These Simple Habits Could Add Years To Your Life (It's Not Diet Or Exercise)
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The central argument of the video is that while diet, exercise, and sleep are important components of health, they are not the single most critical factors for longevity; instead, strong social relationships are paramount. The speaker critiques the wellness industry's obsession with extreme measures and perfectionism, advocating instead for a sane perspective where habits are built over decades rather than through rigid self-denial. This approach allows individuals to enjoy life's pleasures, such as eating ice cream or hot dogs, without guilt, provided these choices do not cause harm or excessive cost. The core message is that living a long and healthy life is a means to an end, not the ultimate goal itself, and that we must be forgiving of ourselves when we inevitably make mistakes or deviate from strict wellness plans.
A key strategy for maintaining cognitive function and overall well-being as one ages is to avoid early retirement and to stay socially engaged. The discussion highlights how work provides structure, challenges, and a built-in social circle that disappears upon retirement, often leading to isolation and accelerated cognitive decline. To counteract this, the speaker suggests finding meaningful ways to remain active and connected, such as taking on new roles like volunteering or working part-time, which provides purpose and interaction. Additionally, acquiring a pet like a dog is recommended not just for exercise but because it naturally facilitates social interactions with other dog owners, creating a "wellness trifecta" of physical activity, mental engagement, and community connection.
The conversation also addresses the importance of movement in daily life, challenging the notion that one must be a gym rat to stay healthy. Evidence suggests that consistent, moderate activities like fast walking, gardening, or even climbing stairs are highly beneficial for reducing cognitive decline and improving longevity. Furthermore, the speaker takes a strong stance against routine PSA testing for prostate cancer, arguing that since almost all men will develop some form of prostate cancer if they live long enough, early detection does not necessarily extend life given other competing health risks at older ages. Similarly, while sleep is essential for memory consolidation and brain repair, the focus should be on establishing a consistent routine and creating a conducive environment rather than obsessing over wearable trackers or extreme durations.
Finally, the video emphasizes that social connection is vital regardless of personality type, citing research that shows even introverts often report higher happiness when engaging in conversation with strangers during commutes. The speaker encourages listeners to overcome their hesitation to talk to others and to view activities like eating dinner or drinking wine as opportunities for social bonding rather than solitary indulgence. By combining healthy food, physical activity, and meaningful social interaction into a single event—what is termed "wellness stacking"—individuals can make maintaining these habits more enjoyable and sustainable. Ultimately, the path to a longer life involves embracing community, staying mentally sharp through engagement, and finding joy in simple, shared experiences rather than adhering to restrictive or fear-based wellness fads.
Read the full video transcript
People who are 80 years old, the fast
walkers, the top 10% of walkers actually
have less cognitive decline.
[music]
You open the book going after the
wellness world's most extreme corners.
Now, I push back on those fads in my own
world right here on this podcast as
well. And I really enjoyed you writing
about what made you sit down and say
enough is enough. Yep. So, I teach at
the University of Pennsylvania and I
finished the semester usually in the
first week of December and when I
finished Peter Rati's Outlive landed on
my desk. We still can't figure out why
cuz I didn't order it. I thought my
brother sent it but he claims not. In
any case, it showed up. I read it and it
just made me pissed as hell and totally
furious. And in the next 3 weeks, I
wrote out 35,000 words, basically the
first draft of this book. And what in
particular made me mad was several
things. First, his emphasis on being
obsessed by outliving as it were some
kind of, you know, you get the gold
medal if you live longer than anyone,
you know, which seems insane. And
in my view, you know, living a long
healthy life is a means to an end. It's
not your goal. And if it's your goal,
you something is wrong. The second thing
is the overemphasis on exercise and a
little bit on food and a little bit on
sleeping. It's like, yeah, all of those
are important, don't get me wrong, but
they're not the most important thing.
And we know the most important thing, as
you point out, is social relationships.
And so that just I had to fix that. And
then there's this sort of emphasis on
getting it exactly right. And you know,
life is not mostly about getting things
exactly right. You know, I I like to say
life is not, you know, the final
performance you need in figure skating
for an Olympic gold. Life is about, you
know, we all make mistakes. We don't do
necessarily take our own advice all the
time. And you have to be a little more
forgiving of yourself and recognize, you
know, you have to get some healthy
habits. Do those habits over decades.
But you don't have to, you know, never
eat a hot dog. I'm a Chicago boy. I love
hot dogs. Are they on the wellness diet?
Absolutely not. You know, they're
processed meats. They've got nitrates
and nitrates. A couple of hot dogs every
6 months or a year ain't going to kill
me. and you know it'll give me a lot of
joy. It'll remind me of you know my
childhood and fun events. It was all of
those things which said to me you know
we got to become more sane when it comes
to wellness. Wellness is important but
we've lost the sort of perspective of uh
normal people. Is there a real line
between a legitimate longevity practice
and all this crazy expensive noise out
there? Yeah, I think the line is what's
the evidence? [laughter]
I think it's just that simple. So, what
I try to do in my book is all right,
what does the data show us? And there
are some things and I have them in the
book where, you know, we don't have
enough data, but and I think I give
people a pretty reasonable way of
thinking about it. If it's not going to
hurt you and it's not going to cost a
lot of money and it might help you,
okay,
>> you grew up in Chicago. Uh, I grew up in
Omaha and Milwaukee and in Omaha I grew
up in in a half Catholic half Jewish
neighborhood and we didn't know the
difference as kids and so I I thoroughly
enjoyed your don't be a schmuck uh to
start with and be a mench at the end.
But can you tell people what don't be a
schmuck means to you? And maybe your
Volvo story is a good starting off
point. [laughter]
>> When I turned 11, we moved to the
northern suburbs of Chicago, just north
of Chicago. Lovely suburb, but I was not
a suburban kid. I was a city kid where I
could walk or ride or take public
transportation wherever I wanted. I did
not rely on my mother and we moved to
the suburbs and there was no public
transportation nearby and you had to
rely on my mother and I hated it. So
when I turned 16, I wanted to liberate
myself. And the way to liberate myself
was to get a car. And at that time,
there was this free newspaper called The
Reader. And it was supported by
hundreds, if not thousands of classified
ads, all about three sentences long. And
I would constantly look in there for a
used car
that I had enough bar mitzvah money so I
could purchase it. And every time my
father caught me, and it came out on a
Friday, and every time my father caught
me over the weekend looking, he would
say, "Don't be a schmuck. You can't
afford a car. You don't need a car.
You're not getting a car." And I would
continue to look and it would aggravate
him. And then one day, I finally found a
car, an old Volvo 122. And I remember
because I was like obsessed by getting a
Volvo or a Sab. They seemed so cool to
me and reliable and all the other stuff.
and
I could afford it. It was like $400. So,
I called the guy up. My younger brother
Ari and I went down there and we checked
out the car so thoroughly. You know, we
rolled down every window. We, you know,
looked at all the fabric, everything,
and we said, you know, to the guy, we
want to take it for a ride. So, we took
it and went around the block, you know,
got it up into third gear. I couldn't
get it to fourth gear because just
couldn't go that fast on Chicago
streets. Seemed fine. So, we got a deal
from the guy, bargained him down, drove
the car home, pulled into the driveway,
and my dad comes out of THE HOUSE. WHAT
THE HELL IS THIS? You know, it's like
[laughter]
uh I said, "Dad, we bought a car and
plus dad, it was a deal." Now, my dad
was a cheapkate beyond cheap skates and
he was having none of it. And he, you
know, he says, "Yeah, you're just a
schmuck." And he said, "You know, pull
out the car. I got to get my car. I got
to go." So then we found out the
problem. It didn't go in reverse.
[laughter] And you know, my father is
like, you know, get the car out of the
driveway. So we pushed it out. And uh,
you know, he said, like, you're just a
truck. And so he said, we're calling
Ralph. We're getting rid of the car.
That was my first car purchase. I
learned a lot of lessons that way.
>> So, you know, you talk about your father
a lot in the book and
how he basically never met a person he
didn't like and never met a person he
didn't want to talk to. And it's a it's
funny because my father was exactly the
same way. And
>> I think it's a kind of generational
thing, you know.
>> Yeah. It was embarrassing
cuz your own your dad would talk to the
person next to him in the restaurant and
whatever. And that brings me to
something I think it's really important
in your book and I want to
>> go there next. Probably the most
underrated longevity marker lever that
you can turn is relationships. [snorts]
And yeah, I'm going to start with one. I
I actually tell my patients and you have
a chapter about this. never retire. What
say you?
>> You know, in America when we talk about
retirement and thinking about and
planning for retirement, it's all about
money, money, money, the finances. Get
the finances right. And no one talks
about the brain, the brain, the brain.
Make sure that you're mentally sharp in
your retirement. Otherwise, as much
money as you have ain't going to be fun
or enjoyable or fulfilling.
And it turns out that there are data
about the potential dangers to
cognitive, you know, cognitive
functioning from retirement. My favorite
one is a Rand study from Rand is a think
tank out in Santa Monica. One of the
economists looked at the average
retirement age in different countries
and as you know in Europe uh they vary a
lot and showed that the earlier the
retirement the more earlier cognitive
impairment occurred and you can
understand why. And I'll tell another
anecdote that's not in the book. When I
publish a book, a guy who worked at the
University of Pennsylvania with me
emailed me and he said, "Well, you know,
what you say about retirement rings so
true to me." And he said, "You know, I
retired a couple of years ago and the
thing that happened is, you know, all
sorts of things just disappeared
overnight. my social circle at work, the
challenges of work, the guys I used to
hang out with and we would go for lunch
every week and and chew the and,
you know, were just my friends. It all
disappeared instantaneously.
And now I'm more isolated than I've been
in decades.
And I think that's what we forget what
work provides us. You know, it provides
us a schedule. So we're we're committed
and and other people are relying on us.
So we want to fulfill the job. We have
challenges with our job that we have to
negotiate. We have challenges with our
colleagues. And then we have uh you know
just friends who we hang out at the
water cooler or some of our closest
friends we make at work. And all of
those things sort of disappear as my
friend communicated. And it's another I
mean it's the main reason not to to
retire or if you retire make sure you
plan it not just for the money but for
how are you going to stay engaged? How
are you going to maintain friendships
and things like that and we so so rarely
do that.
>> Yeah, you're absolutely right. In fact,
you know, I continue to see patients six
days a week and it's a downward spiral
once uh yes,
>> once they retire and and this is now
happening to women and this used to be
just a men issue and now women leaving
the workforce, retiring the same thing
happens to them. Uh
>> yeah, absolutely.
>> Yeah. And your advice is absolutely
correct. My father took early retirement
because he thought his father died at 54
and he thought his number was up very
shortly and it drove him and my mother
crazy and so [laughter]
he joined a lot of civic organizations
but get this he became a greeter at
Walmart uh yeah in his retirement and he
loved it I mean he was you know really
smart guy an executive and he's a
greeter at Walmart so
>> I forget where I went I went and the guy
who was hosting me for, you know, some
kind of speaking event, you know, said
that yeah, he worked at the uh
hospitality desk at a hotel advising
people about what to do. I guess it was
one of these resorts or vacation places
advising people about the activities
that were readily available for exactly
the same reason. It wasn't because he
needed the money. He wanted the
interaction with people. He wanted to be
helpful. And I think that's exactly
right.
>> Now, I also I talk about I actually
write prescriptions for people to get a
dog. I literally write out a
prescription and some of them bring it
back framed as the best prescription a
doctor has ever given them. And you
know, dogs require walking and often it
is a wonderful time to interact with
their dog walkers and
>> they get to sniff each other's butts and
we get to sniff, you know, people's
butts, I guess.
>> Yeah. No, I and um I don't have a dog
now, but I used to have a dog and
Exactly. It's one of those I like to
call them wellness trifectas because
you're getting some physical exercise.
You go to the dog park or wherever
you're walking your dog and yeah, you
begin talking to people because the dogs
are interacting. [laughter]
If you're shy or introverted or, you
know, just get a dog because not only
will you like the dog, but you will
start talking to people inevitably. I
think the other thing that's fascinating
to me, my research over the last 20
years has been on the microbiome.
And it's fascinating how we share our
microbiome with those of us, those
around us. And we know that, for
instance, obese people, people who
frequent around obesity catch obesity.
And part of it is you catch this
obesogenic microbiome. And yeah, so I
think that's another thing we really
should be spending time sharing
microbiomes with other people,
particularly thin people.
>> Would you consider sharing your
microbiome with those around you?
>> Well, it's very funny. you know these
fecal transplants now we're getting off
a little bit from the book but you know
we we the medical profession has begun
using them especially for ced difficil a
terrible overgrowth of particular
bacteria in the gut and you know
antibiotics often don't work because
it's resistant and the one thing that
does work is fecal transplants so we
might make a joke one of the things that
I have always um has perplexed me is the
um sort of rigidity with which the
system allows people to be donors for
freal transplants. You can't have
traveled. You can't and it's like my
daughter told me that there's uh one guy
in Boston who provides all the
[laughter]
stool for fecal transplants in Boston
and like if he takes a trip we're all
dead.
>> You know, it's funny. uh you're like you
say you spent a lot of time talking
about your father and his he just
couldn't resist talking to people and
like I said it embarrassed me for the
num number of years and I guess I was
fairly shy and I was at a meeting oh
about I don't know 25 years ago
something I was chairman of program
committee and I I was out to eat that
night and the only seat was at a bar and
a chef's are. And after a few minutes, I
became best friends with this couple
that I had no idea who they were. By the
end of the evening, they were, you know,
they wanted me to come and visit and
stay at their house. And as soon as we
got off, I I called my wife and I said,
"Oh my gosh." I said, "I have become my
father. This is [laughter]
this is the worst possible thing that
could possibly happen to me." Looking
back, it was probably one of the best
things that could happen to me. Yeah.
And I I think I
>> I think my my experience is exactly
yours. You know, when my dad did this,
right, it just made me uh suddenly
become shy. Yeah. I want to crawl under
the table, leave the restaurant,
whatever. And now I'm the big
evangelist. Um so we were in New Zealand
the other week and having this
unbelievable meal that we we were
celebrating our anniversary. my wife and
I and I happened on this restaurant
which just absolutely superb.
Subsequently, it got two Michelin stars
and I said, you know, I got to find the
chef. I got to go TALK TO THE CHEF and
I'm the guy getting up and, you know,
got to talk to him because he's doing a
great job. And we talked about how he
got trained and all the other stuff and
uh yes, I've become my father.
So you make an incredibly
powerful argument that this is something
that when you look at super aers you
know 95 and above above 100 who are
doing well this community engagement
this support from other people this
interest in other people this interest
in families is rampant in all of these
these, you know, super aers.
>> There are a number of articles out there
that interview these people because of
of course they're still, as you point
out, people over a hundred, um, while
there may be more, they're still pretty
rare, especially ones who are pretty
active. And almost invariably when you,
uh, read those articles and read, you
know, what keeps them healthy, you know,
people will say all sorts of things. Um
and then all of them say family or
friends most important things and
there's actually a study in China that
said you know look at centinarians
people who lived over a hundred and the
ones who were doing the best were when
their family visited them every day. So
not only people coming but a lot of
social interaction
and then you know if they went to like a
maang group or some other communal
activity. So those are the things that
yes keep people quote unquote young even
as they age. All right let's move on to
the title of your book. Eat your ice
cream.
Really? Yeah. talk about everybody
should know he actually wanted to call
this book don't be a schmuck. This is
true. Correct.
>> That's right.
>> And you were talked out of it and
[snorts]
I believe you that whoever talked you
out of it eat your ice cream will
certainly sell a book better than don't
be a schmuck.
>> Yeah. So I was resistant
and very resistant but the publisher is
like you know don't be a schmuck is a
downer. And then we had hard time coming
up with a good title and someone who an
agent actually for me came up with the
title and it is the winner. You know,
I'll tell you how big a winner is. You
know, my brother knows a thing or two.
My brother Ariel knows a thing or two
about um getting to the public and
connecting with the public. And he said
the person who came up with that title,
that agent who happens to work for him,
he said she is worth her weight in gold.
[laughter]
>> So do you really expect me to come out
in favor of we should have a half a cup
of ice cream every day of our lives as
you imply in the book?
>> Well, I will say a number of people have
come up to me and told me that they eat
ice cream every day.
I am not recommending that. For some
people, it's the right thing. I have a
friend who 900 p.m. his quote unquote
night cap is a scoop of ice cream. Not
scotch or anything like that, but a
scoop of ice cream. And my wife's
grandmother, she lived to 101 and lived
in her own house to 100. And she had
literally had ice cream every day. She
always said there ice cream. There's
always a room in the stomach for ice
cream. it'll just squiggle in around
everything else. So, there was a study
in 2014 from Harvard Medical School.
>> I remember that study about it in a
book. Yeah.
>> They were looking at uh dairy products
and type 2 diabetes and they ran the
numbers on about 150,000 maybe 190,000
people in the nurses and physician
health study and it turned out that the
number one best dairy product to reduce
the risk of type 2 diabetes was ice
cream. Number two was yogurt. Now,
what's funny is when you go and read the
abstract of the article, it says not a
word about ice cream because they were
skeptical. This how could this be true?
You know, it's got sugar in it. But
that's what the table in the article
says. Yogurt fit their model, but ice
cream didn't. But that's what the
article
uh points out. And apparently similar
data have been found in other studies.
But you know first of all ice cream is a
mainly a dairy product and we know dairy
products are quite good in terms of
improving the lining of the colon. The
saturated fats tend is uh attenuated.
It's not the same as saturated fats in
meats because of the membrane around it.
>> Yeah. And it also, you know, dairy
products prevent the big spike in
glucose in your bloodstream from having
the sugar in the ice cream. So you don't
get the high glycemic index. So all of
that is consistent with ice cream being
good. But nonetheless, look, to go back
to a point we were talking about
earlier, you know, the fact of the
matter is life is not just about
self-denial. You're not going to become
healthy by self-denial. You'll go off
the wellness activities if you have to,
you know, deny yourself things just to
do them. You know, it's about pleasure
too and it's a life is rich and one of
the things many people like is ice
cream. But let me add one other thing. I
was promoting the book in one place. I
was promoting it. All the interviews
were done in an ice cream parlor and
they made me a special ice cream and I
sat there for hours doing interviews and
one of the things I noticed is people
don't come into ice cream parlors alone.
They come in with their spouse or
friends and it's a social activity.
Eating ice cream is not just I'm going
to have this nice dessert. It's also a
social activity. So again, you've got
this wellness trifecta element. The last
thing I would say is not all ice cream
is created equal.
>> Correct.
>> And that's a really important point. You
want to look for the ice cream that has
the fewest ingredients. The ones that
have emulsifiers and polyorbate 80 and
all of those things. Stay away from
them. I've been approached by a number
of those ultrarocessed ice creams to,
you know, do something with them. I
said, "No, no, your stuff isn't
healthy."
>> Thank you. I have a recipe in in one of
my books for chocolate avocado ice cream
and
>> Oh, wow.
>> And so if you're ever in the Santa
Barbara area, I know you're a cook, so
come on. We'll whip it up and we'll
we'll
>> we'll invite your brother.
>> I'm going to be out there in February,
March sometime. So, I will definitely uh
hold you to that, man.
>> All right. Very good. Cuz that's that's
good ice cream. And you'll be [laughter]
surprised. But you're right.
>> Yeah. Well, I am often surprised. No,
your point about dairy, I think, and you
make a big point about all this.
Fermented dairy
needs to have its day in the sun. There
is so much benefit from fermented dairy.
Now, whether it's these milk fat
globular proteins, whether it's carbon
15, this oddchain fatty acid, carbon 17,
and obviously the fermentation process
itself. So, I fully agree with that
argument in your book. Now,
unfortunately,
most ice cream is not fermented, but
maybe you and I should put our heads
together and [laughter]
all right, let's move on to exercise.
What people were beginning to realize
that, you know, movement is is good. You
again, if you look at these super aers,
one of the things they do is that they
move. And whether it's, you know,
whether it's gardening, whether it's,
you know, chasing a flock of goats up a
hill, whatever, these people have a
constant history of movement. And I
think you make a good point that this
idea that we all need to be gym rats and
beat ourselves up every day is is
probably misplaced when we look at what
these super aagers actually do in terms
of movement. Any thoughts on that? 100%.
Um, as I point out in my book, again,
going back to my father, you know, he he
would never go to a gym, you know,
again, as I mentioned, he's a cheapkate.
He's not paying a gym membership, but he
was a super fast walker. And, you know,
there's a study just out, I think last
week or the week before. I mean really
in just the last few weeks about people
who are 80 years old, the fast walkers,
the top 10% of walkers actually have
less cognitive decline and yeah, walking
and walking fast in particular is an
exercise, gardening, you know, picking
the weeds, mowing, collecting, all of
that stuff is physical activity. Even
house cleaning.
>> Yes. And that you know again we often
think of exercise has to be this sort of
structured organized whatever but it's
not true. A lot of the physical activity
we do in through the day adds to
increasing your heart rate increasing
your respiratory rate. And that's the
thing that is really important. And it
does appear that short intense bursts
where you're for a brief time getting
your heart rate into the hundreds 120
that's really important and that's
really going to add to your health and
longevity. Now you know some people they
like to go to the gym they like the
social aspect or whatever. Some people
like me, you know, I like to go out and
ride my bike uh outside and go for long
rides. You know, there are all sorts of
ways of getting that physical activity.
It doesn't have to be in the gym and it
doesn't have to be organized. It can be
just, you know, whatever you're you
happen to be doing. Uh just doing a lot
of it. Um, so
>> yeah, my great-grandmother on my
mother's side lived in Omaha and she
lived in a three-story house and
>> Oh, wow.
>> Her bedroom was on the third floor and
she died two weeks before her 100th
birthday, went to sleep and was healthy
as a horse until she went to sleep and
she always walked, you know, three
flights of stairs up and down to her
bedroom several times a day. And my my
sister and I were just kind of
apoplelectic. Grandma, you know, you
should move, you know, you should move
your bed down. She said, "No, you know,
that's my bedroom." And you know, you're
looking back, you go, wow, was she
smart. You know, it's like a what a good
idea.
>> Yeah. And you know, up three flights
twice a day is going to get you a lot of
exercise. It does.
>> I don't care who you are. And I think
that does go to the point of, you know,
it it doesn't have to be organized. It
doesn't have to be quote unquote
exercise. It just has to be moving
around every day. And a lot of the blue
zones, they don't exercise. They just
walk or hike or you know. So my wife and
I, especially in the not especially in
the summer months when it's still light
after dinner, we go we go for a evening
walk,
you know, covering a couple of miles and
then come back home and yeah, that's
exercise.
>> Yeah, that's one thing. We spend quite a
bit of time in Europe and walking after
dinner is just one of these
I think secrets of the Mediterranean
that they all do.
>> Yeah.
>> And and there's a reason for it.
>> You know, the sort of in those
Mediterranean countries where people
live outside, right? Yeah. A lot of that
is walking around, walking near the
seashore or walking down the boulevard
and and the outdoor cafes.
>> I particularly enjoyed your take on oh
what sort of tests to get as we get
older, what sort of tests not to get as
we get older. And I know you were
interviewed when President Biden had uh
[snorts] uh prostate cancer diagnosis
and I completely 100% agree with you
about PSAs and would you mind telling uh
the story of why [laughter] that is such
a horrible test and go ahead.
>> So I've had four PSA tests. That's what
we have to begin with. This is an
oncologist, folks. A cancer doctor
>> beginning 30 plus years ago, my first
one. All of them have been against my
will. I don't voluntarily do it. Now,
here is the data on PSA tests. There is
no doubt that PSA tests catch more
prostate cancer and about I think it's
seven to eight uh out of a thousand or
maybe it's one to two a single digit out
of a thousand patients screened get
diagnosed with prostate cancer and for
that reason a lot of people say men
should get a PSA. That is the wrong
endpoint in my opinion. Diagnosing
prostate cancer,
all of us, if we live long enough, all
of us men if we live long enough are
going to get prostate cancer. That's
just the way it's made. And what you
really want to know is, well, if I get
diagnosed with prostate cancer, am I
going to live longer? Is it just going
to catch an early prostate cancer that
would never harm me? I would die of
something else. And it turns out the
latter is true. So, if you look at all
these big screening tests and you ask
the question, not does it catch more
prostate cancer, but ask the question,
well, do men live longer who've gotten
the PSA? The answer to that question is
no. And the reason is that the average
age of getting prostate cancer 67. And
there are competing
threats to your longevity at 67. There's
heart disease, there's other cancers,
there's stroke, there are accidents,
there's pneumonia, there's all sorts of
other ill health potentials. And so just
being screened for prostate cancer does
not tell you you're going to live longer
and avoid being killed by prostate
cancer. You might avoid being killed by
prostate cancer, but that doesn't
guarantee you'll be avoid being dying
from something else. and that and
because there's no longevity benefit
from a PSA, you know, I really don't
care what's written on my death
certificate, whether it's a heart attack
or a prostate cancer. So, I am not
inclined to get a PSA. And as I said,
I've been tested four times, but every
single one of them's against my will.
And one of the problems is, you know,
you get a PSA over four, that's
typically the cutoff. You then have to
get an MRI. Is there a nodule? You have
to, you know, almost invariably they'll
say, "Well, we should be sure we'll take
some biopsies. Not the most pleasant
activity you would invent." And then if
they're not definitive, oh well, we're
going to have to test you again on the
PSA and and you know, you get you become
a patient and you round and round and
all to no added benefit in terms of
length of life. Well, why do that?
>> Yeah, you're right. There was a joke in
medical school that was so true that all
men will die with prostate cancer, but
it's incredibly unusual to die from
prostate cancer.
>> You got it. That's the phrase.
>> Yeah, it's true. And I council my
patients the same way. So, yeah. Thanks.
I know that's an opinion. Well, we're
out on a limb, but I think it's a good
limb to be out on. Finally, sleep. Sleep
is I know it's vague right now and thank
you for addressing that. I want to talk
about one thing that I find quite
humorous. So, I have an aura ring and I
have a hoop band and I take care of a
patient who's very high in a social
media company and he tells me that their
company will not invest in these sleep
trackers because they do not think the
da d d d d d d d d d d d d d d d d d d d
d d d d d d d d d d d d d d d d d d d d
d da is trustworthy enough to back it.
and I enjoyed reading your uh thoughts
on the same subject. Having said that,
um my my wife wears a Whoop and every
morning the first thing we do is well,
you know, how did you sleep? What what
does your whoop say? And you know, we we
compete and I think it's really I it's
comedy to us. But what should we think
about sleep? Let's start there.
>> Well, first of all, sleep is essential.
You know, um I had a when I was in high
school, um uh I I ran in a pretty
intense group of students. Uh we were
debaters and we were constantly debating
as you might imagine.
>> I was debate debate champion and two
time regional oratory champion. No
wonder I love you. [laughter]
my first debate partner would always
bemoone the fact that he had, you know,
got eight hours of sleep and it wasted a
third of the day and on and on. Um, and
he was always trying to figure out how
he could cut back.
And, you know, the best argument for why
you need sleep is the fact that we do
sleep. Because if we didn't need sleep,
evolution would have gotten rid of it.
And the reason is you are at your most
vulnerable. You're asleep unconscious.
Predators can get you. And the fact that
it has survived uh these thousands, tens
of thousands of years tells you it's
super important biologically. And it
allows the brain to consolidate
short-term memories into long-term
memories. It allows the brain to clear
out the garbage. You know, when do you
collect garbage? At night, early in the
morning. And so that's really important.
It allows proteins that are defective to
be to be eliminated and DNA that's
defective to be repaired. Very very
important.
Humans need somewhere
7 to nine. Now there are some genetic
short sleepers who can get away with
four
less than 1% of the population. None of
us are short sleepers.
It's also important to know that you
know people who sleep a long time over
10 hours that's not healthy either. So
there is a window that the body has
regulated and it's again moderation not
one extreme not the other extreme very
very important for human beings and if
you don't sleep uh if you know you're
like a a medical intern at the hospital
you know after about 18 hours of contin
continuously being getting being awake
you're kind of like uh a bit drunk
and the more you stay up the worse your
judgment the more risk risks you take.
All the things that happen when you
consume alcohol happen when you've been
deprived of sleep. You're also wor a
worse uh driver going home. So
>> yeah, we uh I trained at the University
of Michigan in Ann Arbor and uh in
surgery and one of our rotations was out
at Wayne County General, which was the
county hospital for Detroit. And it was
>> a a two-lane road in between Ann Arbor
and Wayne County General. And every year
we had a in the ditch award because uh
that it was 36 hours on and 12 off. And
every year one poor resident, one poor
schmuck
drove off the road into a ditch and
crashed his car. And you could, you
know, the award was given every year
because somebody always got the award.
And it's because, you know, you were
profoundly sleepd deprived.
>> [snorts]
>> Yeah, it was in the ditch award. So,
you're right.
>> Yeah, it's terrible. And and you know
what's terrible is what you and I
experience, which is that the medical
profession deprivives its very people
who it's supposed to be training to
educate its patient in wellness in sleep
deprivation. Terrible. Fortunately, now
it's a little better. Yeah. But, uh,
>> it's a terrible, terrible process. So,
for someone who keeps sabotaging good
sleep with late night screens, I'll
catch up this weekend.
What's one change that you could do
first?
>> Uh, well, I think the most important
change is to get the room ready and to
be regular about it. So, one of the
things that my wife and I have begun
doing is we regularly start the bedroom
routine
uh pretty much at the same time plus or
minus about 5 or 10 minutes. We read in
bed books uh actually paper books. No.
>> Um so that we're not looking at screens
and we're not you know sort of getting
preoccupied
>> and you know when my eyes begin to sort
of flap and I can't remember what the
last paragraph said. I know it's you
know time is up and uh we've already
turned the lights down. We have a light
a reading light.
>> Yeah. and turn off the reading light and
that's bedtime. I will tell you, you
know, different people are sensitive to
different things. My wife is very
sensitive to the light, so she often
wears a mask. I can't wear a mask around
my head, but I'm sensitive to the heat
and cold. I really need a bedroom that's
chilled. You know, you you need to sus
out how how you sleep best. You know,
for me, it's it's a cool room. light
doesn't bother me that uh much, but this
kind of routine and going to bed pretty
much at the same time every night really
really important.
>> Good advice. So, you know, as an author
my myself, I always stumble upon at
least a few mind-blowing stats or
challenges to my current understanding
of achieving health and longevity in
every book I write. Did this happen to
you researching this book? Oh, 100%. So,
uh I I will just say the the probably
the two biggest ones happened in the
first chapter. Don't be a schmuck. So,
when I was writing the first chapter,
which is like taking unnecessary risk, I
said to myself, what's got to be the
schmuckiest thing people can do? And I
thought it was what's called base
jumping, which is you get in this
squirrel suit, puffed up with air,
you've got wings on and
you jump off a mountain and the wind
takes you.
And people do this and it's like that's
got to be the dumbest thing. So I looked
up the statistics and it turns out the
mortality rate is 1 in 2700 jumps. The
injury rate is 1 in 250 jumps, which is
pretty serious. I was like, that's
pretty darn schmuckucky. And then I
looked up and I don't remember exactly
what prompted me to think this could be
even more schmuckucky. Climbing Mount
Everest. It might have been that someone
died that year and in a sort of big
enough, you know, snowstorm or
something.
>> And it turns out the mortality rate
climbing Mount Everest, which you have
to pay about $150,000 for the privilege
of doing, is one in a 100red for all
comers. And if you're like me and you
were over 59, the mortality rate's one
in 25. Now, that statistic just blew my
mind. You're taking a one in 25 uh
chance of dying for what? Um that just
seemed insanely risky. Okay. Finally, if
somebody only remembers one thing from
our conversation today, what would you
hope it would be? do things that involve
multiple
wellness activities in the activity. So,
tomorrow night, I will be having uh my
wife and I are going to have a couple of
couples over for a dinner party, and
we're making uh uh one new recipe. We're
going to serve really healthy food.
I'm making a a special raspberry rhubarb
cstada dessert. One of my favorite
desserts. We're going to have great
conversation. One of the couples is a
historian, an investor. Another couple,
the guy is uh started a healthc care
company and so is an entrepreneur. Um
and uh uh he also happens to be Iranian.
So we're going to he's going to tell me
about what his family is reporting to
him. So it's going to be a really great
dinner. We've got good food, so social
engagement, uh, great conversation
that's going to keep us are mentally
sharp, and afterwards, my wife and I are
likely to go out for a walk and get some
exercise. So, I like to call this
wellness stacking. And that's what I
would think of the things where, you
know, you like walking, walk with a
friend. So, you have social interaction
and the exercise effect of walking. um
those are oh so present in your life and
you know they make doing the wellness
activities much more fun.
>> I must ask are you going to have a glass
of red wine with dinner?
>> So I I do serve wine. I am a tea totler.
I it doesn't cause me any pleasure. I
I've tried to drink wine. I I taste
literally half a teaspoon uh of wine
just to I don't My wife likes wine and
you know so we always have some wine
with dinner because other people enjoy
it and find it helpful but you should
drink wine and and you know responsibly.
So my advice on wine and again I think
you're 100% uh correct. Wine is one of
those controversial things that I don't
think is fully settled and different
people are going to have different
views. We do know that it increases the
risk of about seven cancers. It's bad
for the liver uh um and also pickles
some brain cells. On the other hand, it
also facilitates social interaction.
People drink together uh a lot. So,
here's my rule. You should have, you
know, probably three or four uh glasses
of whatever you're drinking a week, not
more. Uh you shouldn't drink alone. You
shouldn't binge drink. You don't have
those three or four at one sitting. Um
and you don't drink to drown out your
sorrows. You drink in a social setting
and you drink in in moderation. And of
course, don't drive after you've had a
glass of anything. Um so that's how I
view it. And I, you know, I know that
the people who are coming are are go I I
actually know them and and they do enjoy
drinking, but I think it's not wise to
be too sensorious about it because then
the people will just turn you off.
>> And and the other thing we've learned
from our European colleagues is that
wine is had with a meal, not kind of as
a happy hour.
>> Yeah. Totally. Totally.
>> All right. Before I let you go, I want
to bring in a question from a listener
at Tammy Saffron tuned into my podcast
interview episode 145 with Marta Zarasa,
author of the book Growing Young, who
claims loneliness is worse for you than
smoking 15 cigarettes a day. And this
young lady asks, "What about people like
me? I prefer to be alone. Being around
people stresses me out. I thought being
stressed is very unhealthy. I visit my
son and grandchildren three to f four
times per year and enjoy every minute of
it. I talk to a friend occasionally and
I don't need more than that. I hike
alone. I shop alone. I eat alone and I
like it that way. I get out of my house
every day and enjoy the outdoors. Is
there really something wrong with that?
If I am happy, does it still mean I will
not live as long as someone with more
connection with people andor animals?
Well, that's a great question. What do
you think?
>> It is a great question. The first thing
I would say is I would refer her and she
should look up University of Chicago
professor named Nick Epley. Nick Epley
has done some of the great work in
assessing uh people like her who claim
to be introverts who claim to prefer to
be alone. And he's done research
including research that says takes uh
introverts and says to them, "All right,
do your regular thing on a commute, for
example, on a train or a bus." and then
assesses their happiness. And then the
next week he says your obligation as
part of this research is to talk to
someone for the commute and then
assesses their happiness. And it turns
out invariably
both extroverts and introverts
are happier prefer
talking to people and we are very
hesitant. We think of every excuse not
to initiate a conversation. Right? the
other people won't like it. They'll find
it intrusive, right? I won't learn
anything. It'll be a waste of time. Um,
they're going to shut it down because
they don't want to talk to me. All of
those things are nonsense. It turns out
people like talking. You actually learn
something. You enjoy it more if you
commute if you talk to someone. And
these kinds of studies have been done
repeated. And it doesn't matter whether
you're introverted or extroverted. So my
advice to this lady is for a week make
conversation overcome your resistance
and see if it doesn't make you happier
because you're going to find out that
you actually enjoy it more if you talk
to other people and you know make a time
of it and you will over time change your
habits. And if you don't believe me, you
can pick up Nick Epley just has a brand
new book on being more social and uh
he'll convince