December 7, 2025 • 12 mins
We reframe longevity around health span and show how to train today for the life you want in your last decade. We break down exercise as the strongest lever, the role of energy balance, the metabolic power of sleep, key labs to track, and why purpose and relationships extend life.
• defining health span across physical, cognitive, emotional capacity
• how centenarians delay chronic disease and what we can emulate
• exercise as the most potent intervention for mortality and brain health
• practical 80/20 cardio and non‑negotiable strength training
• nutrition through energy balance and sustainable restriction methods
• sleep as a metabolic lever tied to insulin and recovery
• failures of Medicine 2.0 and incentive misalignment
• three must‑know labs ApoB, Lp(a), APOE genotype
• purpose and relationships as drivers of longevity and happiness
• choosing one preventative action to start today
Since the system is slow and the financial incentives are often backwards, what is one immediate unreimbursed preventative action you can take today? Maybe it's finally getting that APOB test, even if you have to pay for it yourself. Or maybe it's just committing to that 80 20 cardio structure. Whatever it is. Think about that one calculated move you can make right now to protect the you that will exist in 30 years.
This podcast is created by Ai for educational and entertainment purposes only and does not constitute professional medical or health advice. Please talk to your healthcare team for medical advice.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
Welcome back to the Deep Dive.
SPEAKER_01 (00:01):
Great to be here.
SPEAKER_00 (00:02):
So today we're jumping into a topic that is,
well, it's fascinating but alsoreally challenging.
SPEAKER_01 (00:08):
It is.
SPEAKER_00 (00:08):
We're taking a look at the science of longevity, and
we're drawing a lot from thework of uh Dr.
Peter Atiak.
SPEAKER_01 (00:15):
Who's, you know, one of the biggest voices in this
whole space.
SPEAKER_00 (00:18):
Absolutely.
And our mission today, it's notjust about figuring out how to,
you know, stick around longer.
It's about making those extrayears actually worth living.
SPEAKER_01 (00:28):
Aaron Ross Powell That distinction is just it's
everything.
For so long, the focus has justbeen on lifespan.
Right.
And as the sources point out,lifespan is binary.
You're either alive or you'renot.
But if you live to be 110 andthe last decade is just
miserable and debilitating.
SPEAKER_00 (00:45):
You haven't really won anything.
SPEAKER_01 (00:46):
You haven't won, no.
SPEAKER_00 (00:47):
So we're shifting the goalpost here.
We're aiming for health span.
Can you just quickly unpack whatthat really means?
SPEAKER_01 (00:53):
Yeah.
So health span has a few keyparts.
There's your physical capacity.
Can you still move?
Can you function?
There's your cognitive health.
Are you still sharp?
And then critically, youremotional well-being.
And this is where we immediatelybump up against our current
system.
SPEAKER_00 (01:08):
Medicine 2.0, as it's often called.
SPEAKER_01 (01:10):
Exactly.
That system is laser focused onprolonging life, on lifespan,
because that's what's easy tomeasure.
SPEAKER_00 (01:17):
What gets measured gets managed.
SPEAKER_01 (01:19):
Right.
It prioritizes keeping the heartbeating, sometimes at any cost,
often at the expense of quality.
Our goal here is to flip thatscript.
SPEAKER_00 (01:28):
Prioritize quality first.
SPEAKER_01 (01:30):
Because that's actually the best way to get
longevity anyway.
SPEAKER_00 (01:33):
Aaron Powell Okay.
So that shift sounds profound,but it must be so hard to
actually do.
I mean, where does a person evenstart?
SPEAKER_01 (01:40):
Aaron Ross Powell The source material has this
brilliant framing question.
It's tactical.
He doesn't just ask, do you wantto live longer?
He asks, what specifically doyou want to be able to do in the
last decade of your life?
SPEAKER_00 (01:52):
I love that.
It makes it concrete.
So we're not talking about someabstract idea.
We're talking about being ableto pick up your grandchild.
SPEAKER_01 (01:59):
Aaron Powell Without throwing your back out.
SPEAKER_00 (02:01):
Yeah.
Or being able to travel and youknow actually walk around the
city you're visiting.
SPEAKER_01 (02:04):
Aaron Powell Exactly.
And here's the crucial insightfrom that.
To be able to do those things inyour 80s or 90s, you have to
start training for them now.
SPEAKER_00 (02:12):
Aaron Ross Powell It's a retroactive requirement.
SPEAKER_01 (02:14):
Trevor Burrus Perfectly put.
If you wait until you're 75 totrick and get strong, it's it's
just too late.
SPEAKER_00 (02:18):
Aaron Powell So you're training today for the
person you want to be in 30 or40 years.
SPEAKER_01 (02:22):
Yes.
Now let's connect that to thepeople who seem to get this for
free centenarians.
SPEAKER_00 (02:27):
Aaron Powell The people who live to be a hundred.
What's their secret?
SPEAKER_01 (02:30):
Aaron Ross Powell Well, it's not some magic diet.
The single thing they all shareis a huge delay in the onset of
chronic disease.
SPEAKER_00 (02:37):
Aaron Powell So the Four Horsemen, as the sources
call them.
SPEAKER_01 (02:40):
Aaron Powell That's right.
Cardiovascular disease, cancer,neurodegenerative disease, and
things like falls from frailty.
Centenarians get these things 20to 30 years later than the
average person.
SPEAKER_00 (02:52):
So they're biologically 20 to 30 years
younger than their birthcertificate says.
SPEAKER_01 (02:56):
In a way, yes, it's a massive phase shift.
But here's the kicker the datashows they're often more likely
to smoke or drink or eat poorly.
SPEAKER_00 (03:05):
Wait, really?
So it's not lifestyle.
SPEAKER_01 (03:08):
For them, it's mostly genetic luck.
They have protective genes thatthe rest of us just don't.
SPEAKER_00 (03:14):
So what's the takeaway for us, the genetically
unlucky?
SPEAKER_01 (03:16):
Aaron Powell The takeaway is that we have to
create that benefit ourselvesdeliberately.
We have to use the toolsexercise, nutrition, sleep to
engineer that same phase shiftin disease.
SPEAKER_00 (03:27):
You have to earn what they were just given.
SPEAKER_01 (03:29):
That's the challenge, and that's the
opportunity.
SPEAKER_00 (03:31):
Okay, so let's get into those tools.
The sources make an incrediblystrong case, for one of them
being, and I'm quoting here,hands down the most potent
intervention.
SPEAKER_01 (03:40):
Exercise.
SPEAKER_00 (03:41):
Exercise.
SPEAKER_01 (03:42):
And the evidence is just, it's staggering.
When you look at all-causemortality, your risk of dying
from anything exercise is thebiggest lever you can pull?
SPEAKER_00 (03:50):
More than anything else.
SPEAKER_01 (03:51):
More than anything.
Hod cardiorespiratory fitness,high muscle mass, high strength.
These are better predictors ofliving a long life than any
other metric we have.
SPEAKER_00 (03:58):
Aaron Powell Okay, hold on.
Are you actually saying that thebenefit of being incredibly fit
is greater than the harm from,say, smoking or having high
blood pressure?
SPEAKER_01 (04:10):
Aaron Powell Yes.
That's what the data says.
It sounds wild, I know.
SPEAKER_00 (04:13):
It feels completely backward.
How does that work?
SPEAKER_01 (04:17):
Well, it's not that fitness makes smoking okay.
It's that the protectivemechanisms that exercise builds
in your body, like loweringinflammation, optimizing your
metabolism, are so powerful thatthey can actually overpower some
of these other huge negativeinputs.
SPEAKER_00 (04:32):
Aaron Powell Wow.
Okay, so that covers lifespan.
What about health span, thequality piece?
SPEAKER_01 (04:36):
Aaron Powell It does double duty.
It's probably the greatest toolwe have for protecting the brain
from neurodegeneration.
And physically, of course, it'swhat builds the strength and
stability you need to do allthose things we talked about
wanting to do in your lastdecade.
SPEAKER_00 (04:47):
Right.
But the pushback is always time.
I don't have time to live in thegym.
So what's the actualprescription here?
SPEAKER_01 (04:53):
Aaron Powell And that's the real drawback, we
have to admit it.
Exercise takes more time than,say, taking a pill.
Right.
And the structure isnon-negotiable.
You must do strength trainingalongside your cardio.
You can't neglect muscle.
SPEAKER_00 (05:06):
Aaron Powell Okay.
And for the cardio, there's aspecific formula, an intensity
split.
SPEAKER_01 (05:10):
Yeah, the 80-20 rule.
About 80% of your cardio shouldbe low intensity.
Zone two, where you can hold aconversation, but you're a
little breathless.
SPEAKER_00 (05:19):
Building that aerobic base.
SPEAKER_01 (05:20):
Exactly, building the mitochondrial engine.
And then the other 20% has to behigh intensity, all out, where
you can't speak at all.
SPEAKER_00 (05:28):
I like how the source material approaches this
with patients.
It's not about dictating.
SPEAKER_01 (05:32):
No, you don't start by saying you need 10 hours a
week.
You start by asking how manyhours are you willing to commit?
And then you build the mosteffective plan within that time
while showing them the data onwhy it's the best investment
they can make.
SPEAKER_00 (05:45):
It becomes a resource allocation question.
Very powerful.
Okay, let's shift from output toinput.
Nutrition.
SPEAKER_01 (05:52):
Yeah, and I'm so glad the sources immediately
pivot away from the diet wars.
SPEAKER_00 (05:55):
Me too.
SPEAKER_01 (05:56):
It's not about specific fad diets, it's about
basic biochemistry.
The single most important factoris the energy balance in your
body.
Are you overnourished or are youundernourished?
SPEAKER_00 (06:07):
And for almost all of human history, the problem
was being undernourished.
Our bodies got really, reallygood at storing energy.
SPEAKER_01 (06:14):
Incredibly good.
We call it fat.
It was a survival mechanism.
But now, in our modern worldwith, you know, food available
2004-7.
SPEAKER_00 (06:22):
That system has backfired.
SPEAKER_01 (06:24):
Completely.
Most people now are chronicallyovernourished.
So the primary strategy forlongevity with nutrition is
reduce energy intake.
SPEAKER_00 (06:32):
And there are three ways to do that.
SPEAKER_01 (06:34):
Right.
The first is the most directcaloric restriction, just
deliberately eating less food.
It's simple, but it can bereally hard to stick with.
SPEAKER_00 (06:42):
Constant hunger is not fun.
The second way is dietaryrestriction.
SPEAKER_01 (06:46):
So this is where you cut out certain things, like a
ketogenic diet cuts out carbs.
And the sources point out thisoften works by indirectly making
you eat less.
You just have fewer options.
SPEAKER_00 (06:55):
Right.
And the third, which is reallypopular right now, is time
restriction, intermittentfasting.
SPEAKER_01 (07:00):
Same principle, just a different method.
You only eat within a smallwindow, say six or eight hours.
It's just harder to cram as manycalories into that shorter time.
SPEAKER_00 (07:09):
So no matter which one you choose.
SPEAKER_01 (07:11):
The benefit comes from the energy reduction.
And the key is that none of themshould be done mindlessly.
Each one has potential pitfallsyou have to be aware of.
SPEAKER_00 (07:20):
Mindfulness seems to be the key for all of this.
Okay, let's talk about the nextpillar.
Sleep.
The sources call it anevolutionary enigma.
SPEAKER_01 (07:29):
Yeah, I love that framing.
Why would evolution make us liedown totally unconscious and
vulnerable for eight hours aday?
SPEAKER_00 (07:37):
It must be doing something unbelievably.
SPEAKER_01 (07:47):
Well, it's essential for the brain.
Cleaning out waste,consolidating memories.
But the big link to longevity isits role in metabolism.
SPEAKER_00 (07:55):
Could you connect those dots for us?
SPEAKER_01 (07:57):
Absolutely.
Poor sleep, not enough of it, orpoor quality can be just as
responsible for things likeobesity, insulin resistance, and
type 2 diabetes as a bad dietis.
You really can't fix yourmetabolic health.
If you don't fix your sleep,they are completely intertwined.
SPEAKER_00 (08:12):
Okay, this holistic view leads us right into a
pretty sharp critique of ourcurrent healthcare system,
Medicine 2.0.
SPEAKER_01 (08:21):
Yeah, the critique is all about the economic
incentives.
The system is built to diagnoseand treat things with pills and
procedures.
It's not built to prevent them.
SPEAKER_00 (08:31):
It's reactive, not proactive.
SPEAKER_01 (08:33):
Entire.
SPEAKER_00 (08:34):
What's the clearest example of that?
SPEAKER_01 (08:35):
It's type 2 diabetes.
Insurance will pay a fortune foryour insulin and doctor's visits
after you get diagnosed, butthey won't pay a doctor much, if
anything, to spend an hour withyou before the diagnosis
counseling you on diet andexercise to prevent it from ever
happening.
SPEAKER_00 (08:50):
The whole reimbursement model is
backwards.
SPEAKER_01 (08:52):
It is.
And to be fair, that model wasamazing for its time.
It doubled our lifespan bytreating infections and
injuries.
But that playbook just doesn'twork for chronic diseases that
build up over decades.
SPEAKER_00 (09:04):
So to fix this, we'd have to change the entire
incentive structure.
SPEAKER_01 (09:08):
Exactly.
You'd have to pay doctors forprevention, and you'd have to
incentivize patients to careabout their health 30 years
before a heart attack shows up.
SPEAKER_00 (09:17):
Since that system change is probably a long way
off, let's give the listenersomething they can do now.
What are the key lab tests theyshould ask their doctor for?
SPEAKER_01 (09:24):
Okay, this is so important.
Three numbers everyone shouldknow.
Number one, your APOB.
SPEAKER_00 (09:30):
APOB.
What is that?
And why is it better than thestandard cholesterol panel?
SPEAKER_01 (09:36):
So APOB is a direct measure of the concentration of
all the lipoprotein particlesthat actually drive
atherosclerosis, the plaque thatbuilds up in your arteries.
SPEAKER_00 (09:46):
So it's measuring the things that carry the
cholesterol, the deliverytrucks, so to speak.
SPEAKER_01 (09:50):
Exactly.
It's the number of trucks, notjust the total cargo.
And heart disease fromatherosclerosis kills about 19
million people a year.
Yeah.
It's the biggest killer by far.
If you don't know your APOB,you're flying blind.
SPEAKER_00 (10:02):
Okay, number one is APOB.
What's number two?
SPEAKER_01 (10:05):
Number two is LP little A.
You only need to get it checkedonce in your life.
SPEAKER_00 (10:09):
Why only once?
SPEAKER_01 (10:10):
Because it's almost entirely genetically determined.
It's another particle thatdramatically increases heart
disease risk.
And knowing you have it tellsyou that you need to be much
more aggressive on preventionfor your entire life.
SPEAKER_00 (10:22):
Got it.
And the third one.
SPEAKER_01 (10:24):
The third is your APOE genotype.
This is a gene that's reallyimportant for both Alzheimer's
and cardiovascular disease risk.
Knowing your genotype helps youand your doctor decide just how
hard you need to press on allthese other levers we've been
talking about.
SPEAKER_00 (10:38):
It's all about having the data to build a
long-term strategy.
SPEAKER_01 (10:42):
Precisely.
SPEAKER_00 (10:42):
Okay, we've covered the physical, the biochemical,
but the sources save the most uhprofound pillar for last
emotional health.
SPEAKER_01 (10:51):
Yeah, and it's framed by this just devastating
question from a therapy session.
Why do you want to live longerif you're so unhappy?
SPEAKER_00 (10:58):
Oof.
Yeah.
SPEAKER_01 (10:59):
I mean, that's the ultimate metric, isn't it?
It's the why.
It doesn't show up on a labreport, but if your life is
empty and you lack connection,living longer is a curse.
It's not a blessing.
Nothing else matters.
SPEAKER_00 (11:11):
So what are the key drivers of emotional health for
longevity?
SPEAKER_01 (11:14):
Two main things a sense of purpose and strong
relationships.
The data is clear on this.
There is a strong correlationand probably causation between
happiness, social connection,and how long you live.
SPEAKER_00 (11:28):
People with strong relationships just live longer.
SPEAKER_01 (11:31):
And happier lives.
And the really empowering partis that this isn't fixed.
You can work on this, you candeliberately bend your emotional
health curve just like you canbend your fitness curve.
SPEAKER_00 (11:43):
It's an active process.
SPEAKER_01 (11:44):
An active process of building a life that's actually
worth living for a long time.
SPEAKER_00 (11:48):
So to pull this all together, this whole deep dive,
this transformation, it's notabout just avoiding death.
It's about demanding quality,that health span in every single
decade.
And it's driven by exercise,mindful nutrition, sleep, and
this bedrock of emotionalpurpose.
SPEAKER_01 (12:04):
And that's the whole point.
We have the knowledge, thecentenarians get these benefits
from their genes, but theinformation we've gone over
today, it gives the rest of usthe tools to earn that same
outcome through decades ofdeliberate effort.
SPEAKER_00 (12:15):
But as we've discussed, our medical system is
set up to wait for the problembefore it acts, before it pays
for anything.
SPEAKER_01 (12:21):
Which brings up a really practical question for
you, the listener.
Since the system is slow and thefinancial incentives are often
backwards, what is one immediateunreimbursed preventative action
you can take today?
Maybe it's finally getting thatAPOB test, even if you have to
pay for it yourself.
SPEAKER_00 (12:40):
Or maybe it's just committing to that 80 20 cardio
structure.
SPEAKER_01 (12:43):
Whatever it is.
Think about that one calculatedmove you can make right now to
protect the you that will existin 30 years.
SPEAKER_00 (12:50):
A powerful thought to end on.
Thanks for diving deep with us.
We'll see you next time.
Welcome back to the Deep Dive.
SPEAKER_01 (00:01):
Great to be here.
SPEAKER_00 (00:02):
So today we're jumping into a topic that is,
well, it's fascinating but alsoreally challenging.
SPEAKER_01 (00:08):
It is.
SPEAKER_00 (00:08):
We're taking a look at the science of longevity, and
we're drawing a lot from thework of uh Dr.
Peter Atiak.
SPEAKER_01 (00:15):
Who's, you know, one of the biggest voices in this
whole space.
SPEAKER_00 (00:18):
Absolutely.
And our mission today, it's notjust about figuring out how to,
you know, stick around longer.
It's about making those extrayears actually worth living.
SPEAKER_01 (00:28):
Aaron Ross Powell That distinction is just it's
everything.
For so long, the focus has justbeen on lifespan.
Right.
And as the sources point out,lifespan is binary.
You're either alive or you'renot.
But if you live to be 110 andthe last decade is just
miserable and debilitating.
SPEAKER_00 (00:45):
You haven't really won anything.
SPEAKER_01 (00:46):
You haven't won, no.
SPEAKER_00 (00:47):
So we're shifting the goalpost here.
We're aiming for health span.
Can you just quickly unpack whatthat really means?
SPEAKER_01 (00:53):
Yeah.
So health span has a few keyparts.
There's your physical capacity.
Can you still move?
Can you function?
There's your cognitive health.
Are you still sharp?
And then critically, youremotional well-being.
And this is where we immediatelybump up against our current
system.
SPEAKER_00 (01:08):
Medicine 2.0, as it's often called.
SPEAKER_01 (01:10):
Exactly.
That system is laser focused onprolonging life, on lifespan,
because that's what's easy tomeasure.
SPEAKER_00 (01:17):
What gets measured gets managed.
SPEAKER_01 (01:19):
Right.
It prioritizes keeping the heartbeating, sometimes at any cost,
often at the expense of quality.
Our goal here is to flip thatscript.
SPEAKER_00 (01:28):
Prioritize quality first.
SPEAKER_01 (01:30):
Because that's actually the best way to get
longevity anyway.
SPEAKER_00 (01:33):
Aaron Powell Okay.
So that shift sounds profound,but it must be so hard to
actually do.
I mean, where does a person evenstart?
SPEAKER_01 (01:40):
Aaron Ross Powell The source material has this
brilliant framing question.
It's tactical.
He doesn't just ask, do you wantto live longer?
He asks, what specifically doyou want to be able to do in the
last decade of your life?
SPEAKER_00 (01:52):
I love that.
It makes it concrete.
So we're not talking about someabstract idea.
We're talking about being ableto pick up your grandchild.
SPEAKER_01 (01:59):
Aaron Powell Without throwing your back out.
SPEAKER_00 (02:01):
Yeah.
Or being able to travel and youknow actually walk around the
city you're visiting.
SPEAKER_01 (02:04):
Aaron Powell Exactly.
And here's the crucial insightfrom that.
To be able to do those things inyour 80s or 90s, you have to
start training for them now.
SPEAKER_00 (02:12):
Aaron Ross Powell It's a retroactive requirement.
SPEAKER_01 (02:14):
Trevor Burrus Perfectly put.
If you wait until you're 75 totrick and get strong, it's it's
just too late.
SPEAKER_00 (02:18):
Aaron Powell So you're training today for the
person you want to be in 30 or40 years.
SPEAKER_01 (02:22):
Yes.
Now let's connect that to thepeople who seem to get this for
free centenarians.
SPEAKER_00 (02:27):
Aaron Powell The people who live to be a hundred.
What's their secret?
SPEAKER_01 (02:30):
Aaron Ross Powell Well, it's not some magic diet.
The single thing they all shareis a huge delay in the onset of
chronic disease.
SPEAKER_00 (02:37):
Aaron Powell So the Four Horsemen, as the sources
call them.
SPEAKER_01 (02:40):
Aaron Powell That's right.
Cardiovascular disease, cancer,neurodegenerative disease, and
things like falls from frailty.
Centenarians get these things 20to 30 years later than the
average person.
SPEAKER_00 (02:52):
So they're biologically 20 to 30 years
younger than their birthcertificate says.
SPEAKER_01 (02:56):
In a way, yes, it's a massive phase shift.
But here's the kicker the datashows they're often more likely
to smoke or drink or eat poorly.
SPEAKER_00 (03:05):
Wait, really?
So it's not lifestyle.
SPEAKER_01 (03:08):
For them, it's mostly genetic luck.
They have protective genes thatthe rest of us just don't.
SPEAKER_00 (03:14):
So what's the takeaway for us, the genetically
unlucky?
SPEAKER_01 (03:16):
Aaron Powell The takeaway is that we have to
create that benefit ourselvesdeliberately.
We have to use the toolsexercise, nutrition, sleep to
engineer that same phase shiftin disease.
SPEAKER_00 (03:27):
You have to earn what they were just given.
SPEAKER_01 (03:29):
That's the challenge, and that's the
opportunity.
SPEAKER_00 (03:31):
Okay, so let's get into those tools.
The sources make an incrediblystrong case, for one of them
being, and I'm quoting here,hands down the most potent
intervention.
SPEAKER_01 (03:40):
Exercise.
SPEAKER_00 (03:41):
Exercise.
SPEAKER_01 (03:42):
And the evidence is just, it's staggering.
When you look at all-causemortality, your risk of dying
from anything exercise is thebiggest lever you can pull?
SPEAKER_00 (03:50):
More than anything else.
SPEAKER_01 (03:51):
More than anything.
Hod cardiorespiratory fitness,high muscle mass, high strength.
These are better predictors ofliving a long life than any
other metric we have.
SPEAKER_00 (03:58):
Aaron Powell Okay, hold on.
Are you actually saying that thebenefit of being incredibly fit
is greater than the harm from,say, smoking or having high
blood pressure?
SPEAKER_01 (04:10):
Aaron Powell Yes.
That's what the data says.
It sounds wild, I know.
SPEAKER_00 (04:13):
It feels completely backward.
How does that work?
SPEAKER_01 (04:17):
Well, it's not that fitness makes smoking okay.
It's that the protectivemechanisms that exercise builds
in your body, like loweringinflammation, optimizing your
metabolism, are so powerful thatthey can actually overpower some
of these other huge negativeinputs.
SPEAKER_00 (04:32):
Aaron Powell Wow.
Okay, so that covers lifespan.
What about health span, thequality piece?
SPEAKER_01 (04:36):
Aaron Powell It does double duty.
It's probably the greatest toolwe have for protecting the brain
from neurodegeneration.
And physically, of course, it'swhat builds the strength and
stability you need to do allthose things we talked about
wanting to do in your lastdecade.
SPEAKER_00 (04:47):
Right.
But the pushback is always time.
I don't have time to live in thegym.
So what's the actualprescription here?
SPEAKER_01 (04:53):
Aaron Powell And that's the real drawback, we
have to admit it.
Exercise takes more time than,say, taking a pill.
Right.
And the structure isnon-negotiable.
You must do strength trainingalongside your cardio.
You can't neglect muscle.
SPEAKER_00 (05:06):
Aaron Powell Okay.
And for the cardio, there's aspecific formula, an intensity
split.
SPEAKER_01 (05:10):
Yeah, the 80-20 rule.
About 80% of your cardio shouldbe low intensity.
Zone two, where you can hold aconversation, but you're a
little breathless.
SPEAKER_00 (05:19):
Building that aerobic base.
SPEAKER_01 (05:20):
Exactly, building the mitochondrial engine.
And then the other 20% has to behigh intensity, all out, where
you can't speak at all.
SPEAKER_00 (05:28):
I like how the source material approaches this
with patients.
It's not about dictating.
SPEAKER_01 (05:32):
No, you don't start by saying you need 10 hours a
week.
You start by asking how manyhours are you willing to commit?
And then you build the mosteffective plan within that time
while showing them the data onwhy it's the best investment
they can make.
SPEAKER_00 (05:45):
It becomes a resource allocation question.
Very powerful.
Okay, let's shift from output toinput.
Nutrition.
SPEAKER_01 (05:52):
Yeah, and I'm so glad the sources immediately
pivot away from the diet wars.
SPEAKER_00 (05:55):
Me too.
SPEAKER_01 (05:56):
It's not about specific fad diets, it's about
basic biochemistry.
The single most important factoris the energy balance in your
body.
Are you overnourished or are youundernourished?
SPEAKER_00 (06:07):
And for almost all of human history, the problem
was being undernourished.
Our bodies got really, reallygood at storing energy.
SPEAKER_01 (06:14):
Incredibly good.
We call it fat.
It was a survival mechanism.
But now, in our modern worldwith, you know, food available
2004-7.
SPEAKER_00 (06:22):
That system has backfired.
SPEAKER_01 (06:24):
Completely.
Most people now are chronicallyovernourished.
So the primary strategy forlongevity with nutrition is
reduce energy intake.
SPEAKER_00 (06:32):
And there are three ways to do that.
SPEAKER_01 (06:34):
Right.
The first is the most directcaloric restriction, just
deliberately eating less food.
It's simple, but it can bereally hard to stick with.
SPEAKER_00 (06:42):
Constant hunger is not fun.
The second way is dietaryrestriction.
SPEAKER_01 (06:46):
So this is where you cut out certain things, like a
ketogenic diet cuts out carbs.
And the sources point out thisoften works by indirectly making
you eat less.
You just have fewer options.
SPEAKER_00 (06:55):
Right.
And the third, which is reallypopular right now, is time
restriction, intermittentfasting.
SPEAKER_01 (07:00):
Same principle, just a different method.
You only eat within a smallwindow, say six or eight hours.
It's just harder to cram as manycalories into that shorter time.
SPEAKER_00 (07:09):
So no matter which one you choose.
SPEAKER_01 (07:11):
The benefit comes from the energy reduction.
And the key is that none of themshould be done mindlessly.
Each one has potential pitfallsyou have to be aware of.
SPEAKER_00 (07:20):
Mindfulness seems to be the key for all of this.
Okay, let's talk about the nextpillar.
Sleep.
The sources call it anevolutionary enigma.
SPEAKER_01 (07:29):
Yeah, I love that framing.
Why would evolution make us liedown totally unconscious and
vulnerable for eight hours aday?
SPEAKER_00 (07:37):
It must be doing something unbelievably.
SPEAKER_01 (07:47):
Well, it's essential for the brain.
Cleaning out waste,consolidating memories.
But the big link to longevity isits role in metabolism.
SPEAKER_00 (07:55):
Could you connect those dots for us?
SPEAKER_01 (07:57):
Absolutely.
Poor sleep, not enough of it, orpoor quality can be just as
responsible for things likeobesity, insulin resistance, and
type 2 diabetes as a bad dietis.
You really can't fix yourmetabolic health.
If you don't fix your sleep,they are completely intertwined.
SPEAKER_00 (08:12):
Okay, this holistic view leads us right into a
pretty sharp critique of ourcurrent healthcare system,
Medicine 2.0.
SPEAKER_01 (08:21):
Yeah, the critique is all about the economic
incentives.
The system is built to diagnoseand treat things with pills and
procedures.
It's not built to prevent them.
SPEAKER_00 (08:31):
It's reactive, not proactive.
SPEAKER_01 (08:33):
Entire.
SPEAKER_00 (08:34):
What's the clearest example of that?
SPEAKER_01 (08:35):
It's type 2 diabetes.
Insurance will pay a fortune foryour insulin and doctor's visits
after you get diagnosed, butthey won't pay a doctor much, if
anything, to spend an hour withyou before the diagnosis
counseling you on diet andexercise to prevent it from ever
happening.
SPEAKER_00 (08:50):
The whole reimbursement model is
backwards.
SPEAKER_01 (08:52):
It is.
And to be fair, that model wasamazing for its time.
It doubled our lifespan bytreating infections and
injuries.
But that playbook just doesn'twork for chronic diseases that
build up over decades.
SPEAKER_00 (09:04):
So to fix this, we'd have to change the entire
incentive structure.
SPEAKER_01 (09:08):
Exactly.
You'd have to pay doctors forprevention, and you'd have to
incentivize patients to careabout their health 30 years
before a heart attack shows up.
SPEAKER_00 (09:17):
Since that system change is probably a long way
off, let's give the listenersomething they can do now.
What are the key lab tests theyshould ask their doctor for?
SPEAKER_01 (09:24):
Okay, this is so important.
Three numbers everyone shouldknow.
Number one, your APOB.
SPEAKER_00 (09:30):
APOB.
What is that?
And why is it better than thestandard cholesterol panel?
SPEAKER_01 (09:36):
So APOB is a direct measure of the concentration of
all the lipoprotein particlesthat actually drive
atherosclerosis, the plaque thatbuilds up in your arteries.
SPEAKER_00 (09:46):
So it's measuring the things that carry the
cholesterol, the deliverytrucks, so to speak.
SPEAKER_01 (09:50):
Exactly.
It's the number of trucks, notjust the total cargo.
And heart disease fromatherosclerosis kills about 19
million people a year.
Yeah.
It's the biggest killer by far.
If you don't know your APOB,you're flying blind.
SPEAKER_00 (10:02):
Okay, number one is APOB.
What's number two?
SPEAKER_01 (10:05):
Number two is LP little A.
You only need to get it checkedonce in your life.
SPEAKER_00 (10:09):
Why only once?
SPEAKER_01 (10:10):
Because it's almost entirely genetically determined.
It's another particle thatdramatically increases heart
disease risk.
And knowing you have it tellsyou that you need to be much
more aggressive on preventionfor your entire life.
SPEAKER_00 (10:22):
Got it.
And the third one.
SPEAKER_01 (10:24):
The third is your APOE genotype.
This is a gene that's reallyimportant for both Alzheimer's
and cardiovascular disease risk.
Knowing your genotype helps youand your doctor decide just how
hard you need to press on allthese other levers we've been
talking about.
SPEAKER_00 (10:38):
It's all about having the data to build a
long-term strategy.
SPEAKER_01 (10:42):
Precisely.
SPEAKER_00 (10:42):
Okay, we've covered the physical, the biochemical,
but the sources save the most uhprofound pillar for last
emotional health.
SPEAKER_01 (10:51):
Yeah, and it's framed by this just devastating
question from a therapy session.
Why do you want to live longerif you're so unhappy?
SPEAKER_00 (10:58):
Oof.
Yeah.
SPEAKER_01 (10:59):
I mean, that's the ultimate metric, isn't it?
It's the why.
It doesn't show up on a labreport, but if your life is
empty and you lack connection,living longer is a curse.
It's not a blessing.
Nothing else matters.
SPEAKER_00 (11:11):
So what are the key drivers of emotional health for
longevity?
SPEAKER_01 (11:14):
Two main things a sense of purpose and strong
relationships.
The data is clear on this.
There is a strong correlationand probably causation between
happiness, social connection,and how long you live.
SPEAKER_00 (11:28):
People with strong relationships just live longer.
SPEAKER_01 (11:31):
And happier lives.
And the really empowering partis that this isn't fixed.
You can work on this, you candeliberately bend your emotional
health curve just like you canbend your fitness curve.
SPEAKER_00 (11:43):
It's an active process.
SPEAKER_01 (11:44):
An active process of building a life that's actually
worth living for a long time.
SPEAKER_00 (11:48):
So to pull this all together, this whole deep dive,
this transformation, it's notabout just avoiding death.
It's about demanding quality,that health span in every single
decade.
And it's driven by exercise,mindful nutrition, sleep, and
this bedrock of emotionalpurpose.
SPEAKER_01 (12:04):
And that's the whole point.
We have the knowledge, thecentenarians get these benefits
from their genes, but theinformation we've gone over
today, it gives the rest of usthe tools to earn that same
outcome through decades ofdeliberate effort.
SPEAKER_00 (12:15):
But as we've discussed, our medical system is
set up to wait for the problembefore it acts, before it pays
for anything.
SPEAKER_01 (12:21):
Which brings up a really practical question for
you, the listener.
Since the system is slow and thefinancial incentives are often
backwards, what is one immediateunreimbursed preventative action
you can take today?
Maybe it's finally getting thatAPOB test, even if you have to
pay for it yourself.
SPEAKER_00 (12:40):
Or maybe it's just committing to that 80 20 cardio
structure.
SPEAKER_01 (12:43):
Whatever it is.
Think about that one calculatedmove you can make right now to
protect the you that will existin 30 years.
SPEAKER_00 (12:50):
A powerful thought to end on.
Thanks for diving deep with us.
We'll see you next time.
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