The Most Important Daily Habits For Longevity (Heal The Body & Mind) | Dr. Pradip Jamnadas

Dr. Rangan Chatterjee 0:00 So you do this kind of three-week program where they unprocess their diet. Then you put them on this kind of 18-hour fast, so they're having two meals a day over six hours, and then for 18 hours they're not consuming anything. Uh, we must talk about any contraindications like insulin or blood sugar medications at some point, just to make sure that, you know, people who are listening who wanna try stuff, that we've- we've covered that. But also, I wanna go a bit further, because I know you have used 24-hour fasting with patients. I know you have used three-day fasts, and you have also shared, in previous conversations, some very powerful statistics. One in particular, I remember, on a seven-day fast, you shared a statistic, a bit of research from Boston, in terms of what that does to your lifetime cancer risk. So maybe you could talk about some of these longer fasts, and then practically, how do people start going about that?

Dr. Pradip Jamnadas 0:57 Yes, yes. So absolutely. So at all times, they are supposed to take their blood pressures twice a day, make sure that, uh, the blood pressure not going down too, because I do not stop the blood pressure medications-

Dr. Rangan Chatterjee 1:07 Okay, okay

Dr. Pradip Jamnadas 1:07 ... right off the bat. So on- the blood pressure medication reduction will be done, uh, depending on your blood pressure readings. As far as blood sugar is concerned, if they are on oral agents, I'll continue those oral agents while they're doing the 18-hour fast periods. Even the 24-hour fast, I'll keep them on it, and I will ask them to monitor their blood sugars. Now, continuous glucose monitoring, the, the, the, the little, uh, devices, I only advise those on, on patients who are on insulin-

Dr. Rangan Chatterjee 1:37 Right, right

Dr. Pradip Jamnadas 1:37 ... when I'm fasting them, because I wanna make sure that their insulins don't drop off. But when a patient is taking insulin and he does the 24-hour fasts, I drop the insulin levels by half first, I mean, insulin dosage by half, and I monitor their blood sugars. And then when they go beyond 24-hour fasts, I stop insulin completely.

Dr. Rangan Chatterjee 1:59 Yeah, yeah.

Dr. Pradip Jamnadas 1:59 Completely, completely. I stop it completely, because I don't want them to become hypoglycemic. So oral agents, I will continue. Insulin, I will discontinue if I'm doing more than 24 hours, but I monitor their blood sugars very closely. And then that brings me to a little longer fast. Before I go to, uh, longer fasts, I make them do a 36-hour fast. So I'll make them do that once a week. Once a week means that evening rolls around, skip that meal also, and then have yourself a breakfast. Treat yourself with a breakfast the next day. And that brings it to 36 hours. So I make them do at least one 36-hour fast for maybe, you know, two consecutive weeks, and then I'll take them to higher levels.

Dr. Rangan Chatterjee 2:44 Can I just clar-

Dr. Pradip Jamnadas 2:44 Can I-

Dr. Rangan Chatterjee 2:45 C- can I just clarify that? So the 36-hour fast, the way you have found it most beneficial for most of your patients is what, you skip one evening meal to the next evening meal? What, how, when, when does that fasting time... I know you can do it any way you want, but what have you found to work? Can we just clarify that?

Dr. Pradip Jamnadas 3:02 Yeah. So the patients already are used to having only one meal a day.

Dr. Rangan Chatterjee 3:06 Okay, okay.

Dr. Pradip Jamnadas 3:06 So then I'll say skip that one meal, and then have the next meal when you're supposed to have, then that'll bring you to 36 hours. So for most patients these days, they're having their evening meals because it's more social, having it-

Dr. Rangan Chatterjee 3:17 Okay, okay

Dr. Pradip Jamnadas 3:18 ... with the families. So they'll skip breakfast, they'll skip lunch. Evening comes around, they're supposed to eat, and I tell them, "Skip it and go and have breakfast the next day." That brings them to 36 hours.

Dr. Rangan Chatterjee 3:28 I guess if they're already used to having one meal a day, then actually skipping that evening meal is kind of, I don't know, just go to-

Dr. Pradip Jamnadas 3:37 Yeah

Dr. Rangan Chatterjee 3:37 ... go to bed early as well, you know? [laughs] Sort of, you know, uh, it's... Yeah, I like that. So what stage do you take them from this two meal a day, which is this, uh, you know, this six-hour eating window, you know, you, you do that initially for the 18-hour fast, then you take them to 24 hours, do you, with just one meal a day? Is that how you do it?

Dr. Pradip Jamnadas 3:55 That's exactly how I do. And then they're doing one meal a day, five days a week, mm? Weekends they're gonna have two meals. They do that for two weeks. And then I say, "Okay, you've been doing this for two weeks now. You've been having only one meal a day. Next few weeks, one day a week, you're gonna go to 36. And the way you're gonna do it is you're gonna skip that one meal also and then have a breakfast the next day. So that'll bring you to th- and I wanna see how you feel." And most of them come back saying, "I just missed the meal in the evening. I watched a movie and went to bed." So why am I going from 24 to 36? Because I want to get them ready for longer fasts, especially if they're tremendously overweight and they're metabolically deranged. What's the biochemical advantage between 24 and 36? At, by 36 hours, almost all of them will be in some degree of ketogenesis. So it's hard to know who's gonna start spilling ketones at 18 hours, 24 hours, 30 or 32 hours. It's hard to know that. So when I prime them, then I'm finding that there's longer and longer periods of ketogenesis. That means they go into ketone production at 16 hours. So long as they made their dietary changes, gradually got into this, the ketogenesis phase starts a little bit sooner, at about 16 hours. And the most motivated patients say that, "Oh, I wanna know." I said, "Okay, if you wanna know, then go to the pharmacy and pick up some keto sticks and just test your urine, and tell me when you started spilling the ketones." So after 24-hour fast, almost all of them are spilling ketones. And when they're spilling ketones, I know what's going on with their physiology at that point. I know that they're getting the benefits of some degree of autophagy, growth hormone, um, uh, BDNF production and mitophagy. I know that's happening because they- they're spilling ketones. So spilling ketones, so that's another motivating thing. In the patient who's showing me the interest, and the ones I really want them to Check your ketones. That's what I find so fascinating. So by 36 hours, they're making the ketones. So they'll do that for a couple of weeks where they now went to 36-hour fasts once a week for two weeks. Now, at that point, depending on how motivated they feel and how well they are doing, now I'll go to more prolonged fasts. And my favorite fast is the three-day water fast. And, uh, most of the-- I'm telling you, greater than 95% of them, when they've graduated to this point, where they've gradually gone and done all this, they're able to do the three-day water fast with no difficulty whatsoever. And if they get cramps, then I tell them, "Okay, take a glass of water and put a pinch of salt in it and just, just down it, and you'll feel better." But most of them don't because they've adapted themselves. If you go into a three-day water fast too quickly, you're gonna get more cramps, but more importantly, you're gonna go through what is known as keto flu, and you just feel terrible and achy, and you just feel really bad. So I do it gradually. But I must make them go to a three-day water fast. I use it in that case. I also use it in patients who are able to lose weight, but then they reach a plateau. So now they're weighing 230 pounds, and I want them to have more weight loss, so they've been doing this now for a month, and they said, "Look, Doc, I just can't shed any more weight now. I've done everything you're saying." And I'll put them on a three-day water fast, and lo and behold, they'll start losing weight again. So I use that in patients who have reached a plateau, going to the three-day water fast.

Dr. Rangan Chatterjee 7:38 Thank you for sharing that. I think something I did wanna bring up today, um, because I know a lot of people-- And again, we're, we're all influenced by the online world or the patients that we've seen or the online world that we inhabit. And, you know, I spoke to David Sinclair, uh, this Harvard professor, who talks about aging in a very, very profound and novel way. And, you know, when I put out that episode with David, a lot of people were saying, look, asking people to skip meals, uh, is very triggering for people with eating disorders. And I know eating disorders are on the rise, uh, massively all over the world, certainly here in the UK and in, and in America. So I think we need to be careful about that. Uh, I think it's worth me, uh, just flagging that here, that potentially this advice is not for people with eating disorders. That's a sort of separate issue. Well, I'd welcome your perspective on that. Um, but also, you know, is it possible that we take these things to extremes? I guess there would be some people, we mentioned Anna Lembke's book before, Dopamine Nation, and, um, that we're all, we're living in a world of addicts now, and that, you know, she mentions that the smartphone is the modern-day hypodermic needle, which I thought was a very provocative way, but, but I, I actually completely agree with her of talking about it. There's health, there's physical biochemical health, but there's also this kind of emotional health and our mental wellbeing. Do you think, as much as you love fasting, do you think some people, they can sort of overdo it and get so addicted to kind of that feeling of fasting and actually go to an extreme which potentially could become problematic?

Dr. Pradip Jamnadas 9:29 I think you're right. It can happen. Fortunately, I haven't seen it here with somebody. I tell them, "Stop now. Stop, stop. This is enough. Now you-

Dr. Rangan Chatterjee 9:36 Yeah, yeah

Dr. Pradip Jamnadas 9:36 ... should be eating two meals a day. And, you know, I think that the pattern you need to settle down in is, for you, I think that two meals a day in a six or eight-hour window period may be a nice thing for you to do chronically to maintain what you've gained, uh, the benefits that you've already gained. Um, then I haven't seen any patients who ignored that and continued to do the three-day-

Dr. Rangan Chatterjee 10:00 Right, right

Dr. Pradip Jamnadas 10:00 ... water fasts on a, on a weekly basis or whatever, or two weekly basis. I haven't seen that. But, but, but you are absolutely right that there are some patients who clearly have an eating disorder, and they clearly have a type of addiction, a- and they're going up at night, and they, and they, they creep downstairs, and they're eating away five bars of chocolates and all this kinds of stuff. And those patients clearly do need help, and I will not-

Dr. Rangan Chatterjee 10:21 Yeah, yeah

Dr. Pradip Jamnadas 10:21 ... deal with those on my own. I will supervise it-

Dr. Rangan Chatterjee 10:23 Yeah, yeah

Dr. Pradip Jamnadas 10:23 ... but I'll send them to a psychologist that actually specializes in addictions because they have to really spend time with that patient about addiction behavior. And it's not just behavior about the food. There may be other issues that are actually triggering, um... 'Cause see, you, you slide from one addiction to the other-

Dr. Rangan Chatterjee 10:39 Yeah, yeah

Dr. Pradip Jamnadas 10:40 ... to the other to the other. So, so you can't take up this alone on its own until you also take care, take care of the sugar and maybe the, the cell phone and, and other digital gadgets that gives you-

Dr. Rangan Chatterjee 10:48 Yeah, yeah

Dr. Pradip Jamnadas 10:48 ... the instant gratifications. And, and there may be even be other issues. He may be a gambler for, you know, or have-

Dr. Rangan Chatterjee 10:54 Yeah, yeah

Dr. Pradip Jamnadas 10:54 ... other type of s- uh, deviant behavior addictions. So no, you're absolutely right. So recognizing those with the biggest problems, and addiction is a huge problem.

Dr. Rangan Chatterjee 11:05 Yeah.

Dr. Pradip Jamnadas 11:05 And it's becoming more, more known now that, uh, the addiction is to not only sugar, but it's also addicted, uh, to, to, to processed food content.

Dr. Rangan Chatterjee 11:15 Yeah. Yeah.

Dr. Pradip Jamnadas 11:15 Processed foods and the content of processed foods, um, are very addictive.

Dr. Rangan Chatterjee 11:21 Yeah. For sure. For sure.

Dr. Pradip Jamnadas 11:22 And I think that that's why you wanna change the, the type of food that you... So you're getting rid of all the addictive substances in the food, the addictive sugar in the food, and then addictive behaviors in other aspects of your life as well.

Dr. Rangan Chatterjee 11:34 Yeah, yeah.

Dr. Pradip Jamnadas 11:35 So, so it's, it's really looking at the whole thing. Uh, it's, it's a, it's a huge problem. It's a huge problem. And yes, we, we are an addicted nation. Um-

Dr. Rangan Chatterjee 11:42 Yeah, yeah

Dr. Pradip Jamnadas 11:42 ... we, we, we-- And that's why it's making it so easier for us to become addicted to food later on in life 'cause it starts at a very young age.

Dr. Rangan Chatterjee 11:49 Yeah. Yeah. Right. Right.

Dr. Pradip Jamnadas 11:50 You know, you're already getting addicted to gadgets, um, and instant gratification.

Dr. Rangan Chatterjee 11:54 I wanna move on to the mental benefits shortly of fasting 'cause I think there's a real, uh, important piece there that we touched on a couple of times in the conversation already. Before I do, w- I sort of feel that, that there's so much, um, divisiveness and, um, you know, frankly, fighting about different diets- That I think sometimes gets so unhelpful for the general public. Um, they see doctors who they admire saying, "This diet has got this evidence, this is really good," and they see another doctor who they admire say, "This diet's really good, it has all this evidence." And I think, and I know this from talking to patients and talking to the public, that many people find this incredibly confusing. I, I really like fasting for the right person and the right state of health. I kind of see it as the great unifier in many ways because as long as you are metabolically able to do that fast, you know, whether you choose to eat meat and fish or whether you choose to be vegan, if you are whole food primarily and not having, uh, much processed food at all in your diet, then you're still gonna get benefits from fasting, right? Whether you're low carb or whether you're vegan. And, you know, it's interesting, that video that you did on fasting, Fasting for Survival, on YouTube, which has, you know, had millions of views, I was reading through the comments just before this conversation, Dr. Jamnadas, and the top comment was, really, I think, encompasses everything that you stand for. He, I think, said he was mostly plant-based, and he started off following your advice with a whole food, mostly plant-based diet. I think he started off with 18-hour fasts. He moved up to 24-hour ones. I can't quite remember. Then he moved to maybe one three-day, one every six months, and he's documented his health journey over two years, and it is utterly remarkable that you put out a video on YouTube, and you have completely empowered that guy to transform his life. So first of all, just I wanna acknowledge you for that. That's just one of millions of people who've seen that video and changed their lives, so that's just incredible work that you're doing. But what do you think about this concept that fasting could be the great unifier? No matter what tribe you belong to, you can still get involved with fasting and yield, and, and, and, and reap many of those benefits.

Dr. Pradip Jamnadas 14:28 Yeah. You're absolutely right. Um, the various dietary programs that have come out have confused the public. It's confused the physicians as well.

Dr. Rangan Chatterjee 14:35 Yeah, yeah.

Dr. Pradip Jamnadas 14:36 I mean, my patients come in and say that, "I'm following this diet, that diet, and nothing happened, and this one's too hard for me, and, a- and this one's too restrictive for me, and it doesn't fit with my lifestyle." I understand that. I understand that. Fasting forgives you. Fasting, in a sense, forgives you for certain foods that, that you may then consume. And actually, think about it this way also. You eat that slice of bread after a fast, your insulin response is totally different in the fasting state than in a fed state.

Dr. Rangan Chatterjee 15:07 Mm-hmm. Mm-hmm.

Dr. Pradip Jamnadas 15:07 You're gonna make less insulin for the same slice of bread in a fasting state. So it's-- And the c- the, the, the type of food that they consume. So when I first started out, I was, years and years and years ago, I would, I would say, "Oh, you gotta be a vegetarian. You gotta, you gotta drop all meats." And being in United States, how many patients are gonna become vegetarian, right? So, and then as the data came out and I started studying more and more, I changed.

Dr. Rangan Chatterjee 15:35 Yeah. Yeah.

Dr. Pradip Jamnadas 15:35 I decided that, hey, th- there's something wrong with this. You know? People should be able to eat ancestral foods and what they grew up with. Uh, uh, but the problem was processed foods. Then we take the foods and we process them, we change them, and all the additives that we put into, and the way we grow our food or way we, we, we, we get our meats has changed. So I said, "No, no, no, no, this is not right." When I studied non-vegetarian diets, um, around the world, how come they had this low instance of heart disease? There are populations that eat only meat and only drink milk and, and blood, or, or, or the populations that only eat starches and a lot of it, and they also live long.

Dr. Rangan Chatterjee 16:23 Yeah. Yeah. Yeah.

Dr. Pradip Jamnadas 16:24 What is the commonality? What is the commonality in all of them? The commonality was no processed foods, no additives, right? No, no sugar. So they, they, they all had simple diets. So then I came up with my own plan, and I said, "Listen, you, you, what do you like to eat? What do you like to eat? So you want to only eat red meat? Okay, then eat grass-finished meat because that'll have-

Dr. Rangan Chatterjee 16:45 Yeah, yeah

Dr. Pradip Jamnadas 16:45 ... more nutrients in it. The fats will be the right kind of fats. You will not have all those omega-6s in there. You, you, you'll have more natural fats in there.

Dr. Rangan Chatterjee 16:52 Yeah, yeah.

Dr. Pradip Jamnadas 16:52 And if you wanna eat eggs, chicken, fi- So I let them do that, and I said, "But you gotta also introduce plants in your diet because you need the plants, not for you. Yeah, and you're gonna get some, some water-soluble, uh, vitamins, et cetera, et cetera, into your system when you eat plants and all, but it's really for your gut bacteria." So again, I had to read a lot about the microbiome to understand that the fiber is hugely important, very important.

Dr. Rangan Chatterjee 17:18 Yeah, yeah.

Dr. Pradip Jamnadas 17:18 And, and, so I tell them, "Eat your vegetables as well." So this is my diet plan.

Dr. Rangan Chatterjee 17:23 Yeah, yeah.

Dr. Pradip Jamnadas 17:23 It's not so restricted. Just stay away from anything that your great-great-grandfather wouldn't eat, and no processed foods. Anything in a packet, box, barcode. Stay away from anything made into a flour, and that's been a hard one, the flour one.

Dr. Rangan Chatterjee 17:36 Yeah.

Dr. Pradip Jamnadas 17:36 Um, also in South Asians-

Dr. Rangan Chatterjee 17:37 It's everywhere

Dr. Pradip Jamnadas 17:38 ... it's a huge, huge, huge problem.

Dr. Rangan Chatterjee 17:40 I, I, I love this, um, you know, I'm, I'm so enjoying speaking to you. There's a real kind of, there, there's just a beautiful energy, but there's also this kind of real-life practicalness that you know what it's like when these patients come in, and you've got in your head the ideal thing, but you gotta work with people and their tastes and their preferences and their culture and what they want. And I really do strongly feel that too many people these days on social media commentate. They look at the science and go, "Oh, this is what everyone needs to do." It's like, that's just not how it works in real life, in my experience. You know, people are different. They've got different desires. They've got different cultures, different preferences. So I really like that. You've mentioned all the- ... kind of physical benefits, the biochemical benefits when we have a period of not taking in food, a period of fasting.

Dr. Rangan Chatterjee 18:31 But there's also something really powerful, isn't there, like you have touched on several times, about what it does for you when you know, oh, I can go 12 hours without food. I can go 18 hours. Wow, oh, actually, I can go 24 hours, and I don't actually need to put something in my mouth. I think we shouldn't undervalue just what that does for someone. You know, I think it's freedom. It's freedom from a dependency on foods, addictive foods, processed foods, sugar. It means that you can go about, you're out on the train station or the airport, and there's no good food to have. Cool, just don't eat. Take the flight, don't eat. It- There's a real freedom, which many people feel that they are ch- they're in chains, I guess, to the food industry and to their, their hunger and their stomach. So, you know, can you speak a little bit about that and why you feel that's so important?

Dr. Pradip Jamnadas 19:29 Yeah. I, I, I love the w- the fact that you used that word freedom because, you know, I said, okay, it empowers the patient, but it is a real freedom. It's a freedom that, that they know that what their behavior resulted in no adverse effect, and that they were able to overcome this, which they never thought they could overcome. So these little hurdles that they're overcoming in their diet actually has r- huge repercussions in other aspects of their life. And really, honestly, it, it percolates into their, into their workplace, into their family life, um, in, in their social interactions, uh, with their friends. Um, and I've seen that these people, they just, they just become more, more, uh, self-confident. Um, and, and I think it's because w- we introduce terms to them like, "That's who you are, the real you." So it opens up a new aspect of their existence, that there is a part of me that's separate and apart from my body and from my mind and my cravings and my stomach and my feelings and, and all these things, and that's the real me. And of course, you know, th- this gets into some of that part that I have a huge interest in, which is, who are you?

Dr. Rangan Chatterjee 20:49 Yeah, yeah.

Dr. Pradip Jamnadas 20:50 What w- you know, who are you really? Um, where is the you? Uh, and why can't you, that, that you, change, uh, your behavior? Of course you can't, because you need to change your identification. So this is an identification change that I see the patients doing.

Dr. Rangan Chatterjee 21:09 Yeah, yeah.

Dr. Pradip Jamnadas 21:10 They realize that they are in charge, that, that, that them, inside them, not the body, not the mind, there's actually an awareness, an am-ness, an I am, and that is huge, huge. And I've found that people who have done this program over the last few years, they actually get work promotions. They actually become better supervisors. They become, uh, just better family, uh, members a- a- and caregivers. Um, and it's miraculous-

Dr. Rangan Chatterjee 21:37 Yeah, yeah

Dr. Pradip Jamnadas 21:38 ... how one thing, because it's, it's showing them that, yes, you are in charge. Look, you can do it. You can do it. And they just self-empower themselves. They feel so good. Self-confidence just goes off the roof. And I think that, that, that, that, th- there's a, you know, I'm learning more about this, um, but, but, but I think it does boil down to, to, because that also brings me to stress management. Because one of the things we do tell our patients is that y- you, if you start getting stressed out during all this, these periods where you're getting into the fasting period, you need to go out and do some, some meditation, we tell them, and we show them how to meditate. And I have a very simple meditation technique where I just basically ask the patients to, okay, just, uh, close your eyes and just concentrate on your breathing only. And when a thought comes, let the thought go. Don't follow up on it, because then another thought will come in a few minutes. Don't follow up on it. Wait. Just come back to your breathing. Concentrate on your breathing as the breath goes in and out, and you will find that there'll be gaps in between your thoughts that get longer and longer and longer. And my patients have all said, "Yes, you're absolutely right. There's blankness." I said, "Well, that blankness when you don't have a thought or when you're not, you know, thinking of something, that's you. That's the real you."

Dr. Rangan Chatterjee 22:57 Yeah, yeah.

Dr. Pradip Jamnadas 22:57 And when you come out of this for 15, 20 minutes, you will realize that there is that you in you, and you can make up your mind about anything. You can, you can do anything. It'll empower you-

Dr. Rangan Chatterjee 23:08 Yeah, yeah

Dr. Pradip Jamnadas 23:08 ... and you'll feel less stressed out. You'll feel less compelled. You're less automatic. You will be y- you, you will become, as you said, that word that you used, you'll have freedom. You'll have freedom.

Dr. Rangan Chatterjee 23:19 Yeah, yeah.

Dr. Pradip Jamnadas 23:20 And I find that fascinating. So you see, th- this whole thing, I, th- th- I said this in the beginning that, you know, fasting seems to open up those, that onion into all different-

Dr. Rangan Chatterjee 23:29 Yeah, yeah

Dr. Pradip Jamnadas 23:29 ... parts of your life. You know?

Dr. Rangan Chatterjee 23:31 Yeah, yeah.

Dr. Pradip Jamnadas 23:31 It's just amazing stuff.

Dr. Rangan Chatterjee 23:32 I mean, I love it. I, I just love it, and, um, if and when we have our second conversation, I c- I could see us going deep into who we are, spirituality, and I, I, I really do feel that's a missing piece in medicine. Like, it's not just about telling someone what they should do for their health. I mean, people don't really do what other people say in the long term, in my experience. They, they, well, might do initially to get them going, but at some point it has to change from being the doctor's plan to being my plan. At some point it needs to be, like they go on your three-week unprocess your diet, uh, sort of regime. They start fasting. At some point, maybe after a month, two months, three months, you want that self-empowerment piece where it's like, yeah, okay, the doctor's guided me, but I know what I'm doing now. Right? I want to eat this way. I want to fast like this because I feel good when I do it, so I'm now doing it Not because he told me to, but because I want to. And I think that, you know, I, you know, I, like you, I teach doctors. I, I always talk to them about this. This is a really important piece of the puzzle. Another thought I had is fasting is, you know, initially at least, a difficult thing for many people to do. And we kinda know that when humans do difficult things, whether it's fasting for 24 hours when you find it hard, or whether it's completing a half-marathon when, you know, six months ago you couldn't walk round the block, what it does for us in terms of who we are and our self-esteem and our confidence, it's very, very powerful, isn't it? So I really love that you are bringing that up also in the context of fasting.

Dr. Pradip Jamnadas 25:17 We, we have to. Y- you know that there's a huge, in health, there's a huge component of your, of your, your, your, your mental being and, and your understanding of who you are and your role in, in, in, in your life and, and the people around you. Um, so I ha- one of my interests, and maybe we can talk about this in other occasions, is, is, you know, what are your relationships like, especially with your mother, because that's gonna tell you how long you're gonna really live. It's amazing. Or, you know, when my patients are in the hospital, how many people come visit them after open heart surgery determines how quickly they're gonna recover from open heart surgery. Same surgery. Well, what's going on here? So we can... You know, there's huge repercussions-

Dr. Rangan Chatterjee 25:57 Yeah, yeah

Dr. Pradip Jamnadas 25:57 ... on how patients' health is, uh, de- depending on their social, and then how do they view themselves in society and their role and, and, and, and their hierarchy in society, and that seems to also dictate, uh, outcomes in health-

Dr. Rangan Chatterjee 26:09 Yeah, yeah

Dr. Pradip Jamnadas 26:10 ... irrespective of how much healthcare, uh, provide- uh, uh, facilities are available to them.

Dr. Rangan Chatterjee 26:15 Yeah, yeah.

Dr. Pradip Jamnadas 26:16 So there's all these other social determinants of health that are extremely important, and I think that we don't talk about that enough.

Dr. Rangan Chatterjee 26:24 Yeah, yeah.

Dr. Pradip Jamnadas 26:24 And I think that that's something that we need to talk about because in cardiology, besides my fasting, my other aspect is, is, is I do want to get into all of that with my patients to see that, you know, um, health is defined by you, you basically metabolize your psychosocial being. You, you metabolize it into your body. So be careful about your thoughts about who you are and how you're interacting with the world and everything that's going around you because in an instantaneous moment, you're actually metabolizing it into physiology in your body.

Dr. Rangan Chatterjee 26:59 Something I've been thinking a lot about, Max, and I, I will put this to you in just a moment, is whether it's more important for people to focus on what to eliminate versus what to bring in. And of course, you know, that's quite black or white. Of course they're both important. But certainly in the UK there's been a tendency for people now to say, "Don't worry about exclusion. It's all about what we're including in our diets." And I understand it. I think people want to hear that message. I think it's a more palatable message, and I, I understand the rationale that if you are filling your plate and your diet with the things that you should be consuming more of, there's gonna be less room for the things that we're trying to avoid or limit. I understand that. My bias is that I have been a clinician for over two decades. I've seen tens of thousands of patients, and I'll be completely honest, Max, I have found more benefit in helping people cut out of their diets the problematic foods in the modern food environments, the, the modern food supply, than by actively focusing on what to bring in. It's not a popular opinion that you can put out there these days. But I underlined this section in the introduction of Genius Foods, which I thought was really powerful, and again, this is, these are your words, Max. "You'll see that actually slowing the aging process, including cognitive aging, is just as much about the foods you omit from your diet as those you choose to consume." So I've said quite a bit there. I'd love your perspective on that, Max.

Speaker 28:39 Yeah. It's, uh, I mean, I think it's, it's, it's definitely, um... We have to lift the veil for people. This idea that all foods fit, right? That all foods are good foods, that there's no such thing as good or bad foods. I understand, like you, where that comes from, and certainly people listening to this, watching this, are coming with a lifetime of, uh, you know, of, of, of cultural attitudes about food, preferences, and, and the like. And I think that, you know, we have to, we have to be able to remove the morality from food-

Dr. Rangan Chatterjee 29:19 Yeah

Speaker 29:19 ... and be able to talk about food in terms of its empirical value, right? Especially in a time where people are sick, right?

Dr. Rangan Chatterjee 29:26 Yeah.

Speaker 29:27 So context is everything, and we have to understand that we're talking to a population that is unwell. A study came out just a couple of years ago that found that about only 10% of people, uh, are free of metabolic illness, meaning 90% of people in the US have some degree of metabolic illness, so this is a, a sick population, and I think that it's the responsibility of, you know, the healthcare provider to, um, to consider context, right?

Dr. Rangan Chatterjee 29:56 Mm-hmm.

Speaker 29:56 And so this idea that all foods fit, indeed that is the mantra of the junk food industry because what that says is, "It's not our fault. It's not, you know, this sugar-sweetened beverage that crams 30 teaspoons of sugar into a 16-ounce serving that's the problem. It's your problem because you were unable to moderate your consumption of these foods." Well, it's not innate to our biology to moderate our consumption of those kinds of foods, right? There is something wrong with drinking 50 grams of sugar, you know, in a beverage in one sitting. There's absolutely something wrong with that. There's not something wrong with you if you decide to indulge every now and then. That's a very human characteristic. It's a human universal, in fact, and I think that's where we have to be able-

Dr. Rangan Chatterjee 30:38 Yeah

Speaker 30:38 ... to separate morality from this conversation about, you know, what makes a food good or bad.

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Speaker 31:10 I think that in an, an environment where 66% of people are either overweight or obese, and where we are trending toward a population where by the year 2030, one in two people are gonna be not just overweight but obese, right? We're talking about clinical obesity here. That obesogenic foods like sugar-sweetened beverages, like these hyper-palatable ultra-processed foods that drive you to overeat, which we've already established, right, which we have good data now to say that these foods drive you to overconsume, that it's hard to argue that those, that those foods are good, right?

Dr. Rangan Chatterjee 31:46 Yeah.

Speaker 31:47 You would argue that... I think a, a strong case could be made that those foods are actually not that good, right? That they are counterproductive to good health.

Dr. Rangan Chatterjee 31:56 Yeah.

Speaker 31:56 And I would also argue that if you can't say that certain foods are bad, then we can't have double standards. You also shouldn't be able to say that certain foods are good, and so does that mean that we shouldn't say that, like, broccoli is good?

Dr. Rangan Chatterjee 32:10 Yeah.

Speaker 32:11 Does that mean that we should be censored when trying to say that, like, whole eggs are good? Whole eggs are great, right? We should be encouraging people to eat these foods. So I think we need to get back to a certain degree of, of logic and common sense-

Dr. Rangan Chatterjee 32:23 Yeah

Speaker 32:23 ... and reason when it comes to talking about food. And again, I understand that everybody's different, and some people have fractured relationships with food-

Dr. Rangan Chatterjee 32:30 Yeah

Speaker 32:30 ... right? Which is super important, and we have to talk about that, but not every message is for every person.

Dr. Rangan Chatterjee 32:35 Yeah. Uh, I think-

Speaker 32:36 And so

Dr. Rangan Chatterjee 32:37 ...

Dr. Rangan Chatterjee 32:37 I, I completely agree with that, Max, and as you say, everyone's different. Everyone's got a different relationship with foods. I think practically if people have never ever done two or three weeks where they are literally only eating whole foods, right, the sort of foods that we're talking about, I think people will genuinely be surprised with how good they could feel. And that's why my approach as a clinician has always been, let's have a two, three-week period where we cut everything out. Of course, you have to eat something in that, so it's not as if I'm starving people. They're eating real whole foods in that time, but the focus really is on what not to eat. And then what I find, like I mentioned with those migraine patients, is that people experience their life in a way that they haven't done before. They have more energy. They're sleeping better. Their skin feels clearer. Often joint aches start to go. Like, uh, you see this so often and then people can go, "Okay. Right. This is getting a bit bland. What can I introduce?" You know, and you... Bit by bit they start expanding their diet again very intentionally to kind of figure out, ah, you know, I'm not so great when I have that type of food. But, you know, th- that sort of education piece, when we're tuned in to how a certain food makes us feel, for me, that's the gold, Max, because then it doesn't matter what I say or what you say, right? Then they've become their own expert. Like, they've used maybe me and you as their guides to help them get going, but ultimately it's like, yeah, I know Max says to eat that food or Rangan says to eat that one, but when I eat that food, I get sinusy. I can't breathe properly.

Speaker 34:26 Mm.

Dr. Rangan Chatterjee 34:27 I get itchy. A- and I think that individualized component is so important. I kinda feel that many people have really outsourced their expertise to other people and, and I think there's value, and obviously we're trying to help there. We're trying to help guide people with our podcast and our books and our work, but I really feel that at some point the reader, the listener, has to go, "No. Okay, I've taken that on board, but now I'm gonna be my own expert. I know what works for me."

Speaker 34:58 Yeah, absolutely. I think we need to... Yeah, the, the, the... This notion of self-empowerment, of, of agency, and podcasts like yours, all the work that I'm putting out, uh, you know, my intent is that people use the advice that I give as a template to do their own research-

Dr. Rangan Chatterjee 35:14 Yeah

Speaker 35:14 ... and to iterate and to tinker and to see what works for them. I mean, we could talk all day long about, for example, the benefits of kale. I happen to be a fan of kale, right? But not everybody is gonna be a fan of kale, and kale is not going to digest well, for example, for some people, right? And so I'm not saying that you have to eat this food, right? But generally when I'm talking about a, a, a, a food, an, a specific food, it's to represent really a food category. And for example, kale represents dark leafy greens for me, which I think is one of these foods that you would think would not be controversial but of course today-

Dr. Rangan Chatterjee 35:49 [laughs]

Speaker 35:50 ... um, is, right? [laughs] I posted about the value on my Instagram of dark leafy greens and how researchers out of Rush University found that people who re- who ingest on a daily basis about a cup and a half of dark leafy greens have brains that perform up to 11 years younger, right? So this, this really interesting insight, which is correlational, to be clear. It wasn't, uh... That wasn't, uh, determined via randomized control multi-center trial, right? But, you know, carnivores come out of the woodwork now, people who only eat meat, and they're, you know... And they, and they have a problem now, a bone to pick with dark leafy greens. But dark leafy greens are, I think, a wonderful- ... food, and for most people can be very well-tolerated and provide a number of different important nutrients, some of which essential, some of which non-essential, but which we see as associated with, with better health, and to me should not, should not be controversial. A very empowering, I think, um, idea that I have, uh, put forth in Genius Foods is that people should ingest a fatty salad every day, just as a general rule of thumb. So a box that people can easily check off every day to consume, uh, a fatty salad every day so that, you know, we're ... if this Rush University finding holds true, that you could prevent brain aging, and in fact reverse brain aging by up to 11 years, to me should be non-controversial.

Dr. Rangan Chatterjee 37:13 What do you mean when you say a fatty salad?

Speaker 37:17 So many of the, um, the phytonutrient ... the phytochemicals in dark leafy greens are fat soluble, but greens don't contain a lot of fat. And so there was a, a very interesting study that looked at the absorption of, uh, actually these carotenoids that we've talked about, lutein and zeaxanthin. And what the study found was that co-ingesting them, these two compounds, which are abundant in dark leafy greens, particularly kale and Swiss chard and spinach, they're ... These, these, uh, these greens are rich in, in those two compounds. That if they're not co-ingested with a fat source, they essentially flow through you, whereas consuming them with fat dramatically increases their bioavailability because they're fat soluble. So the fat generally that I recommend, um, people using liberally in their salads is extra virgin olive oil, which increases the bioavailability, basically the way in which your body can, um ... the capacity for your body to access these very valuable, um, phytochemicals. And so, um, yeah, so that's a, that's a, I think, a great tip. But then there are al- there are other, um, aspects to dark leafy greens that make them valuable as well. For example, arugula is the top source of nitrates, dietary nitrates, which we know helps support our body's nitric oxide pathway, which is important for maintaining healthy blood pressure.

Dr. Rangan Chatterjee 38:43 Yeah.

Speaker 38:44 Which, again, we've es- established super important for good brain health. In fact, one high nitrate meal of, for example, arugula or beets, which are another, um, very, uh, food group rich in nitrates, can potentially boost cognitive function because it, it has the capacity to boost blood flow to the brain. And so you get that in dark leafy greens. You get, um, compounds called flavonoids. There is a very interesting study. And carnivores, which is funny, I don't know how many gravitate to your work, Rangan, but I seem to be a, a magnet for, um, people on all sorts of extreme diets, not least of which carnivore diets. Do you, do you have those-

Dr. Rangan Chatterjee 39:22 I, I do, and I have some views on that. I wanted to br- I wanted to talk about the carnivore diet with you at some point later on in this conversation.

Speaker 39:29 Yeah.

Dr. Rangan Chatterjee 39:29 So I do have experience, um, with it on, on, on a variety of different levels. But, but please continue. We'll definitely get there.

Speaker 39:37 Yeah. So there was a, a randomized control to actual, actual ... actually multiple randomized control trials where they used compounds called flavonoids, which are abundant in dark leafy greens, another aspect of dark leafy greens that make them so valuable and, and add scientific plausibility to this f- this finding, right? That regularly consuming dark leafy greens is associated with reduced brain aging. This randomized control trial, which is the kind of trial required to prove cause and effect, right? So that 11-year reduced brain aging was a correlational finding. But this randomized control trial used compounds called flavonoids, which are abundant in dark leafy greens. And flavonoids are quite literally plant defense compounds, which carnivores love to say are toxic for us, right? That they ... that these kinds of compounds should be avoided. But in fact, what this randomized control trial found was that it's these very compounds that have the capacity to boost BDNF, which is brain-derived neurotrophic factor, sort of thought to be like a Miracle-Gro protein for the brain, supports neuroplasticity, supports the suppleness of, of, of your brain as you age, right? So they looked at levels of BDNF in serum, and also cognitive function with cognitive, cognitive tests, right? And what they found was that when compared to low flavonoid, uh, foods, high flavonoid foods actually boost BDNF and support and enhance, in fact, cognitive function.

Dr. Rangan Chatterjee 41:05 Mm-hmm.

Speaker 41:05 And so you find these food- these compounds, flavonoids, in coffee, in tea, in berries, in citrus, and in dark leafy greens, right? So again, these are a, an, an, a food category that I refer to as genius foods, dark leafy greens. They also were, um, surfaced in a study by Beal et al, 2021, I believe, as being one of the most nutrient-dense foods that we have, um, access to because of the, the, the concentration of folate that you get in dark leafy greens. So not a food group to be, uh-

Dr. Rangan Chatterjee 41:36 Yeah

Speaker 41:36 ... to be avoided.

Dr. Rangan Chatterjee 41:39 Y- you mentioned fatty salads, and then, and I was flicking through Genius Kitchen today. This is y- your cookbook, Mats, and I, I'm gonna find it now. There was a salad towards the end, which I thought, "Right, I'm making that this weekend." You may remember, it had blackberries in. Um, I think it had avocado in it. J- The, the, the imagery was just absolutely beautiful. I thought, "I'm definitely making that." Do you remember the one? I think, I think that would c- that would definitely qualify as one of your fatty salads. I think it had in some of the genius foods we've mentioned so far. Extra virgin olive oil, avocado, dark leafy greens. I think it had ... Was it walnuts or almonds?

Speaker 42:20 Pecans, I believe.

Dr. Rangan Chatterjee 42:21 Yeah. I know, again, those are another one of your genius foods, right?

Speaker 42:24 Yeah.

Dr. Rangan Chatterjee 42:24 The category of nuts that specifically I think you mention almonds in the book. But would you broaden that out beyond almonds?

Speaker 42:31 Yeah, definitely. Nuts I think are great. They are ... Here's the thing, because nuts are, um, rich in fat, but not just any fat, polyunsaturated fatty acids. They also contain, they're an abundant source of vitamin E. Wherever you find polyunsaturated fats in nature, you also find vitamin E. So this is actually another nuance that we didn't, um, touch on in our discussion of these grain and seed oils, which I think is very important, uh, to, to, to bring up. Wherever in nature you find polyunsaturated fats, you find a proportional, um, amount of vitamin E, because vitamin E in nature exists to protect polyunsaturated fatty acids. And in fact, the more polyunsaturated fatty acids you consume, your requirement for vitamin E actually increases, because it's vitamin E that protects these fats in our bodies. Unfortunately, today we're consuming more polyunsaturated fats than ever before in human history, thanks to the preponderance of these grain and seed oils, but we tend to underconsume vitamin E. About 10% of people consume the, uh, RDA for vitamin E, at least in, in the United States. But when you consume whole food sources of polyunsaturated fats, they're actually incredibly healthy, right? Like, nuts are incredibly healthy. They're a rich source of polyunsaturated fats, but they're protected by, uh, uh, a commensurate proportion of vitamin E. So almonds, great source of vitamin E. Um, also magnesium, which is a macromineral that about half the population doesn't consume adequate amounts of, which contributes to everything from ATP synthesis to DNA repair.

Dr. Rangan Chatterjee 44:08 Mm.

Speaker 44:08 DNA damage is at the root of, one of the root causes of aging and possibly even, um, tumor genesis. And so magnesium is an, is an incredibly important, um, mineral, and you get about 25% in just a handful of almonds. Every nut has its own sort of, um, array of, of benefits. So if you don't like almonds, no big deal. I'm also a huge fan of pistachios. In fact, what gives pista- pistachios their characteristic, uh, color are carotenoids, lutein and zeaxanthin.

Dr. Rangan Chatterjee 44:40 Mm.

Speaker 44:41 Pistachios contain, um, these carotenoids which you won't find in any other nut. So if pistachios are your jam, go for it. Macadamia nuts are great. Uh, good source of monounsaturated fat. And we see time and time again that nut consumption is associated with reduced risk for neurodegenerative disease, for cardiovascular disease, for respiratory diseases-

Dr. Rangan Chatterjee 45:03 Yeah

Speaker 45:03 ... for kidney disease. So they're a great food group.

Dr. Rangan Chatterjee 45:06 Yeah, they really are. Of course, nuts are something that is easy for some of us to overconsume. I know I've been guilty of that before. You know, nuts are great for my brain, they're great for my health, and before you know it, like, where did, where did that pack of nuts go? So-

Speaker 45:22 [laughs]

Dr. Rangan Chatterjee 45:23 I, I, I totally agree. They're a fantastic food to focus on. Again, like I mentioned right at the start, even some whole foods some of us certainly can overeat. And certainly I particularly find I have to be quite careful with my intake of nuts. I can easily go, uh, a bit crazy if there's a bag of nuts in the house, certainly for me.

Speaker 45:42 Yeah. So here's a good hack for that, because I, I completely agree that, that nuts are very ... They're among the most calorie dense, um, whole foods that, that exist, and I think it, they become particularly easy to overeat. W- Now, again, sort of a byproduct of modern industrial food is that you can now buy them without shells, right?

Dr. Rangan Chatterjee 46:02 Yeah.

Speaker 46:02 And they come salted. S- Oftentimes they have added sugar. So just contributing to the hyperpalatability of these nuts and making them ever so easy to, to overconsume. So actually my hack for nuts is I very seldom snack on them. I don't use them as a snack. I use them in ingre- in, uh, recipes-

Dr. Rangan Chatterjee 46:21 Mm

Speaker 46:21 ... where they're portion controlled. So a lot of my recipes will integrate nuts, but they integrate them in a very deliberate and portion control way. And so to me, that's a great way to, um, to moderate my consumption of them. Also, you know, when you get them with flavored, as I mentioned, it just, you know, they become all the more easy to just-

Dr. Rangan Chatterjee 46:39 Yeah

Speaker 46:39 ... like eat by the, eat by the fistful.

Dr. Rangan Chatterjee 46:43 There's other kind of plant-based genius foods in your book, of course. We, you know, mentioned a few of them. There's, I think, dark chocolate and broccoli and broccoli sprouts and blueberries and all kinds of things.

Dr. Rangan Chatterjee 46:56 But I wanna move on to animal foods, because I think it's really important. You've, you've touched on the carnivore phenomenon, which is growing at the moment, where people ... Well, many people are going to meat only, or certainly meat heavy diets, and are reporting huge health improvements from doing so. Uh, certainly in the short term at least, but, but some, to be fair, in the l- you know, certainly over three, four years. And as an open-minded physician, I observe that. And because I think, like you, Max, I'm not wearing my dietary affiliation as my identity, I feel I'm able to observe and, and, and stand back a little bit and go, "Well, God, this is really interesting." Because I kind of feel ... And maybe this speaks to why you can post about dark leafy greens, and maybe someone from the carnivore community can be quite vocal. I don't know, 'cause I don't know who that person was, but my theory at the moment is if you have struggled for years with your health, joint pain, skin problems, allergies, and you've been to doctors and you've tried to empower yourself, you've listened to podcasts, you've read books, and you've tried everything, and your life has been really, really negatively affected, and then you have stumbled across, for whatever reason, the carnivore diet, and you've gone onto it, and suddenly a lot of those complaints have vanished or certainly got a lot better- I get it. I get it that it's like, "Oh man, this is it. This is the elixir that I've been waiting for." And I get it. It's, it's like if someone goes suddenly vegan and they've never done it before, and suddenly, you know, if they're going from a standardized Western diet to a whole food vegan diet or plant-based diet and feeling better, we often... You know, we've all got biases as humans, and we often feel, "Oh man, that's it. That's the magic diet. It worked for me." And, you know, certainly my clinical experience has taught me that there is no one diet that works for everyone. I've seen people following paleo diets thrive. I've seen people following vegan diets thrive. And, you know, I've come to the conclusion that the right diet for you kind of depends a little bit on your previous health, what your goals are, where you are at your life at the moment. It's like all these things factor in. And so like you, I have these frameworks and guidelines. But within that, I think people need to play around a bit and personalize them. So my view on the carnivore diet is I know we don't have any long-term data yet on it, you know? But I never want to, um, I never want to make someone feel... You know, someone who's transformed their lives by changing their diet, I get it. Like, I really understand. And, and again, my bias, Max, is I've seen sick patients for over two decades.

Speaker 50:03 Mm.

Dr. Rangan Chatterjee 50:03 So when that person finds something that works for them, I get it. I get why they're potentially even resistant to hear anything else. It's like if I had pain my whole life and suddenly I went carnivore and it healed my pain, you know what? I don't think I'd listen to anyone. I'd be like, "You guys say what you wanna say, but I know that this diet works for me." So that's just a little bit of my perspective. I don't know if any of that resonated with you. We'll be back to the conversation in just a moment. Now, many of us struggle to find time to eat all of these incredible whole foods. That's why I'm a big fan of good quality whole food supplements like this one that's been in my own life for over three years now. It contains over 75 whole food source ingredients, vitamins, minerals, pre and probiotics, and can help us support our energy, focus, digestion, and our immune system. AG1 are giving my audience a fantastic offer, one year supply of vitamin D and five free travel packs with your first order. You can see all details at drinkag1.com/livemore, or just click on the link below. And now back to the conversation. Oh, 100%. I feel the, the exact same way. A lot of people tend to be down on what they're not up on, right? So people that have that, that bring to the field of nutrition their biases. You know, maybe they are, um, they're on a vegan diet, but more so than their dietary, uh, choices, they are... There is a side of them that, that a- is actually an activist for various aspects of- Mm

Speaker 51:40 ... you know, maybe it's animal rights or environment, you know, planetary health and the like. And so people tend to get very, um, heated when confronted with facts that challenge their own-

Dr. Rangan Chatterjee 51:50 Yeah

Speaker 51:50 ... their own biases, right? And I think that's a big problem because people, as you mentioned, are just out here trying to see what's gonna work best for them and to cure, to heal them sometimes, or at least, you know, mitigate s- symptoms with regard to some very pressing, I think, health, health challenges today many people are suffering from. And so I think that it's, um, it's definitely something that we need to study more. I know that they are trying to do that research. Um, I think it's David Ludwig at Harvard, or I know Sean Baker is always on his like Instagram trying, who's a prominent, you know, carnivore personality, trying to recruit people for his studies, um, and the like. So I, I, I think, think that the research is, you know, probably gonna be coming out because of the number of anecdotes that you're seeing on social media. But I think a lot of the people who are seeing the greatest improvement of symptoms, they're coming from, uh, they're coming from sick places.

Dr. Rangan Chatterjee 52:38 Yeah.

Speaker 52:38 You know? They're, they're coming from places of, you know, having sev- crippling, uh, you know, gastrointestinal disorders, autoimmune conditions and the like. And I, I think there, there is some plausibility to the fact that when you cut out, you know, certain plant materials that can instigate what's called molecular mimicry in the body, um, to somebody who has a, a dysfunctional immune system or, uh, an impaired gut microbiome, for example, gut dysbiosis-

Dr. Rangan Chatterjee 53:05 Yeah

Speaker 53:05 ... uh, that you're gonna see a reprieve from, from these symptoms. And, you know, meat, at the end of the day, is a very nutrient-dense food. So I'm... I- I've always considered myself, um, to some degree carnivore adjacent. Uh, I definitely like to promote the value of plant foods. I think, I think, I think it should be a, a-

Dr. Rangan Chatterjee 53:26 Yeah

Speaker 53:26 ... almost like a 50/50 mix. I think, you know, my message is one of balance. I think that we have to embrace plants, but we also have to em- embrace animal products. And I think that, you know, that can sometimes be the hardest message, the hardest line to tow, is that-

Dr. Rangan Chatterjee 53:41 [laughs]

Speaker 53:41 ... that message of balance, right?

Dr. Rangan Chatterjee 53:42 Yeah.

Speaker 53:43 Because you offend both parties.

Dr. Rangan Chatterjee 53:44 Yeah. [laughs] I agree. I think, I think we're touching on something that's really important, Max. If we're gonna truly cut through this and, and help people, I have real sympathy and, and respect for that individual who has found something that works for them. And if that's a carnivore diet, I get it. I understand that. But at the same time, that working for that person doesn't necessarily mean that the research you are sharing about leafy greens is invalid.

Speaker 54:15 Right.

Dr. Rangan Chatterjee 54:15 That, that's the kind of unlogical leap from that. It's like, okay, cool, for you maybe at this moment in time, maybe you've got a damaged gut, maybe you've got molecular mimicry, maybe you've got leaky gut. Maybe at this moment in time you cannot tolerate a lot of the plant foods that Max is recommending. But- I mean, look, you live in America. It's probably worse there than here in the UK, but it's reflective of everything, right? Whether it's food or politics. Like, this kind of nuanced position in the middle, it almost doesn't exist anymore. You offend everyone when you take it. You almost have to nail your colors. You either are hardcore vegan or hardcore carnivore. Because your approach, I really like it, Max. It's very balanced. You know, I'm not gonna, out the gate, recommend a carnivore diet to one of my patients, right? It's not gonna be my starting point. But just as with, let's say, a patient with irritable bowel syndrome, IBS, a lot of the dietary recommendations people make often don't work for them if they've got severe IBS. They have to be very careful initially. Maybe reduce their FODMAPs with the help of a nutrition expert whilst they are healing their gut, dealing with their stress levels, and maybe in a few months down the line they can start to introduce foods that they couldn't tolerate. You know, my own health journey, Max, you know, I can now bring in foods that seven, eight years ago I couldn't tolerate because I've-

Speaker 55:41 Mm

Dr. Rangan Chatterjee 55:41 ... you know, I've repaired everything. I've gone back to basics. I've healed. I've addressed all the areas of my lifestyle that you talk about, you know, in your second book, The Genius Life.

Dr. Rangan Chatterjee 55:51 So yeah, I kind of, it... How do you find it, as someone who is putting out nutrition information regularly with, with the aim to help people, you know, do you sometimes just sort of bang your head against your computer and wanna throw your phone against the wall? I mean, how do you handle it?

Speaker 56:09 Oh, man. Lots of coffee and [laughs] it's... Uh, no, it is, it, it can be, um... It's, it's, it's grating and it can be tiring, but, uh, you know, my North Star is I've, I've never, thankfully, knock on wood, had any major health problems of, of note, um, other than the, the occasional migraine, which has been, uh, an annoyance to say the least. But the reason why I got involved in this, um, is because my mom was very sick for many years. She, at the age of 58, um, started to display the earliest symptoms of what would ultimately be diagnosed as a rare, um, and progressive, incurable form of dementia called Lewy body dementia, which is akin to having both Parkinson's disease and Alzheimer's disease at the same time. And so she had that for eight years, um, and it was a, a real struggle, and when she was initially diagnosed, actually even prior to her diagnosis, when she was in- initially prescribed drugs for both Alzheimer's disease and Parkinson's disease, I had a panic attack for the first time, um, and only time in my life, Googling the drugs, right? Which is what any millennial with a data plan would do. They would just, you know, go to Dr. Google. And when I saw that, that her condition would get worse and that the drugs had no disease-modifying effect, they were mere biochemical Band-Aids, to me that was like a turning point in my life really, where I, I, I became obsessed. I was gonna say I dedicated myself, but it wasn't even conscious. I just became obsessed with trying to learn everything I could about diet and lifestyle, and how all of these different variables play a role in terms of our predisposition to developing conditions like dementia, like Alzheimer's disease, like Parkinson's disease, which we know even less about. But, um, but you know, I, like you, have seen... I, I'm not a medical doctor, so I haven't seen it from the standpoint of a, of a clinician, but I've seen real sickness. Like, real sickness that very few people, um, ha- you know, have the, have the ability to, to see. And in many ways it was kind of a privilege because, you know, I wish I could give it all back and, and have my mom back in, in good health, but it really got me to see the world in a new way and it, and it really cracked open my perspective on all of the different ways that we could be living better-

Dr. Rangan Chatterjee 58:35 Mm

Speaker 58:35 ... living more healthily. And, and you know, I think it's an insight. It also helped me to have empathy for people and, and, and people's struggles, right? Like, not everybody has access to the same kinda food that I have access to. Not everybody has the same kind of, you know, nu- uh, whether it's, you know, nutritional wherewithal or, uh, food access or financial, um, privilege, right? Like, so it, it, it has made me very conscious of the fact that everybody's coming to this topic from a different place, and to do my best, um, to, to spread a message that's gonna do the most good for the most-

Dr. Rangan Chatterjee 59:10 Yeah

Speaker 59:10 ... people. Later in, in, in my mom's health trajectory, she actually developed, um, pancreatic cancer, and she passed away about three years ago. And so yeah, I mean, what I've seen is just, like... I, I don't even know. Sometimes when I think about what I experienced with my mom, I don't even know how I am able to walk on two legs, like, after that experience. It was so incredibly traumatic. But, um, but it's motivated me in a way that I've, I've never experienced with anything else in my life to, uh, do what I can to help separate fact from fiction for p- for people-

Dr. Rangan Chatterjee 59:40 Yeah

Speaker 59:40 ... to help dispel nutritional misinformation. And getting back to your question, to keep my eye on the prize, right? I have a, what psychologist Jordan Peterson has called a noble aim, and that's to help people. So when people come at me, whether it's carnivores or vegans attacking me and my work, it literally, it's like, you know, it's like rain on my windshield. Like, it falls off-

Dr. Rangan Chatterjee 1:00:05 Mm

Speaker 1:00:05 ... because, because I know that I'm motivated by helping people, and that-

Dr. Rangan Chatterjee 1:00:10 Yeah

Speaker 1:00:10 ... that, that, that, you know, my truth is something that, um, is really motivated and will always be motivated by, um, understanding what it was that happened to my mom and the desire that I have to prevent it from happening to myself, others that I care about, and ultimately the public at large.

Dr. Rangan Chatterjee 1:00:27 Running, you know, even within the medical profession, people will say that running is bad for your knees. I'd love you to expand

Speaker 1:00:37 Poppycock. [laughs]

Dr. Rangan Chatterjee 1:00:37 Poppycock, okay.

Speaker 1:00:39 Um, I don't know if I'm allowed to say that. Um, but, um, uh, look, running injuries are, are common, right? I mean, when people do any exercise, they'll injure themselves, and running is a... It can be very repetitive, right? You know, you have thousands and thousands and thousands of steps with high forces, and yes, people do injure themselves. And yes, the knee is the most common site of injury, but we already talked about this, that I think running is a skill, and if you actually learn to run properly, uh, the, the, the forces and the... We actually know from a biomechanical level as well as even epidemiologically that proper running form can decrease the rate of knee injury. But the, but the chestnut of all those injuries, of the myths, is the idea that running causes arthritis in the knee. We've actually done a lot of research on arthritis in my lab and the evolution of arthritis. Turns out, by the way, that your chances of getting arthritis for a given year and your age have doubled since World War II. Doubled, right?

Dr. Rangan Chatterjee 1:01:29 Wow.

Speaker 1:01:29 And that's clearly s- because... not because genes for arthritis have swept through the population. It's 'cause our, our lifestyle has changed, and we're trying to figure out what that's, what that's about. And it's not being... not, not, not about being more physically active, 'cause people have become less physically active today, and it turns out that running is actually heal- a- actually healthy for your knees. It actually... It's good for cartilage, uh, growth. Um, it actually keeps the cartilage healthy as you get, as you, as you age, physical activity does. So... And there have been maybe 15 randomized control studies showing that runners do not have a higher incidence of knee arthritis, and yet I can't tell you how many physicians I've told, I spoke to who just assume that with no evidence.

Dr. Rangan Chatterjee 1:02:07 Yeah.

Speaker 1:02:07 Zilch. They just say it because it's a, it's a, it's a cultural bias, and then they have the authority of being a physician, but they're wrong. It's just, it's just flat out wrong, and it can be disproved. Um, so I don't-

Dr. Rangan Chatterjee 1:02:18 And the problem is... Can I say one of the-

Speaker 1:02:19 Yeah

Dr. Rangan Chatterjee 1:02:19 ... one of the problems is there's a wider problem here, I think, which is we're so far removed from our evolutionary heritage or, you know, evolutionary norms compared to these modern societal cultural norms that I think we've become very... We're so risk-averse when it comes to physical activity. You know, any time we talk about it, we have to give disclaimers. We have to say, "Yes, be careful when you do that." Like, every time I submit a book manuscript, the editors come out, "You know, just make sure that people aren't gonna get injured and do this." And, and I understand it because of course no one wants to get injured, but w- we've made something that is fundamentally part of our, our human nature to move our bodies, we've turned it into something that's quite removed from us. We have to be careful. We need to, you know, we need to keep our back like this. We need... And, and again, please, I'm not trying to say that those things don't have merit for some people. I just really feel very much like you said, we've commoditized it. We've made it feel like it's this thing that's separate from the rest of our lives, and I think that's really problematic.

Speaker 1:03:25 Well, another example is sleep. I mean, one of the things I... So when I wrote this book, I thought, "If I'm gonna do a natural history of physical activity, I better start with physical inactivity," 'cause after all, two sides of the same coin. And I've been very interested in sitting for a while, and I've studied sitting for a while, but I didn't really know... I'd not really delved into the sleep literature, and I was astonished as I started looking at the sleep literature that this idea that you need eight hours is, is also just made up, as far as I can tell. There's, there's actually n- no empirical evidence for it. Um, I mean, some people do need eight hours, but it's, it's been oversimplified and over-commodified and, and, and in, and imbued with kind of cultural significance. So when... Turns out when we look at people in parts of the world who don't have electricity, they don't have internet, they don't have iPhones, they don't have, you know, telephones, they don't have anything that has electricity, right? They don't sleep eight hours. They actually sleep between 5.9 and 7.1 hours, I think. That's the... I can't remember the exact numbers, right? Um, and, um, uh, and furthermore, when you look at epidemiological studies of very large samples of people, the op- you know, in terms of relative risk of heart disease and various other, other, other, you know, illnesses, the optimum always comes out to seven, not eight. I mean, of course there are some people out there, 'cause there's variation around the mean, who do benefit from eight, but there's some people who get by at six. But somehow we've, we've turned eight into this kind of, this, this ideal. And then what happens is that people feel like, "Oh my gosh, I'm not getting eight hours of sleep. There's something wrong with me." Then they get anxious. And of course when you get anxious, you, you produce cortisol, which makes you stressed, and cortisol is the enemy of sleep. And we create this, we create this kind of feedback loop which then gets people to go buy drugs to make them sleep or spend ridiculous amounts of money on some, you know, clip on their nose that helps them sleep or, you know, whatever it is, you know, curtains or new mattress or whatever. And, you know, none of that... You know, we've created a sleep industrial complex based on a, on a cultural norm that's kind of Western and modern but not necessarily rooted in our biology.

Dr. Rangan Chatterjee 1:05:26 Yeah. And I, and I guess it's one of the problems. Really, one of your central arguments is that i- it's n- there's no one size fits all, right? We're all different. We all have to find what works for us, what's gonna get us moving. I guess what's gonna get us sleeping. And some of us, I guess, you know, I would just add from a, from a clinician perspective that I, I found that you can't really make these hard and fast rules for people because the individual in front of me, there are so many other inputs going on into their life. So what are their stress levels like? What has been their state of health for five years? What, what else is going on? And therefore, their sleep requirement is gonna depend on all those things. Whereas some of these communities, let's say, without electricity, without iPhones, um, maybe, m- I'm just hypothesizing here, maybe their stress levels are really, really low. Maybe they're... Actually, maybe they can get by with less sleep than someone who has huge amounts of stress. I, you know, I... Obviously, I c- I can't say the answer to that. I'm just hypothesizing. But it is quite individual, right? And, um-

Speaker 1:06:31 Of course. Of course, yeah

Dr. Rangan Chatterjee 1:06:33 ... and, and we sort of miss that.

Speaker 1:06:34 Yeah.

Dr. Rangan Chatterjee 1:06:34 So sleep, there's a myth there. Running is, uh, good for the knees, of course. If someone ... So, so I'm just, just trying to play devil's advocate. If someone listening to that goes, "Okay, I, I hear what you're saying, Professor Lieberman, but every time I run, I get knee pain. So what should I do then?"

Speaker 1:06:53 Well, I mean, um, well, there's two possibilities. One is you should back off, 'cause pain is a s- is a, is a adaptation. It tells you something's wrong, right? And, and you shouldn't ignore pain. And if, and if you have pain, you have to either ... You can either treat the cause or you can treat the symptoms. So the question is what's causing that pain? And one possibility is you do already have damage in your knee, in which case running will exacerbate it, right? If you already have arthritis in your knee, running is not a good idea because it's gonna, it's gonna exacerbate it. But the other possibility is that the way in which you're running is causing you to get the knee pain in the first place, and, and maybe you should s- instead of ... And, you know, so many people go to a sports medicine doctor, right, who will look at their knee but never look at how they run.

Dr. Rangan Chatterjee 1:07:33 Yeah.

Speaker 1:07:34 Right? They're treating the symptom rather than the cause. Now, you know, these are things ... There's no one answer to it, and it's ... I'm not saying that, you know, barefoot running is gonna solve everybody's running problems. Um, but, uh, but you might wanna look at how you run, and it might be that there's a better way for you to run that might actually alleviate, um, the repetitive stresses that you're putting on the tissues, uh, around your knee that might be causing the running pain. But, you know, it's, uh, there's no one-size-fits-fits-all answer.

Dr. Rangan Chatterjee 1:07:59 Yeah. It's, it is a scale, and I think maybe ... I'd be interested to see what happens with kids. Like, my kids have never really worn cushioned shoes. Like, from a young age, particularly my daughter, they've gone straight to minimalist shoes. So I don't know if you would make a ... Of course, they're not necessarily learning the skill of running, but they're also not wearing cushioned shoes to start them changing their gait accordingly. So I don't know, have you got any research as to what might happen to those kids who've never worn cushioned shoes in the first place?

Speaker 1:08:30 Well, we've been studying that in Africa for ages, right? So we've, we've got lots of data. We've published many s- many papers on, on kids who've grown up never wearing shoes and comparing them to kids from the same tribe who do wear shoes. And what we've not done, and what's really hard to do, is a randomized control study where you, where you randomize people into wearing shoes and not wearing shoes. As you can imagine, that's [laughs] challenging study to do, especially in a place like Boston, where it gets very cold winters. Um, but, um, but yeah, we've ... You know, my lab, we've published lots of papers. Like, we have a paper coming out I think today in, in, uh, in, uh, Nature Scientific Reviews on, on, uh, on toe springs, that cr- upward curvature in almost every shoe that exists on the planet, including many minimal shoes, and how that changes the biomechanics of the foot. So we're, we're very interested in how shoes affect foot function, and then how that affects how we walk and how we run. We had a paper last year in Nature which showed, um, that, about how calluses work, um, how calluses protect the foot, but, but how they, uh, transmit all the f- the f- the, the, the, the sensory information from the ground to the body. So unlike a shoe, which is a trade-off between protection and, and sensory information, calluses don't have that trade-off, which is really interesting. But, uh, so yeah, this is a, a subject of, of, of intense research in my lab. We-

Dr. Rangan Chatterjee 1:09:42 So, so, so-

Speaker 1:09:42 Yeah

Dr. Rangan Chatterjee 1:09:42 ... removing calluses, uh, as is a modern trend to do for cosmetic reasons, could be problematic. You're saying that calluses-

Speaker 1:09:51 Well-

Dr. Rangan Chatterjee 1:09:51 ... actually give us that sensory information that we need.

Speaker 1:09:54 Yeah. Well, calluses also come from just ... You know, calluses come from being barefoot, right? When ... The, the friction and the pressure of being barefoot, you grow calluses, right? And so most of us who wear shoes have very thin calluses, but people who are barefoot have thick calluses. And it turns out that thick calluses ... I, I learned this when, when being barefoot, which is that, you know, I would step on something, and I'd still feel it just as well, you know, as, as, uh, after my calluses had grown than when I ... You know. 'Cause e- every winter, of course, I'm wearing shoes, and then I often take my shoes off in the spring after the Boston Marathon, and I sort of slowly regrow my calluses. And I noticed that as the s- as the spring and the summer went on, I would step on the same pebble or a similar pebble, and I would feel the pebble just as much, but it didn't hurt. So it wasn't that I was losing sensory information, I was just getting more protection. And so we, we th- started a project to kind of to study how calluses work. 'Cause after all, you know, until recently, everybody, that was their ... We didn't have shoes. We just had calluses. And, and my dog, you know, she goes barefoot all the time. Um, I, one of my favorite moments was, uh, I was running barefoot, uh, a few, few blocks from my house. There's a woman I see all, every morning, you know, or many mornings, walking her two, just two beautiful dogs. And I remember one morning I was s- running by her on my way to the river here, and she said, "You're, you're barefoot." And, and I said to her as I whizzed by, "Your dogs are barefoot."

Dr. Rangan Chatterjee 1:11:17 [laughs]

Speaker 1:11:17 And the look of shock on her face, like, "Oh my gosh, my dogs are barefoot." But, you know, the dogs don't mind, right? And our, our ancestors didn't mind. Uh, people in all over the world don't mind. I'm not saying that shoes are bad or whatever, we shouldn't wear shoes, but, you know, shoes change how, how our bodies work. And, and, and, and there's nothing, you know, judgmental about it, nothing wrong with wearing shoes. There's nothing virtuous about being barefoot. Um, but we, you know, we learn something about how biology works by, by studying people unlike us.

Dr. Rangan Chatterjee 1:11:47 Yeah. Super, super interesting.

Dr. Rangan Chatterjee 1:11:50 Couple more myths I'd just like to go through before we wrap up, Daniel. Um, you mentioned early on in our conversation that hunter-gatherers sit down for long periods of time. So-

Speaker 1:12:02 [laughs]

Dr. Rangan Chatterjee 1:12:03 ... there's, there's this idea that sitting is really bad for us. Um, what would you say to that?

Speaker 1:12:09 Well, I mean, you know, we, we, again, oversimplify things, right? So you and I are sitting, um, while we're having this conversation, and, uh, sitting is the new smoking, so we might as well just be smoking a pack of cigarettes, right? And it is true that people who are physically inactive do, do run into trouble, but, um, but it turns out that sitting is a completely natural thing. And again, we pathologize something that's natural. Um, s- recent studies have shown, um, there's a guy named Dave Raichlen and, uh, who, who did a study of the Hadza hunter-gatherers in Tanzania, and they sit almost 10 hours a day, which is basically the same amount as, um, as Brits and, you know, Americans sit. Uh, so sitting isn't something weird and abnormal. It... But, but, but that said, um, how we sit is a little bit different. So-

Dr. Rangan Chatterjee 1:12:54 Yeah, I was gonna ask you about how do they sit?

Speaker 1:12:55 Oh, so there's two important differences. The first is that many of us sit in chairs with backs. So like I have this nice back on my chair, and when I sit with that, that r- seat back, that's a very modern thing. I no longer have to use any muscles to, to kind of keep my, my back upright, and that leads to a weak back, which we think has, has related to lower back pain. The other thing is that, uh, people in non-Western societies, uh, and, and some people in Western societies g- have a lot of interrupted sitting. They just don't sit inertly for hours and hours and hours. So, uh... And it turns out that getting up every once in a while, every few minutes, every 12 minutes or 15 minutes or 10 minutes, whatever, it depends on the study, has all kinds of metabolic benefits. It's like turning on the car engine, right? It, it turns on all kinds of cellular machinery. It lowers blood sugar levels. It lowers, you know, triglyceride levels in your blood. It decreases inflammation. So you might sit the same number of hours as, as, as the next guy, but if you get get up every once in a while, just move a little bit, that has all kinds of metabolic benefits. And then finally, maybe most importantly, it's what you do when you're not at work, right? If I sit all day at work 'cause I have a 9:00 to 5:00 job and then I go home and then I sit in front of a TV, I'm in trouble, right? But if I sit all day at work, but I go to the gym in the morning and, you know, go for a walk and, you know, do some, do some exercise, et cetera, it's not the same thing. And it turns out that when people do epidemiological studies of sitting time against illness, it turns out that leisure time physical inactivity is far more predictive of health than work time. And so we don't often make these distinctions. So, so sitting isn't in and itself abnormal or dangerous or bad. It's how sitting fits into our overall life and how we sit, um, that is important.

Dr. Rangan Chatterjee 1:14:40 I, I, I think that, that's such a great distinction. And how we sit is, is, is fascinating to me because, um, you know, sitting in these chairs... Or I, I guess what we're saying is the more comfortable our chair is, in some ways the more problematic because we can have hours without actually activating muscles. We can just sort s- we can just sort of morph into the chair and not do anything. Whereas I'm guessing the hunter-gatherers don't have an alarm or a smartphone telling them to get up-

Speaker 1:15:08 [laughs]

Dr. Rangan Chatterjee 1:15:08 ... every 12 to 15 minutes. So I'm guessing they're sitting in a way that I wouldn't say is uncomfortable. Well, how do they sit? Why don't you, why don't you explain how it is that they're sitting?

Speaker 1:15:17 Well, so half the time they s- half the time they sit on the ground with their legs out. Maybe 15% of the time they squat. You know, another 15% of the time they kneel. You know, but, but they're always, you know, there's children running around, there's food on the fire, there's... You know, they get up every once in a while, but they're not sitting there glued to their Zoom screen-

Dr. Rangan Chatterjee 1:15:34 Yeah

Speaker 1:15:34 ... 'cause they're, 'cause they're locked down in a pandemic, or they're not watching a, you know, a, a two-hour movie or whatever. They're, they're, they're kind of getting up all the time. And, and-

Dr. Rangan Chatterjee 1:15:44 Yeah

Speaker 1:15:44 ... and we know both epidemiologically, but we also know in terms of the, the, the mechanistic biology that, you know, interrupted sitting is just way more healthy than, than uninterrupted sitting. And, and, and, and while there's nothing wrong with sitting per se, if that's all you do, then yes, you're gonna, you're, you're gonna increase your chances of, of a wide range of diseases.

Dr. Rangan Chatterjee 1:16:05 Yeah. And I'll just admit one of my own personal bugbears is [laughs] a kind of societal norm, which is to tell children to keep their bums on their seat and not move around. It's something that-

Speaker 1:16:15 Oh-

Dr. Rangan Chatterjee 1:16:16 It, it-

Speaker 1:16:16 ... that's so wrong

Dr. Rangan Chatterjee 1:16:17 ... uh, of course you just wanna-

Speaker 1:16:18 Movement is good for you.

Dr. Rangan Chatterjee 1:16:19 Yeah. It's like, you know, it's like you're being a good obedient child if you sit there and don't move, which is just completely, uh, you know, it's so far removed from our innate, uh, uh, needs and wants, you know. But I watch my kids, they wanna move around. My, my son actually in his old school, he used to get told off because halfway into the lesson or 10 minutes in, he'd like, he'd want to squat on his chair. He just felt very natural and comfortable in that position. And he's like, "Bum on chair, stay still." And I'm like... And I was really conflicted 'cause I'm like, I really thought, "Well, that is... I don't want my son having to have his bum on his seat and, and stuck there for 40 minutes." Um, but it's... I think this is where your book, I think, is going to be incredibly helpful for society at large and just really busting a lot of these myths, having a bit more nuance in the conversation around physical activity and movements, which I think is very much needed. Uh, I, I think it's, I think, I think it's such a fabulous deep dive into a topic that frankly affects all of us. I loved the bit about grandparents in the book. Um-

Speaker 1:17:22 Thank you

Dr. Rangan Chatterjee 1:17:23 ... and I-

Speaker 1:17:23 That's my favorite section.

Dr. Rangan Chatterjee 1:17:25 It was such a wonderful bit to read about, and I wonder if you could just sort of expand on it and why it's so important for us to remember. Because many people, I think as they get older, think that they should actually become less active-

Speaker 1:17:37 No

Dr. Rangan Chatterjee 1:17:37 ... and you're sort of saying that may not be the case.

Speaker 1:17:40 Yeah. This is something we're, we're working on further right now, but I th- to me, I think it's maybe the most important part of the book in a way, which is that, you know, we have this idea that as you get older, you know, it's time to kick up your heels and, you know, move to Florida or whatever it is, right? And just kind of be less active and take it easy and, you know, and enjoy the, enjoy your retirement. But, you know, humans are an unusual species. We evolved. We're one of the few species that evolved to live after we reproduce. We evolved to be grandparents, but we didn't evolve just to be grandparents, you know, to enjoy our grandchildren. We evolved to be grandparents to help our grandchildren. So if you look in the hunter-gatherer societies and in farming societies, grandparents are out there foraging and hunting and gathering and digging and doing all kinds of stuff and, and helping out their children and their grandchildren, providing food surplus, you know, helping, you know, being active. And in fact, we have data showing that people tend to be, often are more active when they're grandparents than when they're parents because they don't have kids in tow, right? And, and what's important about that, it's kinda like a chicken and egg question. You know, which came first? Living long in order to be active or being active in order to live long? And you know, they're, they're, they're both there, right? And, and it turns out- That, that physical activity is really important in, in slowing processes of aging and, and decreasing disease because when you're physically active, you turn on all kinds of repair and maintenance mechanisms, right? So when you're, when you're active, you, you know, you, you stress your body. You produce reactive oxygen species. You, you know, you, you, you get- you generate heat. You do all ... You turn up your, your sympathetic nervous system, your fight and flight sy- system. But then you spend energy after you're exercising to, to, to re- to deal with all that, right? We produce antioxidants. We produce molecules to fix all the proteins that we damaged because they got, you know, in- affected by heat. We, we, we lower our blood pre- temperature. We, we, we, we turn on our parasympathetic, you know, rest and digest system to lower sympathetic activity. We turn on all these mechanisms that keep our bodies h- repaired and, and, and maintained, and the trick is that we ne- because we never evolved not to be physically active, we never evolved to turn on these mechanisms in the absence of physical activity. We need that stress to mount the anti-stress response. And so physical activity, this is really at the heart of the book. This is why physical activity is so good for us. It, it turns on all kinds of good processes in our body that, that keep us from aging and keep us from getting sick. And so as we get older, that becomes even more important, right? You wanna keep your muscles healthy. You wanna keep your chromosomes healthy. You wanna keep your, your cells from deteriorating. You wanna keep the mitochondrial numbers up in your muscles. And the, the list goes on and on and on, and that's why physical activity's so important. So as we get older, it, it becomes even more important to stay physically active because that ... And, and of course the data are there. We know the epidemiological data. We know the mechanistic data, but we don't have this sort of cultural idea that, that, that, that as we age, that's the time to keep up the activity, not turn it down.

Dr. Rangan Chatterjee 1:20:38 Yeah. It's really fascinating how we've evolved to be grandparents. I really like that as an idea. Um, you- you've, you've also mentioned in the book that we've not evolved to be too strong, and I found that really interesting.

Speaker 1:20:51 Yeah. [laughs]

Dr. Rangan Chatterjee 1:20:52 Um, and it, it made me think of something, I guess I've been pondering for a while as, with this, with the sort of narrative around exercise and, you know, as a guy, you know, seeing, since I was 13 or 14, seeing Men's Health on the magazine wherever I went with a, with a ripped guy on the cover showing off his six-pack and his pecs, and being quite influenced by that, I think, as a, as a, you know, as an insecure teenager growing up. Um, you now see there's, there's some ... You go into gyms and you see some, you know, really, really muscly people, um, who, who love bodybuilding. And I, I've actually had a few patients, including one when I made a BBC documentary, um, this chap who actually had body dysmorphia, and he had a real negative self-esteem issues, how he viewed himself. And, you know, working out, putting on muscle was, was absolutely linked to that. And I just wanna ... Before you answer this, I just wanna draw a contrast. A couple of summers ago, I was in a place called Chamonix in France, which is at the foot of Mont Blanc.

Speaker 1:21:56 Yeah. Beautiful place.

Dr. Rangan Chatterjee 1:21:57 Beautiful place. Uh, I was there in the summer with my family. I've got a lot of friends there. And one day we went to the swimming pool, the outdoor swimming pool, and what was really interesting to me is that if you looked around in the pool, it, it was so noticeable to me that the physique of people in the pool, whether they were, you know, you know, above the age of 60, 70, you know, in the middle age, young, the physique of people was just a little bit different. That what you never saw every- not everyone, but a lot of people looked really fit, but not in a like a really I've worked on my fitness way. So these typically would be people who live in the mountains, so they're getting around. They, they hike at the weekends. They might go cycling. Uh, they might lug stuff up and down the mountains. It was almost like a functional fitness. They weren't working on being fit, yet they were actually really fit, and I, and I think in some ways that actually supports everything you're making the case for in the book. So just a few thoughts there. I wonder if you could unpack them for me.

Speaker 1:23:01 Well, yeah, I mean, it, to me, for me, the big surprise is, you know, going to a gym and realizing ... I mean, I have a tiny little gym in my basement, and I've actually gone, I've bought weights whose sole function is to be lifted. [laughs] If you think about it, it's kind of a really weird thing, right? Try to explain that to your great-great-great-grandparents, that you go out and spend hard-earned money on something whose sole job is to be lifted, like, why not just do some sit-ups or pull-ups or, you know, go out and do something in the garden, right? It's a, it's a very modern thing, right? And, and again, there's nothing wrong with it. I've done it myself. But, but, um, but we have this idea that, you know, of being ripped and buffed, and a lot of this happened, uh, I ... In the book I go into the history of this kind of modern, uh, uh, you know, physical culture. A lot of it started in the Industrial Revolution as the machines were replacing humans and, and, um, and, and people were insecure and, and, uh, and I think that led to Charles Atlas and this kind of rise of this physical culture movement, this idea of being really ripped and buffed and, you know, you know, uh, Mr. Universe kind of stuff. And, and we have this idea that, you know, to be ... And there's nothing wrong with being really strong. I mean, you know, there's, just for, for many folks it's fun, and so many people really enjoy it, but it's, it's a modern thing, right? And, and, and our ancestors not only didn't do that, but they couldn't afford to do that because muscle is a really expensive tissue. If you add a lot of muscle mass, you have to eat a lot more too. And in a, in a world in which, which, which, uh, which where food is scarce, you can't afford to, to, um, um, to have that kind of extra muscle mass. Furthermore, you don't have nautiluses and other machines that apply, you know, constant loads no matter what the angle of your biceps are, et cetera. There is no way to kinda get that fit in, in a normal world. Uh, so, so again, uh, it's important to stay strong as you get old, uh, particularly to avoid muscle wasting, sarcopenia, which is a really serious disease of aging. Uh, you know, ha- people have a hard time getting out of chairs and stuff like that because they lose strength. But we don't need to be super strong to be healthy. Um, and our ancestors weren't super strong. So if you wanna go to the gym and get ripped- ... fine. That's perfectly okay. And, um, um, or if you enjoy, you know, looking at people whose physiques are ripped, that's fine too, but let's not pretend that this is a kind of a, a, a necessary natural thing. And I... And the other thing I think is, that I, I worry about sometimes is people, people get really into what they do, right? There are aerobic people who do cardio who hate doing weights, and people who do weights who hate doing cardio, and then they kind of self-justify what they do, right?

Dr. Rangan Chatterjee 1:25:32 Yeah.

Speaker 1:25:32 And the answer, of course, is that we, we evolved to do a mixture of, of those things. Ca- cardio still is the bedrock of most fitness programs. You know, as a physician I'm sure you would know this better than most. But if you really were to do one thing to kind of work on your physical, you know, your health, cardio is probably it. But you should also add some, some weights in there too. I mean, that's also important. And some kind of mixture is, is, is, you know, is what, is what we evolved to do and it's probably right. And if you wanna do more of one, more of the other, that's fine, but let's not pretend that's what we evolved to do. We didn't evolve to be, like, super jacked w- you know, cavemen, you know, Charles Atlases any more than we evolved to be, you know, Eliud Kipchoges. We, we evolved to be something in the middle.

Dr. Rangan Chatterjee 1:26:12 Yeah. And, and I, and I love your approach, um, Dan. It's very, it's very respectful of people's autonomy, their, their, their right to choose. It's like, "Look, you do it. Look, I'm gonna present you the science, I'm gonna present you the evolutionary story here. Yeah, if you wanna do something different, go for it. But let's not pretend it's anything other than that's your desire, that's your passion." I think that's, that's a lovely way to approach it. As we sort of close this conversation off, I do think we should briefly touch on the immune system.

Speaker 1:26:41 Oh, yeah.

Dr. Rangan Chatterjee 1:26:41 I, because especially in view of what's been going on in the world-

Speaker 1:26:45 Yeah

Dr. Rangan Chatterjee 1:26:45 ... a lot of people are thinking about their immune system. How does physical activity play a role in the immune system?

Speaker 1:26:52 Yeah. Well, um, um, as I was actually doing the, the edits on the book, uh, you know, c- the lockdown had started and I, and I r- and I, and I, I made sure that there was a, a section on respiratory tract infections. But, but the immune system is, like every system in the body, is affected by physical activity and for the most part, just like everything else, it's, it's improved by physical activity. And, and we don't know exactly why, but I think it's because if you're, if you're in camp and doing nothing, you don't... and you don't leave, you don't encounter new pathogens, right? So I think there's a link between physical activity and immune function because as you, being physical, physically active was a, was the way in which we, we, we, you know, we left camp and, and, and got exposed to pathogens. That might be a hypothesis. Uh, and, and it's also part of the sort of repair and maintenance mechanism. But, but there's plenty of data which shows that physical activity, moderate levels of physical activity upregulate key components of the immune system. So for, for respiratory tract infections, for example, when you're physically active you not only produce more, uh, immune cells, like there's natural killer cells, which I love the name, right? You know-

Dr. Rangan Chatterjee 1:28:00 Yeah

Speaker 1:28:00 ... th- they're, they're naturally killing things in your body. They're, they're, they're your... They, they kill, for example, cells that become infected with viruses, right? Cytotoxic T cells, again, an important part of your immune system, upregulated by physical activity. And not only they're, you produce more of them, but there's compelling evidence that you redeploy them to vulnerable parts of your body.

Dr. Rangan Chatterjee 1:28:20 Yeah.

Speaker 1:28:20 So when you f- when you go for a run, not only do you produce more of these cells, but you send them to the, the linings of your respiratory tract, which is, guess what, where we get, we're vulnerable to COVID, right? To the, to the SARS, uh, coronavirus. In addition, uh, physical activity upregulates the humoral immune system, the antibody production. As people get older, their antibody production, uh, declines, but people who are more physically active have much healthier responses to vaccines-

Dr. Rangan Chatterjee 1:28:45 Right

Speaker 1:28:45 ... and produce more antibodies, and again, for the same reason. And so, uh, so by being physically inactive, we increase our vulnerability to, directly increase our vulnerability to respiratory tract infections. But physical activity also has in- indirect effects by making us more likely to be obese, to have metabolic syndrome, to have all the hypertensive, which are all the covariates that increase your risk to disease. So if we're gonna fight this, this, this, this, this, this, this pandemic, one of the key ways to keep ourselves healthy is to stay physically active. Um, that said, there's interesting evidence, and there's a big debate about whether too much activity-

Dr. Rangan Chatterjee 1:29:24 Yeah

Speaker 1:29:24 ... makes, opens a window and makes you vulnerable. And there's, to be honest, there's not a lot of data 'cause there's so few people who do too much that [laughs] we just don't have a lot of data at that end of the curve. Um, and it's still very debated. So within humans there's not a lot of really good data, but in animal models there certainly is. So there's, I, I cite in the book a, a study that is really quite extraordinary study. They, they gave mice a really virulent form of influenza. And then for the few days where the, where the mice were coping with that influenza, you know, before the symptoms emerged, while their immune system was initially, uh, dealing with it, some of the mice were, were sedentary, some of the mice, they had them exercise, like, 20 minutes a day, and some of those poor little mice, they had them exercise, like, two hours a day. And the ones who exercised moderately had less than half the, the mortality rate of the sedentary mice, but the ones who exercised ridiculous amounts had much higher mortality rates than the-

Dr. Rangan Chatterjee 1:30:17 Yeah

Speaker 1:30:17 ... sedentary mice. And to me, I think that, that highlights I think what every physician knows, which is that, you know, some is good, but be careful. Don't overdo it because you're gonna deplete your body of energy and that then if there's less energy then your, which, and your immune system takes a lot of energy, you, you, you could potentially harm yourself. So, so, so really as we deal with the physical problems, the me- physical health, the mental health of this, this, this pandemic, but also just our, our, our, our immune health, you know-

Dr. Rangan Chatterjee 1:30:46 Yeah

Speaker 1:30:46 ... staying physically active is just absolutely crucial right now.

Dr. Rangan Chatterjee 1:30:49 Yeah. Thank you. That's a, it was a really nice summary of, of the research there a- and sort of how it helps. Daniel, look, thank you so much for your time today. Thanks for writing such a wonderful book. Um, I always like to finish off conversations with some practical tips for people. So the c- the, the podcast is called Feel Better, Live More. When we feel better in ourselves, we're gonna get more out of life. And I'm sure, you know, when we move more, when we move in a way that makes us feel good, that- That allows us to move regularly. We're gonna probably live longer, and we're gonna feel better in ourselves. So do you have a few sort of practical tips for people so they can think about and th- start applying them into their lives immediately to start improving their health and wellbeing?

Speaker 1:31:38 Well, I think, um, I think the tip would vary up depending upon the kind of person. So if you're somebody who's struggling to get enough exercise, right, if you don't get enough and you'd like to exercise more, um, I think that, you know, there's lots of things you can do, but I think the most important thing is to find somebody who f- who, who, who you wanna exercise with. Get, get an exercise buddy, um, and, and, and use each other to help each other. Um, there's nothing like, you know, having a, you know, somebody who you meet for a walk or a run or whatever, and don't feel like you have to, you know, you have to go crazy, you know? S- s- some is better than none. And, and, and once you get better, you enjoy some, then you might decide that you wanna do a little bit more. But don't feel like there's an optimal kind of exercise or you, you know, whatever, just, you know, that you have to do it. Don't make it, you know, don't make it un-fun. Make it fun. And, and if you d- make it fun and make it part of your life, and recognize also that your body has to adapt. It takes time. One of the problems, for example, of being obese is that, um, is that you have less dopamine response to exercise, and dopamine is the molecule that makes you wanna do more. It's the reward molecule. And obesity actually down regulates that. And so we have these expectations that all of a sudden you exercise and af- and a week later you're gonna feel great. Well, it's gonna take more than a week, and, and you have to be in it for the long term, not the short term. And, and so don't do it just for the, for the health benefits. Do it bec- for the social benefits. Do it for all the other things. And if you make it fun and part of your life, um, um, and find ways to make it necessary, um, I think that's the most important thing that we, you know, that's the most important tip. And there are so many ways to do that. I, I, for example, leave my exercise clothes out in the morning when I go to bed, so that when I wake up, that's what I put on. And that like helps, it's like it removes one less barrier to, to starting my run. 'Cause I never wanna go for a run in the morning when I start. Never, ever. On no occasion whatsoever, um, do I ever want to do that.

Dr. Rangan Chatterjee 1:33:28 And, and, a- and how many marathons have you done now?

Speaker 1:33:32 I just did my 25th.

Dr. Rangan Chatterjee 1:33:33 Well, first of all, congratulations, but that, I think, is, is so valuable there at the end what you said, Daniel, that you've had to find ways to remove barriers to that because you don't want to.

Speaker 1:33:47 Yeah.

Dr. Rangan Chatterjee 1:33:48 Yeah. You've just completed your 25th marathon. You don't want to get up and go for a run, yet you are a runner. And-

Speaker 1:33:55 Right. And, and I-

Dr. Rangan Chatterjee 1:33:56 ... that's really, that's really, really key, isn't it?

Speaker 1:33:59 I, I, I, I ne- there's never been a time when I left the door of my house thinking, "I really wanna run." I always like, "Eh, I'm gonna force myself to run." And then I always enjoy it when I come back. Um, another example is the, in my, my building, right? Um, I live in, I, my, my, my, my office, when I get to go to it again aft- after the lockdown, my office is on the fifth floor of this beautiful old Victorian building, and every day when I walk into the building, I wanna take the elevator. Bar none. I always look at the elevator longingly. But the reason I don't take the elevator is that if anybody sees, um, me taking the elevator, they'll call me a hypocrite. And, and, and it's so it's not because I, I'm doing it for my health. I'm doing it because [laughs] because I, I have a social, I have a s- I have, I've socially coerced myself into, into taking the stairs. And I never regret having taken the stairs by the time I get to the fifth floor. But I always regret taking the stairs as I head up the stairs looking longingly at the elevator. And don't beat yourself up for, for, for, for those instincts. Those instincts, even though elevators never existed in the Stone Age, it is a completely normal, natural instinct to wanna avoid exertion, and don't ever feel bad about it.

Dr. Rangan Chatterjee 1:35:06 Typically, people will be in to see me with a specific problem. So I wouldn't say that many people are coming in well saying, "Hey, Doc, what can I do to enhance and optimize my longevity?" You do get it a couple of times, but it's not that common. So typically, the attention goes to what is that person suffering from? Now, my bias is that we overmedicate in medicine. We suppress symptoms along, and that often if we are qui- often if we're careful with lifestyle interventions, you can make big changes, not just in terms of prevention, in terms of preventing getting sick, but often when people are sick, it can make a massive improvement in their symptoms. And, you know, sometimes, you know, you can reverse things. But I'm talking about giving patients a sense of agency over how they feel-

Speaker 1:36:03 Absolutely

Dr. Rangan Chatterjee 1:36:03 ... which I think is really important. I think certainly in almost 20 years of practice, I'd have to say that when a patient feels as though they can't do anything, like they've just got this condition and there's nothing they can do about it, I, I, I just see, you know, you don't see that good outcomes there. People feel very disengaged in the process. I always wanna give people a feeling that they can do something about it. Even if it's five minutes of meditation a day, it's gonna help change their perception of it. Um, but often what I do is when I talk to them about those lifestyle changes, I'll also explain what that's gonna do for them long term. So yes, it's about helping them in the short term with their symptoms, but also I'll say, "Yeah, but this can also..." Like, you know, sleep, for example. Uh, I spoke to Matthew Walker on, on the podcast maybe a year ago or so.

Speaker 1:36:49 He's terrific.

Dr. Rangan Chatterjee 1:36:49 Yeah. The, absolutely fantastic. And, you know, me and Matthew were talking about some of the research that is suggesting that sleep deprivation, chronic sleep deprivation can be causative in the-

Speaker 1:37:00 Oh, absolutely

Dr. Rangan Chatterjee 1:37:00 ... in the development of Alzheimer's.

Speaker 1:37:02 Absolutely. And, and, and, and interestingly, there are many misdiagnosed cases of Alzheimer's where somebody's got memory impairment, and it's they're simply sleep deprived.

Dr. Rangan Chatterjee 1:37:11 Yeah, exactly. So if I had a patient who was struggling with their sleep and who also had a family member with Alzheimer's, for example, the conversation could very easily be about the things that they can do in the short term to help. But I might also bring up some of that research and say, "Hey, look, you know, Alzheimer's doesn't just start, you know, the six months before you get it. It's probably been going on for 20 or 30 years in your brain beforehand, and chronic sleep deprivation is one of those factors."

Speaker 1:37:38 Yeah.

Dr. Rangan Chatterjee 1:37:39 "So not only will you feel good in the short term, but you're gonna help insulate yourself from potentially going down the path that your family member did. So I guess that's the context of which I might bring it up. Is that what you were getting at?

Speaker 1:37:53 Yeah, that's terrific. Yeah, I'm, I'm, I'm really interested in that, and it sounds, it sounds... I, I agree with you completely. If I were a medical doctor, it would be-- I'd be having the same conversations.

Dr. Rangan Chatterjee 1:38:03 Yeah.

Speaker 1:38:03 Um-

Dr. Rangan Chatterjee 1:38:03 Because it's, it... This is-- For me, and I wonder if you subscribe to this, Dan, that it's often the things that we can do day to day that are gonna help us feel good day to day are also the sort of things that are gonna help us age well, right?

Speaker 1:38:21 Yes. Well, although there are some funny exceptions. Uh-

Dr. Rangan Chatterjee 1:38:24 Yeah. So let's-- What are those exceptions?

Speaker 1:38:25 Well, what-- My favorite example of an exception is jogging.

Dr. Rangan Chatterjee 1:38:29 Okay.

Speaker 1:38:29 There's, there's dozens of studies now that show that for every hour that you jog, you get an extra hour, uh, of life. So if you're jogging five hours a week, you're gonna get five hours, uh, added on to the end of your life. Uh, it's a pretty robust finding. But if you unpack it a bit, if you step back and you say, "I love jogging," well, that's a good trade-off. You're enjoying it in the moment. If you hate jogging like I do, I like power walking. I can't stand jogging. Um, why would I wanna spend an hour a day now to get an hour a day later at the end of my life when I'm, you know, possibly catatonic and drooling all over myself? It doesn't seem like the right trade-off. I'd rather have the hour now. If, if it was a two-to-one ratio, that'd be different, but it's not.

Dr. Rangan Chatterjee 1:39:17 So I guess your approach is about giving people information and letting them decide w-what they wanna do with that information.

Speaker 1:39:26 Absolutely. In fact, that's, that's my whole, uh, thing for the-- through the last three books is that I, I wouldn't presume to tell anybody what to do about anything. I feel that my job as a scientist, uh, is to just lay out what I know about the science of various issues, whether it's productivity and creativity, as in The Organized Mind, or the science of trying to sort out what's true and what's not in the newspaper and in Facebook posts, A Field Guide to Lies and Statistics. And here, these are the, these are the trade-offs, these are the choices. You have to decide. It's a very personal thing.

Dr. Rangan Chatterjee 1:40:04 Yeah. And, and, Dan, it's, it's interesting you're saying that as a neuroscientist, but I would echo that as a medical doctor. I actually don't believe it's my job to tell anyone what to do. Um, in fact-

Speaker 1:40:13 Well, I appreciate that because a lot of doctors are, uh, paternalistic.

Dr. Rangan Chatterjee 1:40:17 They are, and I, I fundamentally believe that you don't really connect and make long-term changes with someone when you are paternalistic and you tell them what to do. I guess going back to the book, because I do think it's, it's really interesting, and there's quite a few-- there's quite a few things in there that I think people listening to this podcast can start thinking about applying into their own life, which is ultimately, I think, the goal of, of you sharing that information with people. It's, yes, to educate them, but it's also to hopefully empower them to think, "Hey, I could start doing that," right? So let's actually go into the sort of granular, the nitty-gritty of what it is. What is the number one thing people can do to help ensure that they age well?

Speaker 1:41:02 The number one factor that influences how you're going to fare at any age is a personality trait, um, a mindset, uh, you might call it, of conscientiousness. That swamps all other factors, uh, in terms of whether you're gonna be healthy and, uh, and happy at age eight or age 108. Now, think about it. Conscientious kids don't cross against the light, so they're less likely to get hit by a lorry. Uh, conscientious teenagers and adults are less likely to end up in prison because they follow some marginal rules. Conscientious adults go see a doctor when something's wrong. They say, "It hurts here," you know? And, and then, well, conscientious adults have a doctor. And they, um, at least in the US, their insurance payments are, are current, and w- when the doctor tells them to do something, they do it. Conscientiousness, which is a cluster of traits relating to stick-to-it-iveness, reliability, dependability, uh, doing what you'll say you'll do, that's the biggest single factor. And although it's unevenly distributed throughout the population, some people have a lot of it, some people have none, and on the one extreme, if you've got too much of it, it becomes obsessive compulsive disorder, uh, you know, compulsive hand washing or things like that. Um, you can change that as well as any personality trait or mindset quality at any age. It's never too early to start, and it's never too late to start.

Dr. Rangan Chatterjee 1:42:33 Yeah. And that, that's super interesting because when you talk about personality, 'cause you're basically saying the number one factor that predicts if you're gonna age well is how conscientious you are.

Speaker 1:42:42 Yeah.

Dr. Rangan Chatterjee 1:42:43 And some people will hear that and think, "Oh my God, uh, I'm not that conscientious a person." So that number one factor that Dan said and Dan, that neuroscientist said, I don't have it. But what you're then saying is that you can change your personality.

Speaker 1:43:00 Well, you can. The, the whole field of psychotherapy is based on this idea. And although not all psychotherapeutic techniques work for all people, um, you know, there's a bunch of studies coming out, uh, about behavioral change. Uh, just to take one example, cognitive behavioral therapy, uh, has been shown to be better at improving symptoms of depression and lack of conscientiousness, and it, this CBT is, is not you just lying on a couch and talking about your childhood and, you know, your mo- the relationship with your mother. It's practical tools that the therapist gives you to help you reach the goals you said that you wanted to reach, sort of like your patients coming to you. CBT doesn't tell you what to do. They tell you how to do it, and it's been shown to be more effective than drugs, even antidepressants. And interestingly, perhaps counterintuitively, CBT alone is more effective than the combination of drugs and CBT. But it's not just therapies. Uh, meditation, yoga, finding inspiration from literature or art or, or somebody that you've read about in the news who has made a change, uh, maybe somebody in your family, and saying, "You know, I'm inspired by that. I'm gonna do that."

Dr. Rangan Chatterjee 1:44:18 Super interesting, isn't it, that conscientiousness is that number one trait, uh, and that it's something that you can train or work on certainly.

Speaker 1:44:26 At any age.

Dr. Rangan Chatterjee 1:44:26 At any age, which i- which is very encouraging. Now, when you were describing conscientiousness, I was thinking, okay, so someone who's conscientious, uh, they're not gonna... They're gonna wait for the green man to cross the road. They're gonna go and see the doctor when they're sick. Are you talking about someone then who just follows rules? Because, I guess, and I, I've read your previous book, uh, and I know you talk a lot about creativity, and, you know, there's so many benefits to being creative and, uh, I guess challenging a lot of the assumptions that are already there in society and actually, you know, sort of navigating your way around that. I- is there a clash there somewhere? Can you be someone who is highly conscientious but is also very creative and willing to challenge things?

Speaker 1:45:14 Well, I believe so. Uh, uh-

Dr. Rangan Chatterjee 1:45:16 Do you see what I'm getting at?

Speaker 1:45:17 I do, yeah. I, I... C- 'cause conscientiousness, although rule following is a part of it, it's not all of it.

Dr. Rangan Chatterjee 1:45:23 Yeah.

Speaker 1:45:23 And there are cases where you really have to not follow a rule. Um, if, um, if you're starving and, uh, you see a roll... I mean, really starving. You're about to die, and you see a roll left out on a table in a restaurant that hasn't been picked up yet. I would say you're morally and ethically justified to pick up that roll even though you didn't pay for it. Uh, there are all these kinds of thought experiments about ethics. Um, I think that if you had the opportunity to murder Hitler, murder is supposed to be against the rules, but, you know, there's a, an argument to be made that that would've been a good thing to do. So a- and these aren't... I'm not talking about creative acts here. I'm talking about more practical ones, but, uh, I think of the people I know. Joni Mitchell's a good example, one of the most creative people I know, and she's very conscientious. Uh, although she breaks all kinds of rules with her songwriting and her painting. She's a wonderful painter. Um, the way the conscientiousness shows up is she finishes what she starts. She'll spend months working on a single line of a song to get it just right. That's a kind of stick-to-it-iveness, and, um, she's happy to break rules in songs. For one thing, she doesn't use standard guitar tunings like everybody else does.

Dr. Rangan Chatterjee 1:46:42 Yeah.

Speaker 1:46:42 She invents her own. Interestingly, she... This is not well known, but the reason she did it is because, uh, she had polio as a child. She doesn't have full... I, I can tell you this 'cause you're a guitarist. She doesn't have the full strength of her left fingers to be able to make conventional chords. For the most part, she can only play two strings at once, kind of like Django Reinhardt. So she invents these tunings that allow her to basically take two fingers and move them up and down the neck. I would say that's an interesting case of rule breaking and conscientiousness.

Dr. Rangan Chatterjee 1:47:15 Yeah, I mean, that... It's super interesting, that. That reminds me of, um... I don't know if you heard of a band called Crowded House?

Speaker 1:47:21 Sure, Neil Finn.

Dr. Rangan Chatterjee 1:47:22 Yeah, Neil Finn.

Speaker 1:47:22 Love Crowded House.

Dr. Rangan Chatterjee 1:47:23 Yeah, they, they were one of my favorite bands in the '90s.

Speaker 1:47:25 Oh, me too. Yeah.

Dr. Rangan Chatterjee 1:47:26 Uh, I've seen them a few times play.

Speaker 1:47:27 Don't Dream It's Over.

Dr. Rangan Chatterjee 1:47:28 Yeah.

Speaker 1:47:29 There is reason within.

Dr. Rangan Chatterjee 1:47:30 Yeah, exactly.

Speaker 1:47:31 There is reason without.

Dr. Rangan Chatterjee 1:47:33 It's such a great track.

Speaker 1:47:34 Yeah.

Dr. Rangan Chatterjee 1:47:34 Um, yeah.

Speaker 1:47:35 My friend Mitchell Froom plays the organ on it, the B3 organ.

Dr. Rangan Chatterjee 1:47:38 Oh, really?

Speaker 1:47:39 Da, da, da, da, da.

Dr. Rangan Chatterjee 1:47:41 Yeah, yeah, I know it well.

Speaker 1:47:42 It's amazing.

Dr. Rangan Chatterjee 1:47:42 Oh, my... I mean, w- this, this conversation could fast go down a track of music, which I'm gonna go down for a little bit because I'm super interested. The B3 is one of my favorite sounds, I think, out of all musical sounds. I absolutely love it, and when it's just sitting there in the background, it's, it's just beautiful.

Speaker 1:47:59 And I think that Mitchell managed to get it as close to the timbre and the sound of, um, um, Booker T.

Dr. Rangan Chatterjee 1:48:10 Yeah.

Speaker 1:48:10 Uh, Booker T. Jones. Uh, I think he, he managed to get that sound, the, the Booker T sound, green onions and all that, and it's hard to do. It's, it's all in the draw bars, and it's in the, the micro adjustments you make with touch.

Dr. Rangan Chatterjee 1:48:23 Yeah. I mean-

Speaker 1:48:23 The man, he nailed it.

Dr. Rangan Chatterjee 1:48:24 It, it's... Yeah. I mean, I mean, by the... And, and on, on Crowded House, um, what was relevant in my head based upon what we said about Joni Mitchell is that I remember seeing an interview with Neil Finn once, and he s-... Uh, he s-... You know, not verbatim, but he says something like, "You know, we're a four-piece band, so our limitations become our strength." So he was all... From, from certainly my interpretation of what I heard was that we're gonna only record stuff or play live stuff that we can do the four of us, so we're gonna have to create around that rather than bringing in extra people to be able to play this part or that part or that part.

Speaker 1:49:00 It's the opposite of a la- latter day Beatles or Steely Dan approach.

Dr. Rangan Chatterjee 1:49:03 Yeah, it's-

Speaker 1:49:04 They're a live band like U2.

Dr. Rangan Chatterjee 1:49:06 Yeah, exactly, and it's, it's fascinating that Joni also, because she's, she's got a limitation that lends, that, that gives her some new creativity because if she didn't have that, maybe she would play in standard tuning, and therefore she might not be as creative. Who knows? But it's, it's super interesting, but I guess, Dan, we are talking about aging well and the brain, and you've written a book on music and the brain. Um, so I'm interested, does music play a role for us in terms of how we're aging?

Speaker 1:49:41 Well, um, yes and no. Um, we now believe that 5% of the population are, uh, sorry for a buzzword, but anhedonic for music, meaning they, they don't get pleasure from music, and, you know, this just due to genetic variation or environmental factors. Uh, we see anhedonia, failure to receive pleasure, in many domains. Some people don't like chocolate. Some people don't like sex, uh, or being touched. Some people don't like music, but for the rest of us who do, um- There are some interesting connections between music and aging, uh, some of which are well-known. Uh, if you've got Alzheimer's or, uh, extreme dementia and you no longer recognize where you are or who your friends are, you don't recognize yourself in a mirror, in many, many cases you still recognize songs from your youth. They're preserved. And this is not just kind of a, um, a cool fact. It's an essential part of adults living with, uh, cognitive impairment in, um, in relaxing them or causing them to be less agitated. Imagine what it's like if you look in the mirror, you don't recognize who it is, you were put in some home or facility after your memory impairment started, so you don't know where you are. Uh, you don't recognize the caregivers who come in every single day. Um, and often we see in these patients, as you well know, a great deal of agitation and, uh, anger. And of course, they're angry. They don't know where they are. But you put on the headphones, the earbuds, whatever, you play them a song from when they were 14 years old, they suddenly reconnect with themselves. There's home. There's something in their memory that they recognize, and that's who I am. This is, this is something I can get ahold of. And we find that in these cases, the, the patients as well as their families are tremendously relieved. Now, that's sort of an extreme case of music. Um, a less extreme case that's not as well-known is that older adults who start to learn an instrument, or if they already play a new instrument, that learning is neuroprotective. One of the many myths that I try to bust in The Changing Mind is that, uh, you can't grow new neurons after a certain age or you can't make new neural connections. Neuroplasticity, the buzzword for making new neural connections, new synapses, that goes on your entire life, and the more you can learn, especially new things, the more neuroprotective it is because you're building up neural and cognitive reserves. So you-

Dr. Rangan Chatterjee 1:52:20 That could be anything though, right? You just learning anything, whether it's music or sport or-

Speaker 1:52:25 Absolutely

Dr. Rangan Chatterjee 1:52:26 ... you know, but is it-

Speaker 1:52:27 A new language.

Dr. Rangan Chatterjee 1:52:28 So this sounds like one of the key things we need to be thinking about as we get older is what keep trying new things.

Speaker 1:52:37 Yeah, and in particular, there's this new appreciation for what we call embodied cognition. Uh, Barbara Tversky and Scott Grafton both have new books out about this. Scott's is called Physical Intelligence. Uh, fantastic books. The idea is that your body actually helps your mind grow through the experiences you have manipulating your body. So learning a new language is neuroprotective, but learning something that involves eye-hand coordination, um, musical instruments being one, not so much singing, but playing an instrument or, or taking up tennis or, or ping pong or, you know, anything that involves this kind of body intelligence. Very powerful is simply going for a walk on an uneven trail. As you probably know, some Scottish doctors are now writing prescriptions-

Dr. Rangan Chatterjee 1:53:27 Yeah

Speaker 1:53:27 ... for their patients. Go for a walk outside, you know? Uh, it's because as you're walking on an uneven surface, your foot and your ankle and your legs are ma- and your vestibular system are making dozens of micro adjustments every minute. Uh, you have to change the pressure and the angle, and you have to get feedback about what's happening so you don't fall over, and it's hugely important.

Dr. Rangan Chatterjee 1:53:51 So would you say that, you know, would you therefore not be recommending as people age that they work out in a gym, on a treadmill, or on an exercise bike? Or can you do a bit of both?

Speaker 1:54:02 Well, you can certainly do a bit of both. Uh, I've-- I mentioned at the beginning of our conversation, I've sta- changed a few things in my own life. One was I didn't know about sarcopenia. How would I? As I say, I, I basically know about stuff from the chin up, uh, and a little bit of spinal cord. But sarcopenia is to muscle what osteoporosis is to bone, and, um, so I've started doing resistance training. I go to the gym. I'm not trying to bulk up like Arnold Schwarzenegger, but I do a round of 20, uh, sorry, 12 different weight machines just to keep my muscles going. I spend about 40 minutes there four or five times a week. Jane Fonda has started-- told me she started doing the same thing. Um, and I-

Dr. Rangan Chatterjee 1:54:46 Do you enjoy it?

Speaker 1:54:47 I do. I do. I can't-- I couldn't tell you why, but I do. And I also do the elliptical because I'm trying to get my heart rate up, and I do what's called high intensity interval training. But better than both of those really is the difference between sedentarism and moving outdoors. If you only do one thing, you should move outdoors. But yeah, adding the others is great.

Dr. Rangan Chatterjee 1:55:08 Yeah. I mean, that's, that's great because there's a lot of information we're giving people, and sometimes getting too many things to do, too many things that are great to do can sometimes seem a bit overwhelming.

Speaker 1:55:21 You have to prioritize. Now, if you're in a wheelchair, get somebody to take you out. The visual stimulation of being in nature is neuroprotective. Not as much as if you're walking, and if you can push your own wheelchair, even better.

Dr. Rangan Chatterjee 1:55:32 Yeah.

Speaker 1:55:33 Or walker.

Dr. Rangan Chatterjee 1:55:34 As a doctor, I know that around 90% of what we see on any given day is in some way related to stress, and I just don't think people really get stress still and understand how stressed and how upregulated they are much of the time. In your experience, people who come to your retreats, people who seek you out for help, people you've coached, when they come and see you, what proportion of their daily life do you think they're spending upregulated compared to downregulated compared to, let's say, an indigenous tribe who are living in nature with nature? Can you sort of paint a picture for us of what that difference might look like?

Speaker 1:56:17 Um, I can paint it from Bruce, so Bruce Perry, um-

Speaker 1:56:22 Has been with so many tribes now, documentary tribes, also TY. Um, and I, I had a good chat with Bruce around the book as well, discussing, um, Penan tribe and another tribe called the Banjeli tribes. They're mentioned in the book

Dr. Rangan Chatterjee 1:56:35 They are. I love that bit with the Penan tribe. I, I just underlined it. I thought it was wonderful

Speaker 1:56:39 Amazing story, and he, you know, and he just expressed this. I, uh, he just said, "Look, you'll get it, Tony, because of this right and left hemispheres and being down-regulated and this state of meditation they're operating in, like, 24/7." It's like even if they're in alert states, it's, it's like an alert state that we would talk through the Wim Hof method, let's say, where you're, you're using an upregulating breath technique, but not to bring sh- that kind of upregulation stress. To become an alert state, so there's a positive to that. It might be, oh, I'm, um, having a slump in the afternoon. Say we're having a slump in the afternoon, it's 3:30, I've got to jump on a podcast. I'll use another type of breath practice to just pick me up again. It just brings me up into an alert state. Doesn't mean I'm stressed out, but it's an alert, um, tuned-in practice

Dr. Rangan Chatterjee 1:57:27 So it's like a stressed and focused-

Speaker 1:57:29 Yes

Dr. Rangan Chatterjee 1:57:29 ... as opposed to a stressed and anxious.

Speaker 1:57:31 Yes. It's a c- it's a different mindset.

Dr. Rangan Chatterjee 1:57:33 Yeah.

Speaker 1:57:33 So that's what, that's what Bruce was explaining that these indigenous tribes that, again, they're moving through a landscape, but they're not separate to it. They're totally tuned into the frequency of it, right? That's where they're at. Um, and if we, again, if we look at people that maybe turn up on retreat, they've normalized, they've normalized stress. It's like that's what they operate at the whole time. So it's like these indigenous communities that Bruce is talking about are normalizing down-regulation, parasympathetic, and some of the attendees I see have normalized sympathetic. And what we then do is things like, um, ice baths or breathing techniques enables us, with the ice bath enables us to go up, whew, we get a peak, and then they can drop back under again. So suddenly it's like, ah, there's a stressor because I've just been operating at a stress. Almost need a, um, even more of a peak of stress to be able to drop back under again to recognize where my parasympathetic, my more crystal clear state of mind would be.

Dr. Rangan Chatterjee 1:58:34 Mm-hmm.

Speaker 1:58:35 Um, and I see it just from taking people, again, like w- with the blindfolds on into the forest. You can just see a complete shift in that person's state. You can feel it. It's not just-

Dr. Rangan Chatterjee 1:58:46 Yeah

Speaker 1:58:46 ... seeing it. You just feel it from, like, their whole aura. Th- there's something changing within their energy. Um-

Dr. Rangan Chatterjee 1:58:52 I guess people know that, don't they? Most people will probably recognize the feeling, I, I guess on a Sunday maybe when they haven't got to go to-

Speaker 1:58:58 Yeah

Dr. Rangan Chatterjee 1:58:58 ... work and they haven't got anything, like, to do. Or even on holiday, how, how just they feel and maybe a few aches and pains aren't there. You know, just there, there's a relaxedness, and your experience of the world is very different when you're in that state. And I guess many people think, though, I can only be in that state when I'm on holiday or on a Sunday, right? Many people will listen and go, "Yeah, that's all right for you maybe-

Speaker 1:59:26 Yeah, yeah

Dr. Rangan Chatterjee 1:59:26 ... but I've got a busy life. I've got a busy job. It doesn't apply to me." What would you say to them?

Speaker 1:59:33 Um, I have a coaching business. I hold retreats. Um, I've just produced a book in lockdown, which, uh, is a, I- hats off to anyone that produced anything in lockdown, I believe. Um, and did two major endurance events, built a documentary around that. Um, we unschool our kids as well, so we've been doing that for many years, and still manage to operate in a down-regulated state. So there is this, "Oh, it's okay for you, mate," but there, I, I totally, I'm totally there with you. You know, I, I live it as well. I, I live that environment. Um, it just, you can put practices within your day. You just need little reminders, and sometimes that's all it takes. It's a reminder to breathe. You know, it's a reminder maybe on the hour to say, everyone has a minute, you know, out of your hour. Take one of the minutes away and just say, okay, here's six cycles of breath just to reconnect to the breath again and to find myself within it.

Dr. Rangan Chatterjee 2:00:30 So let's just talk people through that because a lot of people have heard of breathwork, they've heard of practices. They've, they've heard it on this show before. But you mentioned one, the four-six.

Speaker 2:00:39 Yeah.

Dr. Rangan Chatterjee 2:00:39 Right? So maybe just be super practical with people. On the hour, you're recommending that they take a pause and do four-six?

Speaker 2:00:47 Four-six, six cycles. And sometimes, you know what? Don't even get obsessed by the counting of it, you know? There's a breathing app I've recommended in the past, and it has a sound that picks up for four seconds, another sound that drops off for six seconds. That's called Breathing App. It's so simple, right? That's one. Or it can just be, um, if you put your finger on your pulse for a moment and you just inhale up through your nose, you'll notice there's a slight pickup of the pulse. As you exhale and you exhale for longer, you'll notice there's a dropping off of the pulse. So it's as long as you can inhale for and as long as you can exhale for, but just try and extend the exhale a little longer and practice six cycles. You'll be at around a minute, right? Um, prior to that, just try this. Wherever you're sitting, it could be on the floor, office chair, wherever you are, just try and relax the pelvic basin in your lower abdomen because we're also very tense down there, right? So we're walking around very tense. So try and relax that area to begin with. Allow your jaw to settle and your heart to settle. Just tune into that. Very simple language. Relax the pelvic floor, the pelvic basin, the lower abdomen, the jaw.

Dr. Rangan Chatterjee 2:01:50 Yeah.

Speaker 2:01:51 Let the shoulders go and let the heart go. Even that, if you just even think of that, you're already a step there. Like immediately the moment I think of it, I'm like, "Oh, okay, I feel calm again."

Dr. Rangan Chatterjee 2:01:59 Yeah.

Speaker 2:02:00 You know, it just comes in, drops in, and then you breathe into that space. Breathe into the relaxed jaw, breathe into the relaxed shoulders, breathe into the lower abdomen and the pelvic floor and just allow all that being of you just to expand on the inhale. And then don't push your exhale. So you just allow your exhale to go as if Yeah. Otherwise it turns into [exhales] and then we're tense again in the lower abdomen, the jaw, and the shoulders

Dr. Rangan Chatterjee 2:02:24 Yeah

Speaker 2:02:24 So it's just allowing your whole being to be inflated with an inhale, and allow the breath just to leave you. And that's six cycles. That's, I mean, that's such a simple practice.

Dr. Rangan Chatterjee 2:02:33 It's so simple, isn't it? So like an alarm on the hour, maybe on people's phones to remind them. Like even if they're stuck-

Speaker 2:02:38 Post-it. Post-it Note, boom, up on your screen, whatever it is. Just remember to breathe today. You know, it could be... It's, it just little reminders. And we do need the reminders because, again, once that stuff starts kicking in, the next email, the next phone call, and we find ourselves upregulated, we're already operating from a different system.

Dr. Rangan Chatterjee 2:02:55 Yeah.

Speaker 2:02:55 So sometimes we just need l- that little reminder, like a little tap on the shoulder from your favorite uncle or aunt saying, "Just remember to breathe now."

Dr. Rangan Chatterjee 2:03:02 Yeah. I mean, what I love about that practice is that there's n- there's, there's l- literally nobody who is listening to this podcast right now who couldn't do that. It, it doesn't cost any money, right? They don't have to, uh, buy anything. They don't even need to get an app really, you know? You don't even really need to time it, do you? It's just a rough-

Speaker 2:03:21 Yeah

Dr. Rangan Chatterjee 2:03:21 ... um, approximation. You know, roughly in for four, out for six, and just do that for a minute. And what benefits is someone gonna get if they do that? Why should they?

Speaker 2:03:32 I honestly believe that just that, those simple pra- not like the inner work, I call it, but every relationship improves from you doing the inner work, including the one with yourself, right? So that will mean that every relationship within your work environment, home environment, will improve via that. And it could be like with the lady I'm discussing who enters her father's home. Her relationship with her father improves from that, right?

Dr. Rangan Chatterjee 2:03:56 Mm.

Speaker 2:03:56 Just in that moment. Because, again, she's seeing him differently. She's not seeing him from the what might have been way back there in childhood even, because she's not operating at that subconscious layer. It's now she's entered as a conscious adult into that experience, not operating as maybe the six-year-old or the five-year-old back there, right?

Dr. Rangan Chatterjee 2:04:14 Yeah.

Speaker 2:04:14 I guess your, um, ability to think clearly, precisely. You know, so within a work environment, what do we want? We want to be on our game, don't we? You know, we wanna be able to articulate. We want to be, um, focused. We want to be able to deliver on time or targets, and you can do all of that.

Dr. Rangan Chatterjee 2:04:33 You're gonna work better.

Speaker 2:04:34 You just work more efficiently, right?

Dr. Rangan Chatterjee 2:04:36 Yeah.

Speaker 2:04:36 It's, that's, that's it. That's it in its simple form. But again, I think it's really down to, for me, it's the relationships, every relationship improving. With, with parenting, for instance, it might even be working from home. I have a studio outside the house, so I have this really long commute these days across the lawn, right? But I- it's sometimes easy to forget that that's still a work e- e- environment.

Dr. Rangan Chatterjee 2:04:56 Yeah.

Speaker 2:04:56 And I'd suddenly enter the home, and I'm still in the email or the phone call. So what can we do? Okay, we, we put everything down in that moment, breathwork, just for the moment, a minute. Then leave that experience, and leave whatever it is in that space before entering the new space. Because again, the kids are waiting for you. They're waiting to see you. And who do they wanna see? They wanna see kind of, again, the upregulated papa or the down-regulated papa, you know?

Dr. Rangan Chatterjee 2:05:19 Yeah.

Speaker 2:05:19 Who have they been waiting for? And an hou- believe me, like an hour or two hours is like a lifetime to kids if they, if you've been in that, in, in that environment.

Dr. Rangan Chatterjee 2:05:26 It could be I just can do one minute of down-regulation breathing, where my out breath is longer than my in breath, in my car. And then when you walk through the door, your interaction with your partner, with your kids, it's gonna be completely different. It can stop a lot of [chuckles] you know, unnecessary disputes or arguments.

Speaker 2:05:44 Yeah.

Dr. Rangan Chatterjee 2:05:44 And the other thing for me, Tony, as I hear that, why, why I think that's such a ver- such a powerful practice also is because we get to work, and we just start to accumulate, a lot of the time, stress, and what I call micro-stress doses. And if you don't do anything to down-regulate, you just, you just keep going. You just keep going. Keep going. And then by the end of the day, when you've finished, you may not have done anything to pause, to bring everything back down again. So by the time you then rock up at home after work, whether you're working from home or from an office, you know, your state is completely different, and arguably not the best state to then interact with loved ones.

Speaker 2:06:24 I had this moment. I was staying at my friend's space in Somerset. We were there for six months, so we got to live in like a proper community experience. And there was one morning, um, I had s- I had a lot on, and, and I just thought, "I'm just... I know what I'm gonna do. I'm gonna go to the lake. I'm just gonna sit at the lake." So I walked to the lake, did some breath. And in that moment, it was this simple language of, um, it's a choice, right? [chuckles] So you can choose to do the breath and appreciate the privilege, or you can choose not to and feel overwhelmed. And then I realized it was just a fine line between overwhelm and privilege, and what can help me navigate that path is just a simple breathing practice. But equally, being out in nature. You know, just as we're discussing breath, just a walk within a green space or taking your shoes off and going for a walk on the lawn. You know, the study suggests that 20 minutes in a, in a, in a natural environment will lower heart rate, blood pressure, and drop us into parasympathetic as well. What equally it has to highlight though, a bit like the morning practice, is, you know, that why are we upregulated? You know, what is it within this everyday environment that's, that's doing this? You know, and, and what are the other things I could be addressing, right? You know, and that could be, again, getting out into green space might be one. Being, spending more time outdoors. We're known as this indoor species, right? This urbanite species that spends 90, 95% of our time indoors. Um, so we can look at stretching, perhaps try and find more time outside. Or from that natural experience of being outside and recognizing that just a small percentage of time outdoors will lower heart rate and blood pressure, what can I learn from that? Can I perhaps journal what that experience is and what it is I'm feeling? What are those things that m- that I feel drawn to that are doing, that are lowering the heart rate and blood pressure? And what can I bring into my everyday environment from that?

Dr. Rangan Chatterjee 2:08:18 Yeah.

Speaker 2:08:18 What can I learn from this out here to bring into the everyday environment? Because for some, again, it's all right for you, Tony. You might get to spend more time outside, which I get. Um, others, it's not so simple. They maybe can't get out today or can't get out tomorrow. What if, you know, it's dark immediately afterwards, you know?

Dr. Rangan Chatterjee 2:08:34 Yeah.

Speaker 2:08:35 And outdoors doesn't mean, um, the tube, the car, or the shopping center. It means actually outdoors, right? And so-

Dr. Rangan Chatterjee 2:08:42 Where the sky's above your head.

Speaker 2:08:43 Yeah. So, you know, what can I be doing? Maybe try and stretch it, you know, make the next tube stop to walk to or, you know, just try and, try and work with that. But ultimately try and bring more of that organic experience inside the home in those everyday environments. That might be what you see and what you taste and what you smell and what you feel within those environments, but it could also how we move in those environments. How can, how can we move more organically within an environment, right?

Dr. Rangan Chatterjee 2:09:11 It-

Speaker 2:09:11 Including the home.

Dr. Rangan Chatterjee 2:09:12 Yeah. It's, the, you know, getting off the tube one stop earlier. Often the narrative I think in society around health is, okay, well, you can get more movement in then. You know, y- let's say you can, you can get a 20-minute walk in now. Great. And then people naturally often go to, "Oh, I'm ticking off my physical activity box. Uh, what, how many calories is that gonna burn?" Or whatever it might be. But again, it's very reductionist, isn't it? Because that 20-minute walk could be many things. It could be you're getting natural light exposure. You might be getting a bit of sun. You might be hearing the birds, depending on where you're walking. You could be doing some breathing at the same time. It's not just one thing, is it? That 20-minute walk actually can hit multiple parameters.

Speaker 2:09:57 Yeah. You can get many needs met, right? Rather than just the, the want or the desire to get to work on time. You could flip it and just think, well, okay, what can I receive from that experience? How many of those boxes, those natural needs can I tick off? Um, it can be then, oh, I feel so amazing for just doing a 20-minute walk. I'll tell you what, I'm gonna get up a bit earlier now and maybe walk for a bit longer. You know, and that's, that's what can happen through these experiences, and become more of an opportunist even along the way, right? Once you really open things up, what does it feel like? Oh, maybe I'm gonna balance on the curb stone today and get some balancing in, or I'm gonna balance on the wall or, you know, use the stairs down to the tube instead of escalator, and just add more things on. Like Yehudi, I, I, I describe in the book. Yehudi's like, he's 82 now. Um, I think I discussed him on the last podcast, but his commute, right, was that he'd wake up in the morning, but anyway, he'd, he'd have his whole practice at home, and so he'd have, um, a- an office experience at home where he'd set it up. There were mats there so he had no chair. He'd ground sit. Um, he'd answer his emails either on the ground or standing. He'd have a pull-up bar so he could hang from before entering the office. It was in one of those positions where it's always there so he knew he would do it. Um, kitchens are great for that, right? You can pull-up bar in the kitchen so you know whenever you enter, oh, I can hang while the kettle's boiling. And then he'd walk in his Vivobarefoot shoes, right? So he's getting his feedback from his feet, and his feet can behave how they're meant to behave. Get to the tube. People would normally say, um, "Well, would you like, would you like a seat?" And he, "No, no, I'm okay." And as soon as the train starts moving, he's either hanging off the rail above, right? So he's hanging while the train's moving. Or he's surfing, right? So surfing would mean not holding onto anything and just working like, so the tube becomes like a huge power plate, right, where you have to stabilize. Great for the hips. And that would be his experience, and then he'd walk up the stairs. And this, you know, it's just, that's, that's where you can take it, and that's-

Dr. Rangan Chatterjee 2:11:49 Yeah

Speaker 2:11:49 ... that started happening for him when he was 78, and he's now 82, and he's thriving in terms of his capa- capacity to move now, right?

Dr. Rangan Chatterjee 2:11:57 I mean, that is, it, it's such a powerful story. It's empowering for, um, anyone who thinks, you know, k- is it too late? Have I lost a lot of my natural movement? You know, what can I do? You know, w- when did he start seeing you? Was it, did you say he's 70-

Speaker 2:12:10 Well, he's now, he actually started seeing me, this, it's been a big journey. He st- first started seeing me when he was 72, and he wanted to learn how to walk, so he was-

Dr. Rangan Chatterjee 2:12:18 And why did he wanna learn how to walk? Did he feel, "I can't walk properly anymore"?

Speaker 2:12:22 Well, this is a massive story to unpack, but he, um, he had a stooped posture. You know, like really head chasing, collapsed in the chest from-

Dr. Rangan Chatterjee 2:12:29 Yeah

Speaker 2:12:29 ... sitting. I didn't realize this at the time, but anyway, he wanted to learn to walk, so I said, "Okay, let's pop you up on the treadmill and I'll record you." Because un- unless someone shows you a video of you walking, you really have no idea. You're kind of subconsciously incompetent at that stage. And what the video will do is just make you consciously incompetent. [laughs] And then we can do some practices and then readdress it, and then, you know, and then record it again a bit later, and then suddenly that becomes your new template, your new subconscious competence, let's say, through that model. Um, introduced him to ground sitting, um, Vivobarefoot, as I mentioned. So those studies are profound, aren't they? That we know that, um, 60% of foot strength, um, no, it's, it's Professor Dort, I think his name is-

Dr. Rangan Chatterjee 2:13:11 Yeah

Speaker 2:13:11 ... from University of Liverpool, right? Within six months of wearing Vivobarefoot shoes, their foot, people's foot strength had developed by 60%, right?

Dr. Rangan Chatterjee 2:13:19 Yeah.

Speaker 2:13:19 But also balance had increased by 40%.

Dr. Rangan Chatterjee 2:13:22 And, and I just wanna, 'cause I love that study and I, you know, I'm a huge fan of Vivobarefoot Shoes.

Speaker 2:13:26 Yeah.

Dr. Rangan Chatterjee 2:13:26 They're the ones I wear, my wife, my kids. I'm either barefoot or in Vivos, um, probably very much like you. And that study, what I love about it is it wasn't about running.

Speaker 2:13:37 No.

Dr. Rangan Chatterjee 2:13:37 A lot of people hear barefoot shoes-

Speaker 2:13:38 Yeah

Dr. Rangan Chatterjee 2:13:38 ... and they think, oh, gotta be able to run.

Speaker 2:13:39 Immediately.

Dr. Rangan Chatterjee 2:13:40 It's like, hold on, hold on. No, no. This is just living in barefoot shoes. You know, going to the shops, walking around.

Speaker 2:13:46 Yeah.

Dr. Rangan Chatterjee 2:13:46 Do you know what I mean?

Speaker 2:13:47 Within a six-month period. So if you think about that from a parenting perspective, what that means f- as a parent, okay? And we all want the best for our kids, and we wanna create these solid foundations for our kids and foundations for life, right? Um, it's saying that if you wear compromising footwear, you're going to remove 60% of your foot strength and 40% of your balance. Essentially, that's what it's saying, right? It's also saying that after billions of pounds that's been spent in the sports science world for developing footwear, which is mainly for aesthetics and not athleticism, let's say, if we can understand this model, is where has that got us? But, but equal- I think for this parental thing, it's like understanding, well, you know, think about the potential that's perhaps lost.

Dr. Rangan Chatterjee 2:14:32 Hmm.

Speaker 2:14:33 Right? And if we look at, um, things like physical education, we already know that if you're the youngest in the class, you're, you, there's a, you're at a disadvantage for the older kids when it comes to physical education and PE, right? So there's already this feeling of inadequacy when it comes to sports perhaps and PE in later life. But then we're saying we're removing also 60% of foot strength, 40% of balance, you know? But with Yehudi's case, he, um- He, yeah. So introduced him to Vivo. So ga- again, foot strength would improve, balance would improve, of course. Uh-

Dr. Rangan Chatterjee 2:15:05 Naturally, without working on it-

Speaker 2:15:06 Naturally

Dr. Rangan Chatterjee 2:15:06 ... just, just by actually-

Speaker 2:15:07 Yes

Dr. Rangan Chatterjee 2:15:07 ... not compromising your footwear-

Speaker 2:15:09 In that period of time

Dr. Rangan Chatterjee 2:15:09 ... and being in touch with the grounds.

Speaker 2:15:10 So that's removing. So that's operating at the cause level, right? You know, and really understanding that. 'Cause you can do all the foot practices you like, strengthening your feet, balancing work. But if you keep putting them in the same environment that compromised them in the first place, it's merely symptom relief, and quick fixes are further distractions from the truth. You need to get into the real cause, and often it's, it's simply the shape of the foot. You know, it's the environment really-

Dr. Rangan Chatterjee 2:15:33 Yeah

Speaker 2:15:33 ... that we need to work at. And the environment for the foot in modern society is the shoe, is it not, right? So with Yehudi, that foot strength had improved, balance had improved. His overall understanding, his posture had improved because it removed the chair and got him back to f- mobilizing areas that are designed to be mobile and creating stability in areas that are essentially designed for stability. And also bringing the squat back, so squatting instead of sitting, so that his mind could understand where his weight should be when he stands up even, let alone when he walks, right? Um, but later on, as times passed, Yehudi then said, "Well, the reason I wanted to learn to walk was 'cause I wanted to go to Everest Base Camp for my 50th anniversary with my wife." So that's why he'd taken on that challenge.

Dr. Rangan Chatterjee 2:16:16 Mm-hmm.

Speaker 2:16:16 Did Everest Base Camp, did Mount Kenya, Bhutan, um, Atlas.

Dr. Rangan Chatterjee 2:16:21 In his late 70s.

Speaker 2:16:23 In his late 70s. This is closer to 80. And then at 79, um, he came on a workshop of mine, which was originally, um, well, it's now called the Hunter Human Experience, but originally it was called Move, Breathe, Chill, which was movement and play and breathwork and then ice baths. And Yehudi was terrified, right? Properly terrified of the cold. So it took me about an hour the night before the workshop. I mean, he'd agreed to it days before, but an hour the night before to convince Yehudi to come the next morning.

Dr. Rangan Chatterjee 2:16:52 Mm.

Speaker 2:16:52 Yehudi also lived the closest to the workshop. It was in Camden, he lived in Hampstead. People were traveling from all over, and he still managed to be late, right? But once we got him through the breathwork and the play, and the play's great for that 'cause it enters this playful state of mind and it breaks down all the armor in a way, and, um, we become much more open. And we become much more open to the breath, so the breath goes right in very quickly. And he was first in the ice bath, right? First one in, and he let out this huge primal roar. I mean, like, screaming from the belly was coming out of this man. Then stepped out and he thought it was done. I said, "No, we're gonna go back in again. I think we need to go back in," and got him in again. And then since then, um, Yehudi has been going to, um, either Hampstead Ponds or the River Lea five mornings a week, um, for two years now, right?

Dr. Rangan Chatterjee 2:17:41 To make sure you're taking action after watching this video, I've created a free guide to help you build healthy habits. We can all make short-term change, but can those changes become a fundamental part of our life? Often they don't, and that's why in this free guide, I share with you the six crucial steps you need to take that are really, really effective. If you want to get hold of that free guide right now, all you have to do is click the link in the description box below. So he's 82, so like 80 to 82.

Speaker 2:18:15 Again, like the practices, like it, you know, when we think, "Oh, it's too late for me" or, "It's too late for th- I can't start this now, I'm already..." We're talking about someone in their late 70s, and he's not alone. I mean, I, there's a number of my clients that are past their 70s, mid-70s-pluses that have been told, you know, not to take their knees past their toes, and they're now in deep range squats, low gait walking, balancing on rails. And for me, again, it's incredibly inspiring.

Dr. Rangan Chatterjee 2:18:43 Yeah.

Speaker 2:18:44 Because it changes my template even of what the 70s and 80s are, right? Because my personal understanding of 70s, 80s are looking at my grandparents or even 50-pluses at one point. You know, where it's like k- it was just like normal to groan as you sit back in the chair or something.

Dr. Rangan Chatterjee 2:18:59 Yeah.

Speaker 2:18:59 Or groan to get out of the chair. And here we are witnessing empowered 70 to 80-year-olds-

Dr. Rangan Chatterjee 2:19:04 Yeah

Speaker 2:19:04 ... doing quite profound things. But are they that profound or are they, again, naturally normal, just we've, we've become, um, distanced from the path perhaps?

Dr. Rangan Chatterjee 2:19:13 Yeah. I, I, I completely agree. I'm, I'm, I mean, I'm so on board. I, I can't shake this idea of an 82-year-old chap on the tube in London in between stops hanging from the rail or squatting.

Speaker 2:19:25 Yeah.

Dr. Rangan Chatterjee 2:19:26 I, I think it's wonderful, and I think that for me brings up some interesting points. Monday night I was at Edinburgh, last night of my book tour, and, um, I was coming back on the train yesterday and the train got canceled and there was all kinds of... I had to take three trains instead of one train. It was all unplanned. And yeah, I was pretty chilled about it actually, which is, uh, you know, when you practice these sort of things, I feel you naturally... You know, I, I feel I'm a lot more down-regulated these days-

Speaker 2:19:55 Mm

Dr. Rangan Chatterjee 2:19:55 ... naturally, and therefore I just be a lot more. And I'm like-

Speaker 2:19:58 Mm

Dr. Rangan Chatterjee 2:19:58 ... "Oh, train's canceled. Okay, cool. Well, it's gonna be what it's gonna be." And then in the final leg, I thought, "Actually, Tony's coming tomorrow. Let me get back-"

Speaker 2:20:06 [laughs]

Dr. Rangan Chatterjee 2:20:06 "... into his book a little bit more." I'd, I'd been reading it over the weekends, and I was reading about Yehudi. And this was a busy kind of local train. It was coming up to office time. There were a lot of people, there was no chairs and stuff, and I thought, "Yeah, Tony's coming tomorrow, I'm gonna squat." And so for the last hour, um, I, in between the, uh, you know, sitting carriages, you know, I was squatting against the wall and just reading your book and then listening to some music or whatever. But I was rested against the wall. And, you know, after about 10 minutes I was a bit stiff, so I'd stand up for two or three minutes and I, then I'd pop back down again.

Speaker 2:20:41 Yeah.

Dr. Rangan Chatterjee 2:20:42 The thing is, a lot of people will think, "Oh my God, what will people think? People are gonna stare at me." I, I don't recall anyone looking at me. Like, genuinely. Like, people are so tied up [laughs] in their own worlds and their own podcasts and their own music and their own books. I think that's empowering, that actually no one gave two hoots.

Speaker 2:21:00 You know, I always go, "It's none of my business what other people think of me," right? And also, you'll be surprised at s- if people are looking at you, how do you know that they're just not being inspired by you? Why do we immediately go to the negative of, "Oh, they're gonna think I'm, oh, this crazy man on the tube"? They might be inspired, you know? And again, I, I'm inspired by someone like you who'd, who's be hanging off the tube rails and squatting. How could you not be inspired by that? You're not gonna look at, uh, at someone in their 80s and go, "Look at that crazy 80-year-old hanging off the rails and squatting."

Dr. Rangan Chatterjee 2:21:28 You're gonna think, "Legend." [laughs]

Speaker 2:21:29 Yeah, exactly. And there, there's that. And I, I think also it's a cultural thing. Like, our kids are now going to this, uh, forest school. It's a group of parents that live where we live, and we've kind of done something together and created something for them to attend on a Thursday. And, um, one of the dads was there, and he'd listened to our podcast way back and said, "Oh, no way. You're Katarina and Tony, and was talking about ground sitting."

Dr. Rangan Chatterjee 2:21:55 Oh, fantastic.

Speaker 2:21:56 And again, was discussing this, the, oh, how do people react to it? And Katarina said, "Well, it depends where you are. Where you are in the world." 'Cause some cultures, that's what they do. It's just our, our, where we are in the West, perhaps, it's our own lens of how we see it, you know?

Dr. Rangan Chatterjee 2:22:14 Yeah. Has anyone ever said anything to you negative?

Speaker 2:22:17 Not negative. I've never had anything negative.

Dr. Rangan Chatterjee 2:22:19 Yeah, there you go.

Speaker 2:22:20 Even walking around, you know, and being bare... I mean, sometimes I, I mean, I have had kids kind of be like, "Whoa, Papa, why is that man running around with no shoes on?" And, and... But nothing really, not really negative. Sometimes some strange, I guess, strange kind of looks of, "What's he doing over there?" But then again, you, uh, I... It's how it's received, right?

Dr. Rangan Chatterjee 2:22:42 Mm-hmm.

Speaker 2:22:43 Again, what if we're receiving the upregulated versus receiving it downregulated? How about try and do the practices, but work on your breath while you're there, and it might change the lens of which you, you're receiving that look. It might be suddenly that's a positivity look rather than-

Dr. Rangan Chatterjee 2:22:58 Yeah

Speaker 2:22:58 ... a negativity look, a judgmental look. And when it comes to judgment, more often than not, we're judging others for judging us, not them judging us.

Dr. Rangan Chatterjee 2:23:07 Yeah.

Speaker 2:23:08 You know?

Dr. Rangan Chatterjee 2:23:09 I- I-

Speaker 2:23:09 [laughs]

Dr. Rangan Chatterjee 2:23:10 You know, it's, you know, when you are concerned or overly concerned with what other people think, usually, if not always, it comes from a place of an insecurity, doesn't it? When you don't think enough of yourself. Um, you know, for, for me, as a, as a fellow barefoot, uh, shoe wearer and someone who literally has his shoes off as much as I possibly can, it's really interesting. A lot of people who listen to this podcast now wear Vivos, 'cause Vivo have been supporting the show for a, for a few years, and I, I talk very passionately about them. And what's really interesting for me, at the event in Edinburgh on Monday night, a lot of the time in the book signing queues afterwards, people show me their Vivos. Like, "Hey, look."

Speaker 2:23:59 Yeah. [laughs]

Dr. Rangan Chatterjee 2:23:59 "You know, I'm wearing... It's really, it's really nice." And they're like, "Oh, man, I don't have my back pain anymore. I don't have my knee pain. Thank you so much." All this stuff. And then-

Speaker 2:24:06 It's brilliant, right?

Dr. Rangan Chatterjee 2:24:06 There was two really lovely women at one point who said, you know, "They've just gotta make better-looking female shoes, you know, then I'll wear them." [lip smack] And first of all, I, you know, this is a, this is something I had with my own wife a few years ago. She's like, you know. But she's been wearing them probably four or five years now, and wouldn't go back, you know, once you experience them. And I think they do look really good now, actually. I think compared to maybe 10 or 15 years ago, it's-

Speaker 2:24:29 Oh, yeah.

Dr. Rangan Chatterjee 2:24:30 But I think this is a really interesting point. Like, if you look at the research on minimalist shoes, you've mentioned, you know, one of those studies from the University of Liverpool. I know, I think it's Professor Irene Davis in-

Speaker 2:24:42 Yeah

Dr. Rangan Chatterjee 2:24:42 ... um, i- in America talks about as soon as you put a human i- in a cushioned shoe, their gait changes straight away, right? You, you denormalize or you, it's, y- you're changing how you walk.

Speaker 2:24:55 It's come through animal studies as well. They show it. Yeah.

Dr. Rangan Chatterjee 2:24:57 Yeah. A- and then, and then you think, well, I think, well, once you know that, and, and I wanna talk to you about feet in just a second, and they're so important to every aspect of who we are. It, for me, through the lens with which I look at the world, which is, well, why on earth would I wear cushions every day if I know what that's doing to me? But I understand, and many people, yeah, they're persuaded. They give it a go and they're like, "Oh, man. [laughs] You know, I'm actually enjoying walking more now 'cause I can feel the ground-

Speaker 2:25:25 Mm

Dr. Rangan Chatterjee 2:25:25 ... a lot more." And then they're not quite as disconnected. But some people are still very much of the view, "Yeah, man, but they don't look normal. They don't have that kind of pointed end that I'm used to or..." And, and I guess what I'm trying to get to, to be as inclusive as possible, you know, I, I think everyone should try at some point minimalist shoes. Vivo or whatever brand you want, right? Try and just see it for yourself how you feel. Have you had resistance to that? Have you had, uh, clients who come in and go, "Look, I'll do the other stuff. Oh, man, that's not my thing"? Or, or does it almost self-select when people wanna work with you that they're already in tune with that way of thinking?

Speaker 2:26:04 [inhales] Yeah, I have much more compassion these days, like, in my coaching. When I first started out on this journey, I used to be quite strict. It used to be, "Well, you know, if, if you're not prepared to change shoes, then I can't really coach you," because the whole point is that, you know, if we understand the behavior of the foot, 33 articulations, 26 bones, 100 muscles, tendons, ligaments, and all the receptors within the feet, 200,000 extra receptors, and how that feeds and nourishes the whole posture, and all the joint actions above it, and the muscular actions above it. And, and in tune with that, then you'll be super efficient and minimize the risk of injury. If you're not prepared to do that, then it's, then we're really just offering symptom relief. I'm happy to give you symptom relief, but really th- this is, this is where it's at. Um, and I think over time, it's just here's the conversation. This is it, you know? And allow it to just settle a bit. Plant the seeds at least, you know? And the beauty of this work now is we do have those studies there. You know, not many people have heard of that study, and for me, that's, it's quite profound-

Dr. Rangan Chatterjee 2:27:07 Mm-hmm

Speaker 2:27:07 ... to understand that 60% of your foot strength will improve over a six-month period. That can be, okay, if you're not prepared to change it, and I get it. Even my, Lola, Amelia, and Tallulah have started putting Lego blocks in the back of their socks to be like high heels, right? And they're unschooled. It's not that they're even in a school environment. Catherine doesn't wear heels. Just, it's, it's within. It's just within it. They're observing it somewhere. Um, and am I gonna say, "No, take those blocks out of your heels"? And no, of course I'm not. You know, it's just an experience. They're playing with something. Um, but it's also understanding that probably a large proportion of the day they are barefoot, or they're in Vivobarefoot. So what can you do? Okay. Um, could be an unavoidable sitting scenario like now, right? We're sitting, right? Um, do we alienate sitting, or it's the devil's work sitting, smoke- sitting's the new smoking? It's, well, there are unavoidable sitting scenarios. Drive a car, get a flight. You know, in an office environment it's not appropriate to sit on the floor, and for some environments they won't even allow a standing desk. So what do we do? It's what we do outside of that. The, the places where we can possibly take responsibility, or control of what we can take control of. So when you arrive home and you're behind the door, then get the shoes off, and then there's certain toe practices, or what we call toga, or yoga for your feet, that you can then do, which will then help unravel or deconstruct some of that, um-

Dr. Rangan Chatterjee 2:28:34 Yeah

Speaker 2:28:35 ... that environment that you've created, which unfortunately does compromise the foot and the behaviors above it. You know? But-

Dr. Rangan Chatterjee 2:28:42 It's amazing how much y- y- the environment influences our behavior, doesn't it? Not only the environment we see around us and what we think is normal, um-

Speaker 2:28:51 Yeah

Dr. Rangan Chatterjee 2:28:51 ... or, or typical, I should say, [laughs] rather than, 'cause you obviously talk a lot about this concept of biologically normal.

Speaker 2:28:56 Yeah.

Dr. Rangan Chatterjee 2:28:57 Um, but c- culturally, you know, we may have touched on this when you came on the show a few years ago, but in most Indian families you take your shoes off before you come in. That's obviously my cultural upbringing-

Speaker 2:29:10 Yeah

Dr. Rangan Chatterjee 2:29:10 ... which a lot of people certainly in, in the UK and, and America don't have. It, it's, it can be very different, right? And so have you found there's a difference? Do you, do you get clients from different cultures, different parts of the world, and have you found that actually their willingness to-

Speaker 2:29:27 How they respond

Dr. Rangan Chatterjee 2:29:28 ... engage-

Speaker 2:29:29 Yeah

Dr. Rangan Chatterjee 2:29:29 ... is different depending on their belief system?

Speaker 2:29:32 Yeah, it's an interesting one with footwear in the home, isn't it? You know, and some, some haven't actually taken their footwear off. It could be a whole day experience. So even that, as I say, it's, it's suddenly changing that template that within the home, let's just at least try and get that barefoot environment.

Dr. Rangan Chatterjee 2:29:48 Yeah.

Speaker 2:29:48 Change, flip the perception of that one environment. Um, and yes, some people are much more responsive to others. It's what's normalized. It's whatever those templates are, and how long you've had that experience, or what you've observed in your earliest years even play out within that.

Dr. Rangan Chatterjee 2:30:03 Yeah.

Speaker 2:30:03 You know?

Dr. Rangan Chatterjee 2:30:03 I mean, there's even, you know, we say, you said office environment where you can't do that much. You know, we thought long and hard, you know, in this new studio. It's like, okay, well, I'm gonna sit here maybe for two hours with someone having a deep conversation. I don't want them to feel uncomfortable. I don't want to feel uncomfortable myself. Um, yet there's also a certain expectation of what should a chair be in a studio where someone's coming, right?

Speaker 2:30:29 Yeah.

Dr. Rangan Chatterjee 2:30:29 And it's, uh, so I have this, uh, Moveman here. I don't know if you know Moveman.

Speaker 2:30:33 No.

Dr. Rangan Chatterjee 2:30:33 But it's awesome because it's an unstable seat.

Speaker 2:30:37 Yeah.

Dr. Rangan Chatterjee 2:30:37 So I have to, by default, for this hour, two hours-

Speaker 2:30:42 Move, man

Dr. Rangan Chatterjee 2:30:42 ... my postural muscles. Yeah, I think it's M-U- yeah, Moveman, exactly.

Speaker 2:30:45 Yeah. You'll have to move, man.

Dr. Rangan Chatterjee 2:30:46 I have to move, and, and s-

Speaker 2:30:48 Yeah

Dr. Rangan Chatterjee 2:30:48 ... and this is, I think, a lot about movement. I, I, I'd love your perspective on this, but the fact that I can't slump and stop engaging my muscles. Yes, it means that whenever I finish I've never had an ache.

Speaker 2:31:02 Hmm.

Dr. Rangan Chatterjee 2:31:02 Like, never. I just simply walk, it's like, yeah, I feel great because my muscles have been engaging the entire time. Um, but I also think that this helps me think more clearly throughout the conversation, so I'm not... You know, if I, if I'm stagnating into a chair, my, my lymph, my blood, everything's sort of stagnating, right? A- and then that chair that you're sitting in, you know, we got what we consider the best ergonomic chair [laughs] for people to at least... 'Cause I thought, should I give my guest the Moveman? I thought, well, the problem is, is if they're not used to that, it could be really uncomfortable. So instead of engaging [laughs] with the conversation, they can just be thinking about how they're sitting, and they know there's cameras here. Do you know what I mean? How, how would you think about that?

Speaker 2:31:44 I've, with someone at the moment, um, I had someone come and see me. He's about your height. Stuart, his name is. And, um, he had a furniture business, like auditorium kind of lecture chairs. And, um, I'd seen his sister originally. She was like this yogi living off grid in Portugal. Came with a back condition. Very quickly, one session out the door, done. "I need to send you my brother." Brother comes, Stuart, and he just said, um, "Do you think there's a chair in this stuff, Tony?" 'Cause I took him through simple ground resting positions that are in the book. They're just a simple series of ground sitting, from kneeling, to sitting cross-legged, to shin boxing, to, um... And each one of those, you know, a prerequisite almost of how we stand, let's call it. They're almost like the motor skill milestones of what it is we do as children before we stand up. So we then, I, we parked that conversation, and it must have been two years went by. And I said, "I have the idea." He's like, "What?" I said, "I know the chair, so we're gonna, I have it." So we went through this whole design. So we're at the point we're ready to launch that very soon. Um, and that then is a platform that's at normal seat height, and you can perform six different rest positions that you could normally perform on the ground. And you're 100% right. It's about Moveman. It's like this understanding that, well, there should be certain signals to move anyway. You know, if we've been in a position for too long, yes, we're stagnating. What does that mean for f- if we think of flow states, what, what does stagnation have to do with a flow state? You know, on stagnant versus flow. I mean, they're completely different ends of the spectrum, right? So it's enabling, I guess, that movement to be really fluid, um, which then ticks the box of earlier conversation about within an environment of work. Well, do we want to be on our game? Don't we want to be super sharp? Um, and I think with this sitting conversation, it's, it's, yeah, it's individual specific again, isn't it? There's a template there of what we've normalized. So what we've tried to do with this particular chair is you can sit on it like an everyday chair-

Dr. Rangan Chatterjee 2:33:49 Right

Speaker 2:33:49 ... but equally you can be in certain positions which if you don't have the mobility, it can be adjusted, and then over