going from zero activity to just 90

minutes a week is about a 15 reduction

in all cause mortality Jesus Christ Dr

Peter attia world-renowned physician

doctor for anything performance or

longevity related he has the secret for

living a long healthy and happy life

most people listening to us are going to

die in cardiovascular disease cancer

diabetes if we want to really figure out

a way to live longer we need a totally

different Playbook how early do some of

these diseases begin the minute you're

born but we only really think about the

risk over a 10-year time Horizon as a 30

year old you don't get excited about

exercise in your sleep but there's a 400

percent higher risk of dying in the

coming year when you compare the fittest

two and a half percent to someone at the

bottom 25 in the coming year and then

once you hit the age of 65 if you fall

and you break your hip there's a 15 to

30 percent chance you will be dead

within the next 12 months really you

have to realize is you're taking this

for granted when you talk about the

deterioration of Health you have these

three categories emotional health

deterioration why have you included that

because despite being very physically

healthy I was not living a good life I

was in such an awful cycle of anger

workaholism that I don't think my

marriage would have survived I realized

I don't want to be this person and lose

my kids I don't think I could have

survived it and I'm sure many people

listening to us can relate were you able

to discover the root cause of that more

than that I was able to get rid of it

how so what you really need to do is

what are the biggest misconceptions in

your mind about weight loss I have

thought a lot about this so

Dr Peter attia he is the man that wrote

the book on how to live a long happy and

healthy life and he argues that

everything we know about health and what

that actually means health of the Mind

the body and the emotions is wrong and

outdated

he says that there's disease growing in

you and me right now

but the problem is

because we can't see it we're doing

nothing about it Dr Peter's work turns

the light on

it allows you to see

that in many cases

in action now will increase your chance

of disease and a much shorter Life by 70

percent

170 percent and in some cases if we

don't take action Now by 400 percent

I've had lots of conversations on this

podcast about health about diet about

all of these things

but for many of you

this one will be the one that changes

your life this will be the one that

makes you ask some difficult but

important questions about your health

and what health means for you I walked

away from this conversation realizing

that if I don't take action now

I'm going to be forced to take action

then

and I can unequivocally say that this

conversation has changed my life

I have a suspicion it's going to change

yours

[Music]

Peter

[Music]

Dr Peter

you talk about so much in your work I've

been through every interview you've done

your book other conversations you've had

you talk about a lot so many things that

I'm absolutely fascinated by

my first question for you is

what is your mission and why are you

doing this I think that

um there is no

greater

um desire for people than to be healthy

especially when you consider how we can

define health more broadly than just

physical health wins you can include

kind of emotional health

it's kind of the great equalizer and

nothing else really matters if you don't

have it right so it doesn't really

matter if you're famous or not famous it

doesn't matter if you're rich or poor if

if your health is compromised and

anybody who's been through an illness

where their health has been compromised

I think we'll realize in a moment

what they've taken for granted and I

I've just become personally endlessly

fascinated by this topic and

in my own

quest to understand this better and

better

the next natural step was to begin to do

it as a doctor right to begin to kind of

help patients with this

and at some point

you can only treat so many people and so

podcasting and ultimately writing a book

just became a way to put as much of that

information as possible out there for

more and more people to access

do you know why U of old people became

fascinated by this was there a stuff

dominoes that fell I think so yeah I

mean I think

um

you know I'd always been interested in

performance

um because I'd always you know at least

as as far back as you know being 12 or

13 years old

you know I'd always been obsessed with

one form or another of some sort of

physical Obsession whether it be you

know boxing when I was really young or

Marathon swimming later in life

but when my daughter was born when I was

35 that

was the first time that everything kind

of pivoted and I had a little bit of a

glimpse into the future I would say and

I just sort of realized oh you know

the The Joy I'm experiencing In This

Moment is so

surprising to me so unanticipated and

I really want to be able to experience

this again

means not just with other children of

mine but potentially with grandchildren

and on top of that I had a bit of a

wake-up call which was I realized that

all the men in my family died

prematurely of heart disease obviously I

knew that fact before this time but I

think it was the Confluence of those two

things it was the realization that yeah

you know if you don't figure something

out and do something about this you're

probably going to die of heart disease

in your 60s which is not that far from

now you know 25 30 years from now and

you now really have a motivation to live

longer and to live better longer

and so that in many ways kind of began

the change in my direction my focus to

to being one that was not purely just

focused on performance anymore but sort

of focused on understanding Health in a

different way

this concept of medicine 3.0 is a

concept which I only discovered in your

work never had the time used before

um

what is medicine 3.0 and how did you get

to the point when you realized that

there needed to be an iteration on the

current system of Medicine

yeah the reason I think you hadn't heard

of it before is I don't think it's been

described before so you can't be faulted

for that

um but as I began writing the book and

thinking about how

I was practicing and how people like me

practice

I realized that it is a very distinct

change from the current form of Medicine

and in a way to not be just critical of

the current form of medicine I had to

put it in the context of what existed

even before that and that's how I sort

of realized well we're in this version

of medicine called medicine 2.0 but it's

following something called medicine 1.0

and it's an enormous Improvement above

that so maybe I can spend a moment just

kind of explaining what those three are

and I think that's probably the easiest

way to explain the current form so

um

medicine 1.0 is everything that existed

before we really understood the science

of Medicine

so for most of human history we had no

idea why people got sick or why people

died or what an infection meant and we

sort of thought that these were plagues

from the gods or things of that nature

but a couple of things happened in the

past

you know 100 few hundred years the first

was the idea of a scientific method

something that we take for granted today

where you can make an observation about

something in the world formulate a guess

called a hypothesis about why it's

happening and then design an experiment

to test it that's called the scientific

method

that's an invention that's a creation we

had to figure that out

also things like a light microscope

which you know up until 140 years ago or

so didn't exist allowed scientists and

doctors to be able to actually see these

microscopic things called bacteria and

then ultimately the development of

things like antibiotics and eventually

vaccines all of these things made an

enormous difference in reducing the

suffering and death due to what I call

in the book Fast death

so fast death is pretty much how we used

to all die

fast death would be trauma and infection

and up until

about 150 years ago life expectancy

would have been high 30s low 40s and

most of us succumbed to fast death

but with the Advent of medicine 2.0

through all those transitions I just

described

in the span of a few Generations we've

doubled life expectancy right so now

life expectancy is roughly twice what I

just said a minute ago

and most people do not die from Fast

death

but it's been supplanted by slow death

today most people listening to us are

going to die from cardiovascular disease

from cancer Dementia or other

neurodegenerative diseases complications

of diabetes

and on the one hand that's a sign of

progress it means like Hey we're living

long enough to die from those things but

we've made scant progress against those

things

in fact if you go back and

strip out the top eight causes of

infectious death or communicable death

death from communicable diseases or

infectious diseases today if you strip

them out our life expectancy is not much

better than it was in the 1800s

in other words that doubling of life

expectancy that we've experienced comes

almost exclusively to the reduction of

those fast deaths and has little to do

with any success we've had against slow

death

if we want to really figure out a way to

live longer and I would argue more

importantly live better meaning when

we're in the last Decades of our life

not be in a state of total decline we

need a totally different Playbook

and that Playbook is medicine 3.0 and it

involves real prevention so that means

taking True step steps at prevention

very early in life

it also involves being very personalized

in how you do things so it means you

can't just do paint by numbers you can't

just sort of say the same thing to

everybody

clearly there are certain things that

make absolute sense across the board

such as sleep and exercise you know but

the way you might use medications is

going to have to be much more tailored

to an individual

you say that there are there are four

points to Medicine 3.0 which is the

prevention the being unique in your

treatment

um to each individual an honest

assessment and acceptance of risk yeah

one of the things that I don't think we

think enough about as doctors sometimes

is is risk right now I think doctors are

very good at thinking about the risk of

doing something yeah

um I think you know usually a doctor is

pretty good at understanding you know if

you have this surgical procedure there's

a risk of an infection there's a risk of

bleeding there's a risk of all these

things if you take this medicine there's

a risk of this side effect or that side

effect

but I don't think we spend enough time

thinking about the risk of not acting or

the risk of not acting when we do

so this is where I think it gets a bit

more nuanced

um

prevention doesn't come without risk

right I mean you're still going to have

to do something in in the state of

prevention

um so the question is understanding the

time Horizon upon which you're

considering risk

so I'll give you one very specific

example

um

at least in the U.S and it might be the

same in the UK

um

we only really think about the risk of

heart disease over a 10-year time

Horizon so look at someone like you

you're 30 years old right so

what is your 10-year risk of having a

heart attack

I can tell you without knowing anything

about you it's really low good it's as

close to zero as we could have in

medicine

but what if I did a blood test on you

and I found biomarkers in there that

were predictive of very high risk later

in life

now that would be actually quite

possible there's there's about a one in

ten chance you might have a biomarker

called LP little a for example which is

just a certain lipid in your body about

a one in ten chance you have that

dramatically increases your risk of

cardiovascular disease my uncle died

very early I believe in his 50s of a

cardiovascular disease interesting

so knowing that by the way could be

helpful because that would prompt me to

ask you more questions and want to know

more about all the people in your family

so here we have a 1 in 10 chance and by

the way we wouldn't leave it to chance

we would just check it and we let's say

we checked your level and you had that

you had that lipoprotein or you had an

elevated level of another lipoprotein

APO lipoprotein little B and again these

are kind of technical terms but they're

very common things and they're easy to

measure

the medicine 2.0 view here would be well

there's nothing wrong with you now and

there's not going to be anything wrong

with you for the next 10 years

we don't need to do anything about it

conversely if I take a lifetime view of

risk I would say

yeah but the risk to something happening

in the next 40 years is actually quite

significant

so my risk of doing nothing is probably

much higher than my risk of doing

something today so my risk of doing

something today would be non-zero but

small but my risk of doing nothing if I

take the appropriate time Horizon is

much bigger this is one of the things in

your book that really really got me

thinking was I have to say and I believe

a lot of people probably feel the same

way I've gone through my life thinking

to some degree I'll worry about avoiding

these diseases later I'll I'll when I

get to 45 then I'll start taking this

thing seriously because then I'm getting

into that territory where most people I

know that get cancer or Alzheimer's or

all of these cardiovascular things

that's when it tends to happen so I'll

think about it then

totally understandable

um and I'll frame this in the context of

a question I get asked all the time

which is hey Peter when is the best time

to start thinking about this stuff

and I say look I can't answer that

because there are two competing issues

that are crossing

when I meet somebody who's in the last

decade of their life

do you know how much they are thinking

about this like it's all they're

thinking about

it's all they're thinking about every

minute of every day is a confrontation

with their own mortality

the problem is

they don't have much time

to change the direction of the ship you

may recall in the book I write the sort

of I use the metaphor of the Titanic

right

it's not that the Titanic didn't see the

iceberg it's that it didn't see the

iceberg in time it didn't have enough

Runway to really move out of the way and

that's why the Titanic gashed the side

of the boat

now at the other end of the spectrum a

30 year old like you has unbelievable

potential to change the Arc of your life

you have so much runway to

through manipulating nutrition and

exercise and sleep and stress and all of

these things to completely alter the to

the disease trajectory of your life

the problem is and I'm not just speaking

to you personally but more broadly to

someone who's as young as you it's

harder to find the motivation because

there are no reminders of your own

mortality you're Superman

right the worst thing that happens to

you is a hangover so I always get asked

like when is the right time to start

worrying about this and the short answer

is look as soon as possible but then

there's a reality that says for most

people it's not until they're in their

40s

maybe once they have kids that they

start to appreciate their own mortality

and that that provides some of the

motivation

to say you know

maybe I'll be a little less focused on

optimizing everything for today

and I'll start thinking a little bit

about tomorrow so again another way to

think about this is saving for

retirement

a lot of people in their 20s and 30s who

are making good money aren't necessarily

taking the most prudent Financial steps

to ensure Financial Freedom when they're

in their 70s

because let's be honest it's more

enjoyable to spend money today than to

set some of it aside

but there are a lot of people later in

life who think I wish I was a little bit

more responsible earlier on how early do

some of these disease if you looked at

my sort of metabolic health or if you

were able to look inside my body which

I'm sure you're able to do how early do

some of these diseases begin

in my in my life at what age do you see

some of these things coming yeah it's

super interesting because

there are some elements of you as a

person that are going downhill the

minute you're born

and there are others that are not so

let's let's use two examples

let's start with something where your

body is getting better and better and

um you know you're probably only peaking

now but you haven't really started to

age

um your muscle quality okay so when you

were five years old

your muscle quality was nothing like it

is today

but as you enter your 20s the quality of

those muscle fibers these type two one

these type 1 and type 2 muscle fibers so

these are kind of slow to fatigue but

high endurance fibers are the type one

fibers the type two fibers are very very

powerful but they're kind of quick to

fatigue the quality of both of those

fibers is very high and the more you

train them the higher quality they will

be

but as you enter your 30s you will now

start to experience a shrinkage of those

type 2 muscle fibers you will be less

powerful in your 30s in your late 30s

especially than you were in your mid to

late 20s so that's a form of Aging you

are declining it's not an accident that

the most powerful athletes in the world

are at their peak in their late 20s and

early 30s so sprinters for example

that's a prime example of a pure pure

Power Sport

um

we look at other things like more of

your muscular endurance that will Peak

even a little bit later you can keep

that going a little bit later

we look at certain forms of cognition so

if we look at something called fluid

intelligence right this is raw

horsepower processing speed you have

more of it right now than I do meaning

you're going to have faster processing

speed better memory all of these things

are going to be better when you're 30

than at my age I'm 50. because that's

already started to decline in me

there are some things however that began

Aging in you the minute you were born

and one of them is actually going back

to this idea of atherosclerosis or

cardiovascular disease well that's an

example of a disease process that begins

right away at Birth and even though it

almost never rears its head as far as

death before you're 50 make no mistake

about it it's starting on day one

and we know this by the way because when

we look at studies of people who die for

completely unrelated reasons so somebody

who you know dies in a car accident or

soldiers dying in war and we look at

their the arteries of their heart we

already see quite Advanced disease so

the truth of it is you already have

pretty significant disease in your

coronary arteries it hasn't risen to the

level of ever causing a heart attack and

it's unlikely to do so for another 20

years maybe even another 30 years but

it's compounding it is compounding

exactly and if you want to live to be 90

free of cardiovascular disease it makes

a big difference if you can slow it down

when you're in your 20s and 30s

interesting

that's really what I'm trying to change

in myself is I'm trying to find the

motivation like you said when we're not

confronted with our mortality it's

interesting because my life changed

because of the pandemic in part because

I got to see

um the relationship between

things like obesity poor metabolic

health and mortality for the first time

and that's really when I started working

out every pretty much every day now it

was three years ago in

March 2020 2020 when I was watching the

TV and it was that confrontation of like

oh my God the reason why I'm having a

better outcome with this disease is

because I'm in better metabolic Health

metabolic shape and it's funny that it

has to take those things in our lives

for us to make the changes quick one

before we get back to this episode just

give me 30 seconds of your time

two things I wanted to say the first

thing is a huge thank you for listening

and tuning in to the show week after

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the things you love about the show

thank you thank you so much back to the

episode when you talk about the

deterioration of Health you have these

three categories cognitive decline

um decline in loss and function of our

physical body and then emotional health

deterioration why emotional health

deterioration

why why have I included that yeah why

have you included that well I mean maybe

I'll just take a step back and say where

I kind of put these all in perspective

so

you know the the title of the book right

is outlive the science and art of

longevity and what is longevity well

longevity is really about two things

it's about the length of life

and the word for that is lifespan but

it's about the quality of life and the

word for that is Health span and it's

Health span that has those three

components you just described Health

span meaning quality of life is

determined by your cognitive function so

what's your processing speed what's your

executive function what's your memory

all of these things it's determined by

your physical health

how much strength do you have are you

free from Pain how much endurance do you

have what what capacity do you have to

do whatever you want to do physically

are you Limited in any way by pain

strength movement balance

Etc and then the final piece is

emotional health what's the state of

your relationships are you do you have

joy in your life do you have a sense of

purpose are you happy

um not all the time right do but do you

have the capacity to regulate your

emotions and so now to answer your

question why would that be included well

the truth of the matter is it wasn't

something I always included right it

wasn't something I necessarily thought

much about

until it was I think very starkly

pointed out to me by a very astute

therapist who

in observing my own struggles in life

said something to the effect of isn't it

really ironic that you are putting so

much energy into

helping people live longer and yet you

are paying no attention to your own

misery

and I think that was you know and that

was about six years ago and that was

kind of when I realized I needed to

rethink my approach to this problem and

as I write about in the book I think I

would make the case today that if your

emotional health is suffering none of

the others really matter that much

so what you really need to do is think

about a way to have all of these things

in order what does she mean by your own

misery

well I mean I think at that point in my

life I mean

I there's there's no two ways about it I

mean I was just incredibly miserable

incredibly angry

um despite being very physically healthy

right despite doing all of the important

things to be physically healthy right

exercising uh you know

in all the right ways eating well

sleeping well optimizing every aspect of

my health but but living living a bad

life

what were the symptoms of that what were

the kind of for you to start to spot

that because sometimes we don't know in

our own behavior and sometimes it's

reflected back on from other people

we'll get feedback from our wife or our

girlfriend yeah I mean

Detachment from others

um

prone to anger workaholism selfishness

you know it wasn't it wasn't subtle it

wasn't like hmm I wonder if you know I'm

not being my best self no if I if I was

being honest and confronting it I was

not I was not living a good life did you

know that in the moment had I asked you

in the moment are you happy what would

you have responded

I think I would have probably said

to just that question sure

right but but I think to a deeper

prodding

um

no and and there were there were a lot

of things that happened in there but but

certainly a very powerful one was going

to the funeral of

um

a woman my age who was the mother of my

daughter's best friend

so my younger daughter's best friend her

mom died of cancer and so all the

parents you know we're at the free we're

at the funeral

and at the time I was

you know

really going through a lot of difficulty

um in my own marriage and

this woman who died was a very

successful lawyer

um really pretty remarkable

and I was

really sort of struck how at the funeral

people had the nicest things to say

about her what a beautiful mother she

was she had three kids

and

nobody talked at all about her career

like there was not a single word about

her achievements in life it was only a

discussion about the quality of her Life

as a mother

and that might sound very obvious

because when was the last time you were

at a funeral where they talked about

someone's career accolades

but that in a moment really fused

an idea from a book I had just read by a

guy named David Brooks called the road

to character

I don't have you read it

in the book David Brooks talks about

this idea of there being

um resume virtues and eulogy virtues

and I really understood in that moment

that my entire life at that moment had

been only predicated on bolsting my

resume virtues I had never spent a

moment thinking about my eulogy virtues

and at that moment to your question if

someone had asked me how is your eulogy

I would have been brutally honest and

said it is awful

there is not a single nice thing anybody

who matters about me in other words of

the people who should matter most they

won't be able to say anything nice about

me

is that painful to admit

yes it's painful to admit today and it

was painful to acknowledge then

wow I'm so impressed that you're able to

because I thinking about cognitive

dissonance and how psychologically

uncomfortable that must be to face

you hint in the book about I think it

was in the last chapter of the book you

start hinting about

the origins of that behavior the

workholism and all of those things and I

can totally relate I think I'm a total

workaholic I think I sacrifice too much

in the pursuit of like accolades

sometimes in my life everyone knows me

including these guys will all say that

about me

um and I've often tried to in hindsight

figure out where that came from in me

and undo that

it's funny because reading this book the

last chapter I actually wrote in my

notes remember I just wrote Because the

chapters called emotional health I wrote

brackets trauma and the role that trauma

plays I didn't expect to find

that subject matter in this book about

longevity

um what's your thoughts on the role

trauma plays and how we go about

understanding it so that we can live a

have a long Health span

I think there's probably a lot of people

who can relate to the stuff I write

about in the Final Chapter and you're

right that chapter is

a significant deviation from the first

16 chapters so there's 17 chapters in

the book and

I I basically make the argument that I

am the doctor for 16 of them the first

16 I'm talking about this

as though I'm the doctor you're the

patient I'm going to help you and this

is how to do all this stuff and then in

the Final Chapter I'm saying actually

now I'm the patient and I'm going to

kind of walk you through this journey

I've had and hope that it basically

motivates each of you to have a similar

examination of yourselves

and um

I I think that many people I can't tell

you what fraction of people but I think

many people have maladaptive behaviors

in their life that are indirectly or

directly the response to

something that we would Define as trauma

and and Trauma is a very vast uh concept

right I think it's very easy when you

hear the word trauma to think of abuse

and you know that can be physical abuse

sexual abuse spiritual abuse these

things like that and it's true I did

experience abuse in my life

um

but trauma can be much more than that

trauma can be abandonment uh enmeshment

witnessing tragic things so there are

lots of things that are traumatic I

discussed them in the book and

what happens to children who are

traumatized and it can also happen to

adults but I think most often the

formative years of our lives are when

these things happen

is we we adapt and I think that's the

kind of remarkable thing about us is how

adaptive we are

and those adaptations

can often be very positive

but a lot of times they have negative

collateral or maladaptive

consequences in addition

and some of those adaptations that are

negative are addictions some of them are

other maladaptive behaviors like anger

some of them include you know things

like codependencies so you can sort of

look at people and realize that hey you

know maybe that person who grew up in

the home of Alcoholics even if

it was an otherwise reasonably

well-meaning home and it's not like they

were getting hit with a belt buckle

every night but they weren't getting the

type of attention that they needed

and their adaptation was to have an

attachment disorder that wouldn't

manifest itself really fully until they

were apparent so

this this type of analysis really I

think everybody needs to spend some time

thinking about it and needs to spend

some time asking themselves hey which of

my behaviors are maladaptive and it's

something that's done and I think it

needs to be done without judgment this

isn't about saying I'm a bad person

because of X Y and Z even though I think

I can objectively look back at my own

behaviors at that time in my life and

say those are awful behaviors I'm not

proud of those behaviors but it's

separating the behavior from the self

it's not saying I'm a horrible human

it's saying I'm a human who did horrible

things and I want to understand why I

love that approach because I think about

the maladaptive Behavior patterns I had

that stood in the chance stood stood in

the way of my chance of emotional health

and good relationships and a lot of

those stem back to my childhood and

um what I witnessed in my home and then

distort the way that made me adapt and

the beliefs it gave me about romantic

relationships for example so I became

totally avoidant of those until later in

my life when I realized this pattern

um the third point in your in your list

of things that

cause sort of I guess longevity of one's

Health span is that emotional health

deterioration so before we get into the

other two my question really was on that

third point of emotional health

what for you has helped you to

um self-analyze and become aware and to

then get those things out of your way

that stand a chance of

costing you your emotional health was it

therapy was it introspection is it

journaling is it honesty with oneself

well I mean in my case I think the

situation was so far gone that I

actually had to go away

on two occasions

um so I I had to go away in uh in it the

first time for two weeks uh to an

inpatient like what's called a

residential care facility which was two

weeks of

like 14 straight days of 14 hours a day

just doing trauma therapy in group and

individually

and uh you know two weeks might not

sound like a long time but boy that was

about the most

brutal exhausting thing I'd ever done in

my life

and then again

I had to do it for three weeks at a

different facility so again 21 days of

inpatient treatment but also now really

learning what the tools were to manage

myself how do I fix that behavior how do

I how do I manage it so sort of like you

have an injury you go to rehab you know

there's an acute healing phase but then

there's a well now you want to make sure

you're strong and that you don't injure

it again because that injury took place

because of some weakness and and that's

not not a Perfect Analogy but the point

is you know there's a reason that you're

shoulder separated yeah and we want to

make sure it doesn't happen again even

once you're better and you sent yourself

there twice yes and no I mean truthfully

I don't think I had a choice I don't

think my I don't think my marriage would

have survived so I I think it was

um

I'm not sure I had a choice truthfully

so I went very reluctantly

I did not want to go

but it was there was a an ultimatum

essentially yeah

wow

what was the greatest sort of gift that

process gave you

oh it gave me my life

I mean it literally saved my life really

for sure

how

well I don't think

I don't think I would I just don't think

I'd be alive today without it right I

think had I lost I mean I was on such a

I was on I was in such an awful cycle of

Shame and self-loathing and

deterioration that

I don't think I could have survived it

so was that that was a narrative in your

head at the time that you when you talk

about shame and self-loathing that's

what the the voice in your head was

yeah the the voice is

you are an awful human being that's why

you behave this way and

there's nothing that can be done about

it you you're born this way you you are

defective

and this is what defective people do

look in many ways it's a lack of

accountability right

it's sort of saying

you have no agency in this

you you can't change this because you

are you're defective when they do an

autopsy on you they will see something

in the temporal lobe of your brain that

explains your pathology

were you able to discover the root cause

of that narrative in your head

yes absolutely

and and more than that I was able to get

rid of it really yeah

I'll give you one very tangible example

I had

a very very vocal inner critic

um and I think I'm sure many people

listening to us can relate to that which

is you know I was such a perfectionist I

was such a workaholic

but any mistake I made I would

eviscerate myself verbally

so and this was I mean this is mistakes

that don't matter okay so one of my

hobbies is archery I love archery so

every day almost every day certainly if

I'm not traveling I'm going to be out in

the backyard shooting my bow and arrow

now does anybody else care

nobody right is this my livelihood

depend on this no

but if I'm not shooting well

I am screaming at myself

I will break an arrow over my thigh and

these are carbon arrows they'll leave

welts the size of your finger

one of the exercises we had to do

was

and this was once I left the second

therapy place that was three weeks

so the one of the big realizations there

was that this was happening because that

voice like I didn't realize that that

was unusual

so the exercise was

every single day until this voice goes

away

which I thought would never happen which

meant I thought I was signing up to do

this exercise for the rest of my life

you take out your phone

and you talk into the phone with a

replacement voice for that voice

and pretend you're talking to your

closest friend as if it were them who

made the mistake

and I say

hey Chris

I know you're having a bad day today

I can tell it's hard you're not shooting

well

it's okay

you know what some days it's just not

going to go well

plus it is a little windy today let's be

honest it makes it a bit harder and

why don't we just pack it up and come

back and try again tomorrow you know

just talk in a kind way talk in the way

you would literally speak to your friend

and then I would send that recording to

my therapist

so every day my therapist is getting

multiple versions of these voicemails

but this is important because I'm

audibly doing this

multiple times a day

and

within about four months

The Voice just went away really yeah

let's never come back

how has it changed you as a father oh my

God it's a it's a it's a it hasn't

changed me as a person right as a father

as a husband as as a boss as a friend I

mean it's it's just

um again it makes me a little sad to

think oh God I wish I knew this when I

was I wish I wish I did this at 25 you

know instead of

all of this

again I just think of all of the

collateral damage in my life

you know all of the people near me who

have suffered

unnecessarily as a result of

you know

of of of of me being a wrecking ball

um how much of that could have been

prevented in some ways this kind of

comes back to your very first question

right which is I'm 30 I'm Invincible how

do I get excited about this look maybe

the answer is as a 30 year old you don't

need to get excited about

you know

your nutrition and exercise in your

sleep as much as a 50 year old does but

a there's a lot of benefit to doing so

because you'll get more benefit from it

but maybe it's just focusing on

emotional health so that you get

yourself fixed before you start a family

because I think you know and and I think

you know I feel lucky I think my kids

are still young enough I hope that my

kids don't have too many memories of

their of their dad in that in that state

your belief about where that came from

although there's no evidence there's no

memory of anyone you know saying well

this happened and whatever else but

is your belief that you weren't born

with that and that something might have

happened and you've kind of inferred

that in some way

yes I think that was a really really

important breakthrough that happened

on the 19th day of that second stint I

had in therapy in that inpatient therapy

session so that was a 21

Day program

that I assumed was only going to be 14

days and at the end of 14 days they they

needed me to they wanted me to stay

another week everybody wanted me to stay

another seven days and I was so

reluctant at this point I was exhausted

I just didn't think I could do it again

but they were adamant that I stay

another week and I knew the first time I

had gone for two weeks and left I left

kind of against their recommendations

and I realized I never really got fully

better I got somewhat better but not

fully better so I decided

to just submit to them and say okay fine

I will stay as long as you tell me to

and it was on that 19th day that I had

perhaps the single most important

Revelation for me again this is very

personal and

the point of this is not that everybody

else is going to relate to this it's

only that I hope everybody else is

willing to consider their own version of

this

but what I the the last thing I could

never let go of was

that

I was born as a perfect child right like

meaning we all are right not just me but

all of these kind of maladaptive

behaviors were the result of things that

I didn't deserve

and

again it's not all

what we call Capital T dramas it's not

it's not necessarily the abuse I mean I

think in my case perhaps the most

impactful things of my childhood were

were more like neglect

and not not traumatic not like the kind

of neglect that's gonna that has you you

should be taken out of a house or

anything like that I'm just talking

about not getting a certain type of

attention

that I probably should have had

and for whatever reason that

manifested itself in really odd

behaviors that as a kid I just said

those are just bad behaviors but that's

just who I was and I think what I

realized is

and what I finally came to accept is no

those are adaptations to something that

you didn't deserve

and that might sound like a very subtle

distinction but it made all the

difference in the world and it made me

realize in part by it by looking at my

own kids that

you know there is a real innocence to

children that can very easily get

injured and and and when it does they're

going to make sure that they don't get

hurt again

and and the way they're going to do that

is as I said initially in their best

interest but ultimately it tends to

result in really negative consequences

for the way they formulate relationships

with themselves with for the way they

form relationships with others for the

way they're going to parent for the way

they're going to be a husband or wife

um

and so that was that was a huge

breakthrough

so important and so powerful and I I

don't I don't think I've ever said this

but really thank you for sharing that

because

um I got a lot from it and I've had lots

of conversations about this but I've got

a lot from that specifically that point

about

um didn't deserve for it to happen and

really it's a response that's trying to

make sure you don't experience that pain

again so it's really again it's your

body is is doing everything in its power

to help you and to protect you and some

of these behaviors end up being

maladaptive which then stand in the way

of your chance of emotional health

that is the third category of

deterioration which is the emotional

health deterioration

so let's go a little bit earlier in the

book and let's talk about the decline

and the loss of function of our physical

bodies as well

um medicine 3.0 as we talked about

earlier you talk about these five core

things that help to increase our chances

of longevity as it relates to our health

spans what are those five things well

there's the one we just talked about

right so all the tools that deal with

how do you improve your emotional health

yeah again most of modern medicine only

thinks about you know if you think about

where does medicine 2.0 rank on that it

doesn't really except in the arena of

mental health right when it comes to

clinical depression anxiety personality

disorders you know bipolar disorder

there we have a branch of medicine

called Psychiatry that deals with those

things but outside of that medicine

doesn't really deal with people like me

you know I none of my problems quote

unquote Rose to the level of you know a

clinical diagnosis that would require

medical therapy okay tool two exercise

again we can talk a lot about it if you

want a little about it but the point is

it is not remotely given anything beyond

lip service by medicine 2.0 medicine you

know if you go to your doctor here at

the NHS and say okay tell me what my

workouts should be

like good luck right how much time

should I be spending in zone two versus

zone five like what type of lifting

should I mean there's no way they're

going to give you that type of insight

or specificity uh the third one is

nutrition again sure every doctor is

going to tell you eat less exercise more

but they're not really for the most part

going to be able to help you manage

nutrition certainly I didn't learn

anything about nutrition or exercise

when I was going through my medical

training and most Physicians don't so

I'm not saying that there aren't doctors

out there who don't understand these

things what I'm going to say is they had

to learn that stuff on their own outside

of their traditional training so crazy

the fourth one is sleep and that fits in

the same category

sleep is an essential pillar of Health

but we learn nothing about it in our

medical training in fact most of our

medical training is paradoxically sleep

deprived so it's sort of it's a great

irony the fifth and final thing that you

have as a tool in the longevity toolkit

is is all the molecules so drugs hormone

supplements and there that's the one

thing you sort of do learn in

traditional medicine is you you at least

learn about the the pharmacologic side

of it you don't really learn anything

about supplements so most doctors don't

really understand much about supplements

and interestingly most doctors don't

really understand a lot about hormones

as well

so medicine 2.0 is is good at what it

does but it's very limited so it's kind

of like having a contractor that only

has one tool instead of five tools and

as we discussed earlier I think they're

applying those tools too late in the

game how can you prove let's start with

exercise then how can you prove to me

that exercise is important

yeah it's a great question so start with

the easiest way to do this is to look at

what the absence of exercise does versus

looking at the absence or presence of

other known bad things

now for me to explain this I have to

explain a technical term called a hazard

ratio

so if you'll bear with me while I

explain what a hazard ratio is it will

reap lots of fruit later on

a hazard ratio is a mathematical

derivation that comes from looking at a

group of people following them

prospectively following them into the

future and looking at the rate at which

they die

so a hazard ratio is a number

if that number is 1.5

it means that there's a 50 percent

increase in the risk of death for one

group versus the other so for example

if we want to know is smoking bad for

you

we might ask the question what is the

hazard ratio for smokers to non-smokers

when it comes to getting lung cancer

okay and the answer is like 10. really

it's 10 times more about 10 times more

likely to get lung cancer if you're a

smoker than if you're a non-smoker

now if you look at the hazard ratio

across the course of life

for all causes of death it's about 1.5

meaning a smoker is about 50 percent

more likely to die in any given year

than a non-smoker which will all cause

mortality all cause mortality is the

gold standard for understanding death

and disease because it takes into

account every form of death okay okay

what if you have type 2 diabetes

everybody understands that having type 2

diabetes is very problematic and people

with type 2 diabetes are at about twice

the risk more or less of cancer heart

disease maybe one and a half times the

risk of Alzheimer's disease but when it

comes to all cause mortality every cause

of death it's about a 1.4 Hazard ratio

40 out of 40 percent increase in all

cause mortality again that's a stark

number it means at any moment in time if

you take two people who are ever and

otherwise always identical but one has

Type 2 diabetes and one doesn't this

person has a 40 higher risk of dying in

the coming year in the coming year yeah

Jesus Christ yeah wow okay we can keep

doing this what if it's high blood

pressure versus normal blood pressure

that's a hazard ratio of about 1.2

20 percent same everything I just said

but it's twenty percent

okay what if it's someone

who has end-stage kidney disease their

kidneys don't work anymore they're on

dialysis hanging by a thread waiting for

a kidney transplant

it's about 2.7

that's a

170 percent increase in all cause

mortality in the subsequent year

okay

now let's talk about some other things

what if I ask the question what happens

if I take

a group of 50 year olds pick any age

pick any sex and we're going to take the

top

15 to 20 percent in strength and compare

them to the bottom 15 to 20 in strength

for that age and sex what's the

difference what's the hazard ratio there

what would your guess be uh

1.1 to 1.2 yeah yeah it's three two

hundred percent difference in all cause

mortality can you make a distinction

between strength and

muscle mass okay yep we can do it so

muscle mass just if we did it just on

muscle mass it's about two or a 100

difference so muscle mass turns out to

be an amazing proxy for strength but

strength is even better okay yep so high

strength and high muscle mass produce a

hazard ratio of about 3.5 okay because

you can have a lot of muscles but not be

strong yeah kind of and you can be

strong and have not as much muscle okay

and that matters more by the way but but

they're pretty tightly correlated okay

yeah now let's look at VO2 max so VO2

max is the best tool we have to measure

Peak cardiorespiratory Fitness so this

is a test that you actually have to take

it's it's done on a treadmill or on a

bike they put a mask on your face and

then the mask measures how much oxygen

you use

so in the book I talk in great detail

about this test it's something anybody

can do it costs probably 100 quid it's

not like super expensive

um and everybody should know their VO2

max I really think everybody should know

it and in the book I even offer some

ways that you can estimate it just by

running at a track or something like

that so sorry it's the the measure of

how much oxygen you're inhaling and

exhaling no yeah it's the difference

between how much you inhale and exhale

is how much you're using so the way that

the way the test is working is there's a

little oxygen sensor so if you're

breathing in we know that the air you're

breathing in is 21 oxygen we know the

flow rate and we let's just say you're

you're blowing it out at 14 so we know

you used up seven percent times the flow

rate we figure out how many liters per

minute of oxygen you're using at the max

and what's good and what's bad

yeah so it depends on your age and sex

but at your age so for a 30 year old

male we would say

oh I need the table is in the book

um really I could estimate it 60 50

56 would put you in the top two and a

half percent and that means that I'm oh

sorry what's that number mean yeah

that's 56 milliliters of oxygen per

kilogram of body weight per minute okay

so

I think I'm 96 kilograms at the moment

okay very heavy so you would need to be

5.3 5.4 5.5 liters yeah no no yeah you

need to be about 5.5 liters per minute

you would need to consume 5.5 liters of

oxygen per minute to come out to about a

VO2 max of 56 or 57 milliliters of

oxygen per kilogram per minute that

would put you at the top two and a half

percent for your age and sex so I'm

going to figure out is taking more

oxygen from the air that I breathe a

sign of good health yes it means it's it

speaks to how hard how fast and hard

your heart can pump yeah and how good

your muscles are at utilizing oxygen ah

okay it is the most important metric we

have for Peak cardiorespiratory Fitness

and sorry for getting a bit too big

because I really want to understand this

and I'm sure there's a lot of people

trying to understand this as well so

what are the things that stand in the

way of good VO2 max

in terms of my and also the the lungs

yeah it turns out that not much of it is

limited by the lungs so the question is

where are you limited okay okay so how

does this test work

do you prefer to run or bike I prefer to

bike okay so we're going to put you on a

bike we're gonna put this mask on your

face that allows no other air in or out

it's only going to be metered by what's

coming from the machine the bike is

going to be

um one that has forced resistance to it

it's called an ergometer so we're going

to set it to 100 Watts nice and easy I'm

going to tell you to warm up for a while

and then after a 10 minute warm-up it's

going to start increasing the power

that's that you are forced to Pedal

against okay and every two minutes we're

going to add some amount 25 or 50 Watts

and and you're going to say you have to

stay above about 70 rpm

and this test is going to go until you

can't do it anymore

it's going to go till you basically drop

so what's limiting you is clearly not

the amount of oxygen in the air

and it's actually not the ability of

your lungs to get oxygen into your blood

you're limited by the how hard and fast

your heart can pump that blood through

your body and how efficient your muscles

are at taking the oxygen out and using

it

and the difference between

so again a 30 year old who's in the top

two and a half percent of their age

group might be at 56 57 but to put that

in context the guy who wins the Tour de

France this year is 85. wow

and by the way when that number reaches

20

or certainly 18 19 you have a hard time

just getting around like you wouldn't be

able to walk up a flight of stairs

that gives you a sense of the of the

gradient now let's get to my point that

answers your question

you asked how can I say exercise is so

powerful well

what do you think is the hazard ratio

when I compare someone at the top two

and a half percent to someone at the

bottom 25 in terms of VO2 max yes

two percent versus the top bottom 25

bottom 25 that's quite big two percent

is quite narrow um I'd say

1.1.5 which is what so you think it's

less important than strength because

we've just established for strength it's

about three so I'm just I'm increasing

it now because I was so wrong on

strength yeah you see what I mean uh

well

what would I have said had you not told

me the strength one so

um by the way I think your guess is a

completely reasonable guess because the

answer is so absurd I'm gonna say 1.5

Hazard Hazard ratio it's five five which

means 400 percent difference in all

cause mortality

if you compare the fittest two and a

half percent to the least fit 25 percent

wow so it makes a huge difference

so this is why I can say with absolute

certainty nothing compares to exercise

nothing compares to having a high VO2

max High muscle mass and high muscle

strength

they are more beneficial for you than

any bad thing you can think of is bad

for you

why why the is the muscle mass piece so

important and the strength piece why is

that causing me to stay alive I think

there are several reasons as you get so

there's there's I put them in two

buckets structural and metabolic

let's start with the latter

muscles are where you dispose of glucose

so glucose regulation is one of the most

important metabolic functions of the

body

our ability to metabolize glucose and

regulate glucose levels is Central to

our existence on this planet and when we

get it just a little bit wrong we go to

hell in a hand basket that's what type 2

diabetes is type 2 diabetes raging type

2 diabetes

only means you have an extra

five grams of blood sugar one teaspoon

in your circulation that's it

the difference between you and someone

with type 2 diabetes so bad that they're

going to get their digits amputated

is an extra one teaspoon of glucose in

the bloodstream

that's how critical it is that we

regulate our blood sugar

and the most important part of blood

sugar regulation is having muscles that

are big enough to put the glucose into

and that are insulin sensitive enough to

respond to the signal of insulin

and glucose is stored in just a couple

of places in our body it's only stored

in the liver and in the muscles but the

muscles store 80 of it okay so okay so

muscles are really really good for

glucose regulation because it gives

the sugar more place to hide that's

right so the other reason muscle mass

and strength is so important is as we

age

fragility and Frailty become an enormous

liability in death

there's a figure in that book that shows

the mortality associated with falling

and it becomes

catastrophic once you hit the age of 65.

once you hit the age of 65 if you fall

which is pretty likely

and you break your hip or your femur the

long bone in your leg

there's a 15 to 30 percent chance you

will be dead within the next 12 months

really yes it's insane

because you become set a dream yeah

there's a lot of reasons for it but

certainly a loss of function is a big

one you can also just die as a result of

hitting your head you can die from a fat

embolism or a blood clot you can die

from sepsis you can die from you know

heart attack because you you know

there's there's so many things that can

kind of kill you in response to it but

even the people you know the 70 to 85

percent of people who don't die 50 of

them will experience a significant loss

of function that never recovers after

so this this issue of sarcopenia which

is loss of muscle mass and Frailty and

fragility become the you know the

absolute keeper of death for people once

they reach the seventh decade of life

again

if you're 30 years old it's impossible

to Fathom this stuff because you're

indestructible yeah yeah even at my age

I mean I feel indestructible and I'm 50

but this changes and we have to do all

we can to Ward it off so that's why

muscle mass matters so much

there's this kind of long-standing

belief that you as you age there's so

many just it's just kind of inevitable

you put on fat you know you slow down

and you're saying and I think you

communicated very clearly in the book

that it doesn't have to be inevitable

all of this stuff to some degree well I

mean look I I'm I'm very I'm very

careful to to try to be as realistic as

possible I I get a little put off when I

see people in this sort of quote-unquote

longevity space saying things that I

think are just science fiction right

like oh you're at 90 you can be just as

fit as you are at 40 and stuff and I I

see Zero evidence that that's happening

I don't see any biotechnology on the

horizon that is going to completely and

reversibly change aging

um yet

I don't think In Our Lifetime no and

this is something I spend

you know

an absurd amount of time on both as an

investor uh and and just as a you know a

person who thinks about this from my own

podcast and the types of guests that I

bring on and the type of science that

I'm paying attention to but but no I

really do not see anything in our

lifetime that is going to undo aging I

think we have some ideas of

places we can look right I think that

for example

if you could

completely restore the epigenome to what

it looks like in a young State across

the entire genome I think that could

have a profound effect

on function

but do we have do I see ways that we

could do that I

it you know it's a longer discussion but

I think the complexity there is many

many decades away that said

um what I think we do not need to do is

accept the complete and total

inevitability of Rapid decline so the

decline is non-linear

this is the important thing to

understand so what was your decline from

20 to 30.

wasn't that bad no no and from 30 to 40

it's not going to be that bad from 40 to

50 it's going to be more from 50 to 60

it's going to be even more from 60 to 70

it's going to be way more and 70 to 80

is falling off a cliff

so if you if you look at this is

actually one of the figures I wanted to

include in the book but you know you're

always sort of scrapped for space so we

took it out but I have a figure that

shows both muscle mass and spontaneous

physical activity in people by decade

and it's just based on like a huge data

sample of people and it's really

interesting to watch the correlation how

strong it is right so physical activity

and muscle mass go like this and they

just fall off a cliff and the cliff for

both is 75 for both men and women like

that's where you see an enormous

reduction in muscle mass and activity

level

because of Behavioral well I think it's

a you know it's the age-old question is

are they losing muscle mass because

they're becoming less active or are they

becoming less active because they're

losing muscle muscle mass and I think

it's both okay I think these two feed

off each other

and um and they get haunted right

presumably because what you said about

the quality of the muscle as well that's

right so you have to Ward this stuff off

right I mean as your type 2 muscle

fibers are deteriorating and you're

putting more fat into muscle the quality

of that muscle you go from being you

know primed to wagyu so you have to Ward

that stuff off

right and the way to Ward that off is to

lift very heavy things that's the only

way to stimulate the type 2 muscle fiber

this type 2 muscle fiber won't get

stimulated by light movements so it's

not just that resistance training is

necessary but it's it's resistance

training that's actually quite heavy

people who hear that they go okay they

get it they're on board they're going to

exercise how much do I need to do

because listen

can it be is it I've got to change my

whole life in exercise seven days a week

and run marathons now Dr Peter or is

this what would you recommend I always

start this question by saying

how much can you do

but okay I'm gonna I'm gonna play

devil's advocate here I'm gonna respond

as one of my viewers right I'm gonna say

listen I'm so busy you don't understand

Dr Peter I'm I've got kids I've got this

I've got a job I'm already I already

have no time I'm not sleeping out here

so I don't have any time

I mean I I it requires a thorough

discussion around that I mean is that

really true no of course it's not yeah

so then you have to get into the weeds

like how much time are you watching TV

how much time are you on social media

how much time are you doing things that

might not be

um as high a priority as doing this

other thing

um so so once you kind of get through

that I do I do sort of put put it on

them and say I would much rather you

tell me the number than I tell you the

number

I can tell you what I think the number

is right like if you're playing the

optimizing game and if you're saying

I want to be the absolute best fittest

version

of me that is humanly possible when I'm

in my 80s how much do I need to be

training for that the answer is probably

one and a half to two hours a day

one and a half to two hours a day seven

days a week yeah

I mean of course it's not going to be

the same every day and and it looks

different but but it's going to average

out to 10 to 14 hours a week

but but rather than tell somebody that

because I think that's very off-putting

yeah I would just say just tell me what

you got

if you tell me you've got five hours a

week that you can do this I'll give you

a great set of things you can do in five

hours and My Hope by the way is

six months from now you're gonna feel so

much better that you're gonna say you

know what I would like to up this to

seven hours a week

what's the difference in all cause

mortality if I go from doing zero

exercise to doing just a bit yeah that

that's a great question

and for some people that question is all

they need to get started

going from zero activity to just 90

minutes a week is about a 15 reduction

in all cause mortality so I'm 50 less

likely to to die in any given Year from

all causes if you go from being

completely sedentary to just doing 90

minutes a week

which is only like what I know 15

minutes a day 12 minutes a day yeah or

just you know three times 30 minutes a

week

that's a huge that's a huge shifting of

very important odds yeah

and and truthfully like I

probably spend more time convincing

people not on the all-cause mortality

data

but on the health spandex because people

don't we didn't think about it yeah

death is so abstract it really I don't

think it I don't think it even sets in

until you're in your 50s like I think

it's very

it's very hard to capture the finitude

of what it means to be a human when

you're young I think it's true at all

ages but but I really think

it's so much better to just focus on the

quality of life you want to live

what do you want to physically be able

to do throughout your life

and it's easier in people who have been

around aging people

yeah you know which again

a lot of people in their 30s their

parents aren't even necessarily old

enough that they can fully appreciate it

they might have to think well do I still

remember what my grandparents were like

at the end of their life and

was I inspired by them and if so that's

what I want to do great and if I don't

want what they had which is the answer I

think most people will have then what do

I need to do to be different what was it

for you I remember what it was for me

yeah for me it's again it's I didn't

know my grandparents uh

I suspect just my training in medicine

like I was around

so many people at the end of life that

like to see yeah it was it was just

imprinted early my arm I told this story

once or twice in this podcast before but

I was in Bali walking down some a long

set of stairs when I say alongside of

stairs I mean down the side of a cliff

going down to canoe with my partner and

I was walking down those stairs in the

sunshine it dawned on me that my father

probably couldn't walk down these steps

and my dad is maybe a 60 65 and I

thought he wouldn't be able to come down

these stairs which means he wouldn't be

able to go canoeing with his family and

we share a lot of genetic uh information

me and my father of course so that was

one of those real big moments and

actually Jack who films the podcast he

he after I shared that with him he and

we had some guests on the podcast

um he shared with me his own moment

where he was climbing a mountain I think

last month weren't you Jack

and he he got to the top of the mountain

and thought to himself God like it was

such an unbelievable experience for him

uh he correct me if I'm wrong it was an

epiphany moment you go I wouldn't be

able to climb this bloody mountain with

all these people and feel this sense of

accomplishment if I and it's those

moments for me where I thought this

is that's my health span I want to be

able to do this yes

you wrote one of the chapters in your

book is about stability um

found that really

um surprising again I'd never even come

across the concept of stability or why

it's important that's why it needed an

entire chapter because it is a very

foreign concept chapter 13 stability why

why is it important and what does it

mean yeah I think this is this is the

stability is a difficult thing to

explain I mean you can sort of talk

about it technically right stability is

the capacity to transmit force from the

body to the outside world and from the

outside world back to the body without

injury so anytime you're taking a step

you're applying Force to the ground

that's

what's allowing you to walk forward so

you apply Force to the ground the ground

applies an equal opposite Force to you

that's Newton's law and you move forward

um when you're running why are you going

faster

you're going faster primarily because

you're applying more Force to the ground

and therefore the ground is applying

more Force to you and that's propelling

you forward

the difference between me and Usain Bolt

among other things is his capacity to

apply Force to the ground is

two and a half times my ability to apply

Force to the ground

so in all that Force

how do you make sure that the action of

the force mechanism is all for the

desired purpose in this case propulsion

and not for undesirable purposes like

leaking of energy which is what it feels

like when your knee hurts when you're

walking down the stairs or your hip or

something like that

so the analogy I use in the book to

describe this is that of a car because I

love cars and I talk about the

difference between a race car and a

street car

a race car can be even half the power of

A Streetcar in terms of horsepower

but because it's smaller lighter and has

a stiffer chassis and slick tires

much more of its power is being

delivered directly to the road without

slippage or energy loss and therefore

it's going faster

and so this idea is a very important

part of aging so most people who have

some sort of chronic injury it can

really be traced back to an instability

whether it be an instability of their

scapula and that's why they really have

tennis elbow or an instability in the

you know in in their abdomen in their

lower back and that's why they have back

pain instability in the feet that

translates its way up into knee pain all

of these things matter greatly and a big

part of how we train is making sure that

we do exercises that bolster our

stability

again this feels very um relevant to me

because I'm

currently got a Grade Three tear in my

hamstring got a growing problem so I'm

on physio for the grade three tear how

did you tear it

um playing football but I have a couple

of suspicions surrounding it because

about a month before I got the

foot pain that they call plantar

fasciitis plantar fasciitis so I went to

the I think it's called a podiatrist and

I got my foot x-ray things done where

they give you the insoles and then

following that I got loads of injuries

um I think my hypothesis is that I took

these insoles put them straight in and