September 9, 2025 • 33 mins
Are you doing too much in the name of health?
Between supplements, saunas, organic food, and brain games, wellness can feel like a second full-time job. In this episode, I help you filter the noise and focus on what really matters—so you can live long and well without losing your joy in the process.
We break down:
- The true opportunity cost of wellness routines like cold plunges, meditation, and restrictive diets
- The Pareto Principle (80/20 rule) in health: How to get 80% of the benefit with 20% of the effort
- The “Big 6” evidence-based habits that actually move the needle on longevity and function
- How to personalize your wellness plan based on lifespan, healthspan, and joyspan
- Your health type: Are you a Holistic Hacker or a Contentment Creator? Take the quiz to find out.
🧠 Referenced Research & Data:
- 1 in 2 men and 1 in 3 women will develop cardiovascular disease in their lifetime (PubMed)
- Stroke and dementia share many preventable risk factors like blood pressure and exercise (Alzheimer’s Association)
- 4 in 10 people will get cancer in their lifetime (American Cancer Society)
- Americans spend ~9 hours sleeping and ~4 hours on leisure daily (Bureau of Labor Statistics)
🎯 Takeaways:
- Not all health habits are equally impactful. Focus first on sleep, blood pressure, cholesterol, weight, exercise, and screenings.
- Prioritize based on what you value: functional longevity or joyful living—or both.
- Give yourself permission to not do it all. Your health plan should be sustainable, not exhausting.
🔗 Mentioned Tools:
- Live Long & Well Quiz
- Episode 13: Preventing Cognitive Decline
- Episode 18 & 37: Reducing Cardiovascular Risk
- Episode 21: What’s Your Health Type?
🧘♂️ Whether you’re a Purposeful Path Planner or a Holistic Health Hacker, this episode helps you reclaim your time, your joy, and your long-term health.
🔔 Subscribe for research-backed health insights in under 30 minutes—without the wellness overwhelm.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
to live long and well , you hear, take your
supplements, don't drink alcohol, lose weight, exercise more,
sleep the right amount, havesocial contacts, take a cold
plunge, do a sauna, get yourscreening tests, make sure your
vaccines are up to date,meditate, eat organic, free
range, grass-fed, withoutultra-processed ingredients, and
(00:26):
more.
I'm exhausted just listingthese.
We have lives and jobs andfamilies and friends and hobbies
.
How much health and wellness todo?
How to decide what's mostimportant to live long and well,
dr Bobby, please help.
Hi, I'm Dr Bobby DuBois andwelcome.
(00:56):
To Live Long and Well a podcastwhere we will talk about what
you can do to live as long aspossible and with as much energy
and vigor that you wish.
Together, we will explore whatpractical and evidence-supported
steps you can take.
Come join me on this veryimportant journey and I hope
(01:20):
that you feel empowered alongthe way.
I'm a physician, ironmantriathlete and have published
several hundred scientificstudies.
I'm honored to be your guide.
Welcome, my dear listeners, toepisode number 48.
(01:41):
Does achieving optimal healthneed to be a full-time job?
In essence, how much time andmoney should you devote to
health and how to decide what todo and perhaps what not to
worry about?
Well, why, now I'm approachingthe 50th episode and I've
(02:03):
realized that I've asked so muchof you, my listeners, so many
things I've recommended for youto do Exercise, sleep,
meditation, having proper weight, nurturing social relationships
, saunas and cold plunge.
Well, to be fair, I alsoexplored some things that you
(02:25):
don't need to do or worry aboutSeed oils, red light therapy,
most supplements, detox cleanses.
Unless you make it a full-timejob and really none of us can
it's impossible to do everythingwe might do to live long and
(02:45):
well.
So what is best for you and howdo you decide what to focus on
and perhaps what not to worryabout?
I reflected a bit on what Iactually do and how did I decide
what to do and what not toworry about, and I'd like to
share that with you.
By the end of the episode, Ihope you'll be able to look at
(03:09):
what is a very long list ofthings you might do to live long
and well and prioritize whatmatters most to you.
Before we get any further, justwant to ask folks once again if
you haven't had a chance toreview or rate my podcast,
(03:32):
please do so, and if you'reenjoying it which I hope you are
, please tell your friends, andif you're not enjoying it so
much, let me know.
Love feedback of any type.
Okay, I am reminded of agentleman by the name of Jim Fix
who in the 1970s really was theindividual that most
(03:55):
popularized jogging, becausebefore that people weren't
really focused on it.
He wrote a book called theComplete Book of Running.
So Jim Fix wrote, ran about 80miles a week and at age 52, he
died of a heart attack.
So that gives us pause, that nomatter what you do, you can't
(04:19):
necessarily guarantee you'regoing to live long and well.
Now, he had a very tough familyhistory of heart disease, so he
may have lived a lot longerthan he otherwise would, but
that gives us pause.
I'm also reminded of Voltaire,the French philosopher in the
1770s, who has a line that Ireally, really love the best is
(04:44):
the enemy of the good, or letnot the great be the enemy of
the good.
There's many translations forthis.
So really, what we need tofigure out is what is good
enough, because we can't beperfect, we can't do everything,
and that really is our focusfor today.
(05:06):
Now, longevity and health needsto fit into our days, and our
days are busy as it is but whattakes time in those days and
where might we find a bit oftime to do what might be
beneficial to us?
Well, the Bureau of LaborStatistics does a survey of
(05:30):
regular life demands andbasically, in a 24-hour day,
this is how people spend theirtime.
Work is typically about eighthours a day.
Sleep, going to bed, gettingready for bed all of that,
reading in bed about nine hoursa day.
Eating takes up an hour or so.
Household, household chores andcare take up about two hours a
(05:55):
day.
And leisure relaxing, sports,playing with your kids, watching
, watching television, readingbooks that's about four hours a
day and that pretty much takesup your day.
So, part one how much could orshould we do to maximize our
(06:16):
longevity?
Well, it's a lot.
So our exercise alone, theaerobic exercise, the strength,
the anaerobic, the balance andflexibility, that's probably
could take a half hour to anhour a day to do all of that.
Now, if you have to drive toand from the gym, it could be an
(06:36):
extra 30 minutes or an hour todo that.
Well, what about meditation orbreath, or yoga?
Well, ideally we do 30 minutesa day, and we've talked about
sauna and cold plunge.
Well, there you go, another 30minutes.
And if you got to drive to thegym to get to the sauna or the
cold plunge, you got to add thatin.
(06:56):
So already we've consumed twoand a half to four hours a day
Basically all of your leisuretime on those small number of
activities.
What about nutrition?
Well, of course, there'sprotein to worry about.
There's five fruits and veggiesa day to worry about.
(07:20):
We want to minimize highlyprocessed foods.
We need to eat fiber, eatorganic, eat fish, reduce our
sugar, don't eat before bed,minimize alcohol and worry about
your microbiome.
A lot of time and focus there.
If you want to do all thesethings.
And, of course, sleep, theunsung hero we need to get our
(07:40):
seven to eight hours a night ifpossible.
And we talk about socialrelationships, social
connections, strong connections,but that isn't everything.
We want to worry about ourblood pressure, make sure it's
under control, our cholesterolis good, our weight is where it
should be, we got to get ourcancer screenings, our vaccines.
(08:02):
We need to visit the doctoryearly, go to the eye doctor,
perhaps the dermatologist, thedentist and if we have any
medical illnesses, of course wegot to deal with those as well.
And as we get older, people saywe need to do mind active games
or brain games, and the listgoes on and on.
(08:25):
This clearly is more than afull-time job, and for each item
you focus on whether it's doingthe sauna, whether it's doing
that strength training each oneof these comes with an
opportunity cost.
While you're focused on those,you're not playing with your
(08:48):
kids, you're not working on yourhobbies or travel.
So everything you do has a costthat we need to be aware of and
to remind ourselves.
Voltaire tells us let not thebest be the enemy of the good.
So that's part of the laundrylist of everything you could do,
(09:10):
and it's probably gettingpretty clear to you that unless
you spend most of your daytrying to do it, you're not
going to be able to do it all.
All right, part two how muchshould you do?
Well, ultimately, of course,it's a personal choice.
(09:30):
Now, for some, you may haveheard of Brian Johnson.
He basically has a goal to liveforever.
He basically has a goal to liveforever and it is, in fact, his
full-time job to try everythinghe can think of and test out to
do that.
Well, most of us don't have theresources or the time, clearly,
to focus on that, and we haveother things in our life.
(09:52):
Now, you might have heard ofthe Pareto principle or the
Pareto optimization.
If you haven't heard of that,you've probably heard of the
80-20 rule, meaning you can get80% of the benefit with 20% of
the effort.
For example, you don'tnecessarily need to read a whole
(10:17):
book, which might take you five, six, seven hours.
A nonfiction book aboutBenjamin Franklin.
You might be able to read thesynopsis or read an executive
summary of a certain document,which takes a lot less time and
you get much of the benefit.
So that's, I think, how we wantto begin to look at our health
(10:40):
options and try to figure outwhere is the 20% of effort that
might give us so much morebenefit, and then not worry
about the other benefit.
That might take a long time anda lot of effort.
Okay, so how do you begin tobuild the list of things to
(11:00):
worry about?
I'd like to walk through twodifferent ways to think about it
.
One, objective what does theevidence tell us that would make
the most impact in your life?
And then we're going to roundit out with what I call the
personalized approach.
So that's the plan.
So, on the objective side, whatare the most powerful levers or
(11:27):
items that might help yourlifespan and your health span.
So we've talked in many episodesin the past about kind of what
risk factors have great impactand when I think about what you
might worry about, for me thereare three elements.
(11:47):
The problem you're trying toavoid, say, a heart disease or a
stroke or cancer it's a commonthing, a common thing.
Second, there is a risk factorassociated with it and that risk
factor matters a lot.
And finally, the risk factor isactually pretty common.
(12:08):
So the poster child used to becigarettes.
Cigarettes are a problemrelated to heart disease.
It's a true giant risk factorand up until the last 20 or 30
years, many, many people smoke.
Fortunately, fewer do today.
Obesity today probably fitsinto it.
(12:28):
It affects many diseases.
It's an important risk factorand the risk factor is common.
All right, so let's take a fewdiseases and figure out what are
some of the factors you mightwant to build into your list of
how to live long and well.
So in episode 18 and 37, Italked about how to reduce our
(12:53):
risk of heart disease and manyof the critical factors included
blood pressure getting thatunder control.
Cholesterol getting that undercontrol, diabetes avoiding it or
managing it and, of course,exercise and being overweight.
All of these are known powerfulrisk factors.
(13:15):
In another episode, we talkedabout stroke and reducing our
risk of stroke, and we talkedabout something called
population attributable risk.
But, once again, many of thefactors that help us reduce the
risk of stroke are the ones wejust talked about Get your blood
pressure under control, makesure you're getting your
(13:36):
exercise.
So if you're worrying aboutyour heart, you're probably
simultaneously worrying aboutyour brain and strokes.
Okay, third thing that's veryimportant to us dementia.
One in nine people above theage of 65 will have dementia.
(13:57):
Now, when we talked aboutcardiovascular, that's one in
two men or one in three women.
So these are pretty commonthings we want to worry about.
Again, the good news forcognitive decline, which was
episode 13,.
If you want to listen a bitmore about how we reduce our
risk of cognitive decline, again, many of those factors are the
(14:20):
same Our blood pressure, ourexercise, our sleep.
So if you're working on it forone area, you're getting the
benefit that it helps others.
Well, what about cancer?
That's a really important areawe'd like to avoid.
Four in 10 people will getcancer at some point in their
life.
(14:41):
For colon cancer, it's aboutcolon and rectal cancer, it's
about 4%.
For breast cancer, for women,it's about 13%.
So these are real issues to beconcerned about.
Fortunately, screening testslike colonoscopy reduce the risk
of colon cancer.
(15:01):
Mammograms reduce the risk ofbreast cancer.
So, again, these might bethings you want to fold into
your plan.
Action item number one start alist.
A list not of everything you'regoing to do, but a list of what
you might do.
(15:21):
And some of these on your listcould be those risk factors.
Make sure your blood pressureis under control, your
cholesterol you've got a properweight, diabetes is taken care
of and you're not smoking.
And you might add to that listsome of these critical
activities and behaviors likesleep, like exercise and like
(15:44):
social relationships, and youmight add specific interventions
.
Get your screening for cancer,like I talked about.
Get your vaccines for flu orpneumonia or shingles.
Covid is a discussion foranother day.
All of these elements areevidence-based and really,
(16:08):
really impactful.
So that might be what we callour first tier list, where the
evidence says these half a dozenor so things will really make a
difference and you might wantto make sure that you prioritize
those.
Okay, at the beginning of theepisode I rattled off a list of
(16:28):
a zillion things you might do,and on my first tier list you
did not hear sauna cold plungelist.
You did not hear sauna, coldplunge.
Nutrition other than just goodweight, meditation, breath work,
(16:51):
microbiome yes, for each ofthese there's evidence that they
will help us live long and well.
I have episodes on each one.
So of course I believe it.
But in the grand scheme ofthings, the benefit of a cold
plunge, the benefit of breathwork, are not nearly as powerful
, in my opinion, as the ones wejust had above.
So my first tier list may be aplace for you to begin.
(17:16):
Of course, as we'll get to inthe personalized approach.
If these other elements areimportant to you, then Of course
, as we'll get to in thepersonalized approach, if these
other elements are important toyou, then you should add them as
well.
Okay, so to develop now thesecond approach.
So the first approach was theobjective one.
What does the evidence tell uswill make the biggest impact on
(17:36):
living long and well?
Based on the evidence?
So now we need to modify thatwith the personalized approach,
which is built around whatmatters to you most?
In essence, it's a personalizedcost-benefit assessment.
So before we get to what to doand how to do it.
(18:00):
In the personalized area, let'stalk about a few terms.
So, when you think about what'simportant to you, there are two
common words.
We talk about lifespan andhealthspan.
Lifespan is how long you aim tolive or hope to live.
Health span is how many ofthose years are you active,
(18:21):
functional, don't have a lot ofpain, your spirits are good, and
those are the things we thinkabout.
And so, as we've talked aboutwhat might be on your list or
your top tier list, that's whatwe're thinking about, but
there's a third concept that Irecently ran across, called joy
(18:43):
span.
So we have lifespan, we havehealth span and we have joy span
, and this was put together by awoman by the name of Carrie
Burnight, a gerontologist.
She has a book on this withthat title, and basically what
she's putting out is that, as wethink about what we want to
(19:04):
maximize in our life, yes, yearsof life are important, and
being very functional andhealthy is very important, but
ultimately, it may be about howmuch joy we have in our life.
So it may not be we have tohave the most years.
It may not be that we have tobe able to run a marathon when
we're 65 years old, that it maybe a lot about joy.
(19:28):
Now you can define joy in manyways.
Some elements consist ofcontentment or gratitude, or
meaning and purpose, and she hasfour elements in a matrix,
which are that you want tocontinue to grow, you want to
adjust as things change orhappen, you want to connect to
(19:50):
others and you want to give back.
So, as you think through this,one way of personalizing it is
to decide how important islifespan versus healthspan,
versus joy span, because that'sgoing to help refine your list.
Another piece of the puzzle iswe talked in episode 21 about
(20:12):
health type.
Now, what is health type,health type?
There are five of them thatI've put together and there's a
quiz.
I'll have the link in the shownotes.
Many of you have taken it, butit does change over time.
You might want to retake it,and your health type tells you
how you acquire informationabout health, how much
(20:34):
information you acquire and howyou make decisions.
Some of the health typesinclude the holistic health
hacker that's me, who wants tolearn everything about it and do
as much as possible.
Then you have the single-mindedachiever.
They're very focused on oneaspect of health and may not be
(20:55):
focused on all the other areas.
Then you have something, a typecalled the contentment creator.
Life matters, health matters,but the health issues need to
fit into life, so they're notgoing to turn their life into a
pretzel to do everything.
Action item number two take thequiz.
Retake the quiz.
(21:16):
You'll get a report all aboutyour type and how you might
approach health.
This could be a way for you tobegin to refine your list of
what to do.
The third piece of the frameworkpuzzle is think about your
context.
Why do you want to be healthy?
(21:38):
Why do you want to have healthspan?
Well, you might want to be avery active grandfather, and so
you want to stay in shape and bearound as long as possible.
For that you may be an avidskier or golfer or play
pickleball.
Or you love to go backpackingOkay, that's critical to you.
Love to go backpacking?
(22:01):
Okay, that's critical to you.
And as you think about the manythings you could do or not, do
keep that in mind.
You may be someone who loves totravel, wants to have the
energy, wants to have thestrength to take your suitcase
and put it in the overhead binon the plane.
Okay, action item number threewhat matters to you most?
Lifespan, healthspan, joy spanor a blend?
(22:29):
Now we're on to part three, thenext steps.
So you develop the beginningsof your list, maybe use the
objective approach.
Maybe you pulled together thosesix or eight items that
objectively seem to have thegreatest impact and you're going
to put that on your list.
Now you may think about yourlife and you might say from a
(22:50):
personalized standpoint boy, ifyou fell and broke your hip,
that would be a real problem andreally upset your life.
So you might add more strengthwork or more balance work.
You may feel like you don'thave as much energy as you like
and when you do a cold plungeyou do feel energetic.
(23:12):
Well, of course, you're goingto want to add that to your list
.
You may be someone who facesand experiences anxiety a lot.
All right, meditation may besomething to put on your list.
Or if you have digestionproblems, discomfort in your
belly, bloating, you might wantto emphasize nutrition or the
(23:33):
microbiome.
So now you're going to take thebasic tier one list and add
some other items to it.
Now we're back to the Paretooptimization the 20% of things
that get you 80% of the benefitand that may be what you can do
in your life and it may fit in.
(23:54):
So as you think about the 80-20, fit in so as you think about
the 80-20, what is reallyimportant, what's going to give
you the most benefit, what's not?
You might look at your alcoholintake.
You might say you know, I knowI'm supposed to have less than
three or five drinks a week.
I'm going to drink a little bitmore alcohol because that's
(24:14):
very important to me.
Obviously, I'm not saying drink20 drinks a week or have three
or four a night.
But you might edge towards alittle bit more understanding.
Yeah, there's an increase insome risk, but again, life is
about enjoyment.
You might say that's okay.
(24:36):
Or you might say, look, I knowDr Bobby says that a cold plunge
would be really good for me,but I don't enjoy it, I don't
want to do it.
Okay, maybe that's somethingyou don't include because from a
Pareto optimization standpointit isn't going to give you as
much benefit as the other things.
(24:56):
So, ultimately, you take yourlonger list of what you would
ideally like to do, pare it backto meet your reality and your
preferences.
Now, if you're going tocontinue to be able to do this,
day in, day out, week in, weekout.
You need to enjoy what you'redoing.
(25:17):
So, as part of your exercise,as an example, you may enjoy
going to the gym Great, maximizethat.
You may enjoy cooking.
That may be something you love.
So nutrition will maybe be abigger part than it might be for
somebody else.
Ultimately, you need to lay outa realistic plan.
Action item number fourfinalize a list that works for
(25:43):
you.
Finalize it and perhaps onceevery quarter, every three
months or so, review it, updateit, modify it as you need.
Okay, so I've given you a wholelot of things to think about
and ways to think about it.
Now it might be helpful for youto know where do I net out?
(26:05):
So, as I went through thisexercise, what did I come up
with?
Because I realize, even thoughI talk about all these things,
you know I don't have the timeto do everything every day or
every week, because I have aranch to run, I have a bed and
breakfast to run, I haveathletic events like triathlons,
(26:25):
ironmans to train for, I have afamily, I have lots of things
I'd love to do on the ranch.
So when I reviewed all this, Irealized for me, living long is
really important, of course.
But first and foremost I wantto maintain my function.
I want to be able to be on theranch, I want to be able to be
(26:47):
active, I want to be able tocompete in races.
That I do so it doesn't meanI'm ignoring lifespan, but I'm
emphasizing what will help memaintain function, which often
fits into the health span.
Now, as I've thought throughthe joy span element, I'm going
(27:08):
to reflect a bit more and seeare there ways I can incorporate
more of that into my life aswell.
So ultimately I have the big six, dr Bobby's big six.
These are the things that arefirst and foremost for me.
Number one rigorously controlmy heart disease risk and my
(27:32):
brain risk.
So for me critical make sure myblood pressure is under control
, make sure my cholesterol isunder control, so risk factors
that I can absolutely measure,monitor and do something about.
First and foremost for me.
Fortunately, with medicationsI'm doing great on those.
(27:54):
Second of the big six sleep.
I am very focused on getting agood night's sleep, which for me
means getting to bed around 9or 9.30 because I'm always going
to wake up early in the morning.
So that's critical.
Third exercise and strength.
Those are two that are criticalfor me for what I'm hoping to
(28:17):
maintain and accomplish Now.
I could do more balance work, Icould do more flexibility work,
I could do more intervaltraining and I will try to do
more of those, but exercise theaerobic and the strength first
and foremost.
That's number three.
Number four weight.
I want to maintain a good andhealthy weight.
(28:39):
Fortunately, genetically andbecause I'm active, that's been
okay for me.
But that will be front andcenter if at any point I feel
like I'm gaining weight.
Number five alcohol.
I am mindful of the issuesrelated to cognitive impairment
(28:59):
with alcohol over time, thethinning of the brain.
I have an episode on alcohollittle or none, that is the
question, and so I try to limitmy intake of alcohol to two,
three, maybe four drinks perweek.
Three, maybe four drinks perweek.
(29:23):
And finally, number six veryfocused on getting my screening
tests done, my regularcolonoscopies, my PSA levels and
vaccines, because I do believethose are a good way to prevent
preventable illnesses.
So those are the six that arefront and center for me.
They may work for you, they maynot work for you.
Now there are lesser ones, ofcourse.
Meditation is something I try todo the sauna and cold plunge
(29:48):
Intermittently.
I do it a lot, I do it a littlebit, and social relationships
are important, but I have enoughin my life right now.
I think I'm doing okay thereand I generally eat healthy.
Now there are a bunch of thingsI don't worry about because I
have my tier one list.
I don't worry about eatingfermented foods or having enough
(30:11):
fiber in my diet or seed oils,or being obsessive about the
number of fruits and veggies perday or supplements or my
microbiome.
Of course I may eat these foods, I may do some of these things,
but I do pretty much what feelsright.
It's not front and center forme.
(30:32):
All right, let's wrap things up.
Some general thoughts.
To live long and well, to doall the things that we might
want to do, is a marathon, not asprint.
We can't do everything.
Choose the things that mattermost to you.
I hope I've given you aframework for how to think about
that.
Find, from an exercisestandpoint, things that you
(30:55):
enjoy H hiking or pick a ball,or maybe you love being at the
gym.
That will be more maintainableif it's something you love.
Perhaps, since time is limited,double up.
Go to the gym with a friend.
Go for a walk and have coffeewith a friend while you're
walking.
That will allow you to do morethings with a shorter amount of
(31:18):
time.
Give yourself grace to say, no,I'm not going to worry about,
you know, doing a sauna or acold plunge.
I am going to have that youknow, croissant on the weekend,
or maybe two of them.
So have the grace to say I'mnot going to worry about it.
It's not worth it enoughcompared to all the other things
(31:41):
that truly are important.
You may decide some alcohol isokay for you.
You may decide that's not thecase.
You may be willing to give upcertain foods you enjoy.
You may not be.
You may be trying to loseweight and you may say, gosh,
that last 10 or 15 pounds isjust almost impossible to lose.
(32:01):
Okay.
So maybe you give yourself thegrace to say, look, I don't want
to be 30 or 40 poundsoverweight, but the 10, 15
pounds may not be impactfulenough to upend the rest of my
life.
You may have a blood pressureissue and getting it down to the
ideal 120 over 80, less thanthat may not work for you
(32:25):
because you may get dizzy, youmay not feel right.
So again, you're going to getclose to the target, but if you
can't get there, that's okay too.
That's okay too.
So, as we begin to say goodbye,what do you think?
Is it too much work to doeverything in the live long and
well space?
(32:46):
How are you going to frame it?
What are you going to do?
What are you going to perhapsnot do?
Please let me know and I willshare it with others in a
follow-up episode and, again, asalways, share the podcast with
others.
And until next time, let's allaim to live long and well, but
(33:10):
do it from a vantage point ofwhat's feasible, maintainable
and gives us ultimately a wholelot of joy span and gives us
(33:40):
ultimately a whole lot of joyspan.
If you want to continue thisjourney or want to receive my
newsletter on practical andscientific ways to improve your
health and longevity, pleasevisit me at
drbobblivelongandwellcom.
That's, dr, as in D-R Bobbylive long and wellcom.
to live long and well , you hear, take your
supplements, don't drink alcohol, lose weight, exercise more,
sleep the right amount, havesocial contacts, take a cold
plunge, do a sauna, get yourscreening tests, make sure your
vaccines are up to date,meditate, eat organic, free
range, grass-fed, withoutultra-processed ingredients, and
(00:26):
more.
I'm exhausted just listingthese.
We have lives and jobs andfamilies and friends and hobbies
.
How much health and wellness todo?
How to decide what's mostimportant to live long and well,
dr Bobby, please help.
Hi, I'm Dr Bobby DuBois andwelcome.
(00:56):
To Live Long and Well a podcastwhere we will talk about what
you can do to live as long aspossible and with as much energy
and vigor that you wish.
Together, we will explore whatpractical and evidence-supported
steps you can take.
Come join me on this veryimportant journey and I hope
(01:20):
that you feel empowered alongthe way.
I'm a physician, ironmantriathlete and have published
several hundred scientificstudies.
I'm honored to be your guide.
Welcome, my dear listeners, toepisode number 48.
(01:41):
Does achieving optimal healthneed to be a full-time job?
In essence, how much time andmoney should you devote to
health and how to decide what todo and perhaps what not to
worry about?
Well, why, now I'm approachingthe 50th episode and I've
(02:03):
realized that I've asked so muchof you, my listeners, so many
things I've recommended for youto do Exercise, sleep,
meditation, having proper weight, nurturing social relationships
, saunas and cold plunge.
Well, to be fair, I alsoexplored some things that you
(02:25):
don't need to do or worry aboutSeed oils, red light therapy,
most supplements, detox cleanses.
Unless you make it a full-timejob and really none of us can
it's impossible to do everythingwe might do to live long and
(02:45):
well.
So what is best for you and howdo you decide what to focus on
and perhaps what not to worryabout?
I reflected a bit on what Iactually do and how did I decide
what to do and what not toworry about, and I'd like to
share that with you.
By the end of the episode, Ihope you'll be able to look at
(03:09):
what is a very long list ofthings you might do to live long
and well and prioritize whatmatters most to you.
Before we get any further, justwant to ask folks once again if
you haven't had a chance toreview or rate my podcast,
(03:32):
please do so, and if you'reenjoying it which I hope you are
, please tell your friends, andif you're not enjoying it so
much, let me know.
Love feedback of any type.
Okay, I am reminded of agentleman by the name of Jim Fix
who in the 1970s really was theindividual that most
(03:55):
popularized jogging, becausebefore that people weren't
really focused on it.
He wrote a book called theComplete Book of Running.
So Jim Fix wrote, ran about 80miles a week and at age 52, he
died of a heart attack.
So that gives us pause, that nomatter what you do, you can't
(04:19):
necessarily guarantee you'regoing to live long and well.
Now, he had a very tough familyhistory of heart disease, so he
may have lived a lot longerthan he otherwise would, but
that gives us pause.
I'm also reminded of Voltaire,the French philosopher in the
1770s, who has a line that Ireally, really love the best is
(04:44):
the enemy of the good, or letnot the great be the enemy of
the good.
There's many translations forthis.
So really, what we need tofigure out is what is good
enough, because we can't beperfect, we can't do everything,
and that really is our focusfor today.
(05:06):
Now, longevity and health needsto fit into our days, and our
days are busy as it is but whattakes time in those days and
where might we find a bit oftime to do what might be
beneficial to us?
Well, the Bureau of LaborStatistics does a survey of
(05:30):
regular life demands andbasically, in a 24-hour day,
this is how people spend theirtime.
Work is typically about eighthours a day.
Sleep, going to bed, gettingready for bed all of that,
reading in bed about nine hoursa day.
Eating takes up an hour or so.
Household, household chores andcare take up about two hours a
(05:55):
day.
And leisure relaxing, sports,playing with your kids, watching
, watching television, readingbooks that's about four hours a
day and that pretty much takesup your day.
So, part one how much could orshould we do to maximize our
(06:16):
longevity?
Well, it's a lot.
So our exercise alone, theaerobic exercise, the strength,
the anaerobic, the balance andflexibility, that's probably
could take a half hour to anhour a day to do all of that.
Now, if you have to drive toand from the gym, it could be an
(06:36):
extra 30 minutes or an hour todo that.
Well, what about meditation orbreath, or yoga?
Well, ideally we do 30 minutesa day, and we've talked about
sauna and cold plunge.
Well, there you go, another 30minutes.
And if you got to drive to thegym to get to the sauna or the
cold plunge, you got to add thatin.
(06:56):
So already we've consumed twoand a half to four hours a day
Basically all of your leisuretime on those small number of
activities.
What about nutrition?
Well, of course, there'sprotein to worry about.
There's five fruits and veggiesa day to worry about.
(07:20):
We want to minimize highlyprocessed foods.
We need to eat fiber, eatorganic, eat fish, reduce our
sugar, don't eat before bed,minimize alcohol and worry about
your microbiome.
A lot of time and focus there.
If you want to do all thesethings.
And, of course, sleep, theunsung hero we need to get our
(07:40):
seven to eight hours a night ifpossible.
And we talk about socialrelationships, social
connections, strong connections,but that isn't everything.
We want to worry about ourblood pressure, make sure it's
under control, our cholesterolis good, our weight is where it
should be, we got to get ourcancer screenings, our vaccines.
(08:02):
We need to visit the doctoryearly, go to the eye doctor,
perhaps the dermatologist, thedentist and if we have any
medical illnesses, of course wegot to deal with those as well.
And as we get older, people saywe need to do mind active games
or brain games, and the listgoes on and on.
(08:25):
This clearly is more than afull-time job, and for each item
you focus on whether it's doingthe sauna, whether it's doing
that strength training each oneof these comes with an
opportunity cost.
While you're focused on those,you're not playing with your
(08:48):
kids, you're not working on yourhobbies or travel.
So everything you do has a costthat we need to be aware of and
to remind ourselves.
Voltaire tells us let not thebest be the enemy of the good.
So that's part of the laundrylist of everything you could do,
(09:10):
and it's probably gettingpretty clear to you that unless
you spend most of your daytrying to do it, you're not
going to be able to do it all.
All right, part two how muchshould you do?
Well, ultimately, of course,it's a personal choice.
(09:30):
Now, for some, you may haveheard of Brian Johnson.
He basically has a goal to liveforever.
He basically has a goal to liveforever and it is, in fact, his
full-time job to try everythinghe can think of and test out to
do that.
Well, most of us don't have theresources or the time, clearly,
to focus on that, and we haveother things in our life.
(09:52):
Now, you might have heard ofthe Pareto principle or the
Pareto optimization.
If you haven't heard of that,you've probably heard of the
80-20 rule, meaning you can get80% of the benefit with 20% of
the effort.
For example, you don'tnecessarily need to read a whole
(10:17):
book, which might take you five, six, seven hours.
A nonfiction book aboutBenjamin Franklin.
You might be able to read thesynopsis or read an executive
summary of a certain document,which takes a lot less time and
you get much of the benefit.
So that's, I think, how we wantto begin to look at our health
(10:40):
options and try to figure outwhere is the 20% of effort that
might give us so much morebenefit, and then not worry
about the other benefit.
That might take a long time anda lot of effort.
Okay, so how do you begin tobuild the list of things to
(11:00):
worry about?
I'd like to walk through twodifferent ways to think about it
.
One, objective what does theevidence tell us that would make
the most impact in your life?
And then we're going to roundit out with what I call the
personalized approach.
So that's the plan.
So, on the objective side, whatare the most powerful levers or
(11:27):
items that might help yourlifespan and your health span.
So we've talked in many episodesin the past about kind of what
risk factors have great impactand when I think about what you
might worry about, for me thereare three elements.
(11:47):
The problem you're trying toavoid, say, a heart disease or a
stroke or cancer it's a commonthing, a common thing.
Second, there is a risk factorassociated with it and that risk
factor matters a lot.
And finally, the risk factor isactually pretty common.
(12:08):
So the poster child used to becigarettes.
Cigarettes are a problemrelated to heart disease.
It's a true giant risk factorand up until the last 20 or 30
years, many, many people smoke.
Fortunately, fewer do today.
Obesity today probably fitsinto it.
(12:28):
It affects many diseases.
It's an important risk factorand the risk factor is common.
All right, so let's take a fewdiseases and figure out what are
some of the factors you mightwant to build into your list of
how to live long and well.
So in episode 18 and 37, Italked about how to reduce our
(12:53):
risk of heart disease and manyof the critical factors included
blood pressure getting thatunder control.
Cholesterol getting that undercontrol, diabetes avoiding it or
managing it and, of course,exercise and being overweight.
All of these are known powerfulrisk factors.
(13:15):
In another episode, we talkedabout stroke and reducing our
risk of stroke, and we talkedabout something called
population attributable risk.
But, once again, many of thefactors that help us reduce the
risk of stroke are the ones wejust talked about Get your blood
pressure under control, makesure you're getting your
(13:36):
exercise.
So if you're worrying aboutyour heart, you're probably
simultaneously worrying aboutyour brain and strokes.
Okay, third thing that's veryimportant to us dementia.
One in nine people above theage of 65 will have dementia.
(13:57):
Now, when we talked aboutcardiovascular, that's one in
two men or one in three women.
So these are pretty commonthings we want to worry about.
Again, the good news forcognitive decline, which was
episode 13,.
If you want to listen a bitmore about how we reduce our
risk of cognitive decline, again, many of those factors are the
(14:20):
same Our blood pressure, ourexercise, our sleep.
So if you're working on it forone area, you're getting the
benefit that it helps others.
Well, what about cancer?
That's a really important areawe'd like to avoid.
Four in 10 people will getcancer at some point in their
life.
(14:41):
For colon cancer, it's aboutcolon and rectal cancer, it's
about 4%.
For breast cancer, for women,it's about 13%.
So these are real issues to beconcerned about.
Fortunately, screening testslike colonoscopy reduce the risk
of colon cancer.
(15:01):
Mammograms reduce the risk ofbreast cancer.
So, again, these might bethings you want to fold into
your plan.
Action item number one start alist.
A list not of everything you'regoing to do, but a list of what
you might do.
(15:21):
And some of these on your listcould be those risk factors.
Make sure your blood pressureis under control, your
cholesterol you've got a properweight, diabetes is taken care
of and you're not smoking.
And you might add to that listsome of these critical
activities and behaviors likesleep, like exercise and like
(15:44):
social relationships, and youmight add specific interventions
.
Get your screening for cancer,like I talked about.
Get your vaccines for flu orpneumonia or shingles.
Covid is a discussion foranother day.
All of these elements areevidence-based and really,
(16:08):
really impactful.
So that might be what we callour first tier list, where the
evidence says these half a dozenor so things will really make a
difference and you might wantto make sure that you prioritize
those.
Okay, at the beginning of theepisode I rattled off a list of
(16:28):
a zillion things you might do,and on my first tier list you
did not hear sauna cold plungelist.
You did not hear sauna, coldplunge.
Nutrition other than just goodweight, meditation, breath work,
(16:51):
microbiome yes, for each ofthese there's evidence that they
will help us live long and well.
I have episodes on each one.
So of course I believe it.
But in the grand scheme ofthings, the benefit of a cold
plunge, the benefit of breathwork, are not nearly as powerful
, in my opinion, as the ones wejust had above.
So my first tier list may be aplace for you to begin.
(17:16):
Of course, as we'll get to inthe personalized approach.
If these other elements areimportant to you, then Of course
, as we'll get to in thepersonalized approach, if these
other elements are important toyou, then you should add them as
well.
Okay, so to develop now thesecond approach.
So the first approach was theobjective one.
What does the evidence tell uswill make the biggest impact on
(17:36):
living long and well?
Based on the evidence?
So now we need to modify thatwith the personalized approach,
which is built around whatmatters to you most?
In essence, it's a personalizedcost-benefit assessment.
So before we get to what to doand how to do it.
(18:00):
In the personalized area, let'stalk about a few terms.
So, when you think about what'simportant to you, there are two
common words.
We talk about lifespan andhealthspan.
Lifespan is how long you aim tolive or hope to live.
Health span is how many ofthose years are you active,
(18:21):
functional, don't have a lot ofpain, your spirits are good, and
those are the things we thinkabout.
And so, as we've talked aboutwhat might be on your list or
your top tier list, that's whatwe're thinking about, but
there's a third concept that Irecently ran across, called joy
(18:43):
span.
So we have lifespan, we havehealth span and we have joy span
, and this was put together by awoman by the name of Carrie
Burnight, a gerontologist.
She has a book on this withthat title, and basically what
she's putting out is that, as wethink about what we want to
(19:04):
maximize in our life, yes, yearsof life are important, and
being very functional andhealthy is very important, but
ultimately, it may be about howmuch joy we have in our life.
So it may not be we have tohave the most years.
It may not be that we have tobe able to run a marathon when
we're 65 years old, that it maybe a lot about joy.
(19:28):
Now you can define joy in manyways.
Some elements consist ofcontentment or gratitude, or
meaning and purpose, and she hasfour elements in a matrix,
which are that you want tocontinue to grow, you want to
adjust as things change orhappen, you want to connect to
(19:50):
others and you want to give back.
So, as you think through this,one way of personalizing it is
to decide how important islifespan versus healthspan,
versus joy span, because that'sgoing to help refine your list.
Another piece of the puzzle iswe talked in episode 21 about
(20:12):
health type.
Now, what is health type,health type?
There are five of them thatI've put together and there's a
quiz.
I'll have the link in the shownotes.
Many of you have taken it, butit does change over time.
You might want to retake it,and your health type tells you
how you acquire informationabout health, how much
(20:34):
information you acquire and howyou make decisions.
Some of the health typesinclude the holistic health
hacker that's me, who wants tolearn everything about it and do
as much as possible.
Then you have the single-mindedachiever.
They're very focused on oneaspect of health and may not be
(20:55):
focused on all the other areas.
Then you have something, a typecalled the contentment creator.
Life matters, health matters,but the health issues need to
fit into life, so they're notgoing to turn their life into a
pretzel to do everything.
Action item number two take thequiz.
Retake the quiz.
(21:16):
You'll get a report all aboutyour type and how you might
approach health.
This could be a way for you tobegin to refine your list of
what to do.
The third piece of the frameworkpuzzle is think about your
context.
Why do you want to be healthy?
(21:38):
Why do you want to have healthspan?
Well, you might want to be avery active grandfather, and so
you want to stay in shape and bearound as long as possible.
For that you may be an avidskier or golfer or play
pickleball.
Or you love to go backpackingOkay, that's critical to you.
Love to go backpacking?
(22:01):
Okay, that's critical to you.
And as you think about the manythings you could do or not, do
keep that in mind.
You may be someone who loves totravel, wants to have the
energy, wants to have thestrength to take your suitcase
and put it in the overhead binon the plane.
Okay, action item number threewhat matters to you most?
Lifespan, healthspan, joy spanor a blend?
(22:29):
Now we're on to part three, thenext steps.
So you develop the beginningsof your list, maybe use the
objective approach.
Maybe you pulled together thosesix or eight items that
objectively seem to have thegreatest impact and you're going
to put that on your list.
Now you may think about yourlife and you might say from a
(22:50):
personalized standpoint boy, ifyou fell and broke your hip,
that would be a real problem andreally upset your life.
So you might add more strengthwork or more balance work.
You may feel like you don'thave as much energy as you like
and when you do a cold plungeyou do feel energetic.
(23:12):
Well, of course, you're goingto want to add that to your list
.
You may be someone who facesand experiences anxiety a lot.
All right, meditation may besomething to put on your list.
Or if you have digestionproblems, discomfort in your
belly, bloating, you might wantto emphasize nutrition or the
(23:33):
microbiome.
So now you're going to take thebasic tier one list and add
some other items to it.
Now we're back to the Paretooptimization the 20% of things
that get you 80% of the benefitand that may be what you can do
in your life and it may fit in.
(23:54):
So as you think about the 80-20, fit in so as you think about
the 80-20, what is reallyimportant, what's going to give
you the most benefit, what's not?
You might look at your alcoholintake.
You might say you know, I knowI'm supposed to have less than
three or five drinks a week.
I'm going to drink a little bitmore alcohol because that's
(24:14):
very important to me.
Obviously, I'm not saying drink20 drinks a week or have three
or four a night.
But you might edge towards alittle bit more understanding.
Yeah, there's an increase insome risk, but again, life is
about enjoyment.
You might say that's okay.
(24:36):
Or you might say, look, I knowDr Bobby says that a cold plunge
would be really good for me,but I don't enjoy it, I don't
want to do it.
Okay, maybe that's somethingyou don't include because from a
Pareto optimization standpointit isn't going to give you as
much benefit as the other things.
(24:56):
So, ultimately, you take yourlonger list of what you would
ideally like to do, pare it backto meet your reality and your
preferences.
Now, if you're going tocontinue to be able to do this,
day in, day out, week in, weekout.
You need to enjoy what you'redoing.
(25:17):
So, as part of your exercise,as an example, you may enjoy
going to the gym Great, maximizethat.
You may enjoy cooking.
That may be something you love.
So nutrition will maybe be abigger part than it might be for
somebody else.
Ultimately, you need to lay outa realistic plan.
Action item number fourfinalize a list that works for
(25:43):
you.
Finalize it and perhaps onceevery quarter, every three
months or so, review it, updateit, modify it as you need.
Okay, so I've given you a wholelot of things to think about
and ways to think about it.
Now it might be helpful for youto know where do I net out?
(26:05):
So, as I went through thisexercise, what did I come up
with?
Because I realize, even thoughI talk about all these things,
you know I don't have the timeto do everything every day or
every week, because I have aranch to run, I have a bed and
breakfast to run, I haveathletic events like triathlons,
(26:25):
ironmans to train for, I have afamily, I have lots of things
I'd love to do on the ranch.
So when I reviewed all this, Irealized for me, living long is
really important, of course.
But first and foremost I wantto maintain my function.
I want to be able to be on theranch, I want to be able to be
(26:47):
active, I want to be able tocompete in races.
That I do so it doesn't meanI'm ignoring lifespan, but I'm
emphasizing what will help memaintain function, which often
fits into the health span.
Now, as I've thought throughthe joy span element, I'm going
(27:08):
to reflect a bit more and seeare there ways I can incorporate
more of that into my life aswell.
So ultimately I have the big six, dr Bobby's big six.
These are the things that arefirst and foremost for me.
Number one rigorously controlmy heart disease risk and my
(27:32):
brain risk.
So for me critical make sure myblood pressure is under control
, make sure my cholesterol isunder control, so risk factors
that I can absolutely measure,monitor and do something about.
First and foremost for me.
Fortunately, with medicationsI'm doing great on those.
(27:54):
Second of the big six sleep.
I am very focused on getting agood night's sleep, which for me
means getting to bed around 9or 9.30 because I'm always going
to wake up early in the morning.
So that's critical.
Third exercise and strength.
Those are two that are criticalfor me for what I'm hoping to
(28:17):
maintain and accomplish Now.
I could do more balance work, Icould do more flexibility work,
I could do more intervaltraining and I will try to do
more of those, but exercise theaerobic and the strength first
and foremost.
That's number three.
Number four weight.
I want to maintain a good andhealthy weight.
(28:39):
Fortunately, genetically andbecause I'm active, that's been
okay for me.
But that will be front andcenter if at any point I feel
like I'm gaining weight.
Number five alcohol.
I am mindful of the issuesrelated to cognitive impairment
(28:59):
with alcohol over time, thethinning of the brain.
I have an episode on alcohollittle or none, that is the
question, and so I try to limitmy intake of alcohol to two,
three, maybe four drinks perweek.
Three, maybe four drinks perweek.
(29:23):
And finally, number six veryfocused on getting my screening
tests done, my regularcolonoscopies, my PSA levels and
vaccines, because I do believethose are a good way to prevent
preventable illnesses.
So those are the six that arefront and center for me.
They may work for you, they maynot work for you.
Now there are lesser ones, ofcourse.
Meditation is something I try todo the sauna and cold plunge
(29:48):
Intermittently.
I do it a lot, I do it a littlebit, and social relationships
are important, but I have enoughin my life right now.
I think I'm doing okay thereand I generally eat healthy.
Now there are a bunch of thingsI don't worry about because I
have my tier one list.
I don't worry about eatingfermented foods or having enough
(30:11):
fiber in my diet or seed oils,or being obsessive about the
number of fruits and veggies perday or supplements or my
microbiome.
Of course I may eat these foods, I may do some of these things,
but I do pretty much what feelsright.
It's not front and center forme.
(30:32):
All right, let's wrap things up.
Some general thoughts.
To live long and well, to doall the things that we might
want to do, is a marathon, not asprint.
We can't do everything.
Choose the things that mattermost to you.
I hope I've given you aframework for how to think about
that.
Find, from an exercisestandpoint, things that you
(30:55):
enjoy H hiking or pick a ball,or maybe you love being at the
gym.
That will be more maintainableif it's something you love.
Perhaps, since time is limited,double up.
Go to the gym with a friend.
Go for a walk and have coffeewith a friend while you're
walking.
That will allow you to do morethings with a shorter amount of
(31:18):
time.
Give yourself grace to say, no,I'm not going to worry about,
you know, doing a sauna or acold plunge.
I am going to have that youknow, croissant on the weekend,
or maybe two of them.
So have the grace to say I'mnot going to worry about it.
It's not worth it enoughcompared to all the other things
(31:41):
that truly are important.
You may decide some alcohol isokay for you.
You may decide that's not thecase.
You may be willing to give upcertain foods you enjoy.
You may not be.
You may be trying to loseweight and you may say, gosh,
that last 10 or 15 pounds isjust almost impossible to lose.
(32:01):
Okay.
So maybe you give yourself thegrace to say, look, I don't want
to be 30 or 40 poundsoverweight, but the 10, 15
pounds may not be impactfulenough to upend the rest of my
life.
You may have a blood pressureissue and getting it down to the
ideal 120 over 80, less thanthat may not work for you
(32:25):
because you may get dizzy, youmay not feel right.
So again, you're going to getclose to the target, but if you
can't get there, that's okay too.
That's okay too.
So, as we begin to say goodbye,what do you think?
Is it too much work to doeverything in the live long and
well space?
(32:46):
How are you going to frame it?
What are you going to do?
What are you going to perhapsnot do?
Please let me know and I willshare it with others in a
follow-up episode and, again, asalways, share the podcast with
others.
And until next time, let's allaim to live long and well, but
(33:10):
do it from a vantage point ofwhat's feasible, maintainable
and gives us ultimately a wholelot of joy span and gives us
(33:40):
ultimately a whole lot of joyspan.
If you want to continue thisjourney or want to receive my
newsletter on practical andscientific ways to improve your
health and longevity, pleasevisit me at
drbobblivelongandwellcom.
That's, dr, as in D-R Bobbylive long and wellcom.
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Cardiac Cowboys
The heart was always off-limits to surgeons. Cutting into it spelled instant death for the patient. That is, until a ragtag group of doctors scattered across the Midwest and Texas decided to throw out the rule book. Working in makeshift laboratories and home garages, using medical devices made from scavenged machine parts and beer tubes, these men and women invented the field of open heart surgery. Odds are, someone you know is alive because of them. So why has history left them behind? Presented by Chris Pine, CARDIAC COWBOYS tells the gripping true story behind the birth of heart surgery, and the young, Greatest Generation doctors who made it happen. For years, they competed and feuded, racing to be the first, the best, and the most prolific. Some appeared on the cover of Time Magazine, operated on kings and advised presidents. Others ended up disgraced, penniless, and convicted of felonies. Together, they ignited a revolution in medicine, and changed the world.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.