what are some of the other big levers we want to look at when it comes to metabolic Health wow one one that completely caught me by surprise I was unexpected I mean I knew I knew it played a role but I didn't I sort of underestimated the role and that was um mindset and sort of mental approach to things um and it's it's almost like the future we imagine how we look at the world how we envision the future how we envision our future affects the future we will have in other words it's not not just about you know not being depressed not having anxiety which is certainly a big factor we want to be you know we want to be healthy but I think it goes above just a baseline being mentally healthy we want to go beyond that and have it a mindset of abundance and a mindset of having a purpose in our lives I mean it's no surprise that you know many people retire or many people die at age 66 in this country and why is that well that's because they retire at age 65 and they lose their purpose I mean what is it firefighters most of them die within five years after retiring you know I mean there's there's some interesting statistics there about about purpose so I think I think the the future we imagin for ourselves is can be the future we create in other words um if if I look at um older age as a time of infirmity a time of decline a time of uh uh impairment it's nothing I look forward to and it there's a good chance it will likely become that for me if I look at my life as a Time age of a abundance a possibility of of goals I want to accomplish down the road there's a good chance that will happen I mean I used to make a uh not a joke but a comment about you know talking about the phenotypes of Aging all the stuff like wrinkles and you know gray hair that we we talked about before and I and I used to say well you know we could take bot talks for wrinkles right I'm in Southern California you know that's un very popular here I'm obviously without taking it but uh but I I sort of made the comment well you know the the the sad part is that people who you know you could take Bo talks for recal but people will eventually find out that taking bot talks for recal doesn't make you live longer it doesn't affect your longevity at a core level and then then began to have conversations with people and they said you know are you sure of that you know in other words and what they were pointing pointing out is that people who Embrace youthful Vitality they look at their life as you know something happening long term and they make the effort to you know get the botox or they they they look at life as you know powerful rather than someone look looking at it like I'm dying I'm gonna die and guess what one of these days I'll be right you know that's true they will people who look at it as a chance of empowerment actually may live longer so people you know getting the Botox and it it it's about the mindset you know I I have a friend uh you know was talking talking to him and I said yeah what are you doing this summer he goes I'm going to Burning Man is probably the last one I'm gonna go to though you know because he's in his 70s and and I think well why what do you what's going on you know uh is it you planning on dying or something and and that was sort of the unspoken thing I'm going to be I'm old but with that attitude you are old you will be old you know but if uh if if it's like no I'm I'm gonna go I'm waiting I'm gonna go on my H hundredth uh to the burn and you know do this or whatever whatever festival or you know event you look forward to uh that that mindset plays a role and and then I began to ask myself like go well sure that makes sense uh how could it possibly tie in mechanistically you know what what you know we're we're all evidence-based right we we want scientific papers how can we make a mechanism that that ties in mindset to um to aging better well one thing is stress right if we look towards our future Life as a life of Joy abundance accomplishment and purpose you know I'm going to do great things it may be great things with my kids or my grandkids or it may be you know great things for my charity or my job or whatever I'm doing but looking towards the future as a place of abundance um it it changes the way we we experience stress and stress is affecting our inflammation you know directly drives inflammation drives insulin resistance all these things so so how do we affect stress by by our mindset well stress is really interesting this was this is another wakeup call for for me that I hadn't thought of before is stress is one of the biggest drivers in aging and and all these things through inflammation and these other factors but stress you ask people what causes stress is well what happens to me in the world it's the environment right I don't get to you know pick the political candidates or you know pick there's an earthquake or you know stuff happens you know and and and you know it's stressful well that's true true sort of but it's not completely true actually stuff happens in the world and we don't get to control what happens in the world right but stress is not what happens in the world stress is how we respond to what happens in the world how we you me everyone else individually responds to what happens in the world and so a similar thing can have a different response where it starts raining I could get really stressed out because my my nice new clothes ruined and da d da it's a stressful experience on the other hand it's raining it's warm it's beautiful it's glorious it's a I love it you know I love the feel of rain it's a beautiful moment or an extreme example I have surgery it's extremely painful uh I'm extremely stressed out the same amount of pain a similar surgery could be a joyous experience to someone else who's having a baby you know it and it a lot stress we get to filter through our expectations through our view of the world through the reality that we create and and we get to create it through our mindset and I think this is really underestimated and it's a it's it it's really a a overlooked opportunity in in health care and Longevity for all of us you mentioned inflammation there tying the stress to health as a whole any other ties physiology wise yeah I mean the the the the stress I mean inflammation is the you know the ground the the ground truth on that but also driving um metabolic metabolic conditions like infl insulin resistance inflammation insulin resistance metabolic disease are all all interrelated so I think I think it it drives all of those as well and just the stress this stress really frames our reality in other words if I look at the future and it's very stressful that's a very dark future and I'm not I'm not you know happy about it and I'm I maybe I don't want to live that long you know on the other hand if if the future is joyous with opportunities not that everything is Happy um but but if I look at it with a with a attitude a mindset of growth a m a mindset of abundance it changes the way the reality appears I think and pivoting off of stress into exercise these two are tied together exercise being a modality we can use to drive down our stress and also exercise is tied to metabolic Health through even walking after meals putting on muscle mass so I'll have you bring exercise in and talk about how you use that personally and how people can use that as a tool for metabolic health yeah exercise is is is huge and I want to divide it into two parts first is um the the obvious one physical exercise and then if we can we can come to mental exercise but physical exercise is is really important for all sorts of reasons exercise in itself is stressful so um but it's but it's a good kind of stress you know it and we re we could react to it positively and all um one thing I wasn't aware that was sort of a wakeup call but it maybe it shouldn't have been is that exercise like almost everything else we do there's there's a good amount and a bad amount in other words low amounts of exercise which which most of us fall into is bad but there's actually there's actually some growing evidence that large amounts of exercise Beyond a certain point could be harmful so um it's kind of a U-shaped curve and the data came in with ultramarathoners ultra athletes where they actually have increased calcium scores and they have increased corn Rarity of calcium out of proportion to their age group or anything that they felt is tied to this the stress of this exercise but then then you may say well maybe it's maybe it's spous it's related to calcification but it's not really heart disease it's just calcification the vessel maybe due to flow or something but then a darker uh part became revealed and they actually have myocardial fibrosis and uh abnormals of heart abnormalities of heart wall function which is really concerning so I guess the point is that uh that there's a sweet spot for exercise most of us are not doing enough but but on the far extreme we need to be at least aware that you know we don't want to do too much certainly to injure our bodies with our joints and everything else but also there's a basic cardio metabolic Factor going on there so I think you know that's important um uh resistance training you know for osteoporosis muscle mass for glucose metabolism just handling insulin handling all these things there's so many so many advantages of exercise and the physical exercise I think that that's huge the mental exercise is sometimes overlooked with with people but I think it's equally important what blew me away was that my training is in Radiology so you know looking at X-rays and stuff like that um I was blown away by the fact that that things like both physical exercise but also mental exercise could show within a short amount of time in a matter of months actually changes in the brain and actual brain growth uh presumably related to its effects on bdnf brain deriv neurotropic factor which you know certain parts of the brain like you'd expect the hippoc campus can actually increase in size with with these various activities so it's it's really amazing but so for for mental mental activity it's you know it's not it's not like watching TV or watching a movie Something passive but ideally it's something active that's engaging your your brain I mean if ideally you could do something that engages both physical and mental activity like playing a musical instrument or uh something where you're you know doing both is good if you're if you're not doing that um I just started doing uh uh a language uh dual lingo I can do it on my phone it's a free app doesn't cost anything I do it uh five minutes a day I'm now at 1,400 days a continuous streak and uh slowly but surely five minutes a day I'm learning Mandarin Chinese and um uh what I what I'm doing if I the next level up after if you're learning a language and you want to up your game there's so many resources on the internet today so what I did is I took Siri or my uh my app on my phone whatever you're Alexa Siri whatever you use but I just had it change into MADD only so now if I say hey Siri set a timer for 15 minutes yeah well basically it responds in Chinese it says I don't know what you just said so now it forces me every time I interact with Siri I have to do something that I have to one get my pronunciation right so that I so that it works so I now I say uh Hey Siri dingi arong and and now sure enough 20 minutes so there there are all sorts of things you can do like that if you're not into foreign language uh you know obviously Crossroad puzzles you know sodaku those kinds of things like that but but mental stimulation even just going for a walk and talking to your neighbor you know engaging in community engaging in you know the the blue zones were very popular for longevity a few years ago and um with uh certain parts of the country certain parts of the world where people had very long life expectancies and Dan Butner popularized it with a TV series and uh uh and they there were there were a lot of wonderful things about it Community you know certain types of food getting together you know working in the fields um and and they were but the the sense of community a lot of the other stuff has been criticized recently like the recordkeeping probably uh confused the ages and that was probably a thing and then sadly the the whole Blue Zone brand has recently been sold to a um a group with strong religious uh affiliation which has a strong nutritional agenda which may influence the messaging with that but I think there's a lot of good things to be said about community and family and social interactions with the Blue Zone Theory but that applies to the to the brain exercise anyway all right tying in another piece that fits with the brain and with stress sleep let's talk about its impact on metabolic Health when we're getting enough and then when we're not yeah and I think this is a place where the medical profession is so messed up with this uh because um you know I like many people in my profession or or many other professions I used to carry a beeper around a pager and I would be on call 24 hours a day seven days a week and I'd get called at all weird hours my sleep would get disrupted but you know somehow I thought I was being tough and you know uh I was helping my patients when actually I was probably hurting them and and one wakeup call to me in this book was in researching this book was that um you know you hear some people like donon musk saying oh I only need four hours of sleep at night you know D there's a growing evidence that just like for exercise just like for so many of things that the the the the the cost benefit curve for sleep for quantity of sleep is fairly narrow in other words it appears that that risk of cardiovascular disease and other diseases all these metabolic diseases that I've been talking about uh is a fairly narrow window around eight hours you know and so maybe some people can get by at seven hours maybe some people need nine but if you need much more than that or if you think you can get by much less than that you may be you may be kidding yourself and and sleep we know directly with sleep deprivation you take college kids and there have been controlled studies with this they sleep deprive them and immediately their insulin resistance goes up their their metabolism is messed up they go their glucose is is screwed up there's inflammation so it directly affects these metabolic these Primal metabolic markers that that we're taking so the wakeup call for me was sleep quantity which really which really helped and then the other thing was uh Sleep Quality so you know you got to get the right amount but it's got to be good sleep and there are a number of trackers on your phone or different things that you can do um to look at that I mean an interesting thing happened to me once I once I began on this path and changed my lifestyle and everything I noticed that um I was sleeping a lot better I don't know what it I don't know what it was I wasn't paying attention to it but I was sleeping a lot better to the point that I didn't need an alarm clock anymore so I just sort of woke up naturally and now now I figure if I need an alarm clock to wake up I'm probably not getting enough sleep you know uh so it's it's it's fascinating but yeah sleep I think is another area that's that's overlooked in our in our tool kit for metabolic Health you mentioned trackers there for somebody who's tuned in to this point and you know they've taken in a lot of different information different areas where they're wondering where they're at on this Continuum of metabolic Health how does testing fit into this for somebody early on to see where they're at and then ongoing to continue to keep track of their progress yeah I think I think testing is is key uh to know where where we are on that course and like we talked about the you know the earlier the better I mean these changes start happening in the in people's 30s although these chronic diseases usually don't hit till people are 40 or so although they're they getting early and earlier we're seeing now cancer colon cancer hitting in younger and younger populations and you know obesity type two diabetes used to be called adult onset diabetes now it's occurring in children uh similarly hypertension and everything but so tracking early is good some of the markers I would look at is um hemoglobin A1c which is a marker for glucose damage it's a metabolic marker for insulin resistance you can do uh in you can absolutely measure fasting insulin I mean I use a panel that I that I do from U uh I do a finger stick at home I get about 20 markers I do I do it like once a month or two and it gives me hemog A1C insulin uh LDL uh cortisol testosterone uh FSH homoy it's just a whole whole thing and now these tests are getting so inexpensive and so easy you can even do them from your home and and begin to track where you are in this and it's it's never too early to start thinking about metabolic health and to live a healthy lifestyle because because you know we don't know how how early these things really start and and the sooner we engage in prevention I think the better the outcome and what's the name of that test you were just talking about the finger prick yeah I have it on my website uh you can get it from a company called scifox si foox uh but I have a discount on my website it's about I think it comes out to be about $15 a test or so but it's it's uh it's significantly less than the than the C Fox site but that's who we use and it's a great one so either on my website or at at Cy Fox either one you can you can try it out if you enjoyed that clip you're going to want to head over here and catch the full episode I'll see you over there if I put food into my mouth and it goes into my stomach and my GI tract no matter what the food is it's going to drive inflammation because inflammation is the body's natural protection against foreign material fructose when it's metab