you're crashing If you change the way you eat,
01:02:26.000I mean, there's so many things that will change.
01:02:29.000But there's an interesting question, which I spend some time thinking about, and I've sort of accepted the fact that we might not know the answer, which is when I was growing up, I was exercising like crazy.
01:02:40.000Not as much as I was when I was swimming, but...
01:02:43.000I mean, sorry, more than I was when I was swimming.
01:03:39.000And I was eating anything and everything you could put in front of me.
01:03:44.000And then something happened in medical school where that shit just stopped.
01:03:48.000I wasn't even eating as badly at the time, but all of a sudden, the metabolic adaptation just vanished.
01:03:57.000I wish someone could study this, meaning you would have to take a group of individuals and do muscle and fat biopsies over the course of their life, or at least during this window when we think this is happening.
01:04:11.000Many of my patients or just even friends, like it seems that this happens kind of in your 30s if you're a guy.
01:04:17.000For women, it's harder for me to tell because I think pregnancy can interfere with this.
01:04:23.000So sometimes we get a bit of a skewed answer.
01:04:25.000But if I had to hypothesize, I think that we go from having a lot of lipoprotein lipase on muscle cells and not much on fat cells to the reverse.
01:04:36.000So when I was 16 and invincible, My muscles had a lot of this enzyme, LPL, on it that could just absolutely take whatever I was throwing at them and churn it into energy for the muscle, whereas when that LPL exists on a fat cell,
01:04:53.000you're basically just going to store more fat.
01:04:56.000And now, why that would happen over time, I mean, we could guess reasons, but I'd love to know if that's the case.
01:05:02.000Because I still can't really figure out, like, why is it today I am so carbohydrate sensitive when there was a day when I could eat...
01:05:11.000I was probably eating 7,000 or 8,000 calories a day, of which 80% were probably carbohydrates when I was growing up and was lean and mean.
01:05:20.000Did you experience a crash at all, like post-afternoon crash, post-lunch crash?
01:05:59.000For example, that's probably one of the reasons why testosterone, as testosterone goes down, you're going to get fatter, all things equal.
01:06:07.000And part of the reason is testosterone upregulates LPL and hormone-sensitive lipase and all of these other enzymes in the direction of making you leaner versus fatter.
01:06:18.000But I just don't think that that's enough of it.
01:06:21.000I think there's something else that's going on that's triggering that decline.
01:06:26.000So for you with this 22-hour window of not eating, what do you think the benefits are other than your energy and slight spikes in norepinephrine and some other hormones?
01:06:38.000Well, I don't think there's sufficient evidence at this point in time that time-restricted feeding is going to impact my longevity.
01:06:49.000Oh, I mean, I think the claim would be that fasting mimicry, which could be, you know, like what, say, Walter Longo talks about where you do a five-day hypocaloric diet of 750 to 1,000 calories a day for five days, followed by 25 days of ad libitum feeding,
01:07:04.000meaning eat whatever the hell you want.
01:07:07.000In terms of total caloric content, the claim is, well, that's going to enhance longevity.
01:07:13.000Or doing a 16-8 or 18-6 is going to enhance lifespan.
01:07:18.000So just to take a step back, I am only aware of...
01:07:25.000Three things that have universally extended lifespan across all model organisms.
01:07:31.000So if you think of like all eukaryotes, right?
01:07:33.000If you go from yeast to worms to flies to mammals, the only things that uniformly extend life or almost uniformly is caloric restriction and or dietary restriction.
01:07:45.000So total reduction in calories during the lifetime and or reduction of certain subsets of those calories.
01:07:51.000So there's a super famous experiment that was done Actually, if anyone's interested, I wrote about it.
01:07:58.000But it's basically the best experiment ever done in caloric restriction was between monkeys.
01:08:03.000And there was a group at the NIH and a group at the University of Wisconsin.
01:08:06.000And it was like a 19-year experiment or something like that.
01:08:08.000So you could really study the impact of caloric restriction over these things.
01:08:12.000And that experiment showed us that caloric restriction extended lifespan if you had a really shitty diet.
01:08:18.000And it did not extend lifespan if you had a really good diet.
01:08:22.000It's counterintuitive, but it also spoke to the idea that dietary restriction probably mattered.
01:08:27.000So in other words, if you're eating a regular diet of McDonald's every day, and then we put your counterpart eating 70% of McDonald's every day, that's going to move the needle.
01:08:38.000But in the Wisconsin, in the NIH experiment, when you took the monkeys that were eating kind of It wasn't their natural food, but it was less horrible food.
01:08:48.000The caloric restriction did not extend lifespan.
01:08:51.000So that threw a wrench in everyone's understanding of caloric restriction.
01:08:55.000And there are certain strains of mice that also don't seem to be enhanced in terms of lifespan, meaning just time on Earth.
01:09:02.000But for the most part, nutrient deprivation pretty ubiquitously extends life.
01:09:09.000The second thing that uniformly extends life across this is a drug called rapamycin, which is kind of like my favorite drug in the whole world.
01:09:18.000I mean, meaning it's like, I think it's the most important drug in terms of this space, not necessarily because it's a drug that we'll all be taking, though I do believe that is the case, but more importantly because of what it's taught us about the nutrient-sensing pathway and its target, which is this protein called TOR,
01:09:34.000the target of rapamycin, or mTOR, as you've probably heard of it, is a mechanistic target of rapamycin.
01:09:42.000Now, it's a bit complicated because there's two variants of it.
01:09:44.000There's something called mTOR complex 1 and mTOR complex 2. And if you take rapamycin day in and day out every day, which, for example, transplant patients do, it's an immune suppressant.
01:09:55.000That doesn't seem to really extend lifespan.
01:09:57.000But if you take it in a pulsatile way, you selectively get this mTORC1 inhibition without the mTORC2 inhibition.
01:10:04.000That seems to produce longevity big time.
01:10:10.000Well, this is sort of one of my main clinical interests because I obviously am waiting for the day when I can start taking it and ultimately feel that it's safe enough that I could give it to patients.
01:10:24.000If I'm extrapolating from all of the best data out there, so that's looking at the work that's come out of a guy named David Sabatini's lab.
01:10:30.000David's a guy at MIT. He's a professor.
01:10:33.000He's actually the guy that when he was a medical student, I'm doing his PhD in 1994 actually discovered how rapamycin works in mammals.
01:10:41.000He's actually the guy that coined mechanistic target of rapamycin mTORC as a name.
01:10:47.000And so now whatever we are almost 25 years later, you know, he's still running the powerhouse lab that understands it.
01:10:54.000So if you look at all of the literature that's coming out of their lab, Coupled with a guy named Matt Caberlin at the University of Washington, who's doing rapamycin studies in dogs, along with the work done by someone named Joan Manick, who was at the time at Novartis, is now at a company called Restore Bio,
01:11:43.000Well, so you own a dog, you know this, right?
01:11:45.000I mean, if you look at outside of euthanasia or accidents, how do dogs die?
01:11:49.000They basically die of cancer and heart, and they get dilated cardiomyopathy.
01:11:52.000So it's a different type of heart disease than humans get.
01:11:54.000They don't get atherosclerotic disease, they get heart failure.
01:11:57.000Their hearts just get too, too, too big in their ejection fraction, which is the amount of blood, the percentage of blood that leaves the ventricular chamber with every contraction.
01:12:06.000As that number goes down, bad things happen.
01:12:09.000Now, to put that in perspective, you and I sitting here, a couple of normal fit dudes, we probably have a resting ejection fraction of 60%.
01:12:16.000And if, like, we went out there and, like, killed it and worked out as hard as we could at peak, we might get that up to 80, 85% ejection fraction.
01:12:25.000So once the ejection fraction gets below 30%, you know, a person starts to become very symptomatic.
01:12:33.000Well, Matt took these dogs that had low ejection fractions to begin with, and I forget what the exact number was, but it might have been like below 40% or below 30%.
01:12:43.000We put them on rapamycin for 12 weeks and in just 12 weeks saw an absolute 10% improvement.
01:12:50.000So that means that's not going from 30 to 33. That's going from 30 to 40% EF improvement.
01:12:57.000In other words, it's hard to measure an effect in 12 weeks of a drug.
01:13:02.000And certainly you're not going to be able to measure a longevity impact over that.
01:13:05.000So much of the study that's being done with this is looking at surrogate markers that we assume Would portend longevity.
01:13:13.000So Matt's work focusing on the ejection fraction, Mannick's work was focused on immune response, which again was...
01:13:22.000This was like December of 2014 was like when everything in my professional world shifted in terms of my interest towards like rapamycin is the thing I want to know everything about because...
01:13:35.000When I was a surgical resident, we used to give rapamycin out like it was cotton candy to all the transplant patients.
01:13:40.000It was an amazing drug that revolutionized transplant physiology because it had far fewer side effects than massive doses of prednisone and things that we used to have to give patients.
01:13:51.000Now you could give them much less prednisone and you could give them rapamycin or cousins of rapamycin like FK506. And what you're doing with that stuff is you're suppressing the immune system so the body doesn't reject the organ?
01:14:06.000Would that be the case with rapamycin in person taking it for longevity?
01:14:10.000And that's the million-dollar question.
01:14:12.000And so I think in a moment, I'll tell you the story of how rapamycin came to be because I think it's the most interesting story in biology, certainly in the last 25, 30 years.
01:14:22.000But when it was approved in 1999 by the FDA, it was for this indication.
01:15:13.000So there was a group that got one milligram every single day, five milligrams once a week, 20 milligrams once a week.
01:15:21.000They did this for something like 8 to 12 weeks and then they washed out, meaning they got nothing for 8 to 12 weeks and then they were hit with a flu vaccine and then the scientists measured the immune response, doing these really complicated assays where you look at T cell function.
01:15:36.000So relative to the placebo, paradoxically, all groups, and I say paradoxically because even the group that got one milligram once a day, all saw an increase in immunity, which is a good thing.
01:15:47.000But the 5 and 20 group saw an even bigger response.
01:15:51.000The people who just got 5 once a week or 20 once a week saw an even bigger response.
01:15:55.000But the group that took 20 once a week had more side effects.
01:15:58.000And the biggest side effect of rapamycin acutely is these awful, awful mouth sores called apthos ulcers.
01:16:25.000So, once I had one so bad that I was like, this was when I was in residency and I was like, it was just driving me nuts.
01:16:30.000So I went to the OR and I got a bunch of lidocaine, which is a local anesthetic, and I went into the call room and I just grabbed my tongue and just injected like lidocaine in it.
01:16:38.000And just when I did that, somebody walked in and I've got like blood dripping down from my mouth and I've got a needle in my mouth and they're like, and I'm like, no, no, no, it's not what you think.
01:17:04.000And the rest of the day, I just felt like...
01:17:14.000It's a guy named William Stuart Halstead, who was so near and dear to my heart because he was the founding surgeon at Johns Hopkins.
01:17:26.000And one of the original four horsemen, so the four main physicians that basically have shaped medicine in this country, all started out at Hopkins.
01:17:34.000Osler in medicine, Hopkins in surgery, and two other guys, Walsh, and I'm blanking on it.
01:18:04.000So, God, I used to know all of this shit.
01:18:06.000I don't remember any of the exact dates anymore.
01:18:08.000But it was like kind of like mid-1800s to late-1800s when up at Massachusetts General Hospital, I forget the name of who it was, but someone basically came up with ether.
01:18:19.000So ether became the first form of anesthetic.
01:18:22.000But, you know, you were sort of knocking people out.
01:18:24.000Well, it was, you know, fast forward probably 20, 30 years when Halstead figured out that this thing called cocaine could provide local anesthetic.
01:18:31.000So he began experimenting with like crazy and, of course, in the process became like patently addicted to it.
01:18:37.000So you have this entire generation of surgeons at Hopkins from that early era that were completely coke addicted.
01:18:44.000So Halstead and all of his first generation of residents.
01:18:48.000And then, of course, from that, we got lidocaine, bupivacaine, all of these things that don't have the same properties.
01:18:55.000But to this day, cocaine is still used.
01:18:58.000And most people don't realize it, but cocaine is a Schedule II drug, meaning it actually has a medical application, unlike heroin, which is Schedule I in the DEA. And marijuana.
01:19:07.000But cocaine is Schedule II, and it is still used in some ENT surgery because it has some favorable properties over even lidocaine and bupivacaine for nasal surgery.
01:19:17.000Did you know that they still use cocoa leaves for flavor in coca-cola?
01:19:21.000They actually extract the cocaine from it, use the cocoa leaves, and the cocaine goes to medical purposes.
01:21:35.000So that study, I remember reading that and thinking, okay, so if you looked at that study, you realized if you're going to be in the placebo, the one a day, the five once a week, or the 20 once a week, the five once a week was the way to go.
01:22:08.000I mean, all this stuff is in its infancy.
01:22:10.000Now, my shtick is, so right now, rapamycin's off patent, right?
01:22:16.000So the drug was approved in 99 by the FDA, but this is after an unbelievable, amazing story of, like, how, you know, this drug almost got lost forever, right?
01:22:28.000So there's no economic incentive for a company to figure out how to do this thing with rapamycin.
01:22:35.000And even Everolimus, I think ultimately Novartis, and I'm saying this with no actual knowledge other than just my own speculation, but I suspect Novartis was like...
01:22:43.000Well, you know, we're not going to play this game just with Everolimus, and that's, I think, why it probably spun into this other company, RestoreBio, to sort of combine it with other agents.
01:22:55.000But at an end of one level, what I'm kind of interested in doing is, you know, using myself as a guinea pig to start to measure the benefits of it, because...
01:23:07.000My hypothesis is three things have to be true if rapamycin is working.
01:23:11.000Now, I could be wrong, but this is my hypothesis and this is what I test with other scientists is if you are taking rapamycin at the right dose, So assume you're not getting all the nasty side effects.
01:23:24.000You're not getting the mouth sores and stuff like that.
01:23:44.000And I've talked to him a bunch, and when he started it himself, he said, like, the improvements were remarkable just in terms of glucose metabolism.
01:23:54.000But I think he was starting at a pretty bad spot.
01:23:56.000But if you or I took it, we might not notice much getting better, but we definitely should not get worse.
01:24:40.000It is, and it's different on two levels because, you know, when you're giving it every day at a lower dose, you still end up producing tissue levels that might even be comparable to where that person was getting with the spike of 20. And in general, this isn't always true,
01:24:56.000but in general, in pharmacology, certain side effects are the result of the Nader dose, and certain side effects are the result of the peak dose.
01:25:04.000So with every drug, you kind of have to understand this a little bit.
01:25:07.000But going back to this rapamycin thing, the third thing that has to be true, in my opinion, I could be full of shit, but I think the third thing that has to be true if you're taking the right dose is you need to see an uptick in autophagy.
01:26:16.000So the Nobel Prize in Medicine and Physiology was awarded for the genetic...
01:26:22.000Basically, the elucidation of the genetic regulation of autophagy in...
01:26:25.000Actually, it was 2016, so it's very recent, about a year and a half ago.
01:26:28.000This is what the Nobel Prize was awarded for.
01:26:31.000But what I'm hoping is that we can develop a signature for autophagy with a blood test.
01:26:35.000So I believe that you should be able to look at someone's blood and look at all of the, you know, metabolomics, all of the small molecules, all of the proteome, and there should be a signature.
01:26:49.000It should look different from the way we look when we're, you know, fasted, or sorry, fully fed.
01:26:54.000Otherwise, would you just take a sample of the muscle tissue, like punch something out?
01:26:58.000Yeah, and I'm willing to do it all, and I probably will.
01:27:02.000We're just trying to get what's called an IRB, an Institutional Review Board.
01:27:05.000So to do these kinds of studies in humans, even if I'm the only subject and it's just like, I don't care what you do to me kind of thing, we still have to get an IRB. So we're working on getting an N of 1 IRB. So that we can take muscle biopsies, fat biopsies for me,
01:27:21.000blood tests, and then start to actually look for that signature.
01:27:24.000Would it vary in where you got it from?
01:27:51.000One thing that if you're actually doing this kind of testing in people, you'll notice glucose, like insulin resistance in the muscles of the legs.
01:27:59.000So once the legs start to get insulin resistant, you're on a glide path to bad things happening.
01:28:07.000First of all, from years of martial arts, but also because over the last year or so, I've been doing a lot of running, and it's one of the only muscle groups that I can work out every day.
01:28:17.000I can run hills every day, and I'm not sore.
01:28:23.000Like, that's not even possible for any other group.
01:28:27.000I mean, I can kind of do that with boxing.
01:28:29.000You can hit the bag, but as far as, like...
01:28:32.000Running hills is essentially like plyometrics.
01:28:35.000You're pushing your entire weight up, and then you're catching with the other leg and pushing it up.
01:28:45.000I mean, there's probably someone out there doing it that's proven me wrong, but there's nothing like the amount of endurance that you have in your legs.
01:28:51.000But it could just be an adaptation that you've had as well.
01:28:54.000I mean, when I was a competitive cyclist, I mean there were definitely days when I would – especially when we did like multi-day events.
01:29:03.000Like there were days when it's just like – You're beaten down.
01:29:25.000Especially if you really have good proprioception.
01:29:28.000For example, if you're deadlifting, You know, I actually think if you – so you know how you have like the positive and negative motion, concentric, eccentric motion of a weight?
01:29:39.000If you're willing to do away with the negative, you can lift heavy every single day.
01:29:52.000Andre Galvao on his Instagram the other day was doing deadlifts and just dropping the weight.
01:29:56.000And I was like, that seems weird to me.
01:29:57.000So when I was a cyclist, this was my training.
01:30:00.000And it was all put together by this guy named Ryan Flaherty, who I actually introduced.
01:30:04.000That was another one of my sight unseen introductions to Tim for a podcast.
01:30:07.000It's a great podcast with Ryan Flaherty on.
01:30:09.000And he's a, I call him the guru of speed.
01:30:13.000This is a guy who like single-handedly – I shouldn't say single-handedly.
01:30:16.000I mean he's on the shoulders of many other people who have done great work but has really done an amazing job of figuring out how to make people run fast.
01:30:25.000And it's a very long story and I mean he does such a great job on the podcast.
01:30:30.000But for the purpose of this discussion – One of our interests was, hey, could we translate everything you've learned about sprinting into cycling?
01:30:39.000And his biggest observation was the following.
01:30:41.000If he took a hundred runners and lined them up and knew, like before they ran, knew how hard they could hit a force plate treadmill, he could predict the order in which they'd finish the race.
01:30:54.000So a force plate treadmill, as its name suggests, is a treadmill, but it's a special treadmill where it measures the force that you hit.
01:31:01.000And the higher that number divided by your body weight, that became what he described as mass-specific force.
01:31:07.000That number, if you rank order it, is the order in which people would finish the run.
01:31:13.000So it kind of makes sense if you think about it, right?
01:31:16.000The harder you can hit the ground relative to your own weight, the higher you go, and the higher you go, the longer you travel with each stride.
01:31:22.000So Usain Bolt has the highest ever force plate measurement calculation, and I forget what his ratio is.
01:31:32.000I want to say he's like 6.9 or 7 times more force than his body weight every time he hits.
01:31:42.000So then Ryan, once he figured all this stuff out, his next question, this is when he was working at USA Track, his next question was, could you train this?
01:31:49.000In other words, like, okay, if Joe runs a, you know, 4.940 and we want to get that down to a 4.5, can that be done?
01:31:58.000And it turned out the answer was categorically yes.
01:32:34.000So you're never getting the actin myosin filament to tear past, because that's what's happening in the negative, is the actin is coming off the myosin, and that is creating a micro-tear in the muscle, and that's what the muscle rebuilt.
01:32:47.000That's why we get larger when we lift weights.
01:32:50.000But when you drop it, you unload the muscle when you're relaxing it, so the muscle's not going to get bigger.
01:32:57.000So you're getting all the benefits, all the strength, which is primarily around the type 2B muscle fiber and without the size.
01:33:06.000So anyway, when I asked Ryan, hey, could we do this in cycling, we did this experiment, which was he kind of came up – this was for me and two other guys who were very good cyclists.
01:33:16.000But these guys were like – Cat 1, Cat 2, collegiate cyclists, but they were like my training partners.
01:33:22.000So we did this thing where we did the same routine that he had the sprinters doing.
01:33:26.000And it's a bit more complicated than I've described because you're also juxtaposing the positive only with something called a post-activation potentiation, which you may have already experienced this, but I don't know if you've ever tried to do plyometrics after deadlifting, but it seems counterintuitive that you'd be able to do more,
01:34:14.000And so Ryan, you know, he runs a training camp where he has typically the top 10 college prospects every year just before the NFL combine come down.
01:34:25.000And I mean, the changes he makes in their time, like Johnny Menzel was one of them.
01:34:29.000So obviously Johnny Menzel is obviously, you know, not panned out in the pros, but most people kind of forget how good an athlete he was.
01:34:35.000And when he showed up to camp, I don't know.
01:35:00.000I saw something the other day that I'd never seen before.
01:36:46.000Well, we were talking about, like, you really got to be able to get the lats fired.
01:36:50.000But how do you get the lats to fire at such a weight and then without having to do the negative as well?
01:36:56.000So we just couldn't really kind of figure out how to do it.
01:37:00.000So we adapted part of his technique to swimming, which was the actual training routine, meaning...
01:37:06.000So one of the big misconceptions if you're trying to go fast is that you need to still train slow.
01:37:12.000But the reality of it is, like, you know, if you're trying to run a marathon at, you know, call it a pace of 215, you know, world-class marathon runner...
01:37:24.000There's not a lot of benefit to spending much time running at a pace slower than that.
01:37:28.000If anything, you want to be running slightly faster than that.
01:37:30.000You know who Meb is, the American marathoner who won the Boston Marathon three years ago?
01:38:10.000All right, Meb, if you want to win the Boston Marathon, you need to be able to travel like four inches further with every step you take, taking the same number of steps at the same cadence that you currently run.
01:38:20.000And they, you know, Ryan did the math and said, that means your force number has to go from where it is now, which I think was 1.7, meaning he could only deadlift 1.7 times his body weight.
01:38:31.000You have to get that up to like 2.6 or something.
01:38:34.000And so when Meb trained for the Boston Marathon, he was focusing heavily on these deadlifts and doing much shorter, faster runs.
01:38:42.000And, you know, I mean, if you watch the video of his Boston Marathon win, it's incredible.
01:38:47.000Like, you know, he just takes off and, like, leaves everybody behind him.
01:38:52.000And they're like, yeah, there's no way he'll be able to keep that up.
01:39:33.000Meaning you have to have the perfect athlete trained...
01:39:37.000To peak at the right time, you need the right humidity.
01:39:40.000Everything has to fire on all cylinders.
01:39:42.000But just as there was nothing physiologically special about a four-minute mile when Roger Bannister broke it, it was more of a psychological barrier.
01:39:53.000I'm not suggesting for a moment that this will be easy, but we're going to get there.
01:40:13.000I was about a 250 marathon, 255 marathon when I was a boxer, but never trained as a runner.
01:40:19.000I just ran so much and I was pretty fast.
01:40:22.000But when I think about how hard I would have to run to bust out a 250 to 255 and to think, was there any chance I could have ever got that down to a 230?
01:40:36.000That is such an enormous change in pace.
01:40:41.000I don't know that I ever could have done that regardless of all the training tricks in the world.
01:40:45.000And what kind of diet are those guys following?
01:41:07.000I'm not talking about anyone who runs a marathon.
01:41:08.000But if you're talking about the people who are going to win the marathons, They are basically all engine and then chassis in the right place.
01:41:16.000That's basically all they come down to, right?
01:41:18.000I mean, they are enormous cardiovascular system, very strong quads, hams, glutes, and then everything else is very tiny.
01:41:26.000When you say enormous, like, is literally the size of their lungs different?
01:41:30.000Well, I mean, it's all relative, but when you look at their frame, their thorax is going to be larger.
01:41:36.000And is it expanded because of the training?
01:41:39.000I mean, you never know cause and effect sometimes.
01:41:41.000You could argue, like, maybe these guys were, maybe the people who are drawn to those sports are the ones that are, you know, are drawn to be elite in those sports, already had a genetic predisposition.
01:41:52.000That's sort of my feeling is it's a bit of both.
01:41:54.000Isn't that the case with Lance Armstrong?
01:41:55.000Like, doesn't he have a very large heart?
01:42:00.000I think what Lance had that was pretty unique, even amongst the world's best, which is what he competed with, of course, I think his lactate threshold was a lot higher than most people.
01:42:14.000And then, of course—and again, you know, I mean, I know it's such a controversial topic, although my view is I think that every single cyclist, at least from 1991 until 2011, was on highly, highly, you know, augmented programs.
01:42:29.000So, you know, that Lance won seven of those years in that context just tells me that he was, you know— Training harder and being more specific to the race.
01:42:40.000I mean, what people don't understand is like, I mean, Lance only peaked for one race a year.
01:42:45.000Like everything that that team, US Postal, did was geared for that one race.
01:42:50.000And also when you really look at how much doping they did, it actually wasn't that much.
01:42:57.000Like, you know, when they were blood transfusing, it might have been two units over the course of a race.
01:43:01.000And I'm not saying that that wouldn't help.
01:43:05.000But that's nothing compared to what people were doing just a few years before Lance came along.
01:43:10.000So Lance won, I think, his first one in 99. The guy who won before that in 98 was Marco Pantani.
01:43:16.000Before that was a guy named Jan Ulrich in 97. And before that was a guy named Bjorn Reis.
01:43:20.000Bjorn Reis's nickname was Mr. 60 because his hematocrit was always over 60. That's freaking, like how that guy didn't die of a stroke, I don't know.
01:43:33.000Lance never had a crit over 50 to my knowledge.
01:43:35.000They would basically always titrate with EPO and or hemoglobin up to 50, which was the trigger.
01:43:43.000So, you know, but I think, and again, I've never, I don't know Lance at all, and I certainly don't know anything about him beyond, like, the little bits that I have read over time, but I do think his lactate tolerance was remarkable, meaning, you know, we measure lactate in athletes,
01:43:58.000swimmers, and cyclists when they're, you know, trying to figure out what their performance is, and as far as I can tell, there seem to be these two phenotypes.
01:44:05.000There's the one phenotype where people can tolerate staggeringly high amounts of lactate, And again, it's not lactate per se that is causing the pain that you're experiencing.
01:44:14.000It's the hydrogen ion that accompanies the lactate.
01:44:18.000So lactic acid, the acid part of that is the hydrogen ion, and that's actually what's poisoning the muscle and preventing the muscle from having this effortless actin myosin, act, you know, contract, release, etc.
01:44:32.000But we use lactate as a proxy because where lactate is high, the hydrogen ion is high.
01:44:37.000And there are some people who can just tolerate, like, incredible doses.
01:44:40.000I used to work with Olympic swimmers, and I mean, there were just a couple of these guys, like, they could actually be standing with a lactate of 24. I mean, when I was competing, if I had a lactate above 16 or 17, I couldn't be standing.
01:45:01.000And I saw dudes that could stand there at 24. In fact, one of my good friends, he won a gold and a silver medal in the Sydney Olympics and retired from swimming in 2004, then came back to swim Masters.
01:45:15.000He actually was trying to make a comeback to make the 2012 Olympic team.
01:45:19.000When he was training for that, I would poke him between races.
01:45:22.000I saw him get out of a 400 individual medley race, which is the hardest swim race of them all.
01:45:31.000He got out of that, had a lactate of 18. Two minutes later, not two minutes later, maybe seven minutes later, jumped on the blocks and won 100 breast race.
01:45:40.000You know, came out with a lactate of 21, that kind of thing.
01:45:44.000And then I think at the other end of the spectrum...
01:45:47.000The word on the street is guys like Michael Phelps are at the opposite end of that, where they are so efficient at shuttling lactic acid out of the cell back to the liver, where this thing called the Corey cycle actually turns lactate back into glucose, that they never have high levels of lactate.
01:46:07.000I think they were very hush-hush about Phelps' numbers.
01:46:10.000But I heard from reliable and reasonable sources that he would rarely have a lactate above 8.0, including when he's breaking world records.
01:46:22.000But he was so efficient at getting rid of it that, yeah, he could set the world record in the 400 IM and have a lactate of 8. Again, I don't know if this is true, but I've...
01:46:35.000There's certainly a plausible mechanism by which it could be.
01:46:56.000Once you start genetically doing it, if you could, does it become cheating in the same way?
01:47:00.000Well, does it if you have someone like Phelps who has this genetic predisposition to getting rid of lactose, lactate, and you take someone like me, who probably has none of that, and you juice me up to his level?
01:47:18.000I mean, this is why people like Daniel Coyle, who are so critical of Lance Armstrong, say, because on the one hand, you'll have camps that say, look, it's the great equalizer.
01:47:26.000Like, why don't we just let everybody dope?
01:47:28.000That's a steroid argument with MMA as well.
01:47:30.000Well, and frankly, it's more my argument.
01:47:32.000But I have a different reason for arguing that way, which is I think having done these sports and nowhere near at the high level that those guys do it, I just know how destructive they are.
01:47:41.000Like, the Tour de France is the most unhealthy thing on the face of the earth.
01:47:45.000I've heard that it's healthier to do the Tour de France on steroids than it is to do it off steroids.
01:48:01.000I mean, it is a devastating, grueling event.
01:48:04.000Now, nothing's going to completely ameliorate that, but if we think that watching these guys kill themselves riding six hours a day Hitting peak thresholds of, you know, 6 watts per kilogram.
01:48:17.000If we think there's anything physiologically reasonable about that, we're out to fucking lunch.
01:48:23.000I mean, isn't that the point is that you can push your mind to do something your body absolutely doesn't want to do, so you should be rewarded for...
01:48:30.000You know, and these guys are in a league of their own.
01:48:33.000I mean, professional cyclists are some of the toughest athletes out there.
01:48:36.000I mean, obviously, every athlete at the peak of their game is remarkable.
01:48:39.000And no disrespect to, like, the best running back in the NFL. But, like, you can't even compare that to what a guy does.
01:49:10.000I mean, it looks like it's just drained them, like they've forced to live 30 years inside of 10. Yeah, so it's like, what if we just say, guess what?
01:49:18.000Everybody's allowed to use whatever amounts of EPO, blood, testosterone, to be at the 80th percentile of what we consider normal.
01:49:25.000So everybody's allowed to walk around with a hemoglobin of 14.7, or up to 14.7 or 15. Yeah, but people would cheat that, right?
01:49:33.000I mean, if you allow people to use a certain amount.
01:49:37.000But I also think, like, the testing on this stuff is so, like...
01:50:02.000It's so JV. The reason doping is unfair, because the everybody does it argument, doesn't hold water, is because if you're a person who naturally lives at a hematocrit of 47, you're only getting a slight improvement going from 47 to 50. If you're a person who naturally lives at 43,
01:50:21.000you going from 43 to 50, you get a much bigger advantage.
01:50:26.000To which I say, yeah, but that's true on a relative basis, but at an absolute level, if everybody's walking around with a hematocrit of 48 to 50, they still have the same oxygen-carrying capacity.
01:50:39.000The concern, though, isn't—I would believe the concern is you don't want people to think that the only way to do this sport is to take drugs.
01:50:50.000And it's also worth putting in mind that, and this is sort of my pet peeve with this whole drug and sport thing, is like, I mean, personally, I don't really give a shit.
01:51:00.000I mean, I just have bigger things I care about than like how many steroids Barry Bonds took to hit all those home runs.
01:51:05.000But what really does chap my ass is when people don't actually understand how steroids work.
01:51:10.000It bugs the shit out of me when people assume that if you take steroids, you will hit that many home runs or you will run this fast or lift this much.
01:51:20.000The only thing that steroid is doing is enabling you to recover faster from the brutal work that it takes to actually do those things.
01:51:29.000So, you know, if I shot myself full of EPO, I mean, you've probably seen Icarus, right?
01:51:37.000I mean, I thought Brian Fogel did a really good job of showing.
01:51:42.000I mean, and he was a pretty good responder to the EPO. I think he did growth hormone, testosterone, and EPO. Right.
01:52:05.000It's not because the drugs were in him per se.
01:52:08.000It's because the drugs that were in him allowed to train more.
01:52:10.000So the reason he was a fitter rider the second year was because his watts per kilo were higher because of how much more he trained.
01:52:18.000The drugs enabled him to train that much harder.
01:53:01.000I mean, you know, when I stopped cycling competitively, I think a big part of it was I just realized that performance and longevity stopped being co-linear.
01:53:14.000They started to become somewhat orthogonal.
01:53:25.000It seemed to come at the expense of what I believed was going to make me live longer.
01:53:29.000So specifically, the thing I cared most about was cardiovascular health.
01:53:33.000Now, the incidence of atrial fibrillation in highly trained athletes is 10 times higher than that of non-athletes.
01:53:43.000So that's a little counterintuitive, right?
01:53:45.000Why would people who have such amazingly fit cardiovascular systems have 10 times the risk of this horrible condition called atrial fibrillation, which, yeah, many people have it, but not young.
01:53:57.000You're not supposed to have that when you're 40. And it's usually associated with cardiovascular disease.
01:54:02.000And yet people are, you know, showing up with these...
01:54:06.000I mean, I have four patients who have had to get ablations for atrial fibrillation.
01:54:11.000An ablation is a procedure where they stick a catheter up through the femoral artery or in the vein, and then they burn pieces of the heart, specifically around the...
01:54:38.000When your heart is constantly being exposed to that high stretch, high ejection fraction load, you're basically stretching out the electrical system because the electrical system of the heart runs within its muscles.
01:54:47.000So as you stretch it out, a certain group of people, and we don't know why certain people are susceptible and certain are not, but they just develop this dysrhythmia.
01:54:57.000So you're soldering the motherboard, as it were?
01:55:09.000Someone said once, and I don't know if this is true, maybe you would be able to have some insight, that there's a concept that your entire life you have a certain amount of heartbeats.
01:55:28.000Yeah, I don't tend to agree with that.
01:55:32.000Because you can't compare one beat to the other.
01:55:35.000I mean, it's hard for me to say that...
01:55:39.000An 80 to 90% ejection fraction beat under incredible load is the same as the beat that I'm, you know, like is beat per beat the same as the beat I experience when I'm sleeping and my heart's beating at 40 beats per minute?
01:55:52.000I think maybe there's a directional truth to that, but I feel like when you're talking about human longevity, it's a game of inches.
01:56:01.000And that is like something that's probably directionally true within a mile.
01:56:05.000Now, when you're talking about human longevity and you're thinking about all these different things that you could do to extend, how much of that is supplementation?
01:57:09.000You're willing to take one that you buy in a drugstore that's totally unregulated and you're not willing to buy the one that comes from a drug company where the FDA has their foot up the ass of the company making it to make sure it's perfect.
01:57:20.000That just strikes me as a false equivalent.
01:57:22.000So I only say that to just say, like, I think everything should be on the table.
01:57:26.000And then the question should be, how do you decide what to do?
01:57:31.000There are absolutely a bunch of supplements that I take, but I don't have kind of a one-size-fits-all approach to it because I think you've got to be able to kind of measure what's going on in a person, get a baseline, and figure it out.
01:57:42.000So, you know, I mean, my guess is you've had a million people on this show that can talk your ears off about, you know, which people should take methylated vitamins versus which shouldn't, and if you have this MTHFR mutation versus this one, should you be taking this versus that?
01:57:57.000Some of the stuff that I find even more interesting is actually a lot less sexy, and I don't have a good answer for it, but looking at, for example, vitamin D levels.
01:58:06.000So you see a huge disparity in the vitamin D levels people have, and it begs the question, do all people run...
01:58:17.000And is that a function of not just their own individual, like how much sun they're getting, but more importantly, like potentially genetically where they're from?
01:58:25.000So I'm starting to feel like people who have Northern European blood might actually run better at a lower vitamin D level than people like me who, you know, come from places near the equator where maybe I just evolved to see more sunlight and have more vitamin D. What's your ancestry?
01:58:50.000So, and the range, like when you look at a laboratory test, when you check somebody's vitamin D, like the range that's offered is 30 to 100 is optimal.
01:58:59.000Yeah, I'm like, that's probably not the range.
01:59:01.000So I personally think the range is probably 40 to 60, but I also measure something called parathyroid hormone that allows me to further titrate that range and stuff like that.
01:59:09.000Well, when you're talking about this, it's really obvious, really clear that there's so much data to go through, that it's We're learning this.
01:59:18.000I don't want to say it's at its infancy, but if we look back a thousand years from now, we will most certainly say that our understanding of this science is at its infancy.
02:00:05.000May have been correct, meaning there were things that were certainly done back then that proved helpful, but they weren't grounded in a principle of science.
02:00:15.000In other words, even a blind squirrel is going to find nuts sometimes.
02:00:20.000And then we basically, following the elucidation of a scientific method, the development of statistics to actually make sense of data, we then got into the sweet spot where I think we are now, which is Medicine 2.0.
02:00:35.000And to me, Medicine 2.0 is really good at solving problems that are amenable to relatively short, simple clinical trials.
02:00:41.000And there has been no better example in this space than infectious diseases.
02:00:47.000So, like, if you think about the unbelievable improvement in human longevity that has come from antibiotics, antiviral therapy for HIV. I mean, remember, 30 years ago, HIV was a lethal disease.
02:01:05.000For virtually every patient with HIV, it's a chronic disease today, meaning you will die with HIV, not from HIV. That's almost hard to fathom when you consider how shitty we are at addressing other chronic diseases like heart disease, cancer, Alzheimer's disease.
02:01:20.000So the problem is, if you want to know the answer, Should I eat this way or that way?
02:01:28.000Should I exercise this way or that way?
02:01:30.000Should I take this drug or that drug or this supplement or that supplement to live longer?
02:01:33.000We can never know the answer in humans because there is no clinical trial that can answer that question.
02:01:39.000And we can do that experiment in everything that's not human, but we've already learned the hard way that what happens in not humans doesn't necessarily extrapolate to humans.
02:01:49.000And we can do things to be slicker about it.
02:01:51.000When you study rhesus monkeys for 20 years, it's certainly more interesting than studying mice for one year.
02:01:58.000But in the end, they're still animals in captivity.
02:02:01.000They're still not in the same environment and all these things.
02:02:03.000So my view on this topic is the only way to go to this kind of medicine 3.0 is you've got to have kind of a strategy around how you think about it.
02:02:13.000And so in many ways, that's what I spend most of my time dealing with is what is a strategy for longevity that becomes a scaffolding upon which you anchor every new piece of data?
02:02:27.000Because, I mean, I know things today from a data standpoint I didn't know 10 years ago.
02:02:32.000And to your point, even in five years, we'll look back at stuff we're doing today and think, God, we have more data.
02:02:40.000And so that strategy to me is sort of fundamentally based on three bodies of literature.
02:02:45.000And the first is like what did we learn from centenarians?
02:02:48.000So the people who naturally live to a hundred, they have the advantage or that body of literature has the advantage of being based on humans.
02:02:57.000It has the disadvantage of it not being experimental.
02:02:59.000So we, you know, like we don't know like what cause and effect was.
02:03:04.000And then secondly, if you look at all of the animal literature or non-human literature where you can actually do the experiments, what's common there?
02:03:10.000And then if you look at the underlying molecular mechanisms.
02:03:14.000So I feel like if you tie those three together, you come up with a general scaffolding for what it means to live longer and live healthier, then we can try to look at one thing at a time and say, hey, vitamin D,
02:04:48.000So when a paper comes out, if it is never cited again, meaning for the remainder of time, no one ever even goes back to reference that paper, you could probably make the case that that paper is not relevant.
02:05:00.000And if you then further strip out auto citations, Meaning the only time it's ever cited is when the author then goes back and cites his or her own paper.
02:05:10.000Something like 70 or 80% of papers never get cited outside of an auto-citation again.
02:05:18.000Is this because they're not relevant or is it possible to get lost in the shuffle?
02:05:22.000Like some of them might be worth something?
02:05:24.000I mean that's probably possible but I would bet it is much, much more the former than the latter.
02:05:29.000And then on top of it, a lot of stuff comes out and then years later you realize it was wrong.
02:05:34.000You know, or it was, and that's more often the case that it was wrong through an honest mistake than wrong through a dishonest mistake, but there's still a lot of wrong through dishonest mistake stuff's coming out there as well.
02:05:44.000So how much of this data is forcing you or causing you to alter your own patterns?
02:05:50.000Well, we believe internally that probably 100 papers a month enter the literature that are relevant to what we do.
02:05:59.000Meaning, some of the literature that comes out, like the rheumatology literature, might be relevant to them, but that's not what I do.
02:06:17.000Well, we subscribe to a whole bunch of services that basically pre-filter a bunch of shit for us, and then we have a system where we go about kind of pulling that stuff.
02:06:28.000So you get those three a day, and then they bring them to you.
02:06:35.000I was like, literally, as I was driving here today, I was talking to a buddy of mine, and I was like, dude, I'm the fucking bottleneck, and I hate it.
02:06:50.000Because my job is you hire great people who are smarter than you and you just guide them.
02:06:56.000You just point them in the right direction.
02:06:57.000So what we mostly do is create programs where we're going out and looking for new knowledge.
02:07:05.000So for example, one of the questions that is tormenting me right now, because I still don't know the answer is, is there any benefit to taking human growth hormone from a longevity perspective?
02:07:13.000There's clearly a performance benefit.
02:07:15.000Growth hormone is probably the single most abused drug in all of sports.
02:07:19.000But is there a way to take it where it makes you live longer?
02:07:24.000I've never prescribed growth hormone to a patient because, frankly, I'm not yet confident that I know the answer to that question.
02:07:31.000But I feel like it's worth knowing, right?
02:07:33.000Because I can certainly make a teleologic argument for why growth hormone could be helpful, but I can also make a teleologic argument for why it could be harmful.
02:07:40.000And so, like many things, your knee-jerk reaction to something can often be wrong.
02:07:46.000And my knee-jerk reaction to growth hormone has historically been, causes cancer.
02:07:52.000Well, growth hormone tells your liver to make IGF, insulin-like growth factor, and two-thirds of tumors seem to thrive on IGF. So ostensibly, you would think, well, growth hormone can't be right.
02:08:04.000But then one of my analysts, Bob Kaplan, pointed out to me a year ago, he's like, you know, Peter, I've been thinking about this.
02:08:08.000And he's like, given how ubiquitous growth hormone is in sports and how long it's been ubiquitous in sports, like, I mean, this was the drug that turned around US Olympic athletes in the late 70s, early 80s.
02:08:32.000When we went back and looked at literature, I mean, we found that the data on growth hormone and IGF are not nearly as straightforward as people have made it out to be.
02:09:52.000So describe that to people that are listening.
02:09:54.000Well, so what that means is, so, for example, Alzheimer's disease and heart disease have an almost monotonic reduction in risk as IGF gets higher and higher and higher.
02:10:03.000It's only cancer that seems to have that uptick where risk starts to actually rise once you cross past the, call it, 70th percentile.
02:10:11.000And so when you integrate all of these curves together, that's why you see this slight uptick.
02:10:17.000Now, again, this is epidemiology, so one has to take this with a grain of salt, but this is...
02:10:22.000To me, when I saw this graph, which Bob put together, I don't know, a while ago, I was like, wait a minute.
02:10:28.000This doesn't jive with my preconceived notion of like growth hormone is bad.
02:10:32.000This warrants way further exploration.
02:10:35.000And so what that basically turned into is now an enormous internal project that will take us probably a year to complete and will constantly be updated.
02:10:44.000Like we did this already with testosterone two years ago.
02:10:47.000We put together like a 40-page white paper on the topic.
02:10:50.000And then at least once every two weeks, it gets updated every time a new paper comes out.
02:10:55.000Basically asking the question like, is testosterone replacement beneficial or harmful?
02:10:59.000And under what situations should it be considered versus not?
02:11:02.000And again, the goal is to do this unemotionally.
02:11:05.000And that's hard to do because for reasons I'm not entirely clear on, basically everyone's kind of just emotional about this stuff.
02:11:13.000Well, they're emotional about steroids because of all the press about Barry Bonds and all the different baseball players that got caught with it.
02:11:25.000Yeah, I think that's exactly what it is.
02:11:27.000I think people consider taking any kind of hormone, whether it's growth hormone or testosterone, as cheating.
02:11:34.000Even if you're talking about older people that take it, like I was looking at one of those ads, you know, they have those ads for hormone replacement, this really old looking guy.
02:11:44.000Oh yeah, Jeffrey Life, I think is his name, Dr. Life.
02:14:46.000So, I think that science is accelerating our longevity and that's one of my proof points is that we are constantly underestimating how long we can live.
02:15:00.000Now, on the other end of that spectrum, I am not one of these futurists who thinks like there's immortality out there.
02:16:21.000We take that shit for granted now, right?
02:16:23.000And then the third one was basically germ theory.
02:16:26.000You know, starting with Lister and going all the way to Fleming when we figured out like, you know, if you cut open a cadaver and then go and deliver a baby, that's bad.
02:16:38.000Because there are these microscopic things that none of us anticipate, right?
02:16:41.000We haven't had a step function improvement in mortality in nearly 100 years.
02:16:48.000Now, I think there are a couple of potentials for that, but what I don't know is if, like, they're going to happen in my lifetime or in your lifetime.
02:16:56.000But I want to buy the optionality to stick around for it by doing all this incremental little shit.
02:17:01.000With these three plus papers a day, the options are increasing.
02:17:07.000It just seems to me that there's a trend, right?
02:17:11.000The trend is, as you're saying, there is an increase of longevity, but it's not a huge increase.
02:17:16.000But our understanding of the human body, that seems to me pretty radically improving.
02:17:24.000Especially in terms of nutrition, nutritional absorption, the mechanisms behind nutrition.
02:18:54.000No, I think some people are just so insulin resistant that it becomes really hard to fix them without doing draconian stuff.
02:19:02.000I mean, I have one patient who is really now, I think, going to in many ways become the poster child for...
02:19:09.000He's definitely the toughest case I've ever had.
02:19:11.000And why he's such an amazing guy is he was actually able to do something that's really hard to do, which is stick to something with complete blind faith in me, even when it didn't feel good, even when I knew it would take a long time to see the results.
02:19:25.000So he's probably 5'8", weighs 235 at the start.
02:20:09.000It was hard for him to stick to it and blah, blah, blah.
02:20:11.000So I just said to him, look, man, I want to try something completely fucking extreme and I want to try it for six months.
02:20:20.000Every month, you're going to spend the first five days eating 500 calories a day of a ketogenic diet.
02:20:28.000And it's basically just going to be like vegetables, oil.
02:20:30.000You're basically eating a bunch of salad.
02:20:32.000And then for the next 25 days, you're going to do a time-restricted ketogenic diet where you're only going to eat in that eight-hour window.
02:20:40.000And then you're going to repeat that every month for six months.
02:20:43.000And he was like, I won't be able to do it.
02:20:57.000And I'm giving you a grossly oversimplified version of what we did, but it was much more complicated than that.
02:21:02.000There's a bunch of other stuff that we had to do to manage it as well.
02:21:06.000Well, I mean, he just sent me, I mean, we were in touch all the way along, so it was clear that this was working, but it was just kind of amazing to get a picture from him two weeks ago as we just passed that six-month mark.
02:21:22.000His liver, this is, I mean, and that's interesting, but not nearly as interesting to me, is the fact that his transaminases, which are the enzymes that the liver makes in response to how much fat is accumulating, you know, normal is like less than 40. He was like in the hundreds,
02:21:37.000and the ultrasound showed it was just a bunch of fat, and he doesn't drink alcohol, so we knew it was non-alcoholic fatty liver disease.
02:21:54.000The problem is he was metabolically broken, so I'll come back to why I felt like this was a necessary intervention, despite how draconian it was.
02:22:03.000He's on a treadmill 30 minutes a day now.
02:22:19.000And so the reason I have occasionally pulled that trick out, although it hasn't always worked, It's based on this case study I read that's very famous.
02:22:28.000I'm sure there's got to be someone on this show who's talked about it.
02:22:31.000But the paper was published in either the early 70s or late 60s, but it was the longest ever medically supervised fast.
02:22:39.000So it was this guy who weighed somewhere between 375 and 400 pounds.
02:22:43.000He did a 382-day inpatient medical fast where he had only water and minerals.
02:22:49.000At the end of that something like 382 days, He was down from, call it 400 to a buck 65. This paper was published seven years later.
02:22:58.000He weighed like a buck 70, a buck 75. The crazy thing about that guy is his skin shrank too.
02:24:01.000Certainly, if you eat enough shit, that can happen.
02:24:03.000But I think it's more complicated than that.
02:24:05.000I think it could be epigenetic, if not outright genetic, but probably more epigenetic.
02:24:12.000And so I'm interested in this idea of how do you reset people?
02:24:16.000And again, this is all kind of a long-winded way of saying like one of the advantages of practicing medicine is you get to – you stay humble because every time you think you're smart and you're like, I got this shit figured out, like you don't.
02:24:30.000There's like some patient who's got a problem that you can't figure out and it just drives you nuts.
02:24:34.000But you realize like – I mean even just today I was talking to a friend of mine.
02:24:38.000He's not a patient but – I mean, my God, he's just going through this devastating health situation.
02:24:48.000He's been to the best hospitals in this country.
02:24:50.000They can't fucking come close to figure out what's wrong with this guy.
02:24:54.000And so as bad as that is for him, I think that level of humility is actually good for the profession.
02:25:01.000What is going on with him that they can't figure out?
02:25:03.000He's having these horrible neurologic symptoms where he gets these fasciculations and muscle weakness.
02:25:07.000And obviously the big concern about six months ago when this started was he was presenting like he had Lou Gehrig's disease, which obviously is about as bad a fate as you can have.
02:25:19.000Luckily that has been ruled out and they've done a million muscle biopsies and all these other things.
02:25:54.000Well, I told him today, I was like, look, I'm going to send you a kit.
02:25:56.000We're going to do a certain blood test on you and a certain urine test on you.
02:25:59.000And I want to just figure out what's going on with your four hormone systems.
02:26:03.000There's basically four hormone systems that play a pretty big role in how we feel.
02:26:07.000And adjusting those doesn't, I'm not convinced it necessarily makes you live longer, but it can certainly make you live better.
02:26:12.000So I want to kind of understand, I suspect he's not firing on all cylinders on that dimension.
02:26:18.000Whether it's a result of whatever is going on that nobody can figure out or not, but I'd rather focus on something that I think we can fix.
02:26:25.000Yeah, the change in diet thing with that guy where he went and fasted for 360 plus days, what did he eat when he got back on food?
02:27:34.000No difference between him and anybody else.
02:27:36.000And I've got to tell you, I know we love to beat up on fat people.
02:27:41.000We love to turn it into a character defect.
02:27:43.000But I've got to tell you, virtually every fat person that I know or that I've taken care of, they are not disproportionately eating more than their peers.
02:28:07.000I think there are dietary exacerbations.
02:28:09.000I think certainly not exercising makes things worse.
02:28:16.000When you and I eat, like let's take a meal that, like if you had pancakes, bacon, and scrambled eggs, that would be like a really good mix of, that'd be a third carbs, a third protein, a third fat.
02:28:26.000So that's like a shit ton of nutrient, right?
02:28:28.000If you or I ate that, yeah, it probably wouldn't be that good for us.
02:28:32.000But like we, you know, let's say we just finished a workout or something.
02:28:35.000Like we're going to partition such that that glycogen will first and foremost go to replace the muscle and liver stores of glycogen because we have bigger muscles and our muscles are more insulin sensitive.
02:28:46.000We can actually disproportionately put more glycogen into our muscles, into the leg muscles, because you'll have done that run up the hills, right?
02:28:53.000And then furthermore, when we want to recruit energy again, we'll have the ability to actually go back and get fat.
02:29:01.000In other words, break down fat at lower ATP demands than necessarily always going to glycogen.
02:29:06.000So in other words, we partition fuel in a smarter way.
02:29:09.000And these patients, I mean, you can measure this clinically using something called RER and, of course, doing other blood tests.
02:29:16.000Like, they just can't break down their own fat.
02:29:20.000So their body is essentially broken in that regard, and that can be fixed with diet.
02:29:25.000It's a hard problem because the way I explain it to people is...
02:29:28.000So clinically, I'm not interested in weight loss, right?
02:29:33.000I'm much more interested in longevity, and yes, sometimes weight loss comes with that, but if I ever get stuck doing weight loss, I'm doing the wrong thing for my interest.
02:29:44.000The way I say to people when they want to lose weight is, look, you don't want to lose weight.
02:30:32.000More people have to leave the room than enter the room.
02:30:35.000So similarly, if you have a fat cell and you want it to be less fat, you've got to get more fat out of it than enters it.
02:30:40.000And the fat that exits the cell exits via a process called lipolysis, and the inputs to a fat cell are something called de novo lipogenesis, which is turning carbohydrates into fat, and re-esterification, which is turning fat, like in a free fatty acid, into a triglyceride back into a fat cell.
02:30:56.000Each of those three doors is controlled by hormones.
02:31:04.000Or fasting or exercise or drugs or hormones or all these things is to manipulate those hormones in the direction of what I call negative fat flux or what would be referred to in the literature as fat balance, negative fat balance.
02:31:16.000And the hormones that drive that are many.
02:31:19.000Insulin, hormone-sensitive lipase, testosterone, estrogen, cortisol being the five most important in my opinion.
02:31:26.000Maybe someone will disagree with that, but I think those are the five that rule the roost.
02:31:30.000You know, how do you manipulate those?
02:31:33.000Well, insulin seems to be the most important of the five and there's no better way to lower insulin than to not eat.
02:31:40.000So the first thing that happened to that dude, who went 382 days without anything but water and minerals, is he basically had very low insulin levels.
02:31:51.000In fact, once he got into raging ketosis, which he got into by about day seven, his insulin came up only to prevent him from going into ketoacidosis, which was what would happen if he had no insulin response.
02:32:04.000In other words, if he was a type 1 diabetic, he would have died of ketoacidosis.
02:32:07.000Because he wouldn't have had the insulin to regulate the uptick of ketones.
02:32:11.000But if you or I did this, because we have a normal pancreas, we would actually make just enough insulin to suppress ketogenesis and keep that beta-hydroxybutyrate level in the, you know, kind of in the neighborhood of probably 7 or 8 millimolar.
02:32:26.000As opposed to getting north of 12 to 15, which is when you get into trouble.
02:32:31.000So, you know, how do you manipulate insulin?
02:32:48.000And then that's when you start to think about these other things.
02:32:50.000You know, I've seen patients where They just can't lose weight.
02:32:54.000And I watch what they're doing and they're doing everything right but they just can't lose weight.
02:32:58.000But then you notice their cortisol levels through the roof.
02:33:01.000It's hard to get rid of fat when you have lots of cortisol.
02:33:04.000Cortisol is a very anabolic hormone to fat and a very catabolic hormone to muscle, which is the exact opposite of what we want.
02:33:12.000Testosterone, of course, is the exact opposite.
02:33:14.000Testosterone is catabolic to fat but anabolic to muscle.
02:33:19.000And then, of course, women have a harder time because once women go through menopause, they lose all the estrogen and all the testosterone.
02:33:26.000And so now they lose two hormones that play a very important role in regulating this.
02:33:30.000So for these people that are having the issue with cortisol levels, that's exacerbated by stress, right?
02:33:53.000Again, hormones are what's driving fuel partitioning.
02:33:56.000You know, you're responsible for what you put in your mouth, but in many ways at that point, like, the hormones take over and decide where it's going.
02:34:21.000I mean, I kind of lift three days a week, and then I ride like a stationary bike, like a Peloton, or I prefer this thing called a Wahoo Kicker, where you actually put your bike on it.
02:34:30.000So I do that three or four times a week.
02:34:34.000I would guess when I sit down to throw down, it's probably 3,000 calories.
02:36:26.000Like, if I'm tired, like, if I'm coming home from a gig and it's 2 o'clock in the morning, it's very difficult for me to drive past Wendy's.
02:36:32.000You know, I want to go to Wendy's and get one of those triple...
02:38:26.000So I would have got out the peanut butter and the jam and dipped the crust in there.
02:38:29.000And then I would have probably made a sandwich.
02:38:30.000I'm just happy that I didn't eat a sandwich of my own, as well as their crusts, because I probably could.
02:38:35.000Once the fucking gates are open, once I'm out there making spaghetti and meatballs, like, alright, let's get some fucking ice cream in this mix, too.
02:38:46.000So what do you eat when you sit down for these 3,000 calorie meals?
02:38:51.000So if I'm in control of the meal, which I usually am, I'm a super boring dude.
02:38:56.000So I like to have a salad in a bowl that's larger than my head.
02:39:00.000So I always refer to that as a manly bowl.
02:39:03.000That's the definition of a manly bowl.
02:39:04.000So it's got to be like a staggering amount of salad.
02:39:07.000And my salad is the same every freaking day.
02:39:10.000It's romaine lettuce, it's tomatoes, mushrooms, cucumbers, carrots, and then the dressing is just extra virgin olive oil, freshly squeezed lemon, salt and pepper.
02:39:19.000So It's a pretty bland salad in that sense, but I mean, I can eat that all day every day.
02:39:24.000And then it's a serving of protein, and I usually cycle through salmon, pork, steak, you know, some gamey meat, like whatever.
02:40:56.000Luckily, Bob ate more of it than I did.
02:40:57.000And he's way more jacked than me, so he can get away with eating way more naan than me.
02:41:03.000But yeah, that night, I mean, also those sauces are like so fatty.
02:41:07.000Like, I'm sure that was a 4,000 calorie throwdown.
02:41:12.000The other thing I'm pretty good about is when I'm done, I'm done.
02:41:15.000So that's the other thing about time-restricted feeding that I think I get away with more because, like, when I go back to my apartment, I will rarely have another bite.
02:41:25.000And when I wake up in the morning, it's like black coffee.
02:41:28.000You know, I'm not sneaking little shit in throughout the day.
02:41:31.000Like, Whereas if I'm not fasting, it's just too easy for me to just, like, sneak stuff in.
02:43:16.000I didn't realize it, but it closed at 11 p.m., and they just didn't have the heart to tell me, so I was there until midnight before they finally came and escorted me out of the building.
02:43:24.000They're like, sir, we closed an hour ago.
02:44:18.000So if I were to ride at like 8 in the morning and then not eat until 7 at night, I mean, I would still eventually get the glycogen there, but it wouldn't be quite as easy.
02:44:27.000It would require a little bit more insulin.
02:44:28.000So in that case, I just modified my day and was like, you know, Made my schedule such that I could ride at 5 p.m.
02:45:45.000But I think for me, like, I have to be sort of mastering something.
02:45:48.000So that's where archery and race car driving today become just total obsessions.
02:45:53.000And like when we were talking earlier, it's like, yeah, I mean, I don't know that I'll ever go hunt because I don't know that I want to spend three days, you know, taking 10 shots when I could be spending, you know, three days taking 300 shots in my backyard.
02:46:09.000What I really just obsess over is trying to get better at something.
02:46:13.000And the nice thing when you start things late in life, like I didn't get my racing license until three years ago, and I only picked up archery two years ago or maybe a year ago.
02:46:22.000Like when you suck so much, like the opportunity to get better is awesome.
02:46:27.000So I think the bigger itch for me is not intellectual.
02:48:45.000And then I remember when I, you know, got all my kit and my setup and they're like, all right, you got to go to knock on, like you got to just watch this dude's videos and...
02:49:18.000Because you could muscle things and do them wrong and develop bad habits and you'll never reach your full potential.
02:49:25.000Or you could do things correctly and be very, very disciplined and focused and understand why you're doing something and then really actually reach your full potential.