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100 Ways to Live Longer and Better - E100
14 Plays3 hours ago
After 100 episodes exploring longevity, performance, disease prevention, and the science of aging, one truth stands above the rest: living longer means nothing if you stop living well. Healthspan is, after all, what this podcast is about.
This milestone episode distills the biggest lessons from the journey so far - from VO2 max and sleep apnea to dementia risk, metabolic health, and the habits that most strongly predict quality of life. It’s a powerful reflection on what actually matters if you want more energy, resilience, clarity, and vitality for decades to come.
In this episode you will learn:
- Why VO2 max is a top measure for long-term health, more important than blood pressure or weight.
- Simple, proven steps for better sleep that boost your health.
- The role of daily movement and why steady habits beat hard workouts.
- How food choices and meal timing affect your energy and aging.
- The strong link between social connection, touch, and lasting health.
- How to spot common mistakes that drain your energy and what to do instead.
Resources
- Connect with Andrew on Instagram: https://www.instagram.com/mandrewmcconnell
- Follow Alively on Instagram for regular updates and insights: https://www.instagram.com/alively_official
- Learn more about healthspan from Andrew’s blog: https://www.mandrewmcconnell.com/blog
This podcast was produced by the team at Zapods Podcast Agency:
https://www.zapods.com
Find the products, practices, and routines discussed on the Alively website:
https://alively.com
Recommended
Transcript
Introduction to Key Health Biomarkers
00:00:00
Speaker
VO2 max is the most predictive biomarker we have. Period. Bigger than blood pressure, bigger than cholesterol, bigger than weight. The Cleveland Clinic study from a few years ago found that people in the bottom 25th percentile of VO2 max had a five-fold increase in all-cause mortality.
00:00:21
Speaker
This is the Home of Health Spam Podcast, where we profile health and wellness role models, sharing their stories and the tools, practices, and routines they use to live a lively life.
Exploring the Concept of 4,000 Weeks
00:00:35
Speaker
About 4,000 weeks. That's the average human life. Christopher Yates wrote about it. Oliver Bergman wrote an entire book around it. And it's a number I keep coming back to. 4,000 weeks.
00:00:50
Speaker
The depressing version of that number is that it's smaller than you think. The interesting version is that it's bigger than you live. Most of us spend the back half of those weeks trying to undo what we did to ourselves in the front half.
00:01:05
Speaker
Sleep we didn't take. Food we knew was a problem. Stress we wore like a badge. Relationships we let drift because we were busy building something.
00:01:18
Speaker
4,000 weeks, and we have, on average, 4,000 chances to do this differently. Or as a prior Homo Healthspan guest would it, 4,000 Mondays to start again.
00:01:31
Speaker
This is the Homo Healthspan.
Purpose of the Podcast and Learning from Experts
00:01:33
Speaker
I'm Andrew McConnell, and this is episode 100.
00:01:38
Speaker
Okay, so 100 episodes. I'm not going to spend 20 minutes on the meta. I told myself when we hit this number, we wouldn't do that. The whole point of this show has been to sit across from somebody smarter than me on some specific corner of human health and steal everything I could from the conversation.
00:01:57
Speaker
The episode shouldn't be about us. It should be about what they know. But i have to say a few things before we get into the substance. First, thank you. If you've listened to one episode or all 99 to this point, you are the reason this exists.
00:02:13
Speaker
The honest math of an independent podcast is that most never work out. Yet here we are. The downloads, the messages, it's the only reason episode 100 happened.
00:02:23
Speaker
So thank you. Second, the guests. Every single one of them. doctors, the founders, researchers, the patients, the athletes, recovering skeptics.
00:02:36
Speaker
We've had philosophers, physicians, neuroscientists, dieticians, sleep researchers, oncology nurses, longevity investors, fasting researchers, breath workers, strength coaches, CEOs and entrepreneurs, and many, many more.
00:02:53
Speaker
Almost every one of these guests give me something I'm still using. But enough of that. Let's look forward. So here's what this episode is. I asked myself a simple question.
00:03:04
Speaker
If had roughly an hour and a microphone and I had to compress everything I've learned across the 99 conversations to this point into something useful for someone who's never listened before, what would I say?
100 Health Lessons and Key Pillars Overview
00:03:17
Speaker
The answer is 100 lessons for this 100th episode. Some of them are mine. Most, like everything else, are stolen with credit from the people who spent decades doing this work.
00:03:29
Speaker
They're organized into eight buckets. The five pillars we keep coming back to on the show. Sleep, fitness, nutrition, mindset, and social connection. And then three buckets that have grown so much over the last couple of years, they earn their own selection.
00:03:46
Speaker
Hormones and longevity frontier. The biggest mistakes people make. And finally, my own daily routine. A few ground rules before we start. I'm not your doctor. I'm not anyone's doctor.
00:03:59
Speaker
I'm not a doctor at all. So nothing in this episode or this show is intended to be medical advice or should ever be taken as such. I'm not gonna name every single guest beside every single lesson. There are a hundred of them, so only a few of you would even survive to get to the end of the episode if I did that.
00:04:19
Speaker
But I'll call out some specific people where the lesson is so closely tied to them that not crediting them would feel like theft. And the last one, these lessons are not ranked. It's not number one and number 100. Numbers are for navigation, not importance.
00:04:33
Speaker
The best lesson is the one you're gonna actually use this week. Healthspan is not lifespan. Lifespan is how long you live. Healthspan is how long you live well.
00:04:45
Speaker
The gap between the two is the thing this show is about. This whole company is about. This whole stage of my life is built around. The average American now spends the last decade or more of their life in declining health.
00:04:59
Speaker
Not dying, declining. The last decade is where we lose the things that make us feel like life's worth living. Walking without help, eating what you want, recognizing your grandkids, going to the bathroom by yourself.
00:05:13
Speaker
That's the gap. Closing it is not about a single supplement, a single drug, a single hack. It's about 100 small things, mostly free, mostly boring, that compound.
00:05:24
Speaker
That's the show. That's the work. That's this hour.
Importance of Sleep for Health and Productivity
00:05:28
Speaker
So let's get started. Number one, start with sleep. Sleep is not a competitor with productivity.
00:05:36
Speaker
It is the substrate productivity grows in. Every sleep researcher I've had on this show, every single one has said some version of the same thing. The human body has not evolved a workaround for chronic sleep deprivation.
00:05:50
Speaker
There's not a biohack that fixes it. There's no coffee that replaces it. And you can't supplement your way out of it. Number two, seven hours is not a goal. It's the floor.
00:06:01
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The data here is annoyingly consistent. Below seven, almost every health marker we care about gets worse. Cardiovascular, metabolic, cognitive, hormonal, immune. The I only need five if people are statistical anomalies and most of them are all about themselves.
00:06:18
Speaker
Number three, consistency beats duration. The single most predictive sleep variable for longevity is not how many hours you sleep after we just said that. It's actually how close to the same window you sleep those hours in.
00:06:31
Speaker
Going to bed at midnight on Tuesday and 10 on Wednesday is worse for you than going to bed 1130 every single night. Your circadian rhythm runs your hormones, your metabolism, and your inflammation.
00:06:43
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Erratic sleeping wrecks that. Number four, a cool, dark, quiet place. Don't optimize past these three until you lock them in.
00:06:53
Speaker
The fanciest mattress on the planet does not beat 66 degrees, blackout curtains and earplugs. You can get those earplugs very cheaply. Or an eye mask very cheaply if you don't have blackout curtains.
00:07:06
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Number five, alcohol and deep sleep do not coexist. I know nobody wants to hear it, but it is the number one thing people wear where wearables see in their data.
00:07:18
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The data is what it is. Even one or two drinks measurably suppresses REM and slow wave sleep. ah I sleep better with a glass of wine feeling is sedation and not sleep. Get a tracker and you will see the data.
00:07:30
Speaker
It's fact. Number six, the last meal three hours before bed, minimum. Now, Brian Johnson will do his last meal 11 a.m. I'm not suggesting that, but a minimum of three hours before you go to bed.
00:07:44
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Late eating drives glucose variability and cortisol, both of which murder your deep sleep. The rule I follow is simple. I try to eat by six and get to bed, nine, nine, 30.
00:07:57
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Number seven, morning sun within 30 minutes of waking. Not an optional one. Direct outdoor light, even on a cloudy day, anchors your circadian rhythm in a way no indoor light can replicate.
00:08:11
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This one costs you nothing, but it will change your sleep profoundly. Number eight, naps are a tool, not a mortal failure. 20 or 30 minutes before 3 in the afternoon.
00:08:22
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Longer or later will disrupt the night. And I particularly like Ali Boothroy does these amazing NSDRs that I listen to on YouTube that I think are fantastic.
00:08:34
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Number nine, sleep apnea is killing your health span. Most people with sleep apnea don't even know they have it. They think they're tired because they're stressed. They think their morning headache is dehydration.
00:08:47
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They think their afternoon crash is because of the carbs they ate at lunch. It's actually their oxygen levels at three in the morning. Untreated sleep apnea is associated with stroke, dementia, atrial fibrillation, and early death.
00:09:01
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If you snore, if you wake up tired regardless of duration, if your partner has ever shaken you awake worried, get a study. It is the single most underscreen condition we've come across.
00:09:14
Speaker
Number 10, caffeine cutoff is earlier than you think. Caffeine has a half-life of around six hours. The coffee at three in the afternoon is half active in your system at nine o'clock at night.
00:09:25
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Move it to before noon. I try to shoot at 11. Try that for two weeks and tell me if your sleep didn't change. Number 11, set a go-to-bed alarm.
00:09:37
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Michael Chernow came on this show and the simplest thing he said is the one I have stolen the most frequently. Most of us have an alarm to wake up. Almost none of us have an alarm to go to sleep.
00:09:48
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So we drift past our window by 20, 30, 60 minutes, and then we wonder why we're feeling rough. Set a sleep alarm. Honor it the way you honor your wake alarm.
00:09:59
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The day is bookended, and it helps you keep that consistency we already touched on. Number 12, 90 minute pre-bed wind down is non-negotiable. Phones down, lights down, bodies down, whatever combination of reading, journaling, stretching, foam rolling, slow conversation, no screens that you can sustain. I'm not a religious about much, but I do try to protect that wind down routine.
00:10:26
Speaker
Number 13, magnesium glycinate is the cheapest sleep upgrade most people are not using. 200 to 400 milligrams an hour before bed, ah do closer to 500. It's not a sedative, it's not addictive, it's one of those few supplements where the human studies pretty consistently show effect.
00:10:45
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So talk to your doctor if you have kidney issues, otherwise costs less than your coffee, it's worth it. Number 14, a hot bath 90 minutes before bed cools your core or shower.
00:10:56
Speaker
mechanism is counterintuitive you heat up to cool down but it does help number 15 the number that matters is sleep efficiency time of sleep divided by your time in bed most people obsess about duration efficiency tells you whether that time in bed counted 90 percent or higher really good below 85 something's probably off and you need to
00:11:24
Speaker
So 15 lessons on sleep. I could probably do another 15, but you know we're just doing the top 100 now. So let's move on to nutrition. This is one i'm probably least dogmatic about these days.
00:11:37
Speaker
I've had vegans and the whole food plant-based people on the show 20 years younger than they look like. I've had carnivores that also look great. The truth is muddier than the internet wants you to believe.
00:11:51
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There may be something that works for most people, but the thing that works for you is something that gonna have to figure out. So toss around, see what feels good and gives you good data.
00:12:02
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So lesson 16, protein first. Most adults are 30 grams or so a day short of where they should be.
Nutrition: Protein Intake and Processed Foods
00:12:11
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The old RDA was set to prevent deficiency, not optimize health.
00:12:16
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Aim for somewhere between 0.7 and a full gram per pound of lean body mass. For most adults, that's between 90 and 160 grams a day of protein.
00:12:28
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You can't really hit this by accident, so you need to plan for it. 17, fiber is the most underrated nutrient on earth. 40 grams a day and almost no one gets it.
00:12:39
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It feeds a microbiome and it runs your immune system, your mood, your inflammation, and probably half a dozen some other things we haven't even figured out yet. If you fix nothing else, fix your fiber, get it up.
00:12:51
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Number 18, Dr. Michael Greger was right. We had Dr. Greger on the show. He's built his career on one stubborn, deeply researched message. Eat more plants, eat fewer surprises.
00:13:05
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Whether you're full-on plant-based or just trying to be saner, the case for adding more vegetables, beans, berries, greens, nuts, seeds, and whole grains is overwhelming and uncontroversial.
00:13:16
Speaker
Even if you ignore everything he says, ignoring that part is choosing to lose a fight you don't have to lose. He has a new book coming out, How Not to Hurt, and he will be coming back on this show at the end of the year.
00:13:28
Speaker
Closer to that. Number 19, ultra-processed food is the new tobacco. Science keeps getting clear here, and the cultural denial keeps getting louder, though with Maha, it's pushing back.
00:13:41
Speaker
Foods engineered for shelf life, palatability, and profit margin are doing measurable damage to your gut, your brain, and your but blood vessels, and those of our children.
00:13:52
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you don't have to be a saint, but you have to be a skeptic at the grocery store. If it didn't grow on the ground or walk on the ground, you might want to avoid it. Lesson 20. Time-restricted eating works if you don't undereat.
00:14:06
Speaker
The window is a tool, not a religion. 8 to 10 hours most days is enough for most people. If you find yourself cramming 2,000 calories in 6-hour window because you're fasting, you kind of miss point.
00:14:18
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Number 21, fasting mimetic protocols are real. Renee Fitton from El NutriQui and Prolon came on the show and walked us through Prolon's five-day fasting mimetic developed out of Walter Longo's research.
00:14:33
Speaker
The data is striking. Five days, three or four times a year, with the right macronutrient ratios. Your body responds as if it was fasting, even though you are eating. I am literally on day five of this protocol as I record this.
00:14:48
Speaker
I started doing this back in 2019 and I'll continue doing it. Number 22, GLP-1s are not a moral failing. They are also not a free lunch.
00:15:00
Speaker
We've covered this on the show multiple times. Zimpik, Lagovi, Majuro, ZepBound, they work. They work better than almost any prior intervention we've ever had for obesity and metabolic disease.
00:15:12
Speaker
they also come with trade-offs. Muscle loss if you don't strength train. Bone loss if you don't load weight on those bones. Returning weight if you don't change your habits.
00:15:24
Speaker
They are a tool with side effects that should be paired with the rest of the work, not used as a substitute for it. 23. The plate is more important than the supplement.
00:15:37
Speaker
I take supplements. I am not anti-supplement. but I've never seen someone successfully supplement their way out of a bad diet. The order of operations is the plate, then the protocol, then the pill. 24, hydration, half your body weight in ounces daily as a floor, or if you're training, sweating, traveling, or in the heat.
00:16:00
Speaker
Most fatigue, headache, and brain fog complaints I hear go away with just couple extra glasses of water.
00:16:09
Speaker
25, sugar sneaky. Read every label. Salad dressing has sugar. Healthy granola has sugar. Bread has sugar. Most yogurt has sugar. The added sugar in your day is almost never coming from the obvious dessert.
00:16:24
Speaker
It's coming from the things you assumed were neutral. Again, why you want to try to stick to things that grew on the ground or walked on this earth. Number 26, olive oil and avocados earned their place. Don't fear the fat.
00:16:37
Speaker
The 1990s low fat is good era did more damage to American health than almost any other policy term. Saturated fat from processed sources is a problem.
00:16:49
Speaker
Mono and polyunsaturated fats from real foods, they are not. Go eat the avocado. Number 27, coffee is medicine within reason. The body of evidence on coffee is now embarrassingly positive.
00:17:03
Speaker
Overall cause mortality, lower risk of Parkinson's, lower risk of type 2 diabetes and liver disease. Three to four cups a day before noon is the sweet spot.
00:17:14
Speaker
Pass that in you're trading sleep for alertness and you're not going to want to help that trade.
00:17:21
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28. Cooking at home is itself Hellspan intervention. Not because restaurants are evil, want to support those chefs, but because cooking forces awareness. You see what goes in. You taste it while it's happening.
00:17:34
Speaker
eat slower because you cooked it. The act is the thing. 29. The microbiome cares more about diversity than perfection.
00:17:46
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30 different plant foods a week is the target the longevity researchers I trust keep coming back to. Not the same kale seven times, variety, different colors, different families, different roots and leaves and seeds.
00:17:58
Speaker
Your gut bugs are an ecosystem. Feed that ecosystem. Number 30, body composition matters more than weight. Two people can weigh the same and be at completely different metabolic risk levels.
00:18:11
Speaker
ratio of muscle to fat, where the fat is, how much is around your organs. The scale is the worst single tool we have for measuring this. If you can get a DEXA scan once a year, do it.
00:18:22
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If you can't, use a tape measure on your waist. So eat more plants, eat more protein, eat less of the stuff designed in a lab to make you eat more of it.
00:18:33
Speaker
That's almost the whole game. Now we'll move to movement and fitness. If sleep is the most underrated lever, movement is the most powerful lever we know of for healthspan.
Cardiovascular Health and VO2 Max
00:18:46
Speaker
If you handed a magic wand and told me I could fix one thing in someone's life, we pick movement. Lesson 31. VO2 max is the most predictive biomarker we have.
00:18:57
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Period. Bigger than blood pressure, bigger than cholesterol, bigger than weight, the Cleveland Clinic study from a few years ago found that people in the bottom 25th percentile of VO2 max had a five-fold increase in all-cause mortality compares to those in the top 25th.
00:19:15
Speaker
Five-fold, five times. There's no drug on earth that comes close to that effect. And the only way to raise this is to do hard cardio regularly for years. I'll say years, but they they did a study Tommy Wood talked about where they did a few weeks of the Norwegian 4x4, and that's insanely hard. They were doing like three or four times a week, and those effects and benefits lasted for months after that period.
00:19:41
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So there are ways to do this. Norwegian 4x4, I think, is the best item of it. Lesson 32, strength is non-negotiable at past 40.
00:19:53
Speaker
After 40, you lose somewhere between three and 8% of your muscle mass per decade if you're not doing something. After 60, it accelerates. The only intervention that reliably halts and reverses sarcopenia is resistance training.
00:20:07
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Lifting heavy things often for the rest of your life. Two strength sessions a week clears the bar. Three is better. Four, if like me, you love it. Lesson 33, daily steps beat op episodic gym heroics. 8 to 10,000 steps a day is associated with most of the benefits on most outcomes.
00:20:28
Speaker
You don't have to be a marathoner. You just have to be a person who moves through the world on your two feet. Listen 34, walk after meals when you can. 10 minutes is enough. The post-meal walk reduces glucose spikes by 20 to 30%. It's a single highest leverage habit you can layer on to an existing routine.
00:20:47
Speaker
You already eat, so just take a little walk after. 35, carry heavy things. Farmers' carries, suitcases upstairs, groceries without a cart. Loaded carries are the most functional, most under-trained movement pattern in modern life.
00:21:03
Speaker
They build grip, core, and the kind of full-body resilience that translates to everything else.
00:21:10
Speaker
Number 36, zone two is boring and irreplaceable. The mitochondrial density work that Inyagos, San Milan, and Peter Atiyab have made famous is real.
00:21:22
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Two to three sessions a week, 60 to 90 minutes at a pace where you can carry on a conversation, but barely. It's boring, but it works. That being said, if you have limited time, you're better off doing the high intensity stuff.
00:21:35
Speaker
Lesson 37, mobility is healthspan in disguise. The thing that makes the average 85-year-old's life small is not muscle mass. It's not their VO2 max. It's their range of motion.
00:21:47
Speaker
Hips that can't squat, shoulders that can't reach, ankles that can't pivot. Spend 10 minutes a day on your mobility now, and you buy yourself decades of being able to put on your own socks.
00:21:59
Speaker
38, the grip strength test is brutal and accurate. Grip strength is one of the most predictive biomarkers we have for mortality. Simple hand dynamometer test in your doctor's office tells you more about your odds of being functional at 80 than almost any other measurement. If your grip is weak, start training your grip.
00:22:18
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Pick up those heavy things. 39, the single leg stand test is also incredibly helpful. You stand on one foot for 10 seconds, eyes open, no support.
00:22:31
Speaker
The data on this one is striking. People over 50 who cannot are roughly twice as likely to die in the next decade. It's not about balance. It's about everything balance proxies.
00:22:43
Speaker
Leg strength, core stability, neurological function. Test yourself. If you fail, start training on it. try to balance on one leg while I brush my teeth. Alternate when I go from top to bottom.
00:22:54
Speaker
Lesson 40, stop hiding from the cardio. The most common pattern I see in the weekend warriors is heroic strength training paired with zero cardio because they don't like running. Well, find something you do like doing, swimming, biking, rowing, hiking, pickleball, just stop avoiding the work. 41. Recovery is part of the workout, not a reward for it.
00:23:15
Speaker
Sleep, protein walks, mobility, sometimes a sauna, sometimes a cold plunge, but mostly just rest. The growth doesn't happen during the lift. It happens during the days after the lift. If you skimp on recovery, you're wasting the benefits of the work.
00:23:32
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Listen, 42. You don't have to crush yourself to get strong. The more is better model of fitness has produced more injuries and more dropouts than has produced healthy people.
00:23:45
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Heavy enough to be hard, often enough to count, rest enough to recover. That's the protocol. 43, the chair is killing you.
00:23:56
Speaker
Sitting eight, 10, 12 hours a day is its own independent risk factor. Standing desks help, walking meetings help more, treadmill desks if you can swing it, anything that keeps your hips, ankles, and circulatory system from spending the entire day in one shape. 44. Pickleball, dancing, hiking, swimming.
00:24:16
Speaker
Pick one, protect it. The single most reliable predictor of someone exercising in their 70s is having something they actually love doing. The optimal program is the one you'll actually do.
00:24:27
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Find your sport, commit. 45, joints don't wear out. They rust shut. The I can't run because my knee story is one of the most common and one of the most wrong.
00:24:39
Speaker
Most chronic joint pain is the result of inactivity, not overactivity. The cartilage in your joints depends on movement to circulate fluid and stay healthy. Strength train around the joint, move it through full range, get help from a good physical therapist if you need it.
00:24:55
Speaker
But stop using your joints as a reason not to move. Movement is the closest thing we have to a fountain of youth. Treat it that way. Now for mindset.
00:25:07
Speaker
And in full transparency, this is a section where I have the most personal stake. I wrote my first book, Get Out of My Head, on stoicism. I built my second book, Wellness at Work, around the idea that people we work with can carry middle load all day and almost no system in corporate America measures that strain adequately.
00:25:26
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So for me, this is not theoretical. None of it is. It's it's practical.
Managing Stress with Philosophy and Recovery
00:25:31
Speaker
Lesson 46, stress is not the problem. Recovery from stress is.
00:25:38
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There was a framework established 80 years ago and we keep forgetting it. Acute stress is fine. Acute stress is a signal. Chronic unresolved stress is what wrecks us. The question is not how do I live with less stress. The question is how do I recover from the stress I'm going to have anyway?
00:25:57
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47, cold exposure works. Ipe is overdone. Two to three minutes, two to four times a week in cold water in the high thirty s or mid 40s. The data on dopamine, mood, inflammation, it's real.
00:26:11
Speaker
The 15 minute ice bath on Instagram is not the protocol. It's the five minute thing in your shower that makes the difference. 48, stoicism is a sleep aid disguised as a philosophy.
00:26:26
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The dichotomy of control, the view from above, memento mori, the morning pre-meditation. These are not philosophical exercises for ancient men in Tobias. They're the most practical tools I know for getting your nervous system out of fight or flight.
00:26:41
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Marcus Aurelius wrote this in his journals at the end of the long days of running an empire. He was a stressed out CEO with better discipline than most of us. 49, the mind-body line is fake.
00:26:56
Speaker
You have to treat them together. Your gut talks to your brain. Your brain talks to your immune system. Your immune system talks to your hormones. The compartmentalized approach to medicine, where you see one specialist for your stomach, another for anxiety, third for your skin, it's making us sicker.
00:27:12
Speaker
Most corporate wellness programs overwhelm employees with too much or they offer too little to be useful. Alively gets it right. We start with each employee's data and goals, then serve one clear, personalized action at a time.
00:27:26
Speaker
No noise, just real behavioral change. The outcome? A healthier, happier workforce. A measurable impact for your business. Visit Alively.com to see personalized wellness in action.
00:27:41
Speaker
Number 50. The face leads the mind. Raquel Merlini came on the show and made a case I did not expect to be persuaded by. The case for Botox not just as an aesthetic, but as biochemical.
00:27:56
Speaker
When the muscles in your forehead and between your brows can't frown, you don't just look less stressed, you feel less stressed. The science here goes back decades, the pencil between the teeth test that experiments showed, where you hold a pencil horizontally in your teeth and your face is forced something close to a smile and your mood elevates.
00:28:16
Speaker
Hold it between your lips so you can't smile and your mood can drop. Botox runs the same play from the inside out. Whether you ever consider Botox is beside the point, the principle is the lesson. Force the face and the mind follows.
00:28:29
Speaker
Smile in the mirror first thing in the morning before you check your phone. Stand tall. Embodiment is not a metaphor. Your physiology and your psychology are the same conversation. 51. Phones are the cigarettes of our era.
00:28:44
Speaker
We will look back on the way we let our children and ourselves marinate in algorithmic feeds for hours a day, and we're going to be horrified. The data on adolescent mental health since 2012 is one of the most disturbing trends in modern public health.
00:29:00
Speaker
Jonathan Heights, The Anxious Generation is the book on this, and I think he's mostly right. 52, meditation does not have to be about sitting still.
00:29:11
Speaker
If you can do a 10-minute formal practice, do it. If you can't, walk in silence, cook with your full attention, wash the dishes, sit with your coffee instead of with your inbox.
00:29:22
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Meditation is the practice of being present, the shape it takes up in you. 53. Therapy is a healthspan intervention, full stop.
00:29:34
Speaker
The research on talk therapy at a population level rivals the research on most pharmaceuticals. We don't talk about it as healthspan because we still have a stigma about it.
00:29:45
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We should talk about it that way. Find a therapist the way you find a dentist before you have a crisis. Lesson 54, brain training is real.
00:29:56
Speaker
And Sophie Flory came on the show and talked about her rewire program. She walked us through the actual neurological mechanism by which you can change your default response patterns through deliberate practice.
00:30:07
Speaker
The brain is not the fixed object we treat it as. Train it the way you would train a muscle.
00:30:14
Speaker
55, mental health data is the missing pillar. A doctor prescribes something, waits a few weeks, see if it works, tries the next thing if it doesn't work. Mental health has been all about trial and error to date.
00:30:27
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We wouldn't accept that approach in cardiology. We accept in psychiatry because we don't have the data infrastructure yet. Upcoming guest, in Naval Roy, has a company working to solve just this problem.
00:30:40
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56, burnout is not a moral failing. It's a measurable physiological state. Chronic activation of the HPA axis. Cortisol dysregulation, sleep architecture disruption, inflammatory markers off the charts.
00:30:55
Speaker
If you tell me you're just tired, I'm going to ask follow-ups. Some of those follow-ups have led to some hard conversations.
00:31:03
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57, journaling is cheaper than every supplement. Five minutes every morning or every evening using real paper. What are you grateful for? What's been hard today?
00:31:13
Speaker
What did you learn today? What am I committing to for tomorrow? The practice is older than psychology and will outlive every supplement on your calendar. 58, when you wake up in the night in pain, your relationship to that pain decides how easily you'll fall back asleep.
00:31:33
Speaker
Dr. Andrea Furlan, who's been on the show, is a pain physician in Toronto. And she helped me think about when I would wake up, I had this knee pain that I did not have during the day.
00:31:44
Speaker
And she taught me, if you listen that episode, how to just sit with that and give myself peace with that and tell the knee and the pain, it's going to be okay. And after a couple of nights of that, don't get it anymore.
00:31:56
Speaker
I just got a piece. It was a really practical and useful tool. 59, that 4 a.m. voice, it's wrong about you. Most of the worst thoughts I've ever had about myself, my company, my future, have happened between three and five in the morning.
00:32:14
Speaker
Almost none of them have survived by breakfast. Whatever you are convinced is catastrophically true at four in the morning is mostly cortisol pretending to be insight.
00:32:25
Speaker
Drink water, go back to sleep, decide nothing.
00:32:31
Speaker
60, purpose lengthens telomeres. The work on meaning, on having a why, on feeling that your life matters to someone, keeps showing up in longevity research in ways that are almost embarrassing for how hard they are to measure and how clearly they keep mattering.
Purpose, Social Connections, and Longevity
00:32:48
Speaker
The Blue Zones Research found it. The Okinawan Concept of Ikigai names it. Viktor Frankl wrote a whole book about it. Man's Search for Meaning. If you have not read it, please pick it up. Have a reason to wake up tomorrow, the body listens.
00:33:02
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Mind is not a soft factor, it's a vital sign. Social connection, our fifth pillar. And of the five, this is the one i had to be talked into taking seriously.
00:33:15
Speaker
I'm more introverted, I'm a swimmer, and swimming can be a mostly solitary exercise. I built a company and wrote two books, both of which required thousands of hours alone and thinking and working.
00:33:27
Speaker
For years, social connections sounded like the soft thing the wellness industry tacked on at the end so the framework could feel complete. I was wrong. Lesson 61, loneliness is the equivalent of smoking 15 cigarettes a day.
00:33:43
Speaker
The Surgeon General's advisory in 2023 made this national news and most of us still haven't internalized it. The biological signature of loneliness in the blood work, in the brain, in the immune system is closer to chronic infection than to a feeling.
00:33:57
Speaker
We treat it like an emotional issue. It is, and just as much as a physical one. 62. Phone-free events are coming back for a reason. Eventbrite reported a 567% jump events globally last year.
00:34:14
Speaker
Bands on phones at concerts, yonder pouches at venues, sauna raves, and intentional dating apps and intellectual social hubs. Gen Z is reaching for analog connection because the digital version did not do its job.
00:34:27
Speaker
Their nervous systems are telling them something the rest of us should listen to. Listen to 63. Marriage and relationships have health effects no pill can match.
00:34:38
Speaker
The data on long-term partnership and longevity is striking. Lower all-cause mortality, better cardiovascular outcomes, lower rates of depression. The mechanism is not the institution. The mechanism is what good partnership produces.
00:34:54
Speaker
Touch, routine, shared meaning, someone to notice when you're not yourself. 64, friendship is the longevity practice.
00:35:04
Speaker
It doesn't happen by accident past 40. The research on adult friendships is depressing and the prescription is simple. Schedule it, recur it, show up. Two old friends and one new one a year is a respectable target.
00:35:19
Speaker
As I say, you can't make new old friends. Invest in those friendships. 65, eat with people as often as you can. The Blue Zone research keeps coming back to communal eating.
00:35:32
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Not because the food's magical, because the act of eating together is a daily ritual of connection that builds and maintains the relationships that keep you alive. 66, the Rosetto effect was real.
00:35:44
Speaker
Small Italian American town in Pennsylvania had cardiovascular mortality rates roughly half the national average for decades. Researchers eventually figured out that it wasn't the diet.
00:35:55
Speaker
It wasn't the genetics. It was a community. Three-generation households, shared meals, dense social ties. When the social structure changed in the 70s, the heart attacks came.
00:36:06
Speaker
Community is medicine.
00:36:10
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67, having someone to call at two in the morning matters more than a perfect VO2 max. I'll say it again because it's important. Having someone to call at two in the morning is more important than a perfect VO2 max.
00:36:24
Speaker
Both matter. The connection matters more. 68, touch is a vital sign. Hugs, hand-holding, pat on the back. The data on oxytocin and physical contact is consistent. You need it.
00:36:38
Speaker
You need more of it than you're getting. If you live alone, get a massage. Get a dog. Hug your friends. Get that touch. 69, our elders need us.
00:36:51
Speaker
We need our elders. This silver tsunami is real. The 85 and older population the US is set to double by 2040. The infrastructure for taking care of them is breaking.
00:37:02
Speaker
And the loneliness epidemic among older adults is its own public health emergency. Find an older person in your life and call them this week. Number 70, workplace community is health span infrastructure.
00:37:18
Speaker
This is the Alively thesis in one sentence. Most of us spend more of our waking hours with our coworkers than anyone else in our lives. If your workplace is a place of chronic stress, isolation, and disconnection, it's a health span problem.
00:37:34
Speaker
If it's a place of belonging, support, and shared purpose, it's a health span asset. The leaders building the ladder are doing the most under-reported public health work in our country.
00:37:46
Speaker
Connection is medicine. Take your dose.
Future Health Standards: Hormones and Monitoring
00:37:49
Speaker
Now I will get into some of the more frontier things, hormones and and the frontier. So two years ago, I didn't have a strong point of view on hormones.
00:38:01
Speaker
didn't know much about them, was learning about them. Now I have opinion that some of you will love and some of you will hate because it's controversial. Two years ago, longevity tech felt like a Silicon Valley vanity fad.
00:38:13
Speaker
Now I'm tracking real human trial data on half a dozen interventions that may, in relatively short time, be new standards of care. So these are 15 lessons on the frontier, some still with wetting. Lesson 71, TRT prescriptions are up 60% since 2019.
00:38:32
Speaker
is twenty nineteen Men are still dying five years younger than women on average. Something doesn't add up. We need a more honest cultural conversation about hormonal health for men, away from the bro-influencer culture and into clinical reality.
00:38:50
Speaker
Jay Campbell came on the show, and he and I agreed on more than I was expecting. We disagreed on some too, and the conversation is well worth your time if you have not yet listened to 72, hormones matter for women too. I mean, honestly, they matter more.
00:39:06
Speaker
The criminal undertreatment of menopause and perimenopause in this country is one of the largest unforced errors in modern medicine. Every female physician I've spoken to and had on the show has sold some version of the same story.
00:39:19
Speaker
Women are gaslit. Symptoms are dismissed. Hormone replacement therapy was demonized for two decades on the basis of a single misinterpreted study. The science has moved.
00:39:31
Speaker
The clinical practice mostly has not. If you're a woman over 40 and your doctor is telling you this is just aging, you need a second opinion. 73, biological age tests change how you see your body.
00:39:44
Speaker
Epigenetic clocks like Horvath, Grimmage, and others are coming out of the labs. They're not perfect. They can at times be useful.
00:39:55
Speaker
Watching your biological age move in response to your habits is one of the most motivating data exercises modern health. If it's a tool that helps you, use it. 74, rapamycin trials are real.
00:40:09
Speaker
Read them. The PEARL trial published last year showed that low-dose intermittent rapamycin in healthy adults over 48 was relatively safe and showed significant improvements in lean tissue mass and pain in women.
00:40:22
Speaker
The combination of rapamycin and nicarbose has produced up to 36.6% increase in medium lifespan in animal studies. we got to see what it does in humans.
00:40:34
Speaker
We're not yet at a rapamycin is for everyone, but we might not be far from rapamycin for some people with monitoring. 75, therapeutic plasma exchange reduced biological age by up to 2.6 years in a 2025 study at the Buck Institute.
00:40:50
Speaker
It's not typo. The mechanism's still not fully understood, but the results are striking. We're watching decades-old technology originally used for autoimmune disease get repurposed for HealthSpan real time.
00:41:04
Speaker
76. NAD plus is interesting. The hype is louder than the data. The IV clinics are everywhere. The research is uneven. There are real signals around mitochondrial function, and there's real noise around marketing.
00:41:17
Speaker
I take some precursors. I have some of the pure NAD. I'm not certain what it does, what the brochures say, but I am definitely watching the space with interest.
00:41:32
Speaker
77, senolytics are coming. Drugs that selectively kill senescent cells, the so-called zombie cells that accumulate with age, are moving from animal models into human trials.
00:41:43
Speaker
A couple have been in the headlines, but newer compounds are also in the pipeline. This is five to 10 year bet, but it's not science fiction.
00:41:53
Speaker
Lesson 78, peptides are not a fad. They're not a panacea either. BPC-157,
00:42:00
Speaker
Completely healed my shoulder. It was crazy. TB500, JHKCU, the GLP-1 family. Some of these are real tools with real mechanisms.
00:42:11
Speaker
Some are being marketed as miracles. We've had multiple guests on the show, like Scott Sherr and, of course, Jay Campbell, who've helped me personally sort the signal from the noise.
00:42:22
Speaker
Work with someone who knows what they're doing, not someone you saw on Reddit. 79, AI predicts cognitive decline years before symptoms.
00:42:33
Speaker
Mass General Brigham's model can forecast dementia from speech analysis, 78.2% accuracy. The question is not whether we can detect this. The question is what we do with the information once we have it.
00:42:47
Speaker
The healthcare system isn't built for a, we found that problem and we have 10 years to act on it. We're gonna need to change some things. Number 80, microplastics are not fringe anymore.
00:42:59
Speaker
They are in the placenta. They are in the blood-blame barrier. They are in testicular tissue. We are running a massive, uncontrolled, decades-long experiment on ourselves.
00:43:11
Speaker
The exposure is not zero. The damage is not theoretical. The starting point is to stop heating foods in plastic and stop drinking from plastic water bottles. The endpoint is gonna need to be regulatory.
00:43:25
Speaker
81, hyperbaric oxygen is moving into the mainstream, not just for pop wellness, for tissue repair and neurological recovery and a growing body of evidence on mitochondrial function.
00:43:39
Speaker
82. Continuous glucose monitors, CGMs, are the new scale. And the new mirror, wearing a CGM for two weeks tells you more about your metabolism than a year of blood work.
00:43:50
Speaker
You'll learn that the bowl of oatmeal you thought was healthy is wrecking you. And maybe that the slice of pizza you had on vacation caused barely a blood. It's highly personal and totally worth doing at some point, if you haven't already.
00:44:05
Speaker
83. Hearing aids may be the cheapest cognitive intervention we have. Untreated hearing loss is associated with higher rates of cognitive decline, dementia, and social isolation.
00:44:16
Speaker
The intervention is one of the cheapest interventions in modern medicine. And it's widely underutilized because we treat hearing aids as a cosmetic problem rather than a brain health one. Both of my parents, thank goodness, got on this early. They use them.
00:44:31
Speaker
They're so much more engaged. We have better conversations. It's fantastic. 84, astaxanthin is a real one. Sam Shepard, wow, he was an amazing guest. I talked to him for another couple hours after we stopped recording.
00:44:46
Speaker
And he came through on the show and walked us through the data on astaxanthin. It's a marine carotenoid that is one of the most potent antioxidants we have access to. I started taking it after our conversation from his ballasta and I used to get skin issues, mal melanoma, you know every few months when I would go, I'd have another one removed and it would be an issue.
00:45:09
Speaker
And since I started his ballasta astaxanthin, I have not. The data on inflammation, skin, eye health, joint recovery, the whole stack is consistent enough that i no longer treat it as French.
00:45:21
Speaker
Not every supplement is signal. This one, in my experience, it is good. I recommend it. 85, the body signals are not always what they look like.
00:45:33
Speaker
Felice Chan, who came on the show, she's an acupuncturist, explained something that I had been confused about for decades. I always had cold hands and feet, and even in warm rooms, I just thought that's who I was.
00:45:45
Speaker
And Felice helped me understand that it was a signal of stagnation in specific channels, and regular acupuncture has and can change it. The Western medicine you grew up with and the Eastern traditions that have been refining the same observations for thousands of years are not at war.
00:46:02
Speaker
They're looking at the same body from different angles. If you're curious, find a practitioner who's good at the things you do and see what it does for you. This frontier is moving fast. Stay curious, stay skeptical, trust trial data, and don't trust testimonials.
00:46:21
Speaker
Even mine. Alright, this section is a little uncomfortable. I'm going to call out some of the mistakes I see most often. Some of them are mistakes I made. I'm not above any of these. 86. Optimizing one pillar with the others cratering.
00:46:38
Speaker
The classic. The gym rat who doesn't sleep, the marathoner who doesn't lift, the biohacker who has great blood work and no friends, the CEO with a personal trainer and a stomach ulcer.
00:46:50
Speaker
Health is a system. The system fails at the weakest link, not the strongest one. 87, ignoring environmental exposures because you cannot see them.
00:47:03
Speaker
Our blank came on the show with a body of research on electromagnetic fields and the way modern life has a swimming in them. Phones in our pockets, routers six feet from our bed, Bluetooth in our ears for hours a day.
00:47:16
Speaker
The science here is contested in some places and clear in others, and I'm not in the panic camp. I am in the, why are you not at least minimizing this camp? Again, we're living this decades long experiment for the first time in human history.
00:47:31
Speaker
Take the phone out of the bedroom at night. Put the router on a timer. When you're asleep, you don't need it on. Earbuds traded for wired headphones for long calls, like another guest developed, Melanie Avalon, with her Avalon X brand with Art Blank.
00:47:46
Speaker
They have some EMF blocking headphones. None of these have to cost much. None of it hurts you, in worst case, it might help you. All of it could matter if this ends up being a bigger deal than we currently realize. 88, outsourcing health to a single doctor's appointment a year.
00:48:04
Speaker
Your annual physical is a 15-minute snapshot taken by someone seeing 40 patients that day. It's not a system. You are the system. Your habits, your data, your awareness, your doctor can be a partner.
00:48:16
Speaker
They're not the headline.
00:48:20
Speaker
89, confusing motion with progress. Buying the gear, joining the gym, downloading the app, posting about the protocol, none of that is the work. The work is the boring part.
00:48:32
Speaker
The work is showing up on the days you don't want to, and the work is where all the benefit comes from. Number 90, treating wellness is separate from work.
00:48:43
Speaker
Again, this is the wellness at work thesis in one sentence. The hours you spend at your job are not separate from your health span. They are the dominant input.
00:48:54
Speaker
If your job is a chronic stress event, no amount of weekend yoga is going to make up for it. The wellness program your employer offers is mostly cosmetic. The culture, the workload, the autonomy, the community, that is the real intervention.
00:49:10
Speaker
Most leaders are not thinking about it that way. The ones who are will have measurably healthier teams in the years to come.
Sustainability in Health Habits and Living Well Longer
00:49:18
Speaker
91, letting perfection kill consistency.
00:49:22
Speaker
The protocol you can sustain for a decade beats the protocol that's perfect that only lasts a few weeks, every single time. Find the version of the work that you'll actually do on that bad day, the busy day, the travel day.
00:49:39
Speaker
That is your protocol. 92, ninety two Buying the thing instead of doing the thing. Your super expensive Peloton and you put in the guest room.
00:49:49
Speaker
Your wearable that you stopped checking months ago or left in a drawer. The standing desk that you've never actually raised. The cold plunge that sits in the backyard forgotten.
00:50:00
Speaker
The action is the intervention. The gear you've acquired is just the prop. 93. Comparing biological age scores instead of habits.
00:50:13
Speaker
The new social media one-upmanship is, my biological age is 42, but I'm 51, and it misses the point. The score is a lagging indicator. The habits are the asset. Compete with yourself six months ago, 12 months ago, not with the influencer or with the marketing deal. 94, ignoring sleep apnea, alcohol, and stress because you're a high performer.
00:50:37
Speaker
High performance is not what it looks like in your twenty s High performance in your 50s looks like sustainable energy, clear thinking, recovery, and showing up over time.
00:50:48
Speaker
The hard-charging exec who burns out at 52 and dies at 64 is not the model you want to follow. They are the cautionary tale. 95, treating your body like an inconvenience until it stops working.
00:51:03
Speaker
The most common pattern in healthcare, ignore the warning lights, override the signals, push through until the engine seizes, then panic. we can listen earlier. If you recognize yourself in any of those, i do too, most of them.
00:51:18
Speaker
Awareness is the start. Action is all of the rest. So we're about to wrap up with our last five. And so I'm gonna just share some of the things that I do, if helpful. Look, I'm a 44 year old man that has a particular schedule, a particular history, particular set of constraints.
00:51:38
Speaker
Nothing in my routine is universally optimal. It's just mine. Steal what's useful, discard what isn't. I was a competitive open water swimmer. That biases some of my movement choices. I love swimming.
00:51:50
Speaker
I'm an introvert with a public-facing job. That might bias some of my recovery practice. I'm a father, and that biases every single thing I do. So here's what I do. 96, non-negotiables, sleep, swim, sun, supper, and stoic reflection.
00:52:09
Speaker
Sleep. I want to be in bed ideally nine, get sleep by 930. Up 530. Try to have that consistency, get my eight hours, have the non-screen time that works for me.
00:52:20
Speaker
Swim. Ideally, when I'm in Bermuda, every day I can. Sometimes just after the gym, but a couple longer swims are in the week. And when I'm in Atlanta, maybe twice a week and weights and yoga the others.
00:52:35
Speaker
Open water when I'm in Bermuda, pool when I'm in Atlanta. One of those sessions is a longer zone two, and at least one is more the Norwegian four by four, but me being me, of course I do a five by four.
00:52:47
Speaker
And so it's a race that it can take me four minutes to do. So now that I'm older and slower, it's a 350 if short course and just a 300 if long course. Sun, 20 minutes outside before nine in the morning, no sunglasses,
00:53:04
Speaker
Just try to get out. It's probably helped more than anything else with my sleep. Supper, which, you know, dinner, but to keep the S framework going. So with other people, phones away, not at the table, not in my pocket, in a different room.
00:53:20
Speaker
Sit there, be present, enjoy the meal, enjoy the company. And stoic reflection. And again, just to have the S because it it's... I'm currently journaling through a prompt of Christian prompts and I've done Daoist prompts, I've done stoic prompts and it's more about the activity.
00:53:39
Speaker
Some time in the morning, memento mori, premeditation, just getting my mindset right before I start the day and then before bed doing a similar thing, journaling, thinking through it, a realist style review of the day.
00:53:53
Speaker
What did do well? Did I do poorly? What do I need to change for tomorrow? 97, minimum enjoyable action beats the optimal protocol. Inside Alively, we talk about the MEA, that minimum enjoyable action, the smallest version of the habit that you'd still want to do even on a bad day.
00:54:12
Speaker
Mine's that some kind of movement after meal. Could be walking, but I don't have space for it. Could be some squats or lunges, just some kind of movement after i eat. Not a ton.
00:54:23
Speaker
It could be anything. A two-cent, 10-minute strength session that's your backup if that's all you have time for. A two-page reading session if you can't manage to read for 30 minutes. The MEA gets me to the long-term sustainability that the heroic protocol has never been able to deliver.
00:54:40
Speaker
98, track trend lines, not single days. I wear my whoop. I look at my recovery score, my heart rate, my sleep efficiency. If I had a bad night, I just drink some more water, take a slower morning. I don't catastrophize single number.
00:54:56
Speaker
And to be fair, like I said, I'm on this pro-lon-fest. My numbers are insanely good right now. HRV was up 40%. Lesson 99, build the day around your recovery, not around the workout.
00:55:09
Speaker
This is still the hardest one for me. It's the biggest mindset shift over the last year and one I'm not fully there on. So I would always plan my days around the training. Didn't matter how I recovered, just kind of muscle it through, grind it through.
00:55:23
Speaker
And now I'm trying to use what Whoop is intended for and look more at that recovery score and adjust accordingly. Hard sessions on days I'm rested, easy sessions on days I'm not. The volume is the same over the year, but the pain and injury is weight loss.
00:55:40
Speaker
And finally, lesson 100. Stop trying to live forever. Start trying to live well longer. I'm not pursuing immortality.
00:55:52
Speaker
I don't need to live to be 150 years old if it means a decade sitting in a chair forgetting the names of my children or grandchildren. I want what most of us want.
00:56:04
Speaker
To play with my kids when they have kids. To hike with friends and loved ones when I'm old. To finish the things I've started, to be of use.
00:56:17
Speaker
This is what Healthspan is. The pursuit of more good time, not just more time.
00:56:26
Speaker
Thank you for sticking with us through episode 100.
00:56:31
Speaker
Thank you for joining us on today's episode of the Home of Healthspan podcast. And remember, you can always find the products, practices, and routines mentioned by today's guests, as well as many other healthspan role models on Alively.com.
00:56:43
Speaker
Enjoy a lively day.