You Don’t Need Money to Be Healthy (A Doctor Explains What Actually Works)

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Think the biggest mistake that people make is they feel

(00:02):
like they have to spend thousands of dollars to achieve
wellness and longevity, and the best evidence on what makes
people stay healthy for as long as possible those things
are free.

Speaker 2 (00:12):
Doctor Jordan Metzel is a sports medicine position at the
Hospital for Special Surgery, where he's treated thousands of patients
from everyday people to elite athletes, and after decades in medicine,
his biggest takeaway is surprisingly simple. The most powerful tools
for long term health are often the ones we overlook.
Where do movement and medicine intersect.

Speaker 1 (00:31):
Medicine has traditionally been about how do we fix things
when they're broken, But the truth is that medicine needs
to think a lot more about preventive health.

Speaker 2 (00:38):
You've said before that health's approximately twenty percent genetics, twenty
percent interaction with the medical system, and percent lifestyle choices.

Speaker 1 (00:46):
Percent maybe too low. We should incentivize people to get
off their butts and move every day.

Speaker 2 (00:50):
How do you increase your motivation?

Speaker 3 (00:52):
So that's all.

Speaker 2 (00:57):
Hi, guys, Kate here, thank you so much tuning in
to today's conversation with doctor Jordan Metzel. If you are
enjoying post run high. Please be sure to follow wherever
you're listening, and we will be right back after this
short break. Doctor Jordan Metzel, You've treated thousands of patients

(01:20):
and studied the power of movement as medicine. But when
you look at how most people approach their health today,
what do you think we are fundamentally misunderstanding.

Speaker 1 (01:29):
Well, I'm so lucky to first of all be here
and to see you, and I'm very lucky to be
a sports medicine doctor where I've been able to take
care of and help thousands of people meet their goals.
If it's walking a five k, running a marathon, doing
a hike with their grandkids, it's very gratifying. I think
the biggest mistake that people make is they feel like
they have to spend thousands of dollars to achieve wellness

(01:50):
and longevity. They kind of get wrapped up in the craze.
They look at all the peptides people are taking, the supplements,
all the different hacks and biohacks, and they feel like,
I'm not doing that, I'm not going to live as
long or I'm not going to live as healthy. And
the truth of the matter is that the most evidence
and the best evidence on what makes people stay healthy
and achieve healthy longevity, living healthy for as long as possible.

(02:13):
Those things are free, and those are the things that
I want people to focus on. So you don't have
to spend a lot of money. You just have to
be conscious about the things you do, the way you sleep,
what you put into your body, how much you move,
who you surround yourself with, how you internalize stress.

Speaker 3 (02:25):
Those are the things that make a difference.

Speaker 1 (02:27):
And you can start those behaviors when you're young and
hopefully carry them through your entire adult life.

Speaker 2 (02:31):
It must be so interesting for you as a sports
medicine doctor to be existing in this space at the
same time as seeing all of these things like biohacking
and X, Y and Z kind of expensive practice that
people do to improve their long term health.

Speaker 1 (02:48):
Well, I think it's an interesting place to be. And
you know, for me, I feel like the early gen
people talking about longevity. Really we're talking about the right things.
And a lot of the people who are kind of
well known started out talking about you know, those things
muscles and movement and community and prescribing exercise. The things
that I do every day in my office. I think
what's happened is is more money has kind of drifted

(03:09):
into that subject field and has more money, you know,
private equity, money, etc. Has invested into the longevity space.
We've gone from people who are thinking about, you know,
ways to give people things to help them live longer,
healthier too. How can I sell them this supplement stack,
how can I sell them this subscription? How can I
make money off of these things? And I feel like
that's really shifted the focus. I think not for the better,

(03:32):
but I think it started out very well intentioned.

Speaker 2 (03:35):
So for people that are not familiar with HSS, the
Hospital for Special Surgery and what you do as a
sports medicine doctor, can you first tell us a bit
about the hospital and then tell us a bit about
the patients that walk into your office on a day
to day basis.

Speaker 3 (03:48):
That's my pleasure.

Speaker 1 (03:48):
So I'm lucky enough to be here in New York
City at Hospital for Special Surgery, which is the country's
largest and oldest orthopedic specialty hospital. We've been around for
one hundred and fifty plus years. An incredible place. The
original name was Hospital for the Relief of the Ruptured
and Crippled, but they've undergone branding over time and now
we're Yes, I swear, and now we're very much focused

(04:09):
on getting people up and moving. We started as the
first standalone orthopedic hospital in New York, and over time
we have grown to include all aspects of orthopedic care,
sports medicine and joint replacement and physical therapy and rehabilitation
and MRIs and all the things that people's muscular scaltal
system helps.

Speaker 3 (04:27):
We help them move.

Speaker 1 (04:28):
And the nice thing is not only do we take
care of many thousands of patients in the area, we
also do train a lot of fellows that go around
the world, have a lot of research that comes out
of our institution. So we're so lucky to be part
of this big institution. And I'm so lucky to be there,
and I feel like I've really enjoyed being there for
my career. The people that come in to see me.
If you come into my office any day and you
sit in my waiting room, you will see people between

(04:49):
the ages of kind of eight and eighty five, and
the commonality of all them is they want to move.
And so my job is to figure out why are
they having trouble moving? What can I do to help
keep them moving and how can I keep them out
of my office over time and get them on their field.
And so it's very gratifying because people are aligned, and
I have great conversations that happened in my waiting room
of kind of younger athletes talking to older athletes. I

(05:10):
had an eighty three year old person did the marathon
this year, sometimes talking to like a ten year old gymnasts.
It's a really interesting perspective around what makes sports healthy
and also what makes sports unhealthy. And it's an interesting
dichotomy because I see both extremes.

Speaker 2 (05:23):
Yeah, and I know you've talked about before kind of
bridging the gap between movement and medicine, which are which
have historically been kind of treated almost as these two
separate bubbles. You can almost think of them as right,
and then you bring them together, and there are kind
of areas that fall in between both. So like what
where do where do movement and medicine intersect?

Speaker 1 (05:45):
Yeah, Well, when I explain this, I kind of think
of my career as kind of two separate circles. I
had the circle of medicine. I grew up in a
family of doctors, both parents, three brothers, everybody's doctor Metsal.

Speaker 3 (05:56):
My dad was the og doctor Metzsal. Everyone else is
just kind of a imitation.

Speaker 1 (06:00):
And I grew up on the medicine side, you know,
thinking a lot about, you know, fixing people. When I
was like five years old, I was going my dad
did the hospital, who's a pediatrician, making rounds of the
little plastic doctor bag. I mean like I was in
it from the young age I was thought I was
going to be.

Speaker 3 (06:13):
I knew that.

Speaker 1 (06:14):
On the athlete side, I grew up being very, very active,
you know, played soccer and baseball and loved being active
in Kansas City where I grew up. Eventually went to
college and med school, and I learned things about my
brain as I got older. I learned that I could
absorb knowledge a lot more easily when I was after
i'd run, for example, So I started putting exercise into
my life in a more structured way. I started doing

(06:34):
marathons in residency. And then as I started my sports
medicine practice, I had my kind of fitness life, which
was running in triathlon, and then I had my medical
life fixing people when they were broken. And over time,
what's happened is those two worlds have kind of come
right on top of you this. So there was like
one circle and the other circle, and now there's essentially
one circle. And I've learned to prescribe exercise for my patients.

(06:55):
I was lucky enough to start a fitness community to
prescribe exercise for patients, and people in my community started
a seminar with a colleague of mine at Cornell Medical
School to teach exercises medicine to med students doctors of
the future.

Speaker 3 (07:09):
So there's been so much.

Speaker 1 (07:10):
Growth in this kind of overlap, which I find to
be very important because in my view, medicine has traditionally
been about how do we fix things when they're broken,
and fitness has been how do we keep people healthy?
But the truth is that medicine needs to think a
lot more about preventive health. We don't do a good
enough job thinking about that, and we certainly don't teach
people how to do it. And I think we should
be incentivizing people, like we incentivize people to get married

(07:34):
or buy a house or have kids. You know, we
have ways to incentivize behavior in our society. We should
incentivize people that get off their butts and move every
day because it certainly is the most effective way to
think about preventive health. Exercise is one of the most
effective forms of preventive health we have. Everybody should take
this drug every single day to get out and move.

Speaker 2 (07:52):
So where my head's at right is so you know, guys,
I very familiar with the ass. Not only is my
aunt a surge in their shout out doctor Doyle. I'm
sure she's listening to this episode. She's the best.

Speaker 3 (08:01):
I agree, I love her.

Speaker 2 (08:03):
It's so funny. No, did you know going into this
by the way, that to my no clue.

Speaker 1 (08:06):
No, I didn't notice you last night when I texted you.
But she is such a baller. She's an amazing person.

Speaker 2 (08:10):
She's an amazing person. So HSS has a special place
in my family's heart and also in mind because I
when I tore my ACL when I was fourteen years old,
I went to HSS to get my first surgery and
then I ended up tearing ACL you know, a year later,
and I went to physical therapy at HSS, did the
whole thing, and you know, had of surgery a couple
of years ago on my knee, getting my medical screws
rey knee removed. That's a story for another time. But anyways,

(08:32):
but HSS has been kind of the tried and true
place that I've always gone for sports injuries. But what
I'm thinking about is when you talk about prescribing movement
as medicine, every time I've gone to HSS, I've had
a serious injury where the doctor is for sure telling
me you need to stop running, you need to stop moving.
So when does movement as medicine come into play for

(08:52):
your patients?

Speaker 1 (08:53):
Yeah, so it's a great question. So my field of
sports medicine is a lot about and my focus is
kind of non surgical, keep keeping people out of surgery
unless they need surgery, and if they've had surgery, getting
them back in, getting them going. So I have a
big focus on movement in my practice. And you know,
I never shut people down.

Speaker 3 (09:09):
If you take.

Speaker 1 (09:09):
Someone like you who's used to moving through their entire lives.
You told me you like ran an ultra marathon from
like Sleepy Hollow down to the Southern Tip in New York.
You've obviously been moving for your whole life like I have.
You take someone like us and you say, all right,
you're off movement for six months or three months, you know,
there's a real there's a real risk of those kind
of people becoming depressed. I mean, we're used to the
endorphins from moving. When that's taken away, it's like a

(09:33):
kind of a drop off a roller coaster. It really
is a sharp drop for us, even different than people
who are not used to moving as much as we are.
And so I never almost never shut somebody totally down
from exercise. In fact, I think there's if someone comes
in with the stress fracture of their foot, I'll get
them in a pool, water running or biking or strengthening.
I almost never get them out of exercise totally because

(09:54):
their brain and all of their physiology is used to
that endorphin release. When that's taken away, it's very challenging
for people, and it's not great medical advice. So people
really need to move every day. Part of my job
is to figure out what they can do and how
I can not only first of all, diagnose their injury,
then treat their injury, and then figure out how I
can prevent that injury from recurring. And there's kind of
three separate parts of that discussion.

Speaker 2 (10:15):
So you are, you know, not only an incredible sports
medicine doctor at HSS. But you have made your voice
heard outside of the walls of the hospital, which I
think is one of the most impressive things about you.
You've written books, You've written columns for The New York
Times right on workouts for people to do. You also
host group community workouts. You speak at you speak on panels,

(10:36):
you lecture students. You do so much. So I'm curious
when did you decide as a doctor to use what
you know as a practicing professional outside of the walls
of the hospital. When did you find your voice?

Speaker 3 (10:50):
Thank you so much.

Speaker 1 (10:50):
That's such a nice question, you know, I kinda again,
they come from a family of doctors, come from a
family of people that are kind of out front, not wallflowers.
Nobody in the Metal family is a wallflower, and so
I was kind of born into this. Three brothers. You
got to a qual your way to get out there
and be heard situation, which used to be somewhat frustrating,

(11:11):
but I kind of really appreciate it now. But I
would say that over time I realized that I had
a capacity to speak beyond one to one or inside
of the medical system that a lot of people didn't
have or didn't want to develop. And when you look
at it from the outside, like, oh, that doesn't look
that challenging. But at the beginning I was really terrible

(11:33):
at it.

Speaker 3 (11:34):
I was awful.

Speaker 1 (11:34):
I just would get all nervous and I didn't articulate
my thoughts very well.

Speaker 3 (11:39):
But over time and practice.

Speaker 1 (11:41):
I got better. Actually, you make me think about this, this
is funny. I remember the first in my fellowship, I
was giving a grand rounds and grand rounds is when
you give a lecture to the whole department. So I
was in orthopedics at Vanderbilt doing a grand rounds lecture,
and I remember I had slides like the old slide carousel,
and I was going to do a talk on performance
enhancing drugs. And I got off to the front and
there's a big kind of old school auditorium style seating

(12:03):
and all these doctors are looking down at me. And
I got up there and start talking, and all of
a sudden, like the room started spinning, and I.

Speaker 3 (12:11):
Was like, oh shit.

Speaker 1 (12:14):
I did a deep breath, and I was so nervous,
and that was where I started from. But from there
to now, I've just become much more comfortable. And the
nice thing is I think that my platform as a
doctor gives me credibility in a different way, in a
different kind of voice. And I think when people see
me out there, you know, talking about movement, they know

(12:36):
that I am suffering like a son of a bitch
at the mile eighteen of the New York City marath
and I'm coming over that fifty nine street bridge thinking
this sucks. Why would anybody do this? But yet I
get to the finish line every year and I'm like,
thank God, I did that. I mean, they know I'm
pushing up against it myself, and they know that, you know,
my knees hurt sometimes, and they know that.

Speaker 3 (12:54):
I think they know that.

Speaker 1 (12:55):
So I feel like I'm so lucky to be in
a position where I can kind of do my day
job and then do the things I like to do
outside of work, around inspiring people and educating them and
teaching them how to take care of their bodies and
their health. Because, you know, as we talked about at
the top, I feel like the message I want to
give is that the best medicine is movement, and that

(13:15):
when we think about health, many of the things we
really can do to affect change are free, and that
when people can start making lifestyle changes as part of
what they do. It can just enhance their health and
their enjoyment of their lives so much more.

Speaker 2 (13:27):
Right, And I think the really cool thing about what
you're doing, too, is only so many people can access
the healthcare professionals at the hospital for special surgery. Right
it's in New York City, it's not always at everybody's fingertips.
And your voice has been able to be heard globally
through your books and your lectures and all the things
that you've done, you know, outside of the hospital. So
I think that's really impactful. And then I do really

(13:47):
love the point that you made about you're an athlete yourself.
You know, you're a marathon or you're a triathlete. You're
doing all of these things that so many of the
people that come to see you and listen to you
want to be able to do, want to be told
that they can do. And you know, I think everybody's
had an experience with a doctor in the past that said,
you know, you've got to stop doing this one thing
that you love doing. And it's it's nice that you're

(14:09):
able to talk from your own perspective of Okay, we
don't have to stop doing that. We're actually going to
continue moving our bodies in X, Y and Z way.
But it's just it's comforting talking to a doctor that
I feel like as athletes you can relate too in
a different way.

Speaker 1 (14:24):
Yeah, thank you so much. No, that's been a big
emphasis of you know, combining my worlds. And you know,
I think about one of you know, the pandemic was awful,
and was awful here in New York, and so many
of my colleagues were so heroic and you know, really
helping to save so many lives, and our whole hospital
was transformed into a COVID hospital for a while. I mean,
it was terrible, and so many awful things came out

(14:45):
of that, distrusted the medical system. We can talk about
all those things, but I think one of the good
things that came out of that was people being comfortable
with virtual fitness and virtual fitness offerings, and I think
it opened up you know, virtual nutrition consultations and fitness
activations and fitness class asses and ways to get people engaged,
you know, virtual tracking and knowing how much people are moving,

(15:05):
and so many things that we can now do to
access and affect people's behavior, and the old d is
like how much did you move last week? And it
was a kind of self reported and very poor data.
Now I can see how many steps somebody took, or
how much exercise they're doing, how much intense exercise they're
doing on a big fan. I'm actually just working on
a column for the Washington Post on the importance of
exercise intensity, and it's called Yes, your grandmother can do burpies,

(15:27):
and she should all about people being needing exercise intensity
at any phase of their life, especially as they get older,
and so thinking about intensity, thinking about tracking people's movement
is a real interesting change that's happened over time.

Speaker 2 (15:40):
Yeah, if we were to think about movement as a pill,
like what is the dosage? How much are should we
be moving our bodies?

Speaker 3 (15:47):
Yeah?

Speaker 1 (15:47):
Well, I like to say about exercise that if you
took a drug that worked for every single person around
the world, young or old, Richard Port anywhere around the world,
was one hundred percent effective, it had zero side effects,
and it was free, you'd be like, dude, why are
we not prescribing this medicine to every single person that
walks in the door. And the answer is, we have
that drug, which is obviously movement and muscle and getting

(16:08):
people out going every day. And I've made it a
huge emphasis of my life to get people to take
that drug and to keep taking that drug over time.
And so I think it's so important to think about
the medicine of exercise because I have a really interesting
slide I put up when I do a lecture, and.

Speaker 3 (16:24):
On the it's a woman.

Speaker 1 (16:26):
In her seventies doing a single egg squat, and on
her left side of her is all the systems, the
body systems affected by exercise, so brain, cognition, memory, sleep,
cardiac heart attack risk, blood pressure, metabolism, how quickly she's
able to digest and metabolize things like sugar, muscle, body composition,

(16:47):
so many different things that affect how people age. And
the changes that we see on the other side of
her when she's squatting, we see all the cellular changes
of exercise, the ways that we are now learning about
how teal and shortened if you don't exercise, How cellular
attrition changes if you don't exercise, How inter lukens and
myokinds are produced by muscles secreted and affect multiple body

(17:09):
systems at the same time. So what we've seen on
a body system way where now understanding on a cellular basis,
you're hearing about mitochondria a lot more in mitochondria the
magic and it's true that we need as many mitochondria
you need to keep our mitochondria. Now, there's been some
crookedness around this whole thing. And that's the whole kind
of thing I was talking about before about kind of
big money coming into taking this thing to make sure

(17:30):
my mitochondria live as long as possible, and I get
more mitochondria.

Speaker 3 (17:34):
You know.

Speaker 1 (17:34):
The truth is, get off your button, move every day,
put intensity into your life a few times a week,
lift some weights a few times a week, and that's
the best recipe for having a healthy life. It does
not mean you'll live longer. It means you will live
healthier as long as possible.

Speaker 2 (17:48):
I think some people when they here get some intensity
into your life though, might get overwhelmed. Right, So, I mean,
obviously we're runners, We're people that have done marathons. You
do try, you've done it all as well. We like
staying hyperactive. There are people out there that don't want
to go for a long run, They don't want to
go to a strength training class. So how do we
get those people moving and what is the bare minimum

(18:08):
that they have to do to check the box?

Speaker 3 (18:10):
Thank you so much. A great question.

Speaker 1 (18:12):
So, first of all, the bare minimum is a half
hour movement a day is the bare minimum. But there's
an interesting study that I'm writing about in this column
looking at the role of intense periods of movement throughout
the day. So this is not exercise. This is just movement,
getting your heart rate up of movements. So it doesn't
you have to go to run, doesn't mean you have.

Speaker 3 (18:29):
To go to a class.

Speaker 1 (18:30):
It means you have to get your heart rate up
and pounding and things like taking the stairs or doing
squats at a red light, or getting up every hour
from work and doing squats, things that get your heart
rate up throughout the day. Our card variable intensity lifetime
physical activity or VLPA, and it's now there's a big
study looking at the effect of VLPA on health outcomes,

(18:51):
and two minutes of VLPA a day can affect your
actual longevity, your healthy longevity, your cancer risks. There's a
whole host of issues related to just two minutes of
exercise a day. So the concept is, just give me
two minutes a day of breathing heavy. And you may think, well, listen,
if I'm like a sixty four year old grandma, that's
different than if I'm an eighteen year old freshman in

(19:11):
college who's playing soccer. And the answer is, intensity is relative.
So what I'm after is you huffing and puffing, if
that's you walking up the stairs, if it's you doing
gym squats. It's different for everybody. But I'm interested in
you getting that heart rate up for a couple minutes
a day. And if you're not exercising quote unquote formal exercising,
high intensity training, et cetera, getting that VILPA in your
life every day really helps.

Speaker 2 (19:41):
So you've said before that health's approximately twenty percent genetics,
twenty percent interaction with the medical system, and sixty percent
lifestyle choices. So the sixty percent does feel like a
lot of it is in our control.

Speaker 1 (19:54):
Yeah, And there's been a lot of studies now looking
at is sixty percent too low? Meaning that there's been
There was an study that was published looking at what
are called the welderly, and these are people living over
eighty who have no chronic disease. The average person over
eighty has two more chronic diseases, and they were looking
at basically people between the ages of eighty one hundred
who had no chronic disease compared to age match controls.

(20:16):
And they did blood sampling of these people looking for
genomic testing of the well versus the non well or
the people with chronic disease. And the thought was, are
these people must be genetically superior, because it must be
something about their genome which is different because they're living
so long, so healthily, and in fact they were exactly
the same, and so sixty percent maybe too low. But
the take on point here is that when you think

(20:38):
about health lifestyle behaviors, start young. I'm big into youth
sports and talking about the importance of youth sports. The
reason I do that is that I want active kids
to become active young adults, to become active older adults,
to become active parents, to become active grandparents, to basically
be active for their entire lives. We know that that
is linked to a whole host host of favorable health metrics.

(20:59):
They have better psychological attitudes, they have better work experiences,
So movement is the magic elixer and getting people kind
of starting that that pattern when they're young, is really
important for people.

Speaker 2 (21:11):
So I almost got kind of lucky where I and
every we talked about this before. I've torn my ACL twice.
So actually tearing my ACL kicked me out of being
able to play competitive sports that involved lateral movement. And
so that's when I really leaned full force into running,
which at the time, I was devastated, right I had
to walk away from a sport that I loved, which
I was potentially going to college for lacrosse. Got so Northeast.

(21:33):
My brothers played lacross at Yale, Like we have a
lacrosse family, gotcha. I got to get them on the
show at some point because they'd be funny to talk
about point with. But I was almost so grateful that
I got the opportunity to kind of step away from
competitive sports and lean into almost individual individual sports, going
to the gym, going for runs, you know, joining my
cross country team and track team to stay active within

(21:54):
a community, but really doing individualized sports and keeping myself
self motivated because I felt like when a lot of
my friends left group sports and team sports and then
kind of like went into the workforce and didn't have
that structure of a team sport forcing them to work
out that they had trouble moving on their own. And
I'm curious as a sports medicine doctor, if you see that,

(22:17):
and then if you have any tips to kind of
combat that.

Speaker 3 (22:19):
Yeah, definitely.

Speaker 1 (22:20):
So I think when you're younger, it's very easy to
kind of be motivated and have motivation as part of
what you do. My newest book, which just came out,
called Push, is about the science of motivation. And I
wrote this book because and this is actually book number five,
and for this one, it was the most challenging to write.
Took about five years, and so I started interviewing patients
in my practice who were motivated across their entire licenanse.

(22:41):
I interviewed a guy who's ninety two that walks in
Central Park every day.

Speaker 3 (22:44):
He's a superager.

Speaker 1 (22:45):
Are no medicines, he this waits a couple times a week.
He's fully independent, Like we all want to be that guy.
And so what is it about those kind of people?
And I thought at the beginning that some people were
motivated and some people were unmotivated. I don't believe that's
true anymore. I think the people who are consider distantly
motivated have learned to what's called lower their cost to act,
meaning they've made the change they want to have the
behavior they want to have part of their life. When

(23:07):
we're younger, that's not an issue. I'm part of a
lacrosse team, I go to practice, I come home like,
that's my cost to act is so low because it's
built into my life. As we get older, as we
get a job, and as we start in the workforce.
You know, these days more people are going to do
workout classes as part of the socialization. It hasn't been
that way forever, but in general, as you get older,

(23:27):
those opportunities diminish, you know, by decade. And so what
I've really emphasized in the book is to teach people
how to analyze their own motivational health. It's different than
looking at an ACL an ACL you put up your MRI,
here's your torn ACL, your motivation, How motivated are you?

Speaker 3 (23:42):
How do you know?

Speaker 1 (23:44):
How do you evaluate it? Not a lot of good
metrics for that. So I really went through trying to
figure out actually made up a scale in the book
where people can add up and get a sense of
their own motivational score and then three months from now,
compare themselves to themselves to see where they.

Speaker 2 (23:57):
Are, and how do you increase your motivation.

Speaker 1 (23:59):
So that's bout blowing your cost act. It's not about
like you're motivated anyway. The question is how do you
make motivation something that is part of your life. So
you buy new exercise clothes, you prepay a trainer, you
join a gym across the street or in you're building,
You join a group, you join a community, you sign
up for an event, You do things that basically make
the behavior you want to have. Basically, the path of

(24:19):
least resistance is just to do that, and everybody has
a different trigger. That's one of the things I came
to the conclusion of that some people just do it
like us, like it's in our hard wiring, we can't
not do it. But there's not a lot of people
like us. There's a lot more people that struggle to
do it, and so really figuring out how to lower
the cost act. And that's why I was talking about you.
Even companies incentivizing like it. U see people will give

(24:42):
a discount to join the gym, but that hasn't made
a huge dent in many companies because people just go
to the gym or they don't go, they just get
the discount. But now we can say, like if you
do x amount of steps, like those motivational step challenges
help a lot in companies, those kind of things where
we can kind of track the metrics. So people are
doing to really influence the behavior we want to see
that that's the key there.

Speaker 2 (25:02):
Yeah, that's where some of the wearable tech I think
has been really good for people too, especially people that
work like office jobs and are sitting all day, because yeah,
it's important to get your steps in, and it's nice
when people have the Apple Watch on and they can
see kind of their rings of health be completed and
they get almost competitive with themselves.

Speaker 3 (25:16):
One hundred percent.

Speaker 2 (25:17):
Okay, so you prefer the term health longevity over longevity.

Speaker 1 (25:21):
What's the difference, So healthy longevity and so let me
explain it different. So longevity, there's a few terms are
here floating around.

Speaker 3 (25:27):
I'll go through them.

Speaker 2 (25:28):
For day.

Speaker 1 (25:28):
Longevity is just how long we live for healthy health
span or healthy longevity is how long we live healthily for.
So everyone is talking about increasing your longevity, longevity, longevity,
and the truth of the matter is we've made great
strides in longevity already. If you were alive in the
late eighteen hundreds, your life expectancy was about forty years old.

(25:49):
If you're alive today, it's about double that, almost eighty.

Speaker 3 (25:53):
And so what made a difference.

Speaker 1 (25:55):
Vaccines and antibiotics and you know, sanitation and all these
things made a huge difference in basically doubling our lifespan.
So now we're our lifespan about eighty eighty one years old.
But the problem is that people are living longer. We
want them to live healthier as long as possible. That's
called health span or healthy longevity. And I want people

(26:15):
to maximize.

Speaker 3 (26:17):
Their healthy longevity.

Speaker 1 (26:18):
And the good news is that I wouldn't want people
focusing so much on longevity. I really want them focusing
on maximizing their health and the things that make a difference.
We know that if you maintain your skeletal muscle mass
above the age of sixty particularly, you can really influence
your healthy longevity.

Speaker 3 (26:34):
So on people starting.

Speaker 1 (26:35):
If they're listening in their twenties and their thirties and
their forties, they should be hitting the gym with strength
training or on their own. I'm a big fan of strengthening,
have done a whole series of plyometric videos where people
can do plyometrics, which I love. A good plometric, a
rapid elongation contraction like well, jump off the ground, jump squats, burpies,
jump lunges. They make you closer to God. They're fantastic,
and those things really help you. They build cardiopulmonary fitness,

(26:57):
but they also build and maintain muscle, and that muscle
is important not only for function, but it also helps
secrete myokinds, which affect your entire health profile. We're learning
more about the anti inflammatory effects of myokins. You may
have heard the thing this statement like running all destroy
your knees, it causes arthritis. There's no evidence that's true.
In fact, runners have a lesson incidence of arthritis compared

(27:18):
to age match controls. So getting out there and moving
and building muscle and moving every day is really the
best way to start thinking about affecting your healthy longevity.
And finally, let's a long sentence, sorry. The last point
I throw on here is muscle span, how long you
keep your muscles across your life, And we're looking more
about that is a concept of keeping your muscles through
your life.

Speaker 2 (27:36):
Because at what point does muscle loss kick in for
people like, at what age do we have to start
thinking about our muscle loss starting to decline.

Speaker 1 (27:46):
I'm sorry to give you the bad news, but like
twenty eight to thirty, is it.

Speaker 3 (27:52):
Start losing now?

Speaker 1 (27:52):
The issue is you start losing twenty eight to thirty,
but it becomes a logarithmic equation, so you start to down, down, down, down,
and then by the time you're sixty, you lose ten
percent of muscle per decade. And there's a threshold of
kind of you. I was talking about that guy in
his nineties. His secret to success is he's a dedicated
strength trainer and in the back of push I give

(28:12):
people exercises that they can do just with bodyweight. I'm
a big believer in bodyweight. My classes are all body
weight strengthening. I do that because I want people to
have actionable things they can do wherever they are. And
that's what we know about strengthening is it doesn't have
to be fancy, just has to be consistent.

Speaker 2 (28:28):
Yeah, and I have actually found too that the most
efficient workout are the simplest. They're body weights. They are
I mean going for a run, being able to do
a circuit outside. It's just things that you can yeah
do wherever you are and not over complicate. I think
sometimes with fitness people over complicate.

Speaker 3 (28:45):
It one hundred percent.

Speaker 1 (28:46):
And you know, the other piece I found in my
classes in that you know one of the pillars of
healthy longevity is community, and that you know not only
do you need it for social interaction, and you know
it's become problematic because in today's world, we can you know,
we can work from home, we can order food from home,
we can socialize from home. You never have to leave
your couch if you don't want to. But the body

(29:06):
has an imperative need to move. And so with every
technologic advance, from the wheel to the bicycle, to the car,
to the airplane, to the computer to the smartphone, we
move a little bit less because life gets a little
bit easier, But our body has the same need to
move as much as it possibly can, and that's not
great for our health. And so thinking about the ways
to make sure you put movement into your life and

(29:27):
keep it there is just so essential for healthy longevity.

Speaker 2 (29:31):
So we kind of referenced it before, but you talked
about the term longevity and how it is buzzing right
now within the health world. So are we over selling longevity.
And then do you think that we're chasing kind of
optimization before just understanding the basics.

Speaker 1 (29:51):
Dude, you are throwing me a softball right down the
middle of the play here. And as you know, I
wrote an op ed an article for The Atlantic, which
I love The Atlantic, called We're over selling longevity.

Speaker 2 (30:01):
By the way, we had Nicholas Thompson in the CEO
of the.

Speaker 1 (30:03):
Best Dude you see the best Guys. I love that guy.
He's a great dude. And so, by the way, if
you want to get shit done, talk to.

Speaker 3 (30:12):
A runner man.

Speaker 2 (30:13):
Have you guys ran together?

Speaker 1 (30:14):
No, he's way too fast, but he's a great guy.
But you know, so, the concept of over selling longevity
is that, you know, since the time of the ancient Egyptians,
we've been fascinated with the quote unquote longevity. The afterlife
Constilon went out in fifteen thirteen looking for the fountain
of youth. There's been all, you know, in our human history,
we've been obsessed with living longer. Now, as I mentioned,

(30:37):
we've done a great job in the last one hundred
and fifty years of actually making that the case.

Speaker 3 (30:41):
But we've been obsessed with that forever.

Speaker 1 (30:44):
But the idea of like selling longevity, if you do
this red light therapy, if you do these peptides, if
you do this supplement stack, you'll live longer.

Speaker 3 (30:52):
There's just no evidence that's true.

Speaker 1 (30:53):
And I really come down hard on these full body
of our eye screens, or the full body of our
eye scans, where people go in every year for a
full body MRI. Talk about in the article a guy
that I saw in his kind of late forties and
his wife worked was a lawyer for one of the
companies that does these full body MRI scans, and they say, Hey,
you want to go in and get one of these scans.

Speaker 3 (31:13):
They say, sure, I'll go. Now.

Speaker 1 (31:14):
The idea of these things is they say that they're
going to find disease before it happens, and so they're
going to pick up your cancer before it happens. They're
going to pick up your problem.

Speaker 2 (31:22):
Now.

Speaker 1 (31:22):
If I get an MRI, anybody's knee over the age
of forty, they all have a meniscus tear or a
cartilage something. Many over fifty have a rotator cuff, partial
tear hernia, a disk in their back. MRI so sensitive
that it shows things that are part of the normal
aging process, but it just shows up on a picture.
We call these things incindent to lomas or basically findings
on MRIs, and it particularly relates to this concept of

(31:45):
full body MRI screening because they talk about we're going
to find your cancer before it happens, and then they
will tout like, all right, here's one person with pancreatic cancer.
We found his disease before it killed him, and so
you should all do this thing, and it scares people.
But the truth is, we have no evidence that these
things extend longevity at all. We have no evidence these
things do anything. For the vast majority of patients, they

(32:06):
find about it something they've had, they've had, they got
all anxious about it. It's been something that's totally asymptomatic
and not a problem, and then they spend thousands of
dollars getting follow up tests and follow up biopsies for
something they didn't really need to do in the first place.
And so this whole idea of over selling longevity is
that we're focusing on the things that people want to
spend a lot of money on instead of the things

(32:27):
that are free. And that was my point, was that
they were over selling the myth of longevity because people
have a deep seated desire to live as long as possible,
which is great. But what I have I'm here to
tell you is the thing that will get you living
as long as possible is consistency. And the key to
consistency is movement of consistency and about pushing yourself and
learning how to really harness and enhance your own motivation.

Speaker 2 (32:48):
So what are the gurus getting wrong about longevity?

Speaker 1 (32:51):
Well, I think we owe a huge debt of gratitude
to many of the quote unquote big names in longevity.
I think they've done a huge service for us as
a populace. I think they've forwarded this message. I think
they've done a great job of getting out and bringing
these issues to the forefront. I think sometimes there's a
little bit of over exuberance, like you don't have to
eat eight thousand pounds of red meat. You don't have to,

(33:11):
you know, flip the pyramids so much. It's great to
not to eat junk food. It's a great idea to
not eat processed food. It doesn't mean you have to
load tons of red meat in your life to be healthy.
But in general, I think we've done a great job
of They've done a great job of helping to forward
the message.

Speaker 3 (33:27):
But I think what's happened over.

Speaker 1 (33:28):
Time is that there's a perception that longevity and healthy
longevity is only for rich people. In longevity is not
only for rich people. Healthy longevity is about consistency of
thoughtful health over your lifetime, and that when you look
at the blue zones, the areas where people live routinely
ninety plus years of age, you know, these are not

(33:51):
rich areas. These are areas where people, you know, really
have these pillars of healthy activity as part of what
they do. And that's the thing I would really like
to emphasize that I was just actually down in Columbia,
South America. Spectacular place by the way, biking. What an
awesome trip. Everybody go to Columbia at some point, really cool.
And I was looking at the people's faces like in

(34:12):
small villages doing you know, you know, any kind of
tasks and activities, and what really struck me is they
looked so much happier than ninety percent of people on
Park Avenue. Like the things that make people healthy and
happy are just the things that we need, which is
you know, communicating being part of a community and daily movement,

(34:32):
and certainly doesn't hurt to be in a place where
it's sunny and nice and warm all the time. But
in general, those are the things that make a big
difference for us.

Speaker 2 (34:38):
By the way, quick digression, I was so impressed by you.
So I was. We were texting yesterday about our interview
today and to get a text BacT form you saying
I'm about to go for my last bike ride. I'm
currently in Columbia, South America, and then getting on a
plane and I'll be there at nine am though tomorrow morning.
And I was like, this guy does it all?

Speaker 3 (34:56):
Thank you?

Speaker 2 (34:57):
No?

Speaker 3 (34:57):
And I ran here too.

Speaker 2 (35:00):
How far was the run?

Speaker 3 (35:01):
Four miles?

Speaker 2 (35:02):
Wow? Good for you. How many miles do you run
every day?

Speaker 1 (35:05):
I try and get at least three four miles in
a day, just every day, just to kind of get
my everything working. My body is so used to moving
every day that I generally start up my day with
a small, you know, a small kind of wake up.
It's my coffee in the morning.

Speaker 2 (35:17):
Do you feel like a lot of the doctors at
HSS to keep themselves in really good shape.

Speaker 1 (35:21):
I think we probably have the fittest hospital in the
United States. I would say in general, there's no no chance.
Not I mean orthopedics in general is I feel where
people are generally active and I so when I, you know,
look around, you know you'd want to try and keep
up with the with the jones Is, because the Joneses
are jacked and they have huge muscles, and it's a
pretty fit place. But the nice thing is is that,

(35:44):
you know, when a family donated money and we opened
up one of the first wellness centers in a hospital
for the healthcare professional. So we have a center now
where basically doctors and nurses and custodial staff and security
and radiology texts and everybody he comes together and we
have community fitness classes and I get to teach a
couple of those a month, and so in any class

(36:05):
it can be a couple doctors and a couple people
from the cafeteria and a couple of security people, and
it's you know, fitness is the great democratization of life.
Like people are in there, it doesn't matter what the.

Speaker 3 (36:16):
Hell they do.

Speaker 1 (36:17):
If they're like doing you know, wall balls, if they're
doing burpie broad jumps, if they're doing man makers, which
I've read named person makers, if they're doing that stuff
and the music's blaring. It doesn't matter what the hell
you do. You've got to be out there and you're
cheering for your partner and you're getting going. That's why
I love fitness. It really brings everybody to the same place,
and you can all help each other when you do it.

Speaker 3 (36:35):
So that's why I really love it.

Speaker 2 (36:36):
I completely agree, and that's why I love the running
interview show that we do. It's we've interviewed everybody from
famous celebrities to professional athletes, doctors like yourself, experts, people
have that have just reached the pinnacles of their careers.
And the most common question I get asked by people
is do you get nervous when you're interviewing them? And
I'm like, not really, because we're on a run together.
It's it's so human, it's so open, it's so vulnerable.

(36:59):
It's kind of like doing the high school mile.

Speaker 3 (37:01):
I think it's awesome.

Speaker 2 (37:11):
Okay, running, we've referenced a lot. You and I are
both runners, and I have a big sect of people
that listen to this show that are runners. So let's
do a little section just kind of talking about running.
The questions that we want answered. So, first of all,
what are the most common running injuries that you see?

Speaker 3 (37:30):
Gotcha?

Speaker 1 (37:31):
Well, I've been taking care of runners now for as
long as I've been twenty five years plus, and I
love running. I want all my patients to run. Anybody
can do any activity. Anybody can do a marathon, anybody
can do whatever. It's really all about preparing your body,
preparing your mind. That being said, runners do get hurt,
and so the common things we see, you know, foot problems,

(37:51):
shin problems, knee problems, some hip problems. Generally, running injuries
happen from the waist down for most people. And you
know these include everything from what we call all repetitive
use injuries, meaning I get my shin hurts a bit
and the more I run, the worst it gets a
shin splint, which can be one type of injury to
I twisted my ankle on a route running in a
trail and I sprained my ankle, or I broke my

(38:12):
fifth minute tarsl and a cute traumatic injury and running
about eighty percent of the injuries are repetitive use, at
least in about twenty percent or acute traumatic different than
like a sport like soccer where it's almost flipped there
at least fifty to fifty where we see a lot
of acute traumatic I'm running, I pull a muscle on
my leg, or I tear my ACL that's in acute
traumatic injury. Running has many more repetitive use injuries. And
so the advice I tell every single runner of any

(38:35):
age is, if pain is changing your mechanic of movement,
get it checked out. I mean, if you're running differently
because your knee hurts or your shin hurts, figure out
what it is and what you can do to diagnose
it and then prevent it from happening.

Speaker 2 (38:48):
So that's when you know when to pull back versus
one to push.

Speaker 1 (38:51):
Definitely, because if running doesn't hurt a little bit, you're
not doing it right. Right, It's got to hurt it.
The beauty is it's a little bit uncomfortable. But the
problem is that if that pain changes into an altered mechanic,
then it's a problem.

Speaker 2 (39:02):
I know. My dad used to always say, if it
doesn't hurt, you're not going fast enough.

Speaker 1 (39:05):
Dude, He's right, one thousand percent. I love that's the
whole idea of push. I mean, that's the idea I
wrote a book about intensity because I want people to
become comfortable being uncomfortable. That's why running is a great concept,
because it makes you comfortable being uncomfortable.

Speaker 2 (39:17):
Absolutely. What percentage of injuries do you treat that are preventable?

Speaker 1 (39:22):
I'd say in the running space, at leasts probably seventy
seventy five percent of running injuries are preventable, maybe more.
And it's often people not being good body listeners or
violating the rule of two's kind of too much, too fast,
too soon. They're not you know, they're saying, I want
to do X amount of thing, and I want to
ramp up very quickly. You know, the body takes time
to build to a level where it can do what

(39:42):
it wants to do. So the body takes time to
build up to running distance or speed. And if you
just jump right out and try and do it quickly,
your bones, your muscles, your tendons, they're not used to
that amount of load and they break down.

Speaker 2 (39:54):
That's a really interesting point that you bring up because
I talk to a lot of people. I have a
twin brother. He was a lacrosse player and call as
I said, I think it takes a little bit of
time post playing a team sport to get into individual
practice and working out, and it took him in a
little bit of time to find running. But he recently
has gotten very into running and within a few months
he ramped up his mileage. He went from you know,

(40:15):
running two miles and feeling great so three to all
of a sudden doing eight ten mile runs and loving it,
but then realizing, oh, my foot hurts. So I'm curious,
how quickly can you scale up your mileage safely?

Speaker 3 (40:27):
So we actually did a study at that.

Speaker 1 (40:28):
I have a number of great colleagues at HSS and
we've done we have a collaboration with New York road
Owners Club here and we do if you join those events,
you'll get a questionnaire from us about some of the
different health habits you have, including we did a study
looking at the New York City Marathon why people got
hurt running and the idea was that we wanted to
track them and it was a wonderful researcher named Brett

(40:51):
Torzol spearheaded this and he's a doctor now at the
University of Utah and did a collaboration between Strava and
the New York Runners Club and we looked at people's
data in the four months leading up to the New
York City Marathon to try and figure out who got hurt.
And what we thought was if you were kind of older,
or overweight, or inexperience, you'd have a much more likely

(41:12):
chance to get hurt. But none of those things made
a difference. The biggest difference maker was basically ramping up
your mileage too quickly, and that for many people that
ten percent rule was too much. That the idea of
ten percent per week was too much of a rapid increase.
So the key is a slow, steady base build over time.
It takes months and years to build up your body
to do consistent events. I often see people, especially post Code,

(41:34):
we saw a huge boom and running, which has been great.
But the promise you like, I love doing a marathon,
I want to do two and a fall or three
if people to do like Chicago and New York and Berlin,
and they all get hurt because basically, it takes a
long time to build up your body to being able
to do an event. I do like one marathon a
year at this point, maybe two if, but it takes

(41:55):
a lot out of you, and so you've got to
build up your body to that amount of volume, and
so doing kind of violating the rule two is too
much too fast is one of the common reasons I
see people get hurt.

Speaker 2 (42:04):
What about too much, too fast? Too much overall? Like,
do you think there are people that are doing too
much running getting in too much mileage?

Speaker 1 (42:10):
I think it's a very personal thing. I think that
if you're not breaking down and you're loving it and
you're having a good time, I think that it's fine
for you. There really isn't such a thing as too
much for some people. But some people that are getting
hurt all the time, people that you have different kinds
of issues. We want to try and figure out what's
the problem. Is your bone density low? Is your running
mechanics screwed up? Is your training program not right? Are

(42:32):
you in the wrong shoes? Are you you know?

Speaker 3 (42:35):
What are the factors?

Speaker 1 (42:35):
And so we have like a lab at HSS where
you can put people in a running lab and figure
out what are you doing right?

Speaker 3 (42:41):
What are you doing wrong? What change?

Speaker 2 (42:42):
Oh yeah, oh my god, I have to come to
the running lab.

Speaker 3 (42:45):
Done, you're on.

Speaker 2 (42:45):
That's what we should do for our short form running interview,
is we should go to the running lab. Done sold, Okay,
that'd be funny. Me pregnant too, Yeah, we'll make it happen. Okay,
my pleasure. Yeah, think it'd be great.

Speaker 1 (42:55):
And I think that'll be great to kind of think
about mechanics of what your mechanics are, your strength, your mobility,
all these things.

Speaker 2 (43:01):
Okay, So two questions coming out of that. A. How
important are the shoes that we're running in?

Speaker 1 (43:06):
So the shoes are one of the most important decisions
you'll make in your life, like a your partner, maybe
you know your spouse, and your running shoes like those
are the things, hugely important thing. And we've seen a
lot of different trends kind of the you know, the
over cushioned shoes, the minimalist shoes, the flat shoes. And
the answer is that everybody's a little different and everybody's

(43:27):
mechanics are different. So you want to make sure you're
kind of matching your shoe type to how you run,
how you're built, and what you do. You know, I
would as an overall point, I would say that that
most people do the best when they're not having a problem.
That there's a lot of marketing and I want this
trendy shoe. I want that trendy shoe, and that tends

(43:47):
not to be a great solution for most people. What
you're looking at is how do I basically pick this
shoe that is keeping me out of problems? And you know,
we've seen some of these kind of extra speed shoes,
the carbon plated shoes, the propulsion shoes, and you know
it's been great for some people, but but you know,
it puts people's bodies in a place where it's more

(44:07):
load than your body may be used to seeing. And
there's some question on if that may raise your risk
of injury. We're not sure yet, But in general, I
think the key here is that picking the right shoe
based on how you feel and what you're doing is
the key.

Speaker 2 (44:19):
What do you think about barefoot running?

Speaker 1 (44:21):
So I think the concept of barefoot running. I was
very busy when Born to Run came out because basically
there are a lot of people thinking I'm gonna go
run barefoot in Central Park and they all got metatarsal
stress fractures and so, uh, listen, yeah, it's not great,
but but I think in general, the concept and and
what I what I came to believe is it for
many people. Shortening your run mechanic, your run stride puts

(44:45):
less load on your knees, your hips, your back, et cetera.
And some of the elite level runners have a much
shorter stride length than you may think they do. And
so the benefit of barefoot running or minimalist running is
it naturally shortens your stride. And so what I try
and get people to think about is basically adapting and
adopting a barefoot mechanic in a normal type shoe. Most

(45:06):
people can't do the barefoot or minimalist shoe. Some people can,
but it's kind of the few and far between.

Speaker 2 (45:11):
I liked how you said before that you want all
of your patients to run. Do you think that there
are people, though, who should not be running.

Speaker 1 (45:17):
I mean, if they don't want to run, they don't
have to run. If they want run, you know, generally speaking,
most people can run. Now the question is how they run,
how much they run, what kind of running they do.
But if people want to run, I mean, on my
run on the way over here, I saw people of
all ages, shapes, and sizes in Central Park.

Speaker 3 (45:33):
We're lucky in New York.

Speaker 1 (45:34):
We have one of the great running labs of all
time in Central Park and that you know, there's so
much we can learn about people's running, but the beauty
is just getting getting out there and going. I mean,
the thing I love about running is it is accessible
to everybody and that anybody can get out there and
do it and if you want to see you know.
It's actually one of my big knocks on this kind

(45:56):
of longevity influencer culture we have is that a lot
of these people, you know, these influencer folks, they got
great muscles. They look jacked and they're you know, loading
up on all their stuff and they're flexing, but they
don't look happy like a lot of these people look
like they need a good mac and cheese and they
don't look happy like. If you want to see happy,
go to the finish line of an event in Central

(46:16):
Park in near Broader Risk Club. Those people are happy,
like that is what we're after. It's kind of the
joy of movement, and that's I love running for that
because you see all ages and it's such a great
activity for people to do.

Speaker 2 (46:27):
Central Park is one of my favorite places on Earth
because of seeing all the people running. If you go
to Central Park on a beautiful day, early in the
morning and you just watch people run. It really is.
It shows you the power of movement in such a
major way. But you know, one of the things that
I think about too is when you're running in Central Park,
you see a lot of different types of running right

(46:48):
form wise mechanics of the person's body. So I'm curious
when you think about form, is form something you try
to change in somebody or do you kind of lean
in how to how the body naturally has somebody run?

Speaker 1 (47:02):
So there are many different ways to run, and there's
no proper way to run. We can give some suggestions
on different ways to run, but in general, there's not
a one size fits all. If you're not breaking down,
you're not having problems, don't change anything. There are plenty
of different ways to do it. But we do know
is as we get older, we lose muscle, and as

(47:22):
we lose muscle, you know, that becomes more challenging to
do things like running. So I'm a big believer in
strength training and I'm a big believer in strength training
for runners, and I've done a lot of work in
that space because I want runners to learn about the
value of strength training. It just makes the whole experience
a lot more enjoyable.

Speaker 2 (47:47):
So the biggest thing that I've had to be cautious
of recently is, as I said, I'm seven months pregnant
and I obviously do a running interview show. I run
for my job, and I also run for life. I'm
just a runner. And when I got my last surgery,
one of it up my doctor ATHS has told me,
you know, the biggest thing for you for your knee
long term health is going to be keeping as much

(48:07):
weight off of your knee as possible. Anyways, that's kind
of hyper specific to me, but in general, what is
the protocol with running when pregnant?

Speaker 3 (48:16):
Yeah, so great questions.

Speaker 1 (48:17):
And so you know, first of all, in terms of
exercise and pregnancy and congratulations, I think you're a great
role model to get out and keep moving.

Speaker 3 (48:24):
We've come a full stop.

Speaker 1 (48:26):
We had a big shift on the idea of exercise
and pregnancy and that you know, the guidelines now are
we want you to get a minimum of one hundred
and fifty minutes thirty minutes of exercise a day when
you're pregnant. If you're used to running, keep running. If
you're used to swimming, keep swimming. It may not be
a time to start, you know, picking up a running career,
because it can be a little more challenging. But if
you're already doing it and you're comfortable doing it, you

(48:47):
may not be able to go as fast or as far.
It may not feel as comfortable, it certainly won't overtime.
But doing it consistently is the message that I want
people to really take home.

Speaker 3 (48:56):
In terms of.

Speaker 1 (48:57):
Weight, that becomes a tricky issue, especially in the era
GLP one and people wanted to be thin and being
able to be thin, you know. As a side note,
the GLP one movement has really changed my messaging on
the importance of maintaining muscle because you lose so much
muscle selectively that it becomes tough to do things like
things like running can hurt more even if you're a
little more thin, because people are losing a lot of musk,

(49:19):
so you really have to double down on that muscle strengthening.
But it is true that if you have more body mass,
you're putting more loading force across your joints, but it
is not true that that means you can't run. I
have people of all shapes and sizes that I encourage
to run, But it may mean that they run differently,
We shorten their running strat, it may mean we change
the surface a little bit. It may mean that we
change the events they do. But telling people who are

(49:42):
built a certain way, or are kind of dealing with
weight issues or pregnant or whatever that they can't run
is really not great at medical advice. And so what
we need, what my feel like, my job is how
do I get you to be able to do the
thing you want to do consistently and as painfree as possible.
Because what we do know, and what I know about
motivation is that the holy grail of fitness is compliance,

(50:04):
and the holy grail of compliance is fun. People will
do it if they're smiling. And if you go out
and look at an event, people are smiling. Look at
a high Rocks event, people are smiling. Smiling is consistency.
And so that's what I want people to do, is
a smile.

Speaker 2 (50:17):
High Rocks has been a great compliment for runners because
runners seem to love high Rocks, and high Rocks is
great cross trading for running.

Speaker 1 (50:24):
Couldn't agree more. I do a collaboration with them. In fact,
you can come this summer we take over the whole
Intrepid for one thousand people. We do three of these
thousand person fitness classes a summer up on the Intrepid,
and it's a great community and it's all about, you know,
the things I believe in, which is muscle strengthening and
community and fun.

Speaker 2 (50:41):
You know, if somebody wants to be running in their sixties,
seventies and eighties, what do they need to prioritize now?
And is there a universal principle of longevity that applies.

Speaker 1 (50:51):
So I think that people can run and run consistently
at any age. Runners tend to be healthier, they tend
to live longer than age match controls, They tend to
have health let health problems. They do have a slightly
higher risk if they've lifelong runners of atrial fibrillation, meaning
their heart can get a little stiffer, their muscles can
get a little bigger in their heart, and that does
predispose them to a risk of an arrhythmia. So it's

(51:12):
important to check in with your doctor. Just because your
a runner doesn't mean you're healthy. So it's important to
kind of keep your regular medical checks. But in general,
you know, running is a wonderfully accessible form of preventive health.
It's one of the most effective medicines we have, and
that healthy. You know, people should run for their entire lives.
I have people in my practice in their nineties that
are still running and that they're very inspirational and that

(51:33):
we're all going to go slower. When I look at
my like I was looking back my first marathon in Boston,
I was running like I ran like a three h four.
I was running like six forty five miles without even breathing.
I was like waving to people. Now I'm like dying
to break four hours, like with every ounce of energy
I have. And it's just like it really changes over time,
but it's still wonderful to be out there and wonderful
to be part of the community.

Speaker 2 (51:53):
Running is interesting too, because it's one of those things where,
again it's like this scale where people say that, but
I don't know if it's specifically as a woman, but
you can actually get better at running as you get older.

Speaker 1 (52:06):
Yeah, definitely, I mean it's definitely women achieve their physiologic
peak a bit later than men, and in endurance sports
a little bit later than men. You know, the risk
that women like you have who are definitely driven and pregnant,
is that they sometimes try and come back a little
too quickly after delivering. That your body releases a hormone
called oxytocin, which basically relaxes the ligaments in your body,

(52:28):
and so in relaxing and so you end up with
basically looser ligaments, including the ligaments that connect your two
pelvic bones together, and that if you get back to
running too quickly after delivering, sometimes those bones can rub together,
causing something called osteitis pubis, which really hurts a lot.
And I see that in devoted runners who try and

(52:48):
get back to running a little too quickly. So it's
important to talk with your ob about when it's a
safe time to get back to running. It doesn't mean
you shouldn't be exercising postpartum, because you definitely should, but
getting back to run, you want to just make sure
that you're talking with your doctor about how your body's
responding and what it feels like. And I think the
main point I'd like to make on that is that
if it feels like it's not healthy, if your body

(53:10):
feels like, hey, I'm not ready to do that, listen
to your body.

Speaker 3 (53:12):
You may not have the exact same body you.

Speaker 1 (53:14):
Had before for a little while, and so you have
to really respect that and listen to that so you
don't try and push yourself unhealthily, because I'm big about push,
as you know, but I'm big about healthy push, and
that there's an unhealthy push if like, I'm going to
get out and do exactly what I did right away,
and you know, some people are able to do that,
most it takes a little ramp up, and so give
yourself some grace.

Speaker 2 (53:33):
So I was thinking about doing the New York City
Marathon in November. Would that be something that you would
advise there's a point.

Speaker 1 (53:38):
Thank you so much, you know the answers maybe, but
you shouldn't have the exact same you know, don't push
yourself to say I have to do that.

Speaker 3 (53:45):
It may work, it may be too.

Speaker 2 (53:47):
Much party piece.

Speaker 1 (53:48):
If I do it any pace like, it just may
be too much. I want you to see where it is.
I want you to be realistic. But you're not exactly
the same person you were before, and you will be
that person again, but there's a little window in there
where you have to be responsive. But that's exactly and
thank you so much for bringing up because that's a
situation where you know, sometimes it works great and sometimes
it's not. You're not ready yet, and so just make
sure you're listening.

Speaker 2 (54:09):
But I'm exactly one of those people that walks into
your office, like you probably hear the craziest things, right,
It's like, yeah, so I'm like going to be twelve
weeks postpartum, can I run the marathon?

Speaker 1 (54:17):
I love it, and I love it and I love
I love. That's why you are who you are, and
that's why you're doing what you're doing is because that's
that's pushing you, that's driving you, right, which is fantastic.
I don't want to inhibit that, but I also want
you to be realistic about what's healthy for you.

Speaker 2 (54:29):
Yeah, And I think the most important thing for people
to do, especially women postpartum, is set a goal for
yourself postpartum that allows you to come back to yourself
because you know you're not just a.

Speaker 1 (54:39):
Mom, you're also hundred percent Oh, it's essential and essential
to think to figure out how you're going to put
that into your life.

Speaker 3 (54:45):
You know that you need to be moving and moving daily.

Speaker 1 (54:47):
As part of the whole postpartum experience that I've supported
that one thousand percent and a goal. You know, A
big piece of motivational health is also goal setting. You
need a goal and that goal should be out in
the future enough so you know, I can work towards that.
I didn't mention that my lowering the cost to Act discussion,
but that's a big piece of what we want to
think about too.

Speaker 2 (55:04):
Let's talk a little bit more about that.

Speaker 1 (55:05):
Yeah, So in PUSH I talk about, you know, motivation
and motivational health and lowering your cost to act is what,
you know, how you can make your desired activity something
you're going to do and setting a goal of like
an event, a race in the future and it should
be like my my motivational goal. This year, I did
my fifteenth iron Man last summer after ten years away,
and I was like, can I still do this shit?

Speaker 3 (55:25):
And I can still do this shit. It wasn't as pretty,
but I did it.

Speaker 1 (55:29):
And then this year, my youngest brother lives out in
Colorado and he is a big mountain biker. Mountain biking
scares the crap out of me, but he does the
Leadville one Hunter mountain bike every year and he's like,
you're doing that, So I.

Speaker 3 (55:40):
Signed up for it.

Speaker 1 (55:41):
I hope, I know I hope I make it back.
The downhill scares me a lot. So I'm going out
for like mountain biking class and Leadville in June, how
to go downhill without killing yourself. So hopefully it'll all
work out. But that goal is a little scary to me.
So that idea of kind of getting up in Leadville,
highest town in the United States, getting way up above
tree line mountain biking with people all around and rocks

(56:02):
and all kinds of stuff. But I hope it works out,
but it will push me to be consistent. And that's
the whole idea of goal setting, is that I have
something in the future. It's a little scary.

Speaker 3 (56:14):
I know it's important. I want to do it. Let's
get it done.

Speaker 2 (56:17):
What do you think it does for you psychologically? That
idea of pushing yourself.

Speaker 3 (56:22):
I think this.

Speaker 1 (56:23):
So the idea of push was I want people to
learn how to push themselves mentally, physically and physiologically mentally
hugely important to give yourself a goal, give yourself the
confidence to know I can do it. Like right now
you're thinking, God, can I run marathon again? And the
answer is yes. But having a goal mentally knowing I'm
tough enough to do that, which I know you are,

(56:43):
will be so important. Physically, it's important to push yourself
because without your dad was right, if it done hurt
a little bit, Katie, you're not going hard enough. And
he was a spot on correct right, And that's great.
I love that parenting because that's exactly right. It isn't
always rainbows and butterflies. You've got to kick yourself in
the button sometimes that's what makes you better. And then physiologically,

(57:03):
pushing is essential, and that idea is putting intensity into
your life. That intensity is part of the secret sauce
of elevating your fitness, and as you get older, you
need more intense intensity into your life.

Speaker 3 (57:16):
So do those jump squads, do those.

Speaker 1 (57:18):
Burpees, get that heart rate up. Take those stairs. If
one stair isn't enough, take two stairs at a time.
You know, start getting consistent with not only intensity in
your exercise, but intensity in your life. That vilpa I
we've talked about before is really important.

Speaker 2 (57:30):
So you have said that the future of health and
fitness integration is bright. What do you think bright actually
looks like? So?

Speaker 1 (57:37):
I think the future integration of health and fitness and
technology is really bright. Because you know, it has been
getting back to my old vision that I had the
Circle of medicine and the Circle of fitness.

Speaker 3 (57:48):
They were two separate circles.

Speaker 1 (57:49):
You know, those circles are now you know, people can
come in, I can see what they've done, what kind
of activities, you know, So that piece is closing. But
I think in the future, you know, now, something we're
really striving for is your doctor or your health professional
being able to prescribe exercise for you, seeing how you've
done it, monitoring the effects of that on your different
metrics that we're looking at, potentially blood markers, looking at

(58:11):
what kind of markers, and how that's changing in your life.
And I think one thing I'm actually working on now,
which I'm kind of interested in, is and I was
a little hesitant about it at the beginning, but I
really like I get asked so many questions about not
only about my medical practice, but like, hey, how do
I do a five kre what's the best running shoe,
or how do I you know, how do I make
my knee not hurt when I do a high rocks

(58:33):
or stuff like that. And so I started working with
this company and I'm starting I'm coming out with my
own little AI chat bot, a Doctor Jordan Metical chat bot,
where I've uploaded every single lecture I've've done, all my books,
all everything, anything on YouTube, all that stuff put into
a chatbot and then people can basically go on and
ask me a question twenty four hours a day and

(58:54):
they can get the information on that subject. And so
it's kind of cool because it's my exact I'm with
chat Which is fantastic is that it's everybody's information, all coalesced,
and so you don't know if it's like me or
somebody else, it's like anything. But the nice part about
the stuff, at least that I like about this is
it's everything I've done and written and said, which is,

(59:14):
you know, over a lot of years, I've said a
lot of crap, and so it all gets put into
one place and so now people can access that. So
I'm really excited about that as a new concept.

Speaker 2 (59:22):
That's amazing. And one of the questions my aunt wanted
me to ask you is how you're integrating AI into
your practice.

Speaker 3 (59:28):
Yeah, I am so in AI.

Speaker 1 (59:29):
Is this is exactly now because you know, people still
want to come see if their knee hurts, they want
to see their doctor, and they should if they need
an injection in their knee. AI ain't going to do that, right,
But I think it's all the stuff outside of my
quote unquote medical practice, all the advice because you know,
when I started it was mostly as a doctor. Now
I have a lot of crossover. A lot of what
I do is you know, health and fitness and wellness

(59:51):
and longevity and education, and there's so much in there
that's outside of my medical practice. And I just don't
have time to answer all these questions. And I get
people that writing questions from all over the world, which
is great, but I just don't have the capacity.

Speaker 3 (01:00:04):
So AI Me.

Speaker 1 (01:00:07):
Is going to be a neat thing actually comes out
next week, and I'm excited.

Speaker 2 (01:00:10):
That's really exciting. What would you say is one of
the most common questions that you get asked.

Speaker 1 (01:00:15):
People ask me all the time about about aches and
pains and also about the best best type of exercise
for themselves. And it's nice because I get I put
that in my samp. I cried it out already, and
it's kind of neat because it's my exact tone, like
you know, telling people you know you need to do
things that you like to do and this is your
body type, this may be helpful for you, and you know,
it's kind of it's great to sell that.

Speaker 2 (01:00:37):
You know. There's a lot of people also that talk
about how training for men is different than training for women.
I'm curious, as a sports medicine doctor, what your take
is on that.

Speaker 1 (01:00:44):
You know, I think the main training there used to
be a bigger gap between training for men and training
for women. I thinks as muscles have become in vogue
for women, which is awesome. I mean you look at
some of the you know, previous generations and you know,
women just they looked, you know, they didn't have muscle.
Now women are in urg to have muscle. It's the
physique people want and I love it. I think it
looks great, it works great, it keeps them healthier. And

(01:01:07):
so I think training for men and training for women
has come a lot closer together than it used to be,
and that at any number of these different events or
classes or fitness activations, you know, women are doing the
same types of things with different types of weights, maybe
different weight but you know, I was in my biking
trip in Columbia, I was with one of my good
friends and her husband, and she kicked my ass up

(01:01:28):
every single hill, and I was like, God, damn with
this girl's killing me.

Speaker 3 (01:01:31):
It was awesome.

Speaker 1 (01:01:32):
She's the best biker in Today's a birthday also, and
so it was it was a lot of fun to
see that. So I think women and men, I think
when it comes to fitness, I think that gap is
almost I don't think it's much of me. I don't
know if you see it much of a gap. I don't
see much of a gap at all anymore.

Speaker 2 (01:01:48):
I guess it depends on what you're optimizing for body
health wise, right, Like, if you are a woman that
has strength and has muscles, then maybe it's different. Yeah,
I know you reference GLP ones, and the thing that
scares me the most about GLP ones is the way
it shrinks people's muscles. And it scares me for women
long term, because I know osteoporosis is such a big
concern for a large majority of women as we get older.

Speaker 1 (01:02:09):
I will speak to the peptide craze because I feel
like that's one of the pieces where that GLP one
is a peptide and insulin is a peptide. Peptides have
been around these are kind of short chain amino acids,
and they have great functionality, and they're very effective when
they're kind of studied and supervised and prescribed by physician.
But now you can see that, you know, for example,

(01:02:30):
if you go online, you can order GLP one outside
of a doctor, and so this whole kind of peptide
industry is circumventing health professionals and you can kind of
do direct to consumer and people are kind of looking online,
they're seeing influencers who are kind of getting these peptides
using them, and we just don't know the effects of
these peptides. In the short term, they may make you
look better, look thinner. We don't know what these things

(01:02:52):
can do medium term, long term. We have no human
data on this stuff at all. And so the idea
that you're going to start ingesting or injecting these substances,
that you have no idea what they do medium term,
long term, really makes me a little concerned. And you know,
one thing I really have learned in medicine over time,
a great case example, this is probably the most extreme
case example. In the nineteen sixties, thalidimide was a drug

(01:03:15):
that was popularized for women with morning sickness and that
morning sickness sucks, and that people said, listen, if you
take this thalidimide, you'll have you know, will reduce your
morning sickness. Thalidimide basically led to massive birth defects in kids,
and so it was about a two year period of
time where there was something called pholidamide babies, and that
led to the FDA screening medications. But the problem is

(01:03:38):
that these peptides are circumventing the FDA, or if there's
been a pushing now to get these cleared by the FDA,
but we don't. We have no human subject trials on
these things short term, long term, and so we don't
know what they do in people's health longer term. So
I'm really apprehensive of people kind of just gravitating towards
these things because they like it.

Speaker 3 (01:03:58):
Makes them look skinny.

Speaker 1 (01:03:59):
In the short It's fair to say the chronic obesity
is a health risk, because it is, and we know
the effects of that which are terrible. And so when
you're balancing that out, you want to think about what
can I do with diet and lifestyle and strength training
versus what do I need help with? But I think
keeping your your physician in that discussion, loop is essential,

(01:04:20):
and the thing I worry the most about is circumventing
that loop.

Speaker 2 (01:04:22):
Are there any supplements that you swear by?

Speaker 1 (01:04:24):
Yeah, I do glucosamining android, and I do vitamin D.
I do an Omega three and those are my go tos.
I do a fiber pill every morning because it helps
with kind of blood sugar control, and those are my
go tos. And I think we have pretty reasonable evidence
on all those.

Speaker 2 (01:04:40):
IT and D every doctor recommends it.

Speaker 1 (01:04:42):
Yeah, I mean, especially if you live up here. It's
a it's a you know, it's a good thing to do.

Speaker 2 (01:04:45):
Okay, final question, what's one habit that would change most
people's lives if they committed to it today?

Speaker 1 (01:04:51):
The one habit that would change people's lives that they
started it today is doing something that makes them smile.
I know it sounds so simple, but I think that's
the take point. When I started running my fitness classes
in Central Park, and I have one of my bracelets
for you, by the way, So this this bracelet we
give so we give out, we try and get good swag.
We have all kinds of great people that help us
put on these classes, great sponsors, and grateful patients that

(01:05:15):
have donated over time, and so we give different things,
and so we give these bracelets.

Speaker 3 (01:05:19):
This is going to glow in the.

Speaker 1 (01:05:20):
Dark tonight, and this is iron Strength and YC movement
is medicine, and the idea is getting people out to
move every day. So I'm going to give you one
of my official bracelets.

Speaker 2 (01:05:28):
There you go, feel honored.

Speaker 3 (01:05:30):
Good, no problem.

Speaker 1 (01:05:32):
And so the thing that I think would make the
biggest habit change for people is smiling. When I started
my fitness classes, I started with runners and tra athletes
in Central Park doing hill sprints in planometrics, and everybody
kind of looked like me and did the same stuff
I did. Over time, people brought their kids and their
parents and their grandparents, and we started adding in yoga

(01:05:54):
and strength training and salsa and you know, cardio dance
and all kinds of pilates and all kinds of different stuff.
And you know, the commonality is people are smiling and
they're having a good time and they're consistent. I've had
people come into my classes for fourteen years. So the
key is what makes you smile. And that's the biggest
habit change I would say is do stuff that makes

(01:06:16):
you smile, and you'll keep doing.

Speaker 2 (01:06:17):
It and that post run high is real. Guys, Absolutely
we'll get you smiling. Well. Thank you so much for
coming on the podcast today, and I can't wait to
check out the what is it the running center at HSS.
We're going to be We're doing that, OKAYI Hi, guys,
Kate here. If you made it this far into our conversation,

(01:06:39):
thank you so much. We just learned a ton and
this will definitely be an episode that I will be
coming back to periodically when I have questions that I
need answered. We will also be having Jordan on our
running interview show honestly hopefully more than just once, so
any questions you have for him please slide into our
DMS and we will work hard to get your questions
answered as all away. If you are enjoying post friend high,

(01:07:02):
please follow the show wherever you're listening and share this
episode with a friend. We have weekly episodes coming your
way and I will see you next week

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