Welcome to this curated educational transcript of the Joe Rogan Experience. In this session, we provide a deep-dive examination of the critical perspectives and historical dialogues presented in Episode #1108. Our mission is to offer a high-fidelity, searchable research resource for students of cultural history, emerging technology, and global discourse. This transcript has been specifically optimized for academic reference, linguistic study, and archival preservation regarding Ketogenic Diet Science, Fasting Protocols, and Human Longevity Biochemistry. Four, three, two, one. Hello, Peter. Hello, Joe.
What's going on, man? A whole lot. You were just
telling me something that is one of the most
ridiculous things I've ever heard. That you swam
from Maui to Lanai. Right. And you're the only
humans to ever do that. I'm told I was the first
person to swim from Maui to Lanai and back. The
one way is a pretty famous swim race that's done
every year. You're the first person to do it.
And go back. Fuck, dude. Why'd you do that? How
long you got? It started when I was a boy. They
told me I couldn't do it. What made you want
to do that? That's a ridiculous proposition.
So I got into, I decided in, this is going to
sound silly. I 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. So swimming
from Catalina Island to San Pedro, or to, you
typically swim to Point Vicente. And she had
done it in like seven hours and 20 minutes. And
I was like, that's amazing. How far is that?
As a crow flies, it's 21 miles. With the currents,
it's a little longer. And I was like, you know,
I really want to do this, but I got to learn
how to swim. So that's three miles an hour swimming?
She is a phenom. Penny 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. Yeah, I can't hold a cadence
of that for 100 yards. Wow. And she did it for
20 miles? Yeah. What a beast. She's out of control.
Yeah. There's certain people like that, man,
that freak me out. I think marathon swimming
might be one sport where, if you just look at
the numbers, I think women are better than men.
Well, there's that woman who swam from Cuba to
the United States, right? She was the first person
ever to do that. Yeah, Diana Nyhan. And didn't
she do it at a fairly advanced age? Yeah. I mean,
she's, of course, got an amazing pedigree of
swimming, and this wasn't her first rodeo. Right,
right, right. Why do you think women are better
than men? I mean, those of us that I'm not a
member of this community anymore, but when I
was, it was one of our favorite topics of discussion.
I think opportunities or ideas that were put
forth were higher pain tolerance, something about
being, you know, evolving to be able to give
birth just means they can tolerate pain a lot
higher. I think another thing I've heard is buoyancy.
Women are naturally going to have more body fat,
which provides insulation. When you do these
swims, you're not allowed any wetsuits or aids
of any sort. Just shorts. You're in a Speedo
and a single latex cap and that's it. And 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.
We didn't evolve to swim. We're horrible at it
naturally because we swim. Like this, we drag
our hips through the water. And 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, you
know, in water it's that much more important
because the density of water is, you know, thousands
of times greater than air. So swimming is just
100 % about avoiding drag. Wow. So, well, that
totally makes sense. I 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. But the swim one
is particularly crazy because you can't stop.
Right. Like if 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. But if
you're swimming. There's not a damn thing you
can do. You could tread water is about as good
as it gets. But you can't touch the boat or the
kayak or it's an immediate disqualification.
Oh, God. That's so crazy, Matt. That is such
a... Wow. So you heard about this woman doing
it. I read this book and I was like, I really
want to do this. At 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. So I started
taking swimming lessons. And then, I 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. And I did it. I was like, oh, my God,
I just swam two miles in the open water. You
know, it was hard, but I was like, okay, that's
the proof of concept. Now you just got to figure
out how to make it 20, 25 miles. And so I just,
you know, went completely psycho and ratcheted
up the training. And then in October of 2005,
I did my first Catalina swim. Wow. That's got
to be a pretty good feeling, though, when you're
done that you are capable of pushing yourself
to what most people think is an impossible distance.
Yeah. I mean, people you asked a moment ago,
why do you do this? I would say that in life,
velocity means very little. Acceleration means
everything. So what do I mean by that? Right.
Like if you're going 650 miles an hour in an
airplane, you don't actually feel it. You only
feel when speed changes. So I've always had this
theory that emotionally that's also true. Like
happiness is only interesting when it's juxtaposed
with sadness. And so the feeling of crawling
on the shore after you've been swimming for 12
to 14 hours is amazing. But what makes it especially
amazing is that six hours earlier you thought
you were going to die. So you start these swims
in the middle of the night to avoid the shipping
traffic. So that first swim, boat drops you off
at Catalina Island. It's midnight. That's a darkness
you can't imagine. Like you can't even see L
.A. from Catalina. You have to swim for six hours
before you even see the lights of Los Angeles.
Really? Yeah. What do you see? The stars and
the phospho, like bioluminescent organisms in
the water. Whoa. Which is incredible. I mean,
that's worth the price of admission. So every
time your hand comes through the water. You're
pulling and ripping these little things, and
you're seeing the sparks. And you can't tell
where the water ends and the sky starts. In other
words, the stars and the bioluminescence looks
like one cylinder. Wow. So for the first few
hours, that's cool. But then, you know, on my
first swim, the water was incredibly rough. I
had only swum in the ocean for two weeks before
the swim. I did all my training in a swimming
pool and a lake on the East Coast. So now I look,
I wasn't used to how to keep the salt water out
of my mouth. Right. So then I was like puking
my guts out. And then my. While you were swimming,
you're puking your guts out? Yeah, yeah, yeah.
How does that work? You just stop and puke and
then keep swimming. Wow. And then, but then my
tongue started to get really swollen from the
salt water. Because again, as I would learn later
on, I would go on to do many more of these swims.
But what I learned is the importance of spitting
the water out of your mouth very quickly. In
a freshwater pool or lake, you get away with
more. But in the ocean, you swallow that saltwater,
you're going to get sick as hell. So all this
stuff's going on. So by five in the morning,
you've been swimming for five hours. You're getting
cold. You're, I mean, you know, frankly, just
physiologically, like your cortisol levels are
at an eight or you're just. You feel horrible.
It's like it's a really bad feeling. And you're
not even halfway there. And it's like you don't
know if you can do it and blah, blah, blah, blah.
Well, if six hours later you're now crawling
out of the water feeling like you've done this
amazing thing, that's emotional acceleration.
That's like the greatest contrast. I know what
you're saying. I mean, I've never experienced
that. 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.
It was freezing cold. We stayed out there for
five, six days. And then when we finally got
to a hotel room, I took a shower and it was the
most amazing shower I've ever experienced in
my life. And that's a small thing. But you take
a shower every day and it's a big deal when you
do it in that setting. Or think about the meal
you've had if you've been. In a similar situation,
yeah. Or starving or lost at sea. Yeah. Yeah.
I can't imagine. So now that you've done – how
many of these have you done, these crazy swim
races? Or swim – what would you call them? Several.
Yeah. Usually these major, major ones are not
races. You're on your own. You have to – You
go to the federation that oversees that body
of water and you say, hey, I want to do this.
And then you go through all the channels to do
it. They have to have an observer there and you
follow these official rules. So that you can
be registered as someone who's actually completed
it. Right. And someone's there to make sure you
did it correctly. I don't know. I've probably
done all in probably like a dozen of these, but
probably like six of them really long ones. What's
the longest? Well. That's a good question. The
Maui one was 20 miles there and back, so 40 miles
total? No, no, no. The 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. So the Maui -Lenai
one, I wanted to go Maui -Lenai -Molokai -Maui
to do the triangle. And that would have been
30 miles as a crow flies. But we just, you know.
Boat captain wasn't willing to do it at night
because of the tiger sharks. And 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. So 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. And then it took
eight hours to get back. Because I was swimming
like the hypotenuse of a triangle, right? Like
the current's going this way. So I had to swim
this way just to go in a straight line. And I
still couldn't. I almost missed Maui. Jesus Christ.
So I almost got swept out to Molokai just because
the current was about 1 .7 knots, which is about
as fast as I can swim. Maybe two knots. Fuck.
That is a ridiculous thing, man. Why are you
doing this? This is maniacal. Well, I don't do
it anymore. I mean, it was certainly, it was
an amazing season of my life, but I think once
my daughter was born, which was 10 years ago
this summer, that's when I, I only probably did
two of these after she was born because then
the training just got so, I just, you got to
live in the water if you want to do this sport.
Like you got to, including 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 going to 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, the drive to spend 25 hours a week swimming.
Yeah. What was the, what was going on in San
Diego when that guy got bit in half by a shark
a couple of years back, they were training for
something. Yeah. That's funny. You remember that
that was May of 2008. I remember that like it
was yesterday. So at the time I lived in San
Francisco and this is actually just before I
swam the Maui thing. Now that I think about it,
that was 10 years ago. I 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. I actually want to be in warm water, but
I needed one long ocean swim of like 14 or 15
miles as my like last training swim. So I came
down to San Diego to do it. And just by bad luck,
I came down a few days after that guy was killed.
Now, 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.
And I know the beach exactly where it happened
in Solana Beach. And unfortunately, like most
people who get attacked by great whites, they
have a very, they always attack the same way.
which is below and behind stealth bite up and
then they retreat. So they're trying to basically
injure the prey so their prey exsanguinates and
then they take off and then they wait till you
bleed out. So they never saw the shark, but you
could tell from the bite marks it was. I actually
had a friend who was on the beach and saw him
when he came out and he was basically dead when
he got to shore. He had bled to death. The problem
is, so in this case, the shark had bit him and
cut through his femoral arteries and veins. And
the salt water prevents you from having any hemostasis.
So it exacerbates the blood loss. So that's generally
how folks perish when they're bit by great whites.
How did they get him out of the water? You know,
a bunch of other swimmers came to his rescue.
And luckily that commotion prevents the sharks
from wanting to come back. So 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. 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. Because
you can't see. Like 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.
And so you're just thinking, is this the day?
Dude. Yeah, I'm not interested in that. Gee,
I can't see why. Yeah, there's just something
about sharks, too. I mean, they're, to me, one
of the most terrifying things. First of all,
we're so inept in the water. I mean, even a person
like you, who's a great swimmer. Yeah, yeah,
we're a joke. Yeah, what we are in comparison
to what they are, it's just you're throwing yourself
into the world of a super predator. And to know
that one just jacked a person just a few days
before and you're out there swimming around.
Yeah, 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. So 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.
So we did this November swim. It was a nighttime
thing again, swimming from Santa Rosa Island
to Santa Barbara. At about five in the morning,
maybe six in the morning, you're just starting
to get enough light where you can see and you're
out there. So you really have amazing visibility.
And I look down probably 40 feet and I see this
enormous thing swimming like this, which is how
sharks swim. And I see the dorsal fin in the
position that freaks me out and the tails this
way. All of that is shark. Right. And I like,
you know. like lift up out of the water, kind
of hyperventilate for a second. And I'm thinking
to myself, all right, you got to make a judgment
call here. If that's really a great white, you
probably ought to get out of the water. But if
you, the moment you're out of the water, that's
it. The swim is over. Like you just spent like
months doing this. Like it's done. So then I
convinced myself and I think I'm right. I think
it was a dolphin on its side because a dolphin
on its side would, its fin would, its tail fin
would be the same way and it could swim that
way. So in the end, I just kept swimming. But
I mean, that scared the shit out of me. Well,
they have seen quite a few of them off the coast
of Malibu. Oh, there's tons. There's no question.
They are way more plentiful than we realize.
And all you can do is talk to the fishermen.
The fishermen will tell you. They're like, off
Coronado? I mean, it's like there's nonstop great
whites. Really? Oh, yeah. Why are you freaking
me out, Peter? The good news is... They see us
all the time, and most of the time they realize
we're not what they want. Yeah, they want seals,
right? Yeah. Whenever they attack us, they're
making a mistake. Now, is there like a suit you
can wear, like a Kevlar suit that protects you
from getting bitten in half? No, but this is
so funny you bring this up. I became obsessed
with this thing called the – oh, what was it
called? Christ. You put the thing on your ankle
like you had like a little Velcro thing. You'd
wrap it on your ankle and had a tail like this
long, you know, like four foot long thing. And
it was charged and it sends out an electrical
impulse that disturbs the shit out of the sharks.
The shark's nose is an organ that senses electricity.
So when a shark like it could be pitch black,
it could be soot water and they can still scope
you, you know, from hundreds of yards away based
on the electrical activity of your heart. And
that organ is their nose. So this little thing,
I forget what it was called, like the shark taser
or some shit. It puts out a signal that like
tases them and they don't want to get within
like. Oh, there it is. James got it up here.
The world's first shark deterrent band. It's
called the shark bands. One on the wrist or ankle.
I don't know. I thought it had a different name.
But because the one that I was going to get and
did a ton of research into had a really long
tail hanging off it. And that became the problem.
It uses patented magnetic technology to repel
sharks. So the tail was a problem because of
the drag? No, because it would, it sounds silly,
but it would come up and zap you in the nuts.
Oh, Christ. So it became unbearable to practice
swimming in this thing because you're like, every
37 seconds you'd get zapped by the tail. And
I was just like, yes. I like how it says reduce
the risk. Oh, yeah. Can I get some numbers, please?
I don't want to just hear reduce. By how much?
By 1 % statistically. And it also is a leash
for your surfboard, too. You can use one of those
to strap it to your ankle. Yeah, no. It's going
to come to me like in an hour. I'll remember
what this silly thing was called. Jamie will
probably find it. Off of Catalina, I know it's
one of the best shark fishing places in the world.
I have a friend of mine who told me that. If
you think about like wild places on earth that
are just overrun with predators and terrifying
like predator prey activity, Catalina Island
is one of the top spots in the world. I was like,
what are you talking about? He's like, I'm telling
you, man, the shark fishing off Catalina Island
is fucking insane. And then I watched a television
show just. you know, synchronicity a couple days
later. And it was these guys shark fishing off
of Catalina. I was like, what in the fuck? I
could have never guessed. They're catching makos
mostly. Yeah. And it's actually my recollection
because we swam around Catalina once as well.
The backside is way more aggressive than the
front side. The side that faces the Pacific rather
than faces Los Angeles. That's right. Yeah, there's
way more crazy stuff out there. Yeah, I think
that's exactly where they were. Yeah, it looked
pretty nuts. I mean, they were bringing in these
15 -foot sharks. I mean, I was like, what in
the fuck? These are just floating around out
there. You know? I mean, I guess, of course they
are, right? I mean, there's a lot of fish out
there as well. Catalina is amazing. Pretty crazy.
I'd swum to it. I'd swum from it. I'd swum around
it. I'd done a milling 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. Like actually just went to Avalon
for, you know, three days. I'm like, it's not
a place I could live. It's a little, you know,
too quiet. But for three or four days, it was
amazing. I think people hunt on Catalina. They've
got huge buffalo there. Is that what it is? Yeah.
So apparently there was a movie that was made
there back in the 20s or something like that.
And they just let a bunch of buffalo loose? Well,
they had a bunch of buffalo, yeah, for the movie.
And I guess they never corralled or some sort
of shit. So it's totally overrun with buffalo.
Well, there was one of the Channel Islands that
they had actually turned into a bow hunting destination.
Like they had brought in a bunch of deer. I think
they brought in stags and a bunch of weird exotic
shit. And they put them on this island. I think
they even had elk. biologists just weren't having
it. They're like, this is just so out of whack.
Yeah. And so they had them eradicated. And the
way they do that is it's pretty gruesome. They
just gun down from the air and just leave the
bodies. Yeah. They 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. You know, they just decided
just for the ecosystem alone. And there's no
predators there. And they weren't going to. turn
the fucking island into wild kingdom and bring
wolves or something in there, which would be
pretty goddamn crazy. Imagine if there was an
island you could go and they just had wolves
and elk running around on an island. Well, I'm
surprised they would gun them all down, at least
say make it open season for hunting or something
like that. They could have been productive about
it. Well, that's an interesting perspective.
So biologists look at it. In terms of the entire
ecosystem, right? They're looking in terms of
the plants, the amount of waste, fecal waste
that these animals are leaving behind. The fact
that they're literally eating everything that
they can on this island. They're not supposed
to be there. And then they're competing with
whatever things are native to that island. And
probably, I mean, if you've got a thousand pound
elk, it's not supposed to be on a fucking island.
This thing is just eating everything it can.
And they don't. They don't have a winter either.
So it's just like the whole, like they're just
not supposed to be there. The Channel Islands
themselves are kind of amazing. I mean, most
people know of Catalina, but, you know, there's
eight of them. And now two of them you can't
step foot on. You're not allowed to? No, San
Clemente and San Nicolas. They're military bases.
Oh, okay. So we tried to do a swim from San Nicolas
back to Los Angeles. This was a relay swim because
this is like an 85 -mile swim. I spent like six
months researching it, speaking to a bunch of
naval officers. I was like, hey, is there any
way we can – because you officially have to start
a swim. You have to be able to touch dry land
and be out of the water. And they're like, yeah,
you can't come on the island. So in the end,
what we decided was we were just going to do
a stealth landing. By the time they came down
and screamed at us and shot at us, we'd have
been off the island. But then we got to the island.
Now, the other big thing about San Nick is that's
real shark territory because that's where the
elephant seals live. So when we got out there,
we literally could not get to shore because of
the elephant seals. Like we're 200 yards off
Sand Neck. And, you know, this is after taking
a full two days to get out there. I mean, this
place is really hard to get to because the water
is brutal and you're not in a huge boat. And
yeah, you're looking at like thousand pound elephant
seals that are just like licking their chops,
looking at you trying to get in the water. What
would they do with you? I didn't want to find
out. But they're not predatory, right? I mean,
I don't think. No, I mean, I think they're aggressive
as hell. Did 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? Did you ever see that, Jamie? Yeah,
and I didn't think that seals ever did something
like that before. I don't know. I did see a special
once about how dolphins could be kind of aggressive
with each other. Like they could harm, you know.
Here it is. Look at this. So the seal is sitting
there and this girl. The sea lion, actually.
Look at this. It comes up, and they think the
sea lion's being cute. I think it's all cute.
Yeah. But I think it was probably looking for
a handout, and these people weren't giving it
to her. Oh, and then she turns her butt. Oh,
my God. Oh, my God. Oh, my God. Jesus. Yeah,
fuck that thing. Oh, man. I'd be like, I'd be
right back. Fill that fucking puddle with lead.
Oh, my God. Imagine if that bit your kid. Oh,
yeah, yeah. Yeah, they jumped up fast. Yeah,
they're predators. I mean, they eat things. They're
not eating plants in the water. They're eating
fish and shit, whatever they can get a hold of.
They probably eat birds and stuff, too. They're
probably used to scooping things up. But I bet
what that's from is them getting too acclimated
to people, people feeding them. Oh, for sure.
Yeah, they have an issue in Boulder. Where Boulder
is – have you ever been to Colorado? Yeah. Beautiful,
right? Gorgeous. Super liberal. Like as progressive
as it gets, right? You haven't been to San Francisco.
Oh, I have. Yeah. I think Boulder is right up
there but there's less people. Everyone is real
healthy and active and hiking and stuff like
that. They don't allow – hunting for mountain
goats on the weekends because there's so many
people hiking and they don't want people killing
these mountain goats in front of them because
people freak out. Even though they have decided
that they have to control the population and
kill a certain number of them to keep the...
But so many people go out there that these things
aren't scared of people. So it's created this
really weird situation where if you are hunting
them, You're almost hunting something that's
domesticated. People feed them 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. She opened up the bag of Cheetos
and put it and he stuffed his head in the bag
of Cheetos. He knew what to do. And this guy
who was talking about this is a hunter. And he's
like, this fucking goat has, like, Cheeto dust
all over its face. Like, it's the craziest thing.
Its face is all red with Cheeto dust. And it's
sitting there chewing these Cheetos. Like, it's
done it before. Yeah, yeah. And it's just. That
goat had diabetes, I think. Probably eventually,
right? Yeah, I was in Costa Rica. There's another
similar situation. And we were staying at this
Four Seasons out there. And the monkeys. have
gotten very accustomed to people being there
and so um they come by and they hang out and
they're like trying to get things from you and
um my daughter opened up a package of oreos and
the monkey just jumped onto this little ledge
like a couple feet away from her and uh and my
wife was like i really don't think it's a good
idea that we feed this thing oreos and i said
well You know, it's probably going to get eaten
by a fucking crocodile anyway. I mean, are we
poisoning it? Is that what you're thinking? I
mean, it's not going to eat this every day. It's
not going to be a normal part of its diet. But
we hand the monkey an Oreo. It pops open the
Oreo and starts chewing on the frosting like
a little kid. And then we're like, oh, this little
fucker probably gets these things every week.
Right. So it begs the question, does he know
how to do that because he's watched some human
do it? Or are we innately wired to do that with
Oreos? I think he knows how to do it because
someone's given him Oreos so many times that
he knows that's the good stuff. The good stuff's
the middle. They should just sell that in a paste.
I don't know. I think the middle's only good
because you can contrast it. It comes back to
the contrast thing. Exactly. I think you're right.
I think you're really right. I think if it was
just pure middle, it'd be pretty gross. Yeah,
if they probably sold pure middle, nobody would
buy it. But if they sold those... black cookies
by themselves. No one would buy those fucking
gross things either. No. Shitty ass tea biscuits.
They're the worst cookies. Once you eat the white
stuff, you're like, alright, I'll eat this stupid
ass black cookie. It's the sunk cost. It's like
a coal cookie. Here it is. Here's a little monkey
doing it. Look, they grab it from you and they
just fucking love it. Look at them opening it
up immediately. Open it up and start chewing
that white stuff. I love it. Yeah. Crazy. We
had There's a thing that is called Coatamundi.
Have you ever heard of those? It's related to
the raccoon. It'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. Like, it gets
into the areas where it gets cold. But Arizona,
I think, is the only state in the U .S. that
has it. But it's this weird -looking... monkey
raccoon thing that is so domesticated that we
gave it some grapes here it is we gave it some
grapes and this little fucker there it is i mean
look at that weird little thing it came and uh
sat we had like a little uh 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 Like, well, we're hanging around. My daughters
are running around, making noise, and this thing's
just chilling. It's like a pet. It was a total
pet. It was a total pet. Yeah, there they are.
They're cool, man. Weird looking things. People
eat them, apparently. Apparently they hunt them
in Arizona. You see nachos? Yeah. I mean, after
seeing this, I was just like, I don't think I
can hunt that. I'd have to be pretty hungry to
eat one of those. They're so cute. Little face.
Weird little animal, man. Really interesting.
Yeah. Our relationship with animals is very odd
when they get into close proximity. Yeah. Yeah.
We've got a wicked coyote problem in San Diego,
at least in the part I live in. And, you know,
it's just one of those things. Once we got rid
of mountain lions, because no one wants mountain
lions around, the coyotes run amok. Is that what
it is? I think – I 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. And the coyotes just
– they've exploded. There are so many of them
around. And it doesn't really bother me that
much. I mean I actually kind of like listening
to them howl. But if they get into your chicken
coop – Yeah, I had one kill chickens just a few
weeks ago. Yeah, yeah. I have a video of a dead
chicken. It was such a bummer, man. We chased
it away. It was on the roof of the chicken coop.
The way they jump is so stunning. They're so
graceful. I've never seen anything that moves
like that in the wild the way a coyote does.
There's a six -foot fence. It's on the ground.
It 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. I
mean, in like a second. Wow, I haven't seen that.
It's crazy. I have video of one of them jumping
my fence. I caught one of them with a chicken
in his mouth jumping the fence, jumped the six
-foot fence with a chicken in his mouth, just
jumped, boing, touched the top of the fence with
his front paws, back paws went over right behind
it, and it was gone. It's crazy. But, you know,
look, we need them. We need them to kill the
rabbits and the rats. And if we didn't, we'd
have a giant. Well, that's what I tell my daughter
because she, like. Gets all stressed out that
there's coyotes walking around our house. And
I was like, well, first of all, they're pretty
skittish of us. And boy, they keep those rodents
under control. They really do. You need them
for that. But there's a coyote problem across
the country. They're the only animal that's in
every single state in every single city now.
Every single city. There's coyotes in Manhattan.
Come on. I'm not bullshitting. In the park? They
found them in the park. They found them in the
Bronx. They found them in abandoned buildings.
Yeah, there's a great book I read called Coyote
America by a past guest of the podcast named
Dan Flores. He's a wildlife historian. It's fascinating.
They're a really unusual animal in that when
you shoot one, they yell out. Here's this. Coyote's
in New York City. Look at this. In fucking New
York City, dude. In New York City. New York City
Police Department. Coyote running down the street.
Unbelievable. They're everywhere, man. They have
a real problem with them in Chicago. I thought
I could escape them when I'm in New York. No,
you can't escape them anywhere. They're in all
50 states now. They've completely extended their
range. And the reason why they extended their
range is because we went after them. We hunted
them down. You know, they were able to eradicate
wolves. And the way they were able to eradicate
wolves is they 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. And 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. And
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. They've never
been able to do that with coyotes. When 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.
So if one's missing, instead of having like three
pups, you'll have six. So you make more coyotes
when you kill them. And they extend their range.
When you persecute them, they just extend their
range. They're a fucking crazy animal. They are
wicked smart, man. They've been chewing at the
roof of my chicken coop trying to get in. I came
outside the other night. My dog, I have a...
I have three dogs, but one of them is a golden
retriever, and that dog has fucking zero instincts.
I mean, it is just a little human. It's a little
marshmallow. Yeah, he's fun to go running with
and stuff. He's a great dog, sweetheart of a
dog, great pet. But he's like, what's going on
over there? What's happening? There's a fucking
coyote on the roof, dude. What do you mean what's
going on over there? They're literally chewing
the shingles off the roof when we got outside.
You have one job to do. Go bark. He's not interested.
Well, he's only a year old too, but he's just
curious. It'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. I
saw a bobcat once, which is pretty interesting.
I've never seen one of those. They're weird looking.
It's a weird looking thing to see. A friend of
mine, I put it up on Instagram. See if you can
find it. It's fucking old. It's an old one on
Instagram. A friend of mine had a coyote or a
bobcat break into her chicken coop and kill every
one of her chickens. And the coyote, there it
is. Look at that fucking freaky bitch. How'd
you find it so quick? You're an animal. He's
a bobcat. He's got the best searching skills
of all time. But look at that. That's in my friend's
chicken coop. A bunch of murdered chickens scattered
around it. Look at the look on that thing's face.
Yeah. Fuck that. That look is fuck you. Yeah,
that look is fuck you, lady. Yeah, I killed your
chickens. Why do you have them outside? Crazy,
man. So how do you know Jocko? This is how we
got connected. Tell the folks at home. Jocko's
like, prepare to get your brain blown out. I'm
going to send my friend over. I was like, all
right, let's do it. So 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. Basically, it was just like, you guys,
you just got to meet Jocko. You just have to
experience Jocko. That was basically what - He's
like a ride. Yeah, yeah, yeah. So I met Jocko.
We obviously connected pretty quickly. And then
I think, oh, this was before Jocko's book had
come, his first, first book had come out. I said,
I got to introduce you to one of my best friends,
this guy, Tim Ferriss, who obviously, you know,
Tim. And because Tim's always looking for, you
know, a great guest on a podcast. And so I called
Tim and I said, look, you got to just trust me
on this one. Sight unseen. Just have Jocko come
to San Francisco next week. Just I don't need
to say anything else. It will be worth it. And
luckily, I had enough credit in the bank with
Tim. I'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. Yeah, I sent him an email
after that podcast. I'm like, that's one of the
best podcasts I've ever heard in my life. And
I made a post about it. Jocko responded to the
post. And then I got Jocko on. And then I and
Tim convinced Jocko to do his own podcast. And
now it's huge. I mean, his podcast, I get text
messages all the time. From people thanking me
for telling them to listen to it. And then I
get tweets from people thanking me for talking
Jocko into doing it. Because it's just, there's
outliers in this world, you know, in everything.
There's outliers in athletics. But when it comes
to like discipline and motivation and just when
you look at someone who's just undeniable. Like
Jocko's one of those guys. He's just undeniable.
He's a specimen. He's definitely. Off the graph.
Yeah, 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? There's certain dudes that have
got a whole lot of shit going on behind their
eyes. You're like, okay, that guy's seen some
stuff. Yeah, I'll tell you a funny Jocko story.
I guess I can tell this story in public. It's
pretty funny. So 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. And 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 and we're just and we're just sitting there
in his office just shooting the shit and i forget
how it came up but somehow um we were just talking
about like like how good is a sniper like what
does it actually take and um and then of course
we're we're talking very specifically about um
i can't believe i'm blanking on his name um chris
um bradley cooper played him in Yeah, Chris Kyle.
Because Chris Kyle had been part of Jocko's team.
I forget which SEAL team. Maybe it was when he
was SEAL team two. But 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. And so then we were like, what
sets him apart? I mean, obviously any Navy SEAL
sniper has got to be amazing. Chris took it to
another level. What, what was it? And he, and
he said, okay, let me show you what it was. So
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 know,
you could basically see it cause it was like
a pink hat or something. I said, yeah. He goes,
okay, if you're a sniper, you got to be able
to lay down, not move and put your eye up against
this thing and like, look out at him and you
can't. If you ever take your eye off that, you're
going to lose the sight. So you've got to be
able to stay in that position and not move and
do that. He goes, and 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. And
I forget what the number was. Maybe it was like
15 minutes. He's like, Chris could do that for
two hours. He could lay in that position, not
moving and not taking his eye off that thing
with one eye shut. for hours and he you know
he's just like he just had a different he just
had a different gear and um it was just an amazing
i mean i mean those are some of my favorite moments
with jocko is when he like can tell you something
that is like like there are like maybe three
people in the world that would understand why
that matters you know sniping is fat is really
fascinating right because Just sharpshooting,
just being able to shoot something at a distance.
And long -distance shooting is a big sport in
terms of target shooting. I mean, there's guys
that are out there that are shooting 1 ,500 yards
and doing it competitively. That's a crazy distance.
It's amazing. It's a crazy distance. But when
you think about it, you've got a rifle. It's
on a rest. You're sitting. You're either on a
bench or you're prone or whatever it is. You're
lying down most of the time. This is all it is.
It's this with your finger. Pull, pull, pull,
pull, pull, boom. Some people are way better
at that. Just think of that. Coordinating your
vision, getting the reticle set on the target,
pulling that, and without movement. The outliers
are the people who can do that. And 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. But now break it down to just
the movement of your trigger finger. Pull, pull,
pull, pull, pull. Bang. No movement. You know,
I mean, it's I'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. Yeah. And when you
see like I was watching a video with Tim Kennedy
and Tim Kennedy was shooting at the range and
he's he's pulling. Bang, bang, bang. And it goes
click, and he goes, whoo, look at that trigger
control. Because the way he pulled it, it didn't
go off target. It didn't move. There was no punch
to it. But 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. I mean, it's a
fascinating thing to me that just. Just pulling
this one finger, you would think fucking anybody
could do that. I could show you how to do that.
Like I've had friends that say they want to go
hunting. I want to go hunting. What do I do?
Where do I get a bow? I'm like, slow down. Let's
get you a rifle, because I could teach you how
to shoot a rifle. We could get someone, we 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. A rifle, we get into 100 yards of a
wild pig, you're going to be able to kill this
thing, 100%. You got years before you're going
to be able to shoot that thing with a bow. I
mean, fucking years. But it is, and the bow is
like... My wife said this to me a while ago.
She 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.
If I'm on the racetrack and I'm driving a race
car or if I'm swimming or whatever and I just
have a bad day, I'm just not firing on all cylinders,
it just kind of pisses me off. There's something
about archery where even if I'm not having a
good day, maybe it's an extension of what you're
talking about with the trigger finger. So for
me, I got into archery because of Tim and the
story that the thing that he told me, which obviously
for anyone who, yeah, the 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. And he was
like, yeah, you don't take a shot unless you
can kill the animal. Like, you know, and so like
you might take one shot in two days. Like it's,
it's gotta be a kill shot and the kill shots
gotta look like X, Y, and Z. And I was like,
Oh. That's like you got to be dialed in. So it
was this idea of back tension. You know, it was
sort of like, wow, if you're taking a perfect
shot, like it's all in the rhomboids, you know,
it's all back here. And you've got to be able
to do, as you said, you've got to completely
be able to eliminate any anticipation, any of
this business. And so I think that. I think of
archery for me as almost like a meditation. Like
I'm talking in the way like Sam Harris would
talk about sort of 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, in many ways it feels
like meditating. So I think that's why I'm just
like, you know, and I never really thought about
it with shooting a rifle because I don't have
much experience with guns. I'm guessing it's
very similar, but as you said, the difference
between the good and the great in that is less
obvious at a distance. Yeah, 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. Not a sniper, but the average person with
a rifle. You can be pretty fucking accurate.
You can't off a bench. So there's some similarities.
There's a similarity to having the, you have
to have perfect technique, you have to have the
right stance, you have to make sure that everything's
locked in and your structure is correct. But
I agree with you that I think it's some sort
of a meditation. I also think there's something
to hitting a target that is in 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 – what is that
thing called? What's that thing called that they
– Adel Adel thing. Yeah. Is that how you say
it? Adel Adel, right? Yeah. You know what I'm
talking about? Yeah, yeah. Yeah, that's like
an advanced spear throwing thing and then archery
and just – I think when a person would hit a
deer, they knew their tribe was going to eat.
Right. And so there's this like charge. And you
get a small amount of that juice when you hit
a target. Yeah, no, I'm sure there's got to be
dopamine that's being secreted when you do that.
It's the greatest feeling in the world. Yeah,
it shouldn't make sense. Like when you're looking
at someone doing it, you're like, what do you
give a fuck if that arrow goes in there? It doesn't
make any sense. Like why does it make sense?
Fucking sat like Jamie laughs at me because I'll
hit the bullseye from 45 yards, and I'm like
yes It's like get this little woo You get a little
little burst man. I just like the whole experience
even the sound so sometimes like when my veins
get holes in them like sometimes you put a broadhead
through or you put like a field tip through another
one and Now, obviously, sometimes if you trash
the vein, the arrow doesn't work. But like usually
just a single hole in a vein will produce a sound
that is the greatest sound you've ever heard
when that arrow leaves. The whistle? Yeah. Oh,
I love it. That's a problem with certain broadheads.
Certain vented broadheads, they whistle. They
whistle too much. They give the animal the heads
up. Yeah. So that whole experience of like the
perfect release. Even when you surprise yourself,
like I switched over to this Carter Evolution
release. Sure. Back tension release. It's the
most pure back tension. It's better than the
honey. Because the honey, you could still cheat
a little bit. If you were getting lazy, you could
twist. You could twist, yeah. Exactly. But the
Evolution, there is no cheating. Right, you can't.
It's like, so you can surprise yourself with
a shot. Yeah, so there's no anticipation. You
can't explain this to people who don't do it.
Have you noticed that? No, you can't. They're
like, what are you rambling about boring the
shit out of me? I have tried to explain this
to people who don't know what I'm talking about.
I was trying to explain it to Alexander Gustafson,
who was in here the other day, and he's a hunter,
too. But he only hunts in Sweden. You can't bow
hunt. It's not legal. He wanted to learn how
to shoot a bow, and so I was explaining that
I put my finger on this trigger. My finger sits
on the trigger. I use a card or two. I use First
Choice. That's the name of the race. I go, my
thumb is on the trigger, but I never squeeze
it. The squeezing is all done with my back. As
I pull, then it just goes off. And you can see
his head is like, why? But you can just do that,
right? Why don't you just do that? And you don't.
It's so counterintuitive, but once I got into
it, Tim actually sent me this book on back tension,
and then I just devoured it. I mean, it was sort
of like reading the Penny Dean book. Is Tim doing
this a lot now? Not as much as he should be.
Is he trying to hunt with it? Yeah, Tim will
hunt. Has he done it so far? I know he's hunting,
but only with rifles. No, no, no. He's been on
bow hunting trips. That's, in fact, what got
me into it. Because about two years ago, he was
getting ready to go to a trip, do a five -day
trip in Colorado. And he called me and said,
hey, I 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.
You're at altitude. You're running around like
crazy. You've got to be able to sprint and then
be totally relaxed. So he's like, can you help
me think about it? how to train and what the
nutrition would be. And, and I said, okay, tell
me more about what the demands are. And the more
he told me, the more I was like, why am I not
doing this? This sounds really freaking awesome.
So that's, so, uh, and he's got an awesome video
of, of, uh, of this. Uh, he took, I mean, probably
he only took one shot in like the whole five
day trip and it was a perfect kill. What did
he kill? It was a huge bird and I can't even
remember what it was. Yeah. Yeah, it was like
a bird on the ground, like some huge ass bird.
But it wasn't a turkey. It was like, I don't
remember what it was. But the shot, he was like,
you know, it was one of those things where it
was like, because it, you know, like all my practice
is on stationary targets, right? So it's a totally
new dimension when it's like the thing's doing
this. Oh, so it was flying? It was like kind
of like either running on the ground or about
to fly or something. But he hit it in motion.
I mean, it was a great shot. That's crazy. Yeah,
yeah, yeah. I wonder what the fuck that would
be. I don't know what it was. I'll have to ask
him. A big bird in North America. Did he shoot
a fucking eagle? Did he shoot pelicans? It definitely
wasn't an eagle. What the hell is he doing, man?
Yeah, 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. It's funny you
say this. I was in Toronto three weeks ago, which
is where I'm from. And though I don't go often
and we were, I was with my brother and we were
up taking the kids to some place. And sure enough,
like we're walking from like one area to the
other and these geese come up and they kind of
start posturing. And I'm thinking, what the fuck?
And my brother's like, get moving. Like clearly
one of us is near one of their eggs. And I was
like, what? He's like, oh, yeah, yeah, yeah.
He goes, these are the most aggressive creatures.
And they're big. Yeah, they're pretty big. So
I was like, fair enough. Let's just keep walking.
Don't make eye contact. They're big, but you
can cook them. So fuck them. Get out of here.
Goddamn geese. Yeah, there's a... There's a certain
type of geese that they call ribeye in the sky
because they have a delicious red meat to them.
What is that called? God damn it. But they're
very plentiful in Texas. Yeah, they hunt them
in Texas. What's the meat like? Is it marbled?
It looks like a ribeye. It's crazy. Sandhill
crane. Thank you. Sandhill crane. That's what
it is. Is there anything you don't know? He's
a fucking wizard with the Google, man. With Google,
everyone is a wizard, but Jamie's an extra wizard.
He's really good at it. He's a ninja. Yeah, 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. I mean, it tastes like a Wagyu ribeye,
and it's flying around. And you could shoot like
fucking 10 a day. It's crazy. I have friends
that hunt these things. And they're mostly in
Texas? I don't know where they are, but my friends
who have hunted them hunted them in Texas. I
mean, I'm sure they fly all across the country.
But, yeah, it's a crane. It's not a goose. Yeah,
I've only been bird hunting twice. I went once.
with Anthony Bourdain, uh, for his TV show. We
hunted pheasants and, uh, he shot one and then
we cooked it and ate it. That was fun. I shot
at one and missed. And then I shot a turkey once,
which is pretty interesting. Wild turkeys. Very
good. Very delicious. But, um, you know, it's,
um, when I, I like mammals, I like eating mammals.
I prefer, I prefer red meat. I think it's just
better for you. I think it's more nutritious.
It's more exhilarating. There's something about
the meat itself. It just tastes better. I haven't
met too many foods I don't like. Really? Well,
with the kind of exercise that you do, I'm sure
you almost have a voracious appetite. I mean
I do, but nothing like what I used to. I mean
I fast pretty much every day. Are you doing 16
hours? What are you doing? It depends. So when
I'm in – I split my time between New York and
California. When I'm in New York, it's absolutely
one meal a day, no ifs, ands, or buts because
it's just the schedule is such that I'm seeing
patients in the morning and afternoon and I don't
want to do – I don't want to waste time to eat.
What are you doctoring? That's a good question.
I mean – I trained as a surgeon and did cancer
surgery, but my practice is based on longevity.
So it's sort of how do you apply nutrition, exercise,
sleep, stress management, endocrinology, lipidology,
supplements, hormones, all that stuff. Like how
do you engineer how to make somebody live longer
is my. clinical interest um so yeah so in new
york i eat one meal a day so it's basically like
a 22 hour fasting window and then i'm feeding
within a two hour window wow when i'm here um
it's about this well i mean yesterday and today
it's the same like you know today has just been
kind of a busy day you know i won't eat till
dinner tonight but um my short fast would be
16 hours where i would eat that's a short fast
that would be a short fast that's a long one
for me really Dude, you got to get in touch with
your evolutionary self. I had this discussion
with a friend this morning because he was saying
to me he can't do 16 hours. Well, he's a pussy.
That's why I said he's a pussy. You just told
him. No, but I said you got to understand if
our ancestors couldn't function when they were
hungry, we wouldn't be here. So it's not just
that starvation – a short -term adaptation to
starvation is necessary. It's probably beneficial.
In other words, during these short periods of
– deprivation of food. You know, we get just
a little bit more epinephrine and norepinephrine.
We just get a little bit sharper, a little bit
better. Um, I, I can't even, I can't even remember
what it's like to eat three meals a day. It's
been so long. Really? Yeah. How long have you
been doing this? I mean, I've been doing crazy
shit for 10 years, nutritional wise. Like I spent
three years in ketosis where it was actually
one day I was in ketosis for three years. Um,
Lots of fasting. But I think intermittent fasting
or time -restricted feeding, probably at least
five years. And for people listening, what are
the benefits of that? Well, 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. And a lot of the benefits are things
that we've only studied in animals. So 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. For example,
a 16 -hour fast in a mouse produces unbelievable
results. If 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 eight hours
let them eat whatever the hell they want, they
can't gain weight. And the reason we think is
that— 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 burn –
I hate that term fat burning machine. It's so
overused. But they basically just become unbelievably
efficient at metabolizing fat. So we have to
be careful though when we extrapolate that because
you and I have a very different metabolism than
a mouse. Like a 16 -hour fast to a mouse is –
much longer than it is to us. So I don't know
if those benefits would extend. Also, 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. So for me, what it comes down
to is, I mean... Honestly, it's just an easier
way. It gives me a much more liberty with what
I eat during my feeding window. I don't have
to be nearly as restrictive when I'm feeding
if I have that period off, just in terms of like
my physiologic response. Secondly, there's a
convenience thing. Like I kind of hate being
tethered to eat. I like knowing that, hey, if
I get into a pinch, like I don't have to eat
right now. If I'm sitting on the airplane and
they're serving dog shit, I don't have to eat.
I can wait another five hours until I eat. Um,
I also just feel much more steady in my energy
levels. I, I kind of vaguely remember like 10
years ago when I was kind of like eating a normal
diet, how I always had this lull in energy after
lunch. Like there was the post lunch pre dinner.
I just don't feel good. Like, not that I feel
bad, but like, I'm not sharp. I'm not in my a
game. And I don't even remember what that feels
like anymore, which is not to say. feel great
all the time but i definitely don't have that
vacillating energy level yeah i've said that
to people when i eliminated most carbs from my
diet you know and i have a friend of mine who
He talked to his trainer about that. His trainer
was like, you're crazy. Eat bread. Eat pasta.
Don't listen to him. I'm like, no, don't listen
to him. Just Google it. That stuff's fucking
terrible for you. If you want to eat carbohydrates,
get it from fruits. Get it from some natural
sources. If you have a trainer that's telling
you to eat bread, get a new fucking trainer.
It's nothing wrong with eating it if you want
to occasionally and in small doses. But when
I eliminated most of that stuff from my diet,
I felt the exact same thing. that midday nap
desire go away. And then just the fogginess about,
like at the end of the day, you're like, oh God,
I'm fucking tired. And then I'd have to drink
a cup of coffee to get ramped back up again.
And it's just like never ending cycle of having
this insulin spike and then this crash. And that
is. That's from carbohydrates. It's from refined
carbohydrates and having too much fucking sugar
in your body. And everybody does it. It's like,
look around. So this will be funny for you. So
Google my name and just put like Peter Atiyah
Fat. And you're going to see a picture of me
when I was a swimmer. Because all this time we
were talking about me swimming, you're assuming
like I'm a fit dude. I was a fit but fat dude.
Fit but fat. Fit but totally fat. What were you
eating? Oh, nonstop carbs. Look, there I am.
See on the left there. Well, I wouldn't say you're
fat. I would say you got a little paunch on you.
I don't know. Wait, wait. There's another picture
after I swam across Lake Tahoe. Go to that one
right there. Yeah. Got a little gut there, fella.
Yeah, I don't know. It's like you're boozing
it up. Yeah. But it's also the way you're sitting
down. If you stood up and sucked it in for a
picture on Instagram, it might look okay. I don't
know. I was definitely, you know, probably what?
Maybe 30 pounds heavier. But, you know, body
fat was much greater. And what were you eating?
Oh, I mean, I probably went through three or
four bottles of Powerade a day because, you know,
you're training all day. And, you know, every
post -workout was a carb refeed. And so you're
in sort of this vicious glycogen -dependent state.
Yeah. It'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. They just think this is eating and exercise.
This is what happens. But it's not. Your body,
if you shut up, cut that off, push it away, enter
into a completely different food source. Just
change the way you eat. your body will change.
And just that concept, people, that sounds like
horseshit. It sounds like, what are you saying?
Are you offering some miracle cure? No, I'm saying
you will change the dimension of life that you
operate in. It will change because you won't
be the same person. 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, you
change the energy you have. You change the way
you feel. It will change your behavior. It will
change your choices. It will change your ambitions.
It will change your potential. I mean there's
so many things that will change. But 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. Not as much as I was when I was swimming.
I mean, sorry, more than I was when I was swimming.
But I ate like I had the world's worst diet growing
up. So I would eat breakfast was a bowl of like
a box of cereal. So I'd take like one of these
Tupperware bowls that was this big and fill it
with a full box. So each day I would have just
a box of Cocoa Puffs or whatever I would start
the day with. And then lunch was. a full loaf
of bread, which would seven sandwiches, plus
a plate of fries, plus a big tub of like, like
a two liter jug of orange juice. But I was training
six hours a day, right? So I would, you know,
run 10 miles in the morning, in the gym, you
know, boxing, like it was, you know, you know
what that shit's like. I mean, it's ridiculously
energy expending. But the point is, I had a hard
time holding my weight. And I was a middleweight,
160, walked around at 158. Who walks around below
their fight weight? So, you know, my waist was
28 inches. I was probably four and a half percent
body fat and I was eating anything and everything
you could put in front of me. And then something
happened in medical school where that shit just
stopped. And I wasn't even eating as badly at
the time, but all of a sudden the metabolic adaptation
just vanished. And, you know, I mean. I 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. And I think for many of my
patients or just even friends, like it seems
that this happens kind of in your 30s if you're
a guy. For women, it's harder for me to tell
because I think pregnancy can interfere with
this. So sometimes we get a bit of a skewed answer.
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.
So 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, you're basically
just going to store more fat. And now why that
would happen over time, I mean, we could guess
reasons, but I'd love to know if that's the case.
Because 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, you know,
I 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.
Did you experience a crash at all, like post
-afternoon crash, post -lunch crash? That's a
good question. Back then, I don't think I did
that much back in the day, which would also speak
to the idea of better fuel partitioning. Fuel
partitioning meaning this sort of technical term
for where your body knows to go to excess energy.
Are you going to glycogen? Are you going to the
fat? And then where are you storing energy? So
I suspect I was just better at fuel partitioning
as a kid, which I'm sure most of us were. Anyway,
it's kind of... Of course, the real question,
the reason we care about this is like what could
you do about it, right? Like what – for example,
like that's probably one of the reasons why testosterone
– as testosterone goes down, you're going to
get fatter, all things equal. And 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. So – but that – I – I just don't think
that that's enough of it. I think there's something
else that's going on that's triggering that decline.
So 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? Well, I don't think
there's sufficient evidence at this point in
time that time -restricted feeding is going to
impact my longevity. So I think that's the big
claim. What is the claim? What are they saying?
Oh, 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, meaning eat whatever the hell
you want. in terms of total caloric content,
the claim is, well, that's going to enhance longevity.
Or doing a 16 .8 or 18 .6 is going to enhance
lifespan. So just to take a step back, I am only
aware of... three things that have universally
extended lifespan across all model organisms.
So if you think of like all eukaryotes, right,
if 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. So total reduction in calories
during the lifetime and or reduction of certain
subsets of those calories. So there's a super
famous experiment that was done. Actually, if
anyone's interested, I wrote about it. It's on
my blog somewhere. But it's basically the best
experiment ever done in caloric restriction was
between monkeys. And there was a group at the
NIH and a group at the University of Wisconsin.
And it was like a 19 -year experiment or something
like that. So you could really study the impact
of caloric restriction over these things. And
that experiment showed us that caloric restriction
extended lifespan if you had a really shitty
diet. And it did not extend lifespan if you had
a really good diet. counterintuitive, but it
also spoke to the idea that dietary restriction
probably mattered. So 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. But 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, the caloric restriction
did not extend lifespan. That threw a wrench
in everyone's understanding of caloric restriction.
And there are certain strains of mice that also
don't seem to be enhanced in terms of lifespan,
meaning just time on Earth. But for the most
part, nutrient deprivation pretty ubiquitously
extends life. The 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. I 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, the target of rapamycin, or mTOR,
as you've probably heard of it, is mechanistic
target of rapamycin. And rapamycin inhibits that.
Now, it's a bit complicated because there's two
variants of it. There'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, that doesn't seem to really
extend lifespan. But if you take it in a pulsatile
way, you selectively get this mTORC1 inhibition
without the mTORC2 inhibition. That seems to
produce longevity big time. And how does that
work? How would you take it selectively? Well,
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.
If 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.
David's a guy at MIT. He's a professor. He's
actually the guy that when he was a medical student
doing his PhD in 1994 actually discovered how
rapamycin works in mammals. He's actually the
guy that coined mechanistic target of rapamycin,
mTORC, as a name. And so now whatever we are
almost 25 years later. You know, he's still running
the powerhouse lab that understands it. So 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, and a few other people. My
intuition is that somewhere between two to six
milligrams every five to seven days is probably
the sweet spot. Um, but you know, am I confident
enough in that to say that we should all be taking
it? Not yet. There's a couple of things that
like, I want to be able to measure before we
do that. But, um, you know, in the animal data,
this stuff's remarkable. If you look at Matt
Caberlin's dog data, it's remarkable. Like what
are they doing with it? Well, so you own a dog.
You know this, right? I mean if you look at outside
of euthanasia or accidents, how do dogs die?
They basically die of cancer in heart and they
get dilated cardiomyopathy. So it's a different
type of heart disease than humans get. They don't
get atherosclerotic disease. They get heart failure.
Their hearts just get too, too, too big and their
rejection fraction, which is the amount of blood,
the percentage of blood that leaves the ventricular
chamber with every contraction. As that number
goes down, bad things happen. Now 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%. And 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. So once the ejection
fraction gets below 30%, you know, a person starts
to become very symptomatic. So 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%, put them on rapamycin for 12 weeks, and
in just 12 weeks saw an absolute 10 % improvement.
So that means that's not going from 30 to 33.
That's going from 30 to 40 % EF improvement.
In other words, it's hard to measure an effect
in 12 weeks of a drug. And certainly you're not
going to be able to measure a longevity impact
over that. So much of the study that's being
done with this is looking at surrogate markers
that we assume would portend longevity. So Matt's
work focusing on the ejection fraction, Manick's
work was focused on immune response. So this
was the turning point for me. This 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 when I was a surgical resident,
you know, we used to give rapamycin out like
it was cotton candy to all the transplant patients.
It 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. Now you could
give them much less prednisone and you could
give them rapamycin or. cousins of rapamycin,
like FK -506. And what you're doing with that
stuff is you're suppressing the immune system
so the body doesn't reject the organ? Exactly.
Now, when you do that, does that leave them susceptible
to illness or disease? It does. Would that be
the case with rapamycin in person taking it for
longevity? And that's the million dollar question.
And 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. But When
it was approved in 1999 by the FDA, it was for
this indication. It was an immune suppressant.
It was 10 years before anybody figured out that,
oh, wait, this could also extend life. And therein
you had this paradox, which was, wait a minute,
how can an immune suppressant extend life? I
mean, everybody acknowledges that immunity is
a core element of health. In December of 2014,
I feel like it was like almost Christmas Day.
I remember thinking this is like the best present
I've ever got. Mannix Group published this paper,
which they did in a group of about 320 65 -year
-olds -ish. So they put them into four groups.
There was a placebo group. There was a group
that got – and it wasn't actually rapamycin.
It was Everolimus, which is an analog of rapamycin.
It's basically the same drug. So there was a
group that got one milligram every single day.
5 milligrams once a week, 20 milligrams once
a week. They 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.
So relative to the placebo, paradoxically, all
groups, and I say paradoxically because even
the group that got 1 milligram once a day, all
saw an increase in immunity, which is a good
thing. But the 5 and 20 group saw an even bigger
response. The people who just got 5 once a week
or 20 once a week saw an even bigger response.
But the group that took 20 once a week had more
side effects. And the biggest side effect of
rapamycin acutely is these awful, awful mouth
sores called aphthous ulcers. They're nasty.
They're brutal. I used to get them all the time
just from, I think, sleep deprivation or something
that was weakening my immune system. It's an
internal sore, not like a cold sore? No, no,
no. Like a canker sore. It's a really nasty type
of canker sore, yeah. 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.
So 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. And 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.
It's not what you think. I swear it's lidocaine.
They're like, dude. We got you into help. We
have support groups for people like you. Lidocaine
is disgusting. I had my deviated septum fixed
and they shoved the lidocaine up there. It's
harsh stuff. And the rest of the day I just felt
like shaky and just weird. And then I realized,
oh, this is almost like a cocaine type thing.
It's a cousin. Do you know why we have lidocaine?
Because of cocaine. Yeah. Yeah. It's a guy named
William Stuart Halstead, who was so near and
dear to my heart because he was the original.
He was the founding surgeon at Johns Hopkins
and one of the original four horsemen. So the
four main physicians that basically have shaped
medicine in this country all started out at Hopkins.
Osler in medicine, Hopkins in surgery and two
other guys, Walsh and I'm blank on Kelly was
the third one. And he basically figured out because
you got to remember, like. there was a day when
surgery was staggeringly barbaric. Like prior
to ether surgery was like, all right, can you
hold them down? Like gag them, get them drunk,
gag them. And like, we're going to do our thing.
It's just crazy. So God, I used to know all of
this shit. I don't remember any of the exact
dates anymore, but it was like kind of like mid
1800s to late 1800s when up at, um, Massachusetts
General Hospital, I forget the name of who it
was, but someone basically came up with ether.
So ether became the first form of anesthetic.
But, you know, you were sort of knocking people
out. Well, it was, you know, fast forward probably
20, 30 years when Halstead figured out that this
thing called cocaine could provide local anesthetic.
So he began experimenting with like crazy. And
of course, in the process became. like patently
addicted to it. So you have this entire generation
of surgeons at Hopkins from that early era that
were completely coke addicted. So Halstead and
all of his first generation of residents. And
then, of course, from that, we got lidocaine,
bupivacaine, all of these things that don't have
the same properties. But to this day, cocaine
is still used. And 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.
That's right. But 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. Did you know
that they still use cocoa leaves for flavor in
Coca -Cola? They actually extract the cocaine
from it, use the cocoa leaves, and the cocaine
goes to medical. I didn't know that. I had cocoa
tea for my first time this summer. Like real.
Cocoa de latte. But like brought up from. Mate.
Mate de cocoa. That's what it is. Oh. Yeah. It's
great. I could not get enough of that stuff.
You can't shut the fuck up on it, though. It's
a weird sort of high. It's a very strange thing.
It's very talkative. Sort of high. I thought
it was just, everything about it was like just
such a great taste. You ever chewed the leaves?
You ever done that, like in Peru? No, no. I've
never done it either, but apparently it's really
interesting. It's like a coffee sort of a thing,
and it's got flavonoids. It's actually probably
healthy for you. I just love plants in general.
We think of the coca leaves as producing cocaine.
Cocaine we think of as inherently negative. But
the leaf itself, if you just don't extract it,
it's actually really good for you. Well, that's
the thing. Even thinking about the difference
between... eating fruit versus eating Oreos.
Yeah. Like, yeah, like nature's pretty good at
regulating how fast this stuff. So in the case
of fruit, like how quickly does fructose hit
your liver? There's a sort of governor built
into it. If you're eating raspberries, like.
Could you get non -alcoholic fatty liver disease
from eating enough raspberries? Yeah, probably.
You'd have to go crazy. Yeah, you need to become
a full -time job. Or you could just drink a giant
gallon of orange juice every day. Right. That
would do it. That would do it. Crazy. Most people
think of fresh squeezed orange juice as being,
oh, you're eating healthy. Look at you over there
with your fresh squeezed orange juice. Yeah,
you're juicing. It's totally healthy. Super healthy.
Meanwhile, you're just drinking a big old glass
of sugar. Literally, your body doesn't know the
difference between that and a Coca -Cola. Very
little difference between the two, unfortunately.
Well, Coca -Cola's got some other stuff in there,
caffeine. But other than that, just the sugar
itself. Yeah, your liver would have a hard time
telling the difference. So crazy. Most people
would think. A glass of orange juice at breakfast
is a healthy choice. A glass of sugar. Have a
Mountain Dew. Yeah. It might be better. It might
get more shit done. So the dosage of 1, 5, and
then 20. So 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 1 a day, the 5 once a week,
or the 20 once a week, the 5. Once a week was
the way to go. That's the sweet spot. That's
right. You got all the benefit of 20, more benefit
than one, and the fewest side effects. And how
long is this study? That was an eight -week intervention
with an eight -week washout was enough to see
the enhanced immunity. Do you think that a longer
-term study is necessary to see whether or not
the body adapts? Yeah, absolutely. I mean, all
this stuff is in its infancy. Now, my shtick
is... So right now, rapamycin is off patent,
right? So 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. Like, you know, so there's
no economic incentive for a company to, you know,
figure out how to do this thing with rapamycin.
And 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, well, 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, Restore Bio, to sort of combine
it with other agents. But at an N 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 My hypothesis
is three things have to be true if rapamycin
is working. Now, 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. You're not getting
the mouth sores and stuff like that. Three things
have to get better. One, your glucose metabolism.
Should at least get no worse but potentially
better. I suspect it's a function of where you
start. So there is one doctor in New York who
has like a rapamycin practice. I think he's in
the Bronx actually. And 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. But I think he was
starting at a pretty bad spot. But if you or
I took it, we might not notice much getting better,
but we definitely should not get worse. So that's
easy to measure clinically. You do as an oral
glucose tolerance test would give you that answer.
But two things should get significantly better.
The first is immune function should get better,
not worse. There is no clinical way to measure
that. But we do know how to measure it. I mean,
when I was doing my postdoc, it was in an immunology
lab. Like I know how to do that assay. I just
don't have like a million dollars worth of equipment
to measure it. What is the difference in the
dosage, even in the high end at 20 versus what
you would give someone if they got a liver transplant?
Yeah. Yeah. Typical transplant dose would have
been like two, three milligrams every day. Okay.
So it's quite a bit. different. It 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, but in general, in pharmacology,
side effects are the result of certain side effects
are the result of the nadir dose and certain
side effects are the result of the peak dose.
So with every drug, you kind of have to understand
this a little bit. But 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. What does that mean? Autophagy
is this process where the body cells start eating
themselves. So it's kind of like a programmed
cell death, although technically we reserve that
term for something called apoptosis. But when
you're fasting, what's... Why would fasting produce
a benefit? I think the most logical explanation
is enhanced autophagy. So the body basically
has to prioritize in the absence of nutrients.
The underperforming cells are basically told,
eat yourself. And we can recycle some of your
components. Maybe this mitochondria is worth
saving. This Golgi apparatus is worth saving.
And then we selectively, when we refeed, repopulate
the better cells. And in many ways, I think rapamycin
can do that in a pill. So the problem is we don't
have a blood test to measure autophagy. So in
the lab when you measure autophagy, you need
muscle biopsies or they typically even just sacrifice
the animals. This has become a very hot area.
So the Nobel Prize in Medicine and Physiology
was awarded for the genetic – basically the elucidation
of the genetic regulation of autophagy in – actually
it was 2016. So it's very recent, about a year
and a half ago. This is what the Nobel Prize
was awarded for. But what I'm hoping is that
we can develop a signature for autophagy with
a blood test. So I believe that you should be
able to look at someone's blood and look at all
of the metabolomics, all of the small molecules,
all of the proteome, and there should be a signature.
it should look different from the way we look
when we're, you know, fasted or sorry, fully
fed. Otherwise, would you just take a sample
of the muscle tissue, like punch something out?
Yeah. And, and I'm, I mean, I'm willing to do
it all and I probably will. We're just trying
to get what's called an IRB and institutional
review board. So 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 one IRB so that we
can take muscle biopsies, fat biopsies from me,
blood tests, and then start to actually look
for that signature. Would it vary in where you
got it from? Like would you want to get it from
more than one muscle group? That's a very good
question. I don't know the answer. I probably
have to talk to people who have a lot of experience
doing this with animals. It actually wouldn't
surprise me. Like if I were going to do it, I
would just start in the legs because the muscles
in the legs tend to be the harbinger of what's
going on in the body. So for example, one of
the first signs of diabetes, like a decade before
you get diabetes, one 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. So once the legs start to
get insulin resistant, you're on a glide path
to bad things happening. I'm fascinated by legs,
first 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.
I can run hills every day, and I'm not sore.
Like, that's not even possible for any other
group. I mean, I can kind of do that with boxing.
You can hit the bag. But as far as like running
hills is essentially like plyometrics. Like you're
pushing your entire weight up and then you're
catching with the other leg and pushing it up.
Yeah, yeah. You can't do that. You can't bench
press every day. Your fucking arms will fall
off. I mean, there's probably someone out there
doing it that's proven me wrong, but it's nothing
like the amount of endurance that you have in
your legs. But it could just be an adaptation
that you've had as well. I mean, when I was a
competitive cyclist, I mean, there were definitely
days when I would, especially when we did like
multi -day events, like there were days when
it's just. You're beaten down. Yeah, yeah, yeah.
Oh, for sure. You're going to learn in the first
10 minutes. Like everybody else is riding together.
You're riding alone today. The fatigue level,
though, is significantly different than it would
be if you were doing something with your arms
every day. It seems like your ability to recover.
Well, you can definitely recruit more. That's
probably part of it, right? Okay, so there's
more tissue. I think you have more options. Like
you can, you know, especially if you really have
good proprioception. But, for example, like if
you're deadlifting, you know, I actually think.
So you know how you have like the positive and
negative motion, concentric, eccentric motion
of a weight? If you're willing to do away with
the negative, you can lift heavy every single
day. So there's this guy named Ryan. Oh, unfreaking
believable data. I've seen people doing that.
You know, I saw that Andre Galvao on his Instagram
the other day was doing deadlifts and just dropping
the weight. And I was like, that seems weird
to me. So when I was a cyclist, this was my training.
And it was all put together by this guy named
Ryan Flaherty who actually introduced – that
was another one of my sight unseen introductions
to Tim for a podcast. It's a great podcast with
Ryan Flaherty on. And he's – I call him the guru
of speed. This is a guy who like single -handedly
– I shouldn't say single -handedly. I 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.
It's a very long story. And I mean, he does such
a great job on the podcast. I won't go into it.
But for the purpose of this discussion, one of
our interests was, hey, could we translate everything
you've learned about sprinting into cycling?
And his biggest observation was the following.
If he took 100 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. So
a force plate treadmill, as its name suggests,
a treadmill, but it's a special treadmill where
it measures the force that you hit. And the higher
that number divided by your body weight, that
became what he described as mass -specific force,
that number, if you rank order it, is the order
in which people would finish the run. So it kind
of makes sense if you think about it, right?
The 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.
So Usain Bolt has the highest ever force plate
measurement calculation. And it's, I forget what
his ratio is. I want to say he's like 6 .9 or
seven times more force than his body weight every
time he hits. Freaking staggering. Wow. So then
Ryan's, 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? In other words, like, okay. Joe runs a
4 .940, and we want to get that down to a 4 .5.
Can that be done? And it turned out the answer
was categorically yes. You have to do two things.
You have to get stronger, and you have to get
lighter. So how do you do that? And that's when
he came up with this idea of we do hex bar deadlifts.
We lift really heavy, so you're only doing fives,
fours, threes, or twos, never more than five
reps. And so you'll do five sets every single
day. And you'll pick it. So some days it'll be
five sets of three. Some days it's five sets
of five, whatever it is. And they're very well
prescribed, like at what percentage of your one
rep max you're doing these at. And it's up, drop.
Up, drop, up, drop. So 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. That's why we get larger when
we lift weights. But when you drop it, you...
to unload the muscle when you're relaxing it.
So the muscle's not going to get bigger. So you're
getting all the benefits, all the strength, which
is primarily around the type 2B muscle fiber
and without the size. So 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. Like I was like, I'm a popper,
but these guys were like. cat one, cat two collegiate
cyclists, but they were like my training partners.
So we did this thing where we did the same routine
that he had the sprinters doing. And 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, but you can. Really?
Yeah. It has to be a heavy deadlift. More in
terms of numbers or more in terms of? No, more
in terms of distance, like more in terms of vertical.
Really? So your highest like plyometric jump
is going to come after you've done like, you
know, three sets of three at, you know, 95 %
of your one rep max. And three sets of three
dropping or using eccentric? No, definitely dropping.
No eccentric. Absolutely. Yeah. Huh. Wow. And
so we would superset the plyometrics with the
deadlifts. And you would do this every day. And
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.
And I mean, the changes he makes in their time,
like Johnny Menzel was one of them. So 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. And when he showed
up to camp, I forget what his time was, but I
want to say it was about. I don't know. You could
probably look this up for me. You know, it was
three tenths slower than what he ultimately ran
at the combine. And he I think he had the fastest
or second fastest quarterback time at the combine
after just 12 weeks of doing this. Wow. I mean,
it was unbelievable. how fast he can get these
guys to run. I saw something the other day that
I'd never seen before. It's an eccentric bike.
It changes back and forth. I've heard of this
thing. You're the second person to tell me about
this. I think I saw it yesterday, in fact, now
that I think about it. It was eccentric and concentric,
but it alternates. Yeah, yeah, yeah. And it looked
really weird. It forces movement, and you're
resisting the movement. See if you can find that,
Jamie. It's like an eccentric, I forget what
it's called. Someone sent me this, like, hey,
this thing's amazing. I was like, it's a bike.
The fuck are you talking about? It looked different
than that. The one I saw was also different.
I think it was like a recumbent bike. Yeah, that's
what I saw, too. Eccentric. Yeah, you're spelling
it wrong. Oh, it says just centric. Oh, okay.
Huh. Eccentric exercise bike? Try that. But the
thing is it alternated between eccentric and
concentric. It wasn't just, hmm, the one with
the red on the top row looks like it. What is
that? Pediatric ergometer. No, that's not it.
It's for little kids. Well, whatever. I wish
I had saved it because I was like, I'm never
buying this. It just looked interesting. There's
always these new methods of stimulating the body
and tricking it into doing things. And I guess
that's essentially what a lot of people – the
way a lot of people think of intermittent fasting.
You're kind of stimulating the body. You're hacking
it. You're tricking it. And I wonder – one of
the things that Ryan and I talked about was could
we ever adopt his training system to swimming?
In running and cycling, it's primarily going
to be quads, hams, glutes have to be the muscles
that do it. Would you throw things? Well, we
were talking about like you really got to be
able to get the lats fired. But how do you get
the lats to fire at such a weight and then without
having to do the negative as well? So we just
couldn't really kind of figure out how to do
it. So we adapted part of his technique to swimming,
which was the actual training routine, meaning.
So one of the big misconceptions if you're trying
to go fast is that you need to still train slow.
But 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, there's not a lot of benefit to spending
much time running at a pace slower than that.
If anything, you want to be running slightly
faster than that. So you know who Meb is, the
American marathoner who won the Boston Marathon
three years ago? No. So amazing marathoner. I
think he's the only person to have won the New
York Marathon, the Boston Marathon, and to have
won an Olympic medal in marathon. He won a silver
medal in the 2004 Athens Games. But when he won
the Boston Marathon, he was like 38 years old,
which in marathon. parlance is like, he might
as well be a hundred. And he had not really had
a great race in the previous few years. So he
had been effectively written off in the sport
and Ryan actually helped train him. And all they
did was apply this principle of sprinting into
marathon running, which was all 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. And 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. You have to get that up to like
2 .6 or something. And so when Meb trained for
the Boston Marathon, he was focusing heavily
on these deadlifts and doing much shorter, faster
runs. And, you know, I mean, if you watch the
video of his Boston Marathon win, it's incredible.
Like, you know, he just takes off and like leaves
everybody behind him and they're like. Yeah,
there's no way he'll be able to keep that up.
We'll let him go. And they couldn't rein him
in. Wow. Do you think that someone's going to
be able to break two? We were just talking about
it the other day. Some guy got really close.
What did you say he hit, Jamie? Like 206 or something?
I think someone's gone closer. Didn't that guy
in Germany last year go even closer? I think
it was 202 or something along those lines. And
you think that this sort of method is what they're
using? So I don't know if I'm allowed to talk
about this stuff publicly. Don't worry, no one's
listening. So short answer is yes, I think this
can be done. Everything has to be perfect, right?
Meaning you have to have the perfect athlete
trained. to peak at the right time you need the
right humidity like everything has to fire in
all cylinders but just as there was nothing physiologically
special about a four minute mile when roger bannister
broke it it was more of a psychological barrier
um you know i'm not suggesting for a moment that
this will be easy but you know we're gonna get
there i mean like this can happen that is incredible
if you think about how fast you're running to
run 26 miles In two hours and two minutes. It's
staggering. I don't think people understand like
what a – I mean I was never a great runner. I
was about a 250 marathon, 255 marathon when I
was a boxer but never trained as a runner. Like
it was just – I just ran so much and I was pretty
fast. But like when I think about how hard I
would have to run to bust out a 250 to 255 and
to think like was there any chance I could have
ever got that down to a 230? That is such an
enormous change in pace. I don't know that I
ever could have done that regardless of all the
training tricks in the world. And what kind of
diet are those guys following? Well, I know Meb
personally. I can't speak to what the other guys
do, but I think a lot of those guys are frankly
in the state of where I was when they were younger,
meaning they can probably get away with a lot
more. If you look at the physiques of most of
these guys, they're... they're perfectly built.
Like I'm talking elite level. I'm not talking
about like anyone who go runs a marathon, but
if you're talking about like the people who are
going to win the marathons, they are basically
all engine and then chassis in the right place.
That's basically all they come down to, right?
I mean, they are enormous cardiovascular system.
very strong quads, hams, glutes, and then everything
else is very tiny. When you say enormous, like
is literally the size of their lungs different?
Yeah, you actually look at, well, I mean, it's
all relative, but when you look at their frame,
their thorax is going to be larger. And is it
expanded because of the training? I think so.
I mean, you never know cause and effect. Sometimes
you could argue like maybe these guys were, maybe
the people who are drawn to those sports are
the ones that are, you know. or are drawn to
be elite in those sports, already had a genetic
predisposition. That's sort of my feeling is
it's a bit of both. Isn't that the case with
Lance Armstrong? Like, doesn't he have a very
large heart? I don't know. I 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. Genetically. Yeah.
And 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 till 2011, was on highly,
highly, you know, augmented programs. So, 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. I mean, what people don't understand is
like, I mean, Lance only peaked for one race
a year. Like everything that that team US Postal
did was geared for that one race. And also when
you really look at how much doping they did,
it actually wasn't that much. Like, you know,
when they were blood transfusing, it might've
been two units over the course of a race. And
I'm not saying that that wouldn't help. It would
help a lot, but. That's nothing compared to what
people were doing just a few years before Lance
came along. So Lance won, I think, his first
one in 99. The guy who won before that in 98
was Marco Pantani. Before that was a guy named
Jan Ulrich in 97. And before that was a guy named
Bjorn Ries. Bjorn Ries' 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. Is that from EPO? Yeah. Lance never
had a crit over 50 to my knowledge. They would
basically always titrate with EPO and or hemoglobin
up to 50, which was the trigger. So, you know,
but but I think and again, I've never I don't
know Lance at all. So 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, swimmers,
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. There's the one phenotype where people
can tolerate staggeringly high amounts of lactate.
And again, it's not lactate per se that— causing
the pain that you're experiencing. It's the hydrogen
ion that accompanies the lactate. So 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,
et cetera. But we use lactate as a proxy because
where lactate is high, the hydrogen ion is high.
And there are some people who can just tolerate
like incredible doses. I used to work with Olympic
swimmers and, uh, 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. Like that was just too much pain.
Like I was on the floor. If I was over 17, I
was puking and 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. And he actually was trying
to make a comeback to make the 2012 Olympic team.
And when he was training for that, I would poke
him between races. And I saw him get out of a
400 individual medley race, which is the hardest
swim race of them all. The 400 IM is, I mean,
you might as well just shoot yourself. It's so
painful. He 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 a hundred breast race, you know, came
out with a lactate of 21, that kind of thing.
So there are those guys. And then I think at
the other end of the spectrum, the 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 Cori
cycle actually turns lactate back into glucose,
that they never have high levels of lactate.
Now, again, all of this is sort of speculation,
because I think they were very hush -hush about
Phelps's numbers. But I heard from reliable and
reasonable sources that he would rarely have
a lactate above 8 .0, including when he's breaking
world records. Whoa. which for me at 8 .0, like
I'm smoking and joking, like that's fine. But
for, you know, he was so efficient at getting
rid of it that, yeah, he could, you know, set
the world record in the 400 IM and have a lactate
of eight. Again, I don't know if this is true,
but I've, there's certainly a plausible mechanism
by which it could be. Well, it's fascinating
that this could potentially all be engineered,
right? That like through use of CRISPR or something
else, you could take all these various facets
of performance enhancing. modalities extend a
person's ability in so many different ways and
create a super person yeah of course it's interesting
right once you start genetically doing it if
you could does it become cheating in the same
way like would we would we have 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 know you juice me up to
his level is that cheating I mean, I don't know.
I mean, those are the questions. I 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. Like, why don't we just let everybody
dope? That's a steroid argument with MMA as well.
Well, and frankly, it's more my argument. But
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.
Like the Tour de France is the most unhealthy
thing on the face of the earth. I've heard that
it's healthier to do the Tour de France on steroids
than it is to do it off steroids. Abso -fucking
-lutely. When those guys finish the Tour de France,
they are osteopenic. I mean their bone density
has eroded. They have lost so much muscle mass.
I mean it is a devastating, grueling event. Now
nothing is going to completely ameliorate that.
If we think that, like, watching these guys kill
themselves riding six hours a day, hitting peak
thresholds of, you know, six watts per kilogram,
if we think there's anything physiologically
reasonable about that, we're out to fucking lunch.
But is that the point? I 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 that. And these guys are
in a league of their own. I mean professional
cyclists are some of the toughest athletes out
there. I mean obviously every athlete at the
peak of their game is remarkable. And no disrespect
to like the best running back in the NFL. But
like you can't even compare that to what a guy
does. For workload for sure. Yeah for just the
pain. Like the absolute sheer. discomfort and
the physiologic torture and the duration of it
and all of these other things. Well, you see
it in their faces, too. Those guys, like when
they retire, they look like they're 10 years
older than they are. Yeah, yeah, yeah. I mean,
they've lost all of the fat. A lot of them, you
know, they just if you don't have fat in your
face, I mean, you age dramatically. They just
look exhausted, too. I 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? Everybody is allowed
to use whatever amounts of EPO, blood, testosterone
to be at the 80th percentile of what we consider
normal. So everybody is allowed to walk around
with a hemoglobin of 14 .7 or up to 14 .7 or
15. People would cheat that, right? Wouldn't
they? I mean if you allow people to use a certain
amount. But I also think like the testing on
this stuff is so like. It's so JV. Now, there's
this idea called the biological passport that
was introduced many years ago, which basically
said, look, we're going to develop a signature
for every person. And now if you deviate much
from your signature, that'll be the trigger.
And the argument, again, by certain people, and
I think Daniel Coyle argued this a lot in one
of his books that he wrote, Ripping Apart Lance,
was 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, you going from 43 to 50, you get
a much bigger advantage. To which I say, yeah,
but that's true on a relative basis, but an absolute
level. If everybody's walking around with a hematocrit
of 48 to 50, they still have the same oxygen
carrying capacity. It does level the playing
field. The 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. Well, absolutely. And 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. I mean, I just have bigger things I care
about than like how many steroids Barry Bonds
took to hit all those home runs. But what really
does chap my ass is when people don't actually
understand how steroids work, right? Like it
bugs the shit out of me when people assume that
if you take steroids, you will have, you know,
you will hit that many, you know, home runs or
you will run this fast or lift this much. The
only thing that steroid is doing is enabling
you to recover faster. from the brutal work that
it takes to actually do those things. So, you
know, all the, if I, if I shot myself full of
EPO, I mean, you've probably seen Icarus, right?
I mean, I thought that was, I thought he did
it. I thought, uh, Brian Fogle. Yeah. I thought
Brian Fogle did a really good job of showing
like, I mean, and he was a pretty good responder
to the EPO. I think he did a growth hormone,
testosterone and EPO. I mean, you saw in the
end of the day. he he finished worse the second
year round because yeah but his bike ran out
exactly that's my point you see like people don't
realize like one little thing makes all the difference
from a performance standpoint yeah he probably
would have done a little bit better but It's
not because the drugs were in him per se. It's
because the drugs that were in him allowed to
train more. So 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.
The drugs enabled him to train that much harder.
Yeah, that's what it does. It allows you to train
harder so you recover better so you have more
output. Correct. But we don't want young kids
to think that the only way to do this is start
taking steroids and fuck up your endocrine system.
No, of course not. But we also want to keep in
mind. Like, see, it almost requires like a broader
discussion, which is like, why do we care? Well,
we care in combat sports because it allows you
to inflict more damage. No, no, no. I'm saying
like, why would, why do, why? Let's just say
I'm not a professional athlete. Okay. Why do
I actually care how fast I run or how fast I
ride or any of these other things? Well, because
you want to brag about it. Okay. So maybe you're
a weightlifter. Right. So maybe therein lies
the problem. I mean, I mean, I, you know, when
I stopped. cycling competitively, I think a big
part of it was I just realized that performance
and longevity stopped being collinear. They started
to become somewhat orthogonal. They started to
deviate. In other words, the things that I was
doing that were enhancing my performance, and
I'm not even talking about drugs, I'm just talking
training -wise, it seemed to come at the expense
of what I believed was going to make me live
longer. So specifically, the thing I cared most
about was cardiovascular health. Now, the incidence
of atrial fibrillation in highly trained athletes
is 10 times higher than that of non -athletes.
So like that's a little counterintuitive, right?
Like why 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. You're not supposed to have that
when you're 40. And it's usually associated with
cardiovascular disease. And yet, People are showing
up with these – I mean I have four patients who
have had to get ablations for atrial fibrillation.
What is an ablation? An 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 pulmonary
veins. And they basically are trying to burn
away and create – or remove the ability of the
electrical system to move in this way. So what's
basically happening with this type of athlete's
heart is when 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. So 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. This dysrhythmia.
So you're soldering the motherboard, as it were?
Yeah, yeah. You can effectively think of that,
right? You're creating new lines to block the
connection. Whoa. That's fucking crazy. Yeah,
so think about it. Someone 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. Does that make sense? Oh, no,
of course. I've heard it many times. I don't
know if that's correct. That's fucking scary.
I don't tend to agree with that because you can't
compare one beat to the other. I mean, you can't,
you know, it's hard for me to say that, you know.
An 80 % to 90 % ejection fraction beat under
incredible load is the same as the beat that
I'm – 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? I 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. And that is like something
that's probably directionally true within a mile.
Now, 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? And do you supplement?
Like are you a person who takes colloidal minerals
or are you a person that is interested in antioxidants?
Like what do you do in terms of that? So my view
on longevity is it's the hardest problem. There
is. And so you got to have every like I'm agnostic
about what the approach is. So I want to understand
everything that you can do with respect to, you
know, food, drugs, supplements, hormones. And
to be clear, the only difference between a drug
and a supplement is one's regulated and one is
not. But, you know, I have patients that will
say things like, oh, you know, doctor, I don't
want to take that drug. I'd rather do it naturally.
Can I do it? And it's sort of like, well, OK,
you don't want to take a statin, but you do want
to take red yeast rice. Well, they both inhibit
HMG -CoA reductase, the enzyme that catalyzes
the first step of cholesterol synthesis. You'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.
That just strikes me as a false equivalent. So
I only say that to just say like I think everything
should be on the table and then the question
should be how do you decide what to do? There
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.
So, 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? I
think all those things are valid. Some 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, you know, looking at, for example,
vitamin D levels. So, you know, you see a huge
disparity in the vitamin D levels people have.
And it begs the question, do all people run effectively
at the same vitamin D level? And 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? So
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
come from places near the equator where maybe
I just evolved to see more sunlight and have
more vitamin D. What's your ancestry? My parents
are both from Egypt. Oh, interesting. So, 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.
That's a big range. Yeah, I'm like, that's probably
not the range. So 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.
Well, when you're talking about this, it's really
obvious, really clear that there's so much data
to go through. And we're learning this. And I
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. Yeah, for sure.
I mean, the issue is how do you make sense of
a problem or how do you try to solve a problem
which is unsolvable? And the reason I say that
is the following. You know, you have what I call
kind of the medicine 1 .0 world, which was. I
define that as everything that took place before
Francis Bacon. You can probably tell me when
that was. I'm going to guess Francis Bacon is
like 1650 to 1670 or something like that. But
that was basically the first person to come along
and codify the scientific method. So anything
that came along before the scientific method
may have been correct, meaning there were things
that were certainly done back then that proved
helpful. they weren't grounded in a principle
of science. In other words, even a blind squirrel
is going to find nuts sometimes. And 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. And to me, medicine 2 .0 is really good
at solving problems that are amenable to relatively
short, simple clinical trials. And there has
been no better example in this space than infectious
diseases. So 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.
No questions asked lethal condition. Today, it's
a chronic disease. For 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. So
the problem is if you want to know the answer.
should I eat this way or that way? Should I exercise
this way or that way? Should I take this drug
or that drug or this supplement or that supplement
to live longer? We can never know the answer
in humans because there is no clinical trial
that can answer that question. And 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. And we can do things to be slicker
about it. When you study rhesus monkeys for 20
years, it's certainly more interesting than studying
mice for one year. But in the end, they're still
animals in captivity. They're still not in the
same environment and all these things. So 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.
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? Because,
I mean, I know things today from a data standpoint
I didn't know 10 years ago. And to your point,
even in five years, we'll look back at stuff
we're doing today and think, God, we have more
data. Is that still the right thing to do? And
so that strategy to me is sort of fundamentally
based on three bodies of literature. And the
first is like what did we learn from centenarians?
So the people who naturally live to 100, they
have the advantage or that body of literature
has the advantage of being based on humans. It
has the disadvantage of it not being experimental.
So we don't know what cause and effect was. And
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? And then if you look at the underlying
molecular mechanisms. So 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, yay or nay, antioxidant, yay or nay. So when
you're, it's got to be very time consuming for
you. I have a research team. I mean, that's when
I started this practice about three years ago,
I realized like I was losing the battle. My ability
to sit down and read scientific papers was like
shrinking. Yeah. So I hired an analyst. He had
worked with me in the past. He was amazing. I
brought him over full time to do this, then another
one, then another. I mean, now I have four full
time analysts. And I mean, as this practice grows
and or whatever, I have the revenue to justify
it. Like I'll have 10 analysts one day in this
practice. And even that's not enough. I mean,
approximately 100 ,000 papers are published every
month on PubMed. Jesus Christ. So I forget. I
did the math on that once. I think it's like.
three papers a minute. It's pretty stunning when
you think about the amount of human achievement
that we've experienced just in our lifetime in
that regard, like how many people are working
on understanding just the mechanisms of the human
body. And this data is just piling up as we speak.
Yeah. But the problem is the signal to noise
ratio is almost zero. So I would say. conservatively
90%, if not 99 % of that is completely useless.
Really? Absolutely. I actually wrote about this
once. So 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. And 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. Something
like 70 or 80 percent of papers never get cited
outside of an auto citation again. Is this because
they're not relevant or is it possible to get
lost in the shuffle? Like some of them might
be worth something? I mean that's probably possible,
but I would bet it is much, much more the former
than the latter. And then on top of it, a lot
of stuff comes out and then years later you realize
it was wrong. You 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. So how much of this data is forcing you
or causing you to alter your own patterns? Well,
we believe internally that probably 100 papers
a month enter the literature that are relevant
to what we do. Meaning, I mean, some of the literature
that comes out like, you know, the rheumatology
literature. Might be relevant to them, but that's
not what I do. Even that's crazy. That's more
than three a day. Yeah, yeah, yeah. So that's
why when I say I want 10 analysts, you see why.
Because first of all, it's finding those papers
too. So how do you do that? Well, 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 so you get those three a day and then
they bring them to you how do you have the time
no so that's the thing and it's funny you say
that I 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 like I'm now the bottleneck because
the analysts are now churning out stuff faster
than I can even provide ancillary feedback. Because
my job is like, you know, you hire great people
who are smarter than you and like, you just guide
them. You just point them in the right direction.
So what we mostly do is create programs where
we're going out and looking for new knowledge.
So 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,
there's clearly a performance benefit. Growth
hormone is probably the single most abused drug
in all of sports. There's no question about that.
But is there a way to take it where it makes
you live longer? I've never prescribed growth
hormone to a patient because frankly, I'm not
yet confident that I know the answer to that
question, but I feel like it's worth knowing,
right? Because 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. And so Like many things,
your knee -jerk reaction to something can often
be wrong. And my knee -jerk reaction to growth
hormone has historically been causes cancer.
Because why? Well, 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. But 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. And 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. He's like, where's the body count?
Like, where are all of these people dying of
cancer from all these years of staggering growth
hormone use? We don't really see it. When 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. In fact, there's – I mean,
I could draw it actually for you. Not that anyone
will necessarily see this, but at least you'll
see what I'm talking about. If this is percentile,
so higher, and this is IGF level, right? So IGF
level. Most people are listening to this. Well,
actually, it's getting close to 50 -50. We were
actually talking about that before, yeah. The
overall mortality curve for IGF and growth hormone
is like a J curve, meaning low IGFs, really high
mortality. Yes, as you go from about the 70th
or 80th percentile up to the 90th percentile,
there's a slight increase in mortality. But this
is not what you would think of. Like you would
sort of, if you were just reading the headlines,
you would think it looks like this. Right. So
there's a sweet spot. Not only that, this is
overall mortality. What if you parse this out
by disease? Well, that's when it gets really
interesting. So cancer's curve looks like this.
Very similar. Yes. But Alzheimer's curve looks
like this. Heart disease curve looks like this.
So describe that to people that are listening.
Well, 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. It's only cancer
that seems to have that uptick where risk starts
to actually rise once you cross past the, call
it 70th percentile. And so when you integrate
all of these curves together, that's why you
see this slight uptick. Now, again, this is epidemiology.
So one has to take this with a grain of salt,
but this is, To me, when I saw this graph, which
Bob put together, I don't know, a while ago,
I was like, wait a minute. This doesn't jive
with my preconceived notion of like growth hormone
is bad. This warrants way further exploration.
And 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. Like we did this already with testosterone
two years ago. We put together like a 40 -page
white paper on the topic. And then at least once
every two weeks, it gets updated every time a
new paper comes out, basically asking the question
like, is testosterone replacement beneficial
or harmful? And under what situations should
it be considered versus not? And again, the goal
is to do this unemotionally. And that's hard
to do. Sure. Because for reasons I'm not entirely
clear on, basically everyone's kind of just emotional
about this stuff. Well, they're emotional about
steroids because of all the press about Barry
Bonds and, you know, all the different baseball
players. But why do you think that is? Cheating.
Is it the cheating aspect of it? Yes. 100%. Yeah.
Yeah, I think that's exactly what it is. I think
people consider taking any kind of hormone, whether
it's growth hormone or testosterone, as cheating.
Even 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. Oh,
yeah, Jeffrey Life, I think is his name. Dr.
Life. He's jacked. I mean, he's got a full six
-pack. He's out of control. He's built like a
gorilla. And my friend was like, God, that can't
be healthy. I'm like, what the fuck are you talking
about? Look at him. I go, what do you think a
70 -year -old dude is supposed to look like?
They're supposed to be knocking on death's door.
That guy looks like he could fuck his way through
a building full of teenage girls. You know, he's
like, I shouldn't say teenage, 20 -year -old,
21. Or 19. He looks like a man who's really fit
and healthy with an old guy's head. Yeah. It's
weird. And I was like, you know, if it's not
healthy, then what is it? If that's not healthy,
like, oh, he's going to die of cancer. He's going
to die of a heart attack. He's going to die,
period. If you look at his head, how much time
would you give him? If I gave you a bet, okay,
we have a million -dollar bet, give you an over
-under of 10 years, how many years are you going
to give this guy? Are you going to give him 20?
You're going to give him 30? Wait, wait, wait.
You're moving the over -under. You said I had
a 10 -year window on that. Right. I'll take over
on the 10 -year. Okay. How many years do you
give him? Impossible to know. Am I allowed to
talk to him first? No. No fucking clue. You're
looking at a magazine, right? No, no, no. I can't
because I've got to know his family history.
I mean, honestly. Of course. Your parents will
tell me more about how long you'll live than...
What you look like. But 70 in America is basically
death's door. No, I think today. Well, so this
is a complicated question, actually, which is
actually prompts another analysis. It's in the
10 year range. Yeah, no. So it depends how you
ask the question. So the question is, what is
the average life expectancy of a man and a woman
today in the United States? And I mean, someone's
going to correct me. So I feel like it doesn't
matter what I say. I think it's 79 and 81, respectively.
for a man and a woman today. But the more interesting
question is this one, which is, so what year
were you born? 67. Okay. So in 1967, what was
the annual life expectancy or the average life
expectancy of a man and a woman? And we could
look that up, but I'm guessing it would have
been, let's see, life expectancy has been going
up at 0 .3 to 0 .6 % per year. We could back
out that CAGR. And let's just say for shits and
giggles, like the number was 69 or 73 or something
like that. I promise you, you were going to live
longer than that. What was it? 67. 67. All right.
So would I take the bet that you're going to
live longer than 67, even though that was the
median life expectancy the year you were born?
Hell yeah. I'll take that all day long. And so
what we're actually putting, this is just a dumb
analysis. I don't even know why we're doing this.
Sometimes we just do dumb shit that has no bearing.
But what I want to do is create a graph of actual
life expectancy. as realized versus projected
life expectancy in the year of birth. My hypothesis
is that is always a positive number. What I want
to know is what's the derivative on it? Is it
increasing or decreasing? So 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. Now, on
the other end of that spectrum, I am not one
of these futurists who thinks like there's immortality
out there. You know, I would be if right now
I could sign a piece of paper that would say,
Peter, are you willing to commit to a lifespan
right now? So you're willing to acknowledge that
if there's some major breakthrough, you'll miss
out on it. But I guarantee you this duration.
Like, what would you take right now? If I said,
Joe, you can be 100. And be fully functional
at 100. So when you're 100 – So you could run
at 100. Yeah. You're going to be like a fit 60
-year -old at 100. So you're still working out.
You're still shooting. Pretty good. Yeah. Would
you take it? Nope. In other words, you're willing
to bet that by the time we get there – Yeah,
because when it's over, it's over anyway. Yeah.
Yeah. So, I mean, to me, I think most people
have a greater sense of confidence about where
technology goes. I think there really only been
a handful of step function changes in longevity.
So, you know, the reduction of infant mortality
was huge. Like once we actually figured out how
the fuck to deliver babies and not kill moms,
like that was a big deal. That had a step function
improvement in human longevity. The next one
was really sanitation. Like once we figured out
that like don't shit where you drink, huge improvement
in human mortality. Isn't that hilarious? It's
amazing, right? We take that shit for granted
now, right? And then the third one was basically
germ theory, you 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 because
there are these microscopic things that none
of us anticipate, right? We haven't had a step
function improvement in mortality in nearly 100
years. So what's next? Now, 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. But I want to buy
the optionality to stick around for it by doing
all this incremental little shit. Well, these
three plus papers a day, the options are increasing.
It just seems to me that there's a trend, right?
The trend is, as you're saying, there is an increase
of longevity, but it's not a huge increase. Right.
But our understanding of the human body is. That
seems to be pretty radically improving, especially
in terms of nutrition, nutritional absorption,
the mechanisms behind nutrition. On some level,
yeah. On some level, I still feel like we're
in the dark ages. Right, because you recognize
the potential. Well, no, because I think I'm
just humbled by how hard it is to actually take
care of people. I'm about as good a responder
as you're going to have to carbohydrate reduction.
Doing something as simple as just not eating
carbs and not eating sugar, like, completely
changed my health. I mean, at 40, if you compare
the 40 -year -old me to the 30 -year -old me,
like, the 40 -year -old is, like, literally twice
as healthy as the 30 -year -old me. And that
was through something as simple, conceptually
simple, as making this radical dietary shift.
And by what standards are you saying that you're
twice as healthy at 40 than 30? How old are you
now? 45. But what is the... I mean, again, I'm
speaking a bit glibly. How you feel, your blood
levels. Well, even let's just talk objective.
Yeah, yeah, yeah. So like what would be my lipid
levels? What would be my triglyceride levels?
How much body fat do I have? What's my VO2 max?
Like by all of those metrics, like everything
was just so much better at 40. I mean, and so,
but yet I've seen a lot of patients where you
take the carbs out of their diet, doesn't matter.
You make them fast. You do this. You do the other
thing. You just can't fix some of the underlying
metabolic problems. Like what kind of problems?
No, I think some people are just so insulin resistant
that it becomes really hard to fix them without
doing draconian stuff. I mean I have one patient
who is really now I think going to in many ways
become the poster child for – he's definitely
the toughest case I've ever had and 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.
So he's probably 5 '8", weighs 235 at the start.
So 5 '8", 235, metabolic syndrome, huge amount
of fatty liver disease. Not the typical patient
in my practice. Most of my patients are kind
of young, healthy people who want to like. you
know, want this immortality thing. But this is
someone who doesn't fit that description, probably
70 years old on like, you know, four drugs for
blood pressure. That's very heavy for a seven
-year -old. Yeah, it is. Yeah. Oh, and he just
had a hip replacement. He basically couldn't
walk. You know, everything was, and we had tried
carbohydrate restricting him before. It just
didn't work. And part of it was, I don't know
how he just, it was hard for him to stick to
it and blah, blah, blah. So I just said to him,
look, man, I want to try something completely
fucking extreme, and I want to try it for six
months. Every five days, pardon me, every month,
you're going to spend the first five days eating
500 calories a day of a ketogenic diet, and it's
basically just going to be like vegetables, oil.
You're basically eating a bunch of salad. And
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.
And then you're going to repeat that every month
for six months. And he was like, I won't be able
to do it. And I was like, I know, I know. It
seems crazy. I think you will be able to do it.
Because remember, all that time that you're not
eating, your body's going to have to start eating
itself. And so you'll be all right. And I'm giving
you a grossly oversimplified version of what
we did. But it was much more complicated than
that. There's a bunch of other stuff that we
had to do to manage it as well. Well, 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. He weighs a buck 75. Whoa.
That's 60 pounds in six months. Holy shit. His
liver. And that's interesting, but not nearly
as interesting to me as 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. And, you know, 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. You know, now he's in the
20s and 30s. What was his previous diet? What
was he eating? Just a normal dude. He wasn't
a particularly junk food. He wasn't a junky guy.
The 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. He's on a treadmill 30 minutes a day
now. He couldn't walk before. I mean you take
60 pounds off a person. When you say treadmill,
you mean walking on a treadmill. Yeah, he walks
on a treadmill now. Yeah. Walks briskly. He can't
really run once you get the hip replacement,
right? Yeah, he's got the hip replacement. So
it's just – it's basically reprogrammed him.
And so the reason I have occasionally pulled
that trick out, although it hasn't always worked,
is based on this case study I read that's very
famous. I'm sure some – there's got to be someone
on this show who's talked about it. The paper
was published in either the early 70s or late
60s, but it was the longest ever medically supervised
fast. So it was this guy who weighed somewhere
between 375 and 400 pounds. He did a 382 -day
inpatient medical fast where he had only water
and minerals. At the end of that something like
382 days, he was down from call it 400 to $1
.65. This paper was published seven years later.
He weighed like $1 .70, $1 .75. The crazy thing
about that guy is his skin shrank too. Yeah.
So he didn't have that problem that a lot of
people have when they lose a lot of weight where
they have all this extra skin. His skin went
along with his body. Yeah, and I wonder if that's
just due to genetic elasticity. Yeah, exactly.
I would like to know. I would like to know if
he had stretch marks when it shrank, you know.
You know, it's funny. I've never tried to figure
out, like, whatever came of that patient. I can't
imagine he'd be alive now, though I know he was
young at the time. But the part that interested
me was that he didn't regain all the weight seven
years later. And that suggested that there was
a, like, it was a reprogram. You got the blue
screen of death on the computer. You did the
hard reset. He got to be a new person again.
Because I'm not of the camp that thinks, like,
that guy got to be 400 pounds just because he
was a glutton and a sloth. Like something fundamentally
broke in that dude. And what broke was he basically
lost the ability to partition fuel correctly.
Now, could food play a role in that? Absolutely.
Certainly if you eat enough shit, that can happen.
But I think it's more complicated than that.
I think it could be epigenetic, if not outright
genetic, but probably more epigenetic. And so
I'm interested in this idea of how do you reset
people? And again, this is all kind of 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. There's like some patient who's
got a problem that you can't figure out and it
just drives you nuts. But you realize like –
I mean even just today I was talking to a friend
of mine. He's not a patient but – I mean, my
God, he's just going through like this devastating
health situation. He's been he has seen every
doctor. He's been to Mass General. He's been
to Stanford. He's been to Hopkins. He's been
to the best hospitals in this country. They can't
fucking come close to figure out what's wrong
with this guy. And so as bad as that is for him.
I think that level of humility is actually good
for the profession. What is going on with him
that they can't figure out? He's having these
horrible neurologic symptoms where he gets these
fasciculations and muscle weakness. And 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. Luckily, that has
been ruled out and they've done a million muscle
biopsies and all these other things. But they
don't know what's going on. Has he altered his
diet? Has he taken? No, no. We don't know what's
going on. This is certainly far outside of my
area of expertise. I mean, what we talked about
today was, look, man, all we really need to be
doing is fixing your symptoms at this point.
In other words, there's understanding what's
causing this and then managing the symptoms around
it. I think the smartest people in the country
have figured out they have no goddamn clue what's
going on. Let's now figure out how to manage
your symptoms, your energy levels, your mood,
all of these other things. What has he done for
that? Well, I told him today, I was like, look,
I'm going to send you a kit. We're going to do
a certain blood test on you and a certain urine
test on you. And I want to just figure out what's
going on with your four hormone systems. There's
basically four hormone systems that play a pretty
big role in how we feel. And adjusting those
doesn't, I'm not convinced it necessarily makes
you live longer, but it can certainly make you
live better. So I want to kind of understand.
I suspect he's not firing on all cylinders on
that dimension, whether 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. Yeah, 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?
Great question. I do not know the answer. Now,
it might be that that just I don't recall that
being in the paper. But if it wasn't, I don't
know if anybody did the follow -up. But to me,
that's the interesting question too, right? That
guy's got to feel amazing. Like he got his life
back, right? And my recollection is he was a
young man. He was in his late 20s, I think. Yeah,
I believe I remember that as well. I think I
would like to find out what he's eating now to
keep his weight at the same level. I mean, he
must just be so thankful. First of all, he might
be like, I mean, I have friends that are... pretty
overweight and one that died pretty recently
who was really big and he just had this feeling
when he would meet people i mean he talked about
it a little bit he was just obese you know it
was just this thing where you're just oh look
at this enormous fat guy and then to go from
that to oh there's a guy there's a normal guy
yeah that's just a guy it's 168 pound guy normal
No difference between him and anybody else. And
I got to tell you, I know we love to beat up
on fat people. We love to turn it into a character
defect. But I 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. In some cases, yes, but not
on balance. The problem is that they simply.
do everything incorrectly metabolically you know
so their body is functioning incorrectly yeah
and it's you know and it's a genetic component
i think there are dietary exacerbations i think
certainly not exercising makes things worse so
there are lots of predisposing factors but at
the end of the day what's happening is when you
and i eat like let's let's take a meal that 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 so that's like a Shit ton of nutrient, right?
If you or I ate that, yeah, it probably wouldn't
be that good for us. But let's say we just finished
a workout or something. 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, we can
actually disproportionately put more glycogen
into our muscles, into the leg muscles, because
you'll have done that run up the hills, right?
And then furthermore, when we want to recruit
energy again, we'll have the ability to actually
go back and get fat. In other words, break down
fat at lower ATP demands than necessarily always
going to glycogen. So in other words, we partition
fuel in a smarter way. And these patients, I
mean, you can measure this clinically using something
called RER and, of course, doing other blood
tests. Like they just can't break down their
own fat. So their body is essentially broken
in that regard and that can be fixed with diet.
It's a hard problem because the way I explain
it to people is – and so clinically I'm not interested
in weight loss, right? I mean that's just not
– I'm much more interested in longevity. And
yes, sometimes weight loss comes with that. But
I – like if I ever get stuck doing weight loss,
like I'm doing the wrong thing for my interest.
But the way I say to people when they want to
lose weight is, look, you don't want to lose
weight. You want to lose fat. Let's be very clear
on our semantics. Weight is irrelevant, right?
Unless you're a cyclist or some athlete for whom
the actual scale means something. But for people
like us, you want to lose fat, not weight. And
then when you say you want to lose fat, what
does that mean in English? Well, do you want
fewer fat cells or do you want each fat cell
to be smaller? Those are totally different questions.
If you want fewer fat cells, have liposuction.
But we know that that doesn't fix you metabolically.
So if you want... If you want to be less fat,
you have to have smaller fat cells. Now, a fat
cell conceptually has two inputs and one output.
So now I say, let's reframe the question. You've
got a room with 100 people in it. You want fewer
people in the room. What has to happen? More
people have to leave the room than enter the
room. So 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. And 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. Each
of those three doors is controlled by hormones.
And so the purpose of nutrition or 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. And the hormones that drive
that are many, insulin, hormone -sensitive lipase,
testosterone, estrogen, cortisol being the five
most important in my opinion. Maybe someone will
disagree with that, but I think those are the
five that rule the roost. And so, you know, how
do you manipulate those? Well, insulin seems
to be the most important of the five. And there's
no better way to lower insulin than to not eat.
So 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. In 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. In other words, if
he was a type 1 diabetic, he would have died
of ketoacidosis because he wouldn't have had
the insulin to regulate the uptick of ketones.
But 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. as opposed to getting north of
12 to 15, which is when you get into trouble.
So how do you manipulate insulin? Nutrition is
the first way. If you can't fast, the next best
thing is to reduce carbohydrates. Carbohydrates
obviously are the most insulogenic of food, although
protein can be quite insulogenic as well. It
has a different response. And then that's when
you start to think about these other things.
I've seen patients where They just can't lose
weight. And I watch what they're doing and they're
doing everything right, but they just can't lose
weight. But then you notice their cortisol levels
through the roof. It's hard to get rid of fat
when you have lots of cortisol. Cortisol is a
very anabolic hormone to fat and a very catabolic
hormone to muscle, which is the exact opposite
of what we want. Testosterone, of course, is
the exact opposite. Testosterone is catabolic
to fat, but anabolic to muscle. And then, of
course, Women have a harder time because once
women go through menopause, they lose all the
estrogen and all the testosterone. And so now
they lose two hormones that play a very important
role in regulating this. So for these people
that are having the issue with cortisol levels,
that's exacerbated by stress, right? Yes. So
stress actually exacerbates your weight gain.
Absolutely. Wow, that's interesting. In addition
to a whole bunch of other stuff. You could literally
eat the same diet and gain more weight because
of stress. Absolutely. Wow. Again, hormones are
what's driving fuel partitioning. You're responsible
for what you put in your mouth, but in many ways
at that point, the hormones take over and decide
where it's going. That's fascinating. Now, you
yourself, what's your diet like? I mean, you
told me you only eat once a day, but. Yeah, one
meal a day or sometimes two meals a day. How
many calories are you taking in? You know, nowhere
near what I used to. I just don't train that
much anymore. I 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. So I'll do that three or four times a
week. I would guess when I sit down to throw
down, it's probably 3 ,000 calories. That's a
lot in one meal, huh? Yeah, although the problem
is I'm a fucking pig. I'm kind of disgusted.
I can eat a lot. It's gross. I gross people out
how much I can eat, actually. For me to only
eat 3 ,000 calories in a sitting is tame. Really?
Yeah, yeah. No, I have an eating disorder. Really?
Sort of. I think I have disordered eating. It
seems like you just enjoy it because you do it
once a day. No, under any circumstance. I stress
eat. I do get a dope. I don't get a dopamine
high from gambling or alcohol. Those things are
not things that I can abuse. When I'm really
in a shitty place in life, I soothe and punish
myself with food. A lot of people do. So you
could relate. And as a thin man, you know, when
you're talking to people that are large and have
the same issue, it's got to be. No, it's totally.
I mean, I completely understand what these people
are going through, at least in as much as what
they as the as the physiologic desire for it.
I mean, obviously, they will experience something
even worse because there's the like I can like,
look, I don't have abs on. I don't have veins
in my abs anymore. I used to when I was in a
ketogenic diet. You know, I was 7 % body fat.
I was completely ripped. I'm not ripped anymore,
you know, relative to that. That kind of bugs
me, but, like, nobody really knows that. I mean,
nobody really gives a shit. So I can still, like,
look like a super healthy dude, a super lean
dude, even if I'm not. But, oh, my God, like,
when shit's going wrong, like— I want to eat
some of the worst foods that have ever been created.
Why is that instinct there? Why is the instinct
that when you're not feeling like for me, it's
tired. Like if I'm tired, like if I'm coming
home from a gig and it's two o 'clock in the
morning, it's very difficult for me to drive
past Wendy's. You know, I want to go to Wendy's.
That could be an adrenal issue. So a lot of times
we'll see when people. either turn to sugar or
salt in times of fatigue. A lot of times it can
be, you know, they don't have the right level
of free cortisol at that moment in time. I've
always feel it's a willpower issue because if
I could just get home, I'll cook something healthy.
And then I have victory, you know, because if
I get home, I know I've got healthy food at home.
I'll eat something really good and it's just
as good. But there's something about also there's
like you're doing something, you know, you shouldn't
do. There's a little weird little charge there.
Yeah, that's interesting. I mean, I guess it's
different for different people. I think for me,
if I'm really going to be brutally honest about
it, I think it's that I sometimes just want to
punish myself. And I'm like, you know, like eating
bad food is like when you're bad, you eat bad
food. Do you give yourself a cheat day? You know,
I don't—not really. I mean, I think these days—and,
you know, you've got kids, so you know it. I
mean, cheat days just present themselves often
enough for other reasons. And unfortunately,
I think for me, the cheat meals are a lot of
times cleaning up a kid's plate or something
like that, you know? Like, I mean, the funny
thing is I just—I really— I don't know why. I
just like shitty food. I like macaroni and cheese.
Of course we do. Of course. If they don't eat
their macaroni and cheese, I got to eat it. My
kids asked me to make them peanut butter and
jelly the other day, and they don't eat crusts.
Which is really good. Fucking fantastic. Especially
with a glass of milk. They don't eat the crusts.
And I'm like, well, these crusts shouldn't go
to waste. Oh, God. There's kids in Africa that
should eat that crust. So I ate the crust. And
then I thought about all the bread with peanut
butter and jelly I ate in those crusts. I basically
ate a fucking sandwich. It's like I'm pretending
that I'm just eating a little crust. I eat a
lot. I'm worse than you, dude. You know what
I would have done in that situation? I would
have been like. Peanut butter and jelly sandwich?
Fuck it. Well, I would have started by saying,
there's not enough peanut butter and jam on these
crusts. I don't have the right ratio. So I would
have got out the peanut butter. You put it in
the jam and dip the crust in there. And then
I would have probably made a sandwich. I'm just
happy that I didn't eat a sandwich of my own
as well as their crusts because I probably could.
Once the fucking gates are open, once I'm out
there making spaghetti and meatballs, like, all
right, let's get some fucking ice cream in this
mix too. Once I'm already fucking off. So what
do you eat when you sit down for these 3 ,000
-calorie meals? So if I'm in control of the meal,
which I usually am, I'm a super boring dude.
So it's I like to have a salad in a bowl that's
larger than my head. So I always refer to that
as a manly bowl. That's the definition of a manly
bowl. So it's got to be like a staggering amount
of salad. And my salad is the same every freaking
day. It's romaine lettuce. It's, you know, tomatoes,
mushrooms, cucumbers, carrots. And then the dressing
is just extra virgin olive oil, freshly squeezed
lemon, salt and pepper. It's pretty bland salad
in that sense. But I mean, I can eat that all
day, every day. And then it's a serving of protein,
and I usually cycle through salmon, pork, steak,
some gamey meat, like whatever. I just sort of
cycle through that. And then I usually have some
sort of starchy vegetable to go with it. So potato,
rice. You know, lately, the last couple of weeks,
I've been skipping the starch and just mainlining
extra salad and extra protein. You know, but
that's when I'm in San Diego where I have control
over what I eat more. In New York, I never eat
in my apartment. Like I just never cook. So I
always go out. And there it's a little less regulated.
So, I mean, I just love Indian food. I love Persian
food. I love food that unfortunately is, you
know, got more carbs in it than I'm probably
suited for. But I try to modify. So like last
week I had. this Bob, who's actually one of my,
my head analyst, he lives in Boston. He came
down to New York for a couple of days. We were
doing some work and we went out for, he loves
Indian and I love Indians. We went out for Indian
one night and we hadn't eaten all day. So we
ordered, I think seven or eight entrees and the
waiter's like, you know, uh, you guys know you
ordered seven or eight entrees, right? We're
like, yeah, we got it. We got it. We're good.
And so, you know, we sort of skipped the naan
or maybe had one naan to split. Instead of normal,
I would have had like four naans and only had
one bowl of rice. It's still a lot of carbs.
It is. Yeah, yeah, yeah. That naan bread is insane.
Yeah. Luckily, Bob ate more of it than I did.
And he's way more jacked than me, so he can get
away with eating way more naan than me. But,
yeah, that night, I mean, also those sauces are
like so fatty. Like I'm sure that was a 4 ,000
-calorie throwdown. pretty good about is when
I'm done I'm done so 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 and when I wake
up in the morning it's like black coffee you
know I'm not sneaking little shit in throughout
the day like whereas if I'm not fasting it's
just too easy for me to just like Oh, yeah. Like
in my office, like I share my office in New York.
I share with another doctor who it's his office.
Actually, I kind of sublet an office there. But
like I've never seen more shit in my life like
than the stuff patients bring for him to eat.
Patients bring him shitty food? Non -stop. To
a doctor? Of course. What, are they trying to
torture him for torturing them? I don't know.
Maybe. Or drug reps will bring stuff by or something
like that. There's an endless barrage of bad
food to eat. But it's good bad food. Delicious.
If they were bringing Oreos, that actually wouldn't
tempt me, despite the monkey. But a home -cooked
brownie. Yeah, exactly. Smell it. Or I forget
the name of... God, I can't even remember the
name of some of these bakeries up there. But
yeah, there's some. ridiculous shit that shows
up and every once in a while like I'm like okay
the fast is breaking at four o 'clock today give
me one of those scones but as long as you do
it with moderation you think you're okay yeah
except that my motto in life is moderation is
the only thing worth doing in moderation so the
problem is once I start like It's usually the
wheels come off the bus pretty quick. Do you
try to mitigate that with exercise? Like do you
say that I went off the rails today, so let's
hit the gym and go hard? It's less that. It's
usually I anticipate it. So last week a buddy
of mine went to see the David Bowie exhibit.
Did you see it, by the way, the Brooklyn Museum?
No. Are you a Bowie fan at all? Yeah. Oh, dude,
it's there until mid -June or July. It's in Brooklyn?
Yeah, it's at the Brooklyn Museum. I was in Brooklyn
a couple weeks ago, but I was only there for
two days for the UFC, and I had a show out there.
So probably one of the best shows I've ever seen
in my life. Really? Yeah. Unbelievable. I didn't
realize it, but like it closed at 11 p .m. and
they just didn't have the heart to tell me. So
I was there till midnight before they finally
came and like escorted me out of the building.
They're like, sir, we closed an hour ago. I was
like, damn, sorry, man. So what is it? It's like
an exhibit of all of his art, all of his music,
all of, and it's like, it's done. You know, when
you go to museums and they put the headphones
on you and you have to like push the button to
hear the thing, it doesn't work that way. Whatever
you stand near, you get the music associated
with that plus or minus a narrative as necessary.
But it was – like I've never – like I think they
had every one of his costumes. Wow. I mean it
was epic. So anyway, that night I knew we were
going to go out for a killer dinner before –
in Brooklyn before we went to the show. And so
normally I exercise in the morning. But that
day I was like, look. Your muscles will be a
little bit more insulin sensitive if you can
exercise about 30 minutes before you eat. That's
probably about the sweet spot. So 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. It would require a little bit more insulin.
So 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. in anticipation of that.
And I also wrote a little longer and a little
harder. Just, you know, like, let's really crush
this session so that, you know, I can go and
enjoy dinner a little bit more. Well, it sounds
like you enjoy a lot of things. You have a lot
going on. You've got your medical practice. You
have all these different things you participated
in as far as athletics, boxing and swimming and
cycling. What jazzes you up now? You obviously
have a mind that requires a lot of stimulation.
What keeps you going? I think this longevity
thing is the perfect culmination of all of my
previous lives in terms of professional lives.
So, I mean, I used to be an engineer and then
I went into surgery and then I left that and
went into management consulting and had nothing
to do with medicine for several years. I just
worked in credit risk modeling. And so in many
ways, like when you combine medicine with engineering
with... risk management, that is what longevity
is all about. Like if you want to take the practitioners,
you know, the roll up your sleeves approach,
that's what it is. So I think that scratches
that itch. But I think for me, like I have to
be sort of mastering something. So that's where
archery and race car driving today become just
total obsessions. And 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. Like
in the end, I think what I really just obsess
over is trying to get better at something. And
the nice thing when you start things late in
life, like I didn't get my racing license till
three years ago and I only picked up archery
two years ago or maybe a year ago. Like when
you suck so much, like the opportunity to get
better is awesome. So I think the bigger itch
for me is not intellectual. I think it's like,
It's like figuring out how to do shit better.
Yeah, I share a similar interest in things I
suck at. And that's one of the things that was
so compelling to me about archery. When did you
start? 2013, I think I bought. Well, I bought
a bow before that, but I didn't really use it.
2013, I think, is right when I got pretty serious
about it. You had John Dudley on your show once,
didn't you? Yeah, a couple times. Dude, I wasn't.
I mean that shot through the handle of the kettlebell.
Yeah. Was that a hundred yards? I think it was
a little more, but yeah. Yeah. That is, that's
one of my favorite things in the world. He's
helped me a lot. He's a remarkable archery coach
and just a great person too. Just a great guy.
I once saw on Instagram him and Jocko in the,
like they bumped into each other in an airport.
And so like I saw Jocko like two days later,
we had coffee one day. To be clear, Jocko had
tea. I had coffee. Jocko's a tea guy. But I was
like, dude, I can't believe you know John Dudley.
He goes, I don't know him. He just grabbed me
in the airport. And I was like, dude, I would
have been. There's the shot. Dude, I want to
see this. He did it with a lighted knock. Yeah,
he had a lit knock. Good God damn. People don't
have any idea how crazy that shot is. They cannot
fathom what he just did. Yeah. I've seen him
do some pretty ridiculous shit. He's a bad motherfucker
when it comes to archery, that's for sure. And
he's helped me tremendously. Where does he live?
He lives in Iowa. He moved to Iowa just so he
can kill big, giant deer because he literally
bought a farm in Iowa, a giant chunk of land,
and raises it for – he does do some farming,
but essentially what he does is raises deer.
He doesn't raise them. There's no fence, but
he makes it very – Make it favorable for them
to be there. He has food plots that he grows.
I mean, I hunted on this place a couple years
ago. It's amazing. It's an incredible place.
He loves it. I just, I remember when I bought
my bow, like I just sort of, you know, went into
the archery, like performance archery in San
Diego is like the place to go, right? Yeah. Went
in there and was like, okay, here's what I want
to do. They're like, why? I'm like, just want
to do it. Like, okay, great. And 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. Yeah. No, he's literally the best in
terms of like the average person who's interested
in it. He's got a great podcast about it. Knock
on podcast. But he gets so geeky and technical
in his descriptions and his understanding of
it. I mean, he constantly obsesses about form
and structure and, you know, archery. To me,
my history as a martial artist, it really. It
jives with me. It makes sense. Because you could
muscle things and do them wrong and develop bad
habits, and you'll never reach your full potential.
Or 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. There's really no
other way. And with archery specifically, it's
so satisfying, like as we were saying before,
when you do pull it off. And you do execute that
perfect shot with your rhomboids, and the hand
goes over the back shoulder, and you watch that
arrow go right into that bullseye. You're like,
yes! I have my daughter come out and do the slow
-mo shot of me from behind. I've got like 100
of these dumb things on my phone, and it's just
like I can watch them all day, and it's like,
did I do it? Did I do it? Nope, not there. Oh,
yeah, look at that. Oh, sweet. A lot of it is
elbow position, too, the height of the elbow.
The elbow has to be in line with the arrow. And
sometimes people are pulling, but they're pulling
in their elbows up here instead of way back here.
I think that's an interesting point about certain
things, right? So to me, the other thing I like
about archery and race car driving is you have
to learn some emotional discipline. So you can't
get pissed off and work your way through either
of those things. You can sort of get pissed off
on the bike and it can actually charge you, which
is not to say that cycling doesn't have technique
in it. But it plays a much smaller role, and
in the end, the grr factor can out -trump it.
But you can't grr your way out of a shitty shot,
and you cannot. In a car, if you start getting
pissed, you're done. I would imagine. You're
absolutely done. The same thing can be said for
a lot of things, I think. Pool is one of them.
Yeah. That's a big one. Golf, which I don't do,
but yeah. Yeah. Listen, Peter, we just did three
hours, believe it or not. I don't believe that.
It's 2 .30. Huh. Isn't that crazy? Look at that.
This place is a time warp. It really is. But
I really appreciate this conversation, man. It
was really fun. Thanks, man. Thank you. If people
want to get a hold of you on Twitter, give them
your Twitter address, your website, all that
stuff. Yeah, yeah, yeah. PeterTiaMD on both.
A -T -T -I -A. All right. Thanks, man. Thanks,
man. It was awesome.