Bruce Lee is a legend.

He revolutionized movies and martial arts.

He also boasted incredible strength and all-around physicality.

Lee could place his fist one inch from the chest of a man twice his size and unleash a quick, cobra-like strike that’d send his opponent flying. 

Lee could perform push-ups using just two fingers of one hand. 

Lee wasn’t huge, but his lean, chiseled, defined physique was widely admired, and bodybuilders like Arnold Schwarzenegger, Lou Ferrigno, Flex Wheeler, Shawn Ray, and Dorian Yates all acknowledged the impact it had on their careers.

Co-star and fellow martial artist Chuck Norris described Lee’s ripped physique as “muscle upon muscle.”

A woman who asked if she could touch Bruce Lee’s flexed bicep (a common request he appreciated receiving) described it as “warm marble.”

How did Lee develop his strength and physique? Was he simply a genetic freak?

Nope. If you look at early pictures of the Little Dragon, he was a pretty scrawny guy.

Instead of genetics, Lee systematically and relentlessly built his body with physical training.

Thanks to the meticulous research of martial artist and writer John Little, we know exactly what Lee did to achieve his results. Little shares the details of Lee’s fitness training in his 1998 book Bruce Lee: The Art of Expressing the Human Body. The book is an absolute gold mine of fitness history and information, and I highly recommend picking up a copy.

In today’s article, we take a look at the principles that informed Bruce Lee’s training and the components of his regimen that turned a man into a legend.

The Moment Bruce Lee Got Serious About His Physical Training

Throughout his childhood, Lee was incredibly active. He got in trouble at school, and his spiritedness drove him to mischief and street fights. If Lee had grown up in the 21st century, he probably would have been diagnosed with ADHD. His hyperactivity inspired his family to call him “never sits still.”

To channel Lee’s energy into less destructive activities, his father signed him up for kung fu instruction under the tutelage of master Ip Man. Thus, at age thirteen, Bruce began the lifelong practice that would make him a worldwide legend.

By the time Lee was in his twenties, he had developed enough physical conditioning to excel as a martial artist, but remained a skinny guy.

Then came a moment that would take his physical training to the next level.

In the early 1960s, Lee lived in Oakland, CA, and had begun teaching kung fu. Lee didn’t discriminate in who he took on as a student, and according to some accounts, some traditional Chinese kung fu masters in the area weren’t happy with him teaching the martial art to non-Chinese. So in 1964, they presented an ultimatum to Lee: take part in a kung fu battle against their best fighter; if Lee lost, he had to shut down his kung fu class.

While different versions of exactly how the fight went down exist, according to Bruce, the fight lasted three minutes and primarily involved him chasing his opponent around a building until he forced him to submit.

Despite winning, Lee was disappointed with how he performed. He was unhappy about the shape he was in and had begun to feel that the parameters of traditional martial arts were impractical for street fights. He concluded that to realize his full physical potential and become the best martial artist in the world, he’d need to move beyond kung fu and expand his repertoire of physical modalities.

This moment of discontent not only inspired Bruce Lee to get serious about his physical fitness, but birthed a martial art and overall life philosophy he called Jeet Kune Do or the Way of the Intercepting Fist.

The Sources of Bruce Lee’s Physical Training Philosophy

In moving forward from the fight, Lee sought to develop a physical training system that emphasized “practicality, flexibility, speed, and efficiency” and drew from a wide range of training methods.

While Jeet Kune Do sounds like a formal martial art style like Tae Kwon Do, Lee intended it to be “the style of no style” — a martial art that transcended formal rules and incorporated the best ideas from various disciplines.

To find these ideas, Lee became a devoted student of the art and science of physical training.

Even though Bruce had struggled in school, he had a strong commitment to continuous learning and was a voracious reader throughout his adulthood. Over his life, he amassed a huge personal library of over 2,500 titles.

He trained his mind by reading Eastern and Western philosophy (Summa Theologica by St. Thomas Aquinas; The Book of Five Rings by Miyamoto Musashi), as well as American self-help (As a Man Thinketh by James Allen; How to Win Friends and Influence People by Dale Carnegie).

He also religiously studied everything he could get his hands on about training the body.  

Lee thought there was something to be learned from all combatives and read books about boxing by Jack Dempsey, Joe Louis, and Rocky Marciano, texts on karate and aikido, and over sixty volumes on fencing.

In the 1960s, bodybuilding magazines were the primary sources of information on strength training, and Bruce Lee subscribed to them all. If he found an article that contained useful information, he’d clip it and put it in his filing system.

Lee also browsed used bookstores and bought copies of health and fitness books from the late 19th and early 20th centuries, including Strength and How to Obtain It by bodybuilder and strongman Eugen Sandow and The Application of Measurement to Health and Physical Education written in 1945 by H. Harrison Clarke.

Lee continued to add fitness books to his extensive library throughout his life and never let a set lens contort his reading choices; if a book or magazine had some useful info in it, he bought it and read it.

Besides magazines and books, Lee would ask his friends and students for training advice. Two men who had a huge influence on Lee’s physical education were James Yimm Lee and Allen Joe. James Lee (no relation to Bruce Lee) was an Oakland-based martial artist and weightlifter, and Allen Joe was the first Chinese-American bodybuilding champion. Both men introduced Lee to the way of the iron and helped develop his first weightlifting program.

For a fuller list of the varied books in Bruce Lee’s personal library, check out this article.

The Elements of Bruce Lee’s Physical Training

If you’re talking about combat — as it is — well then, baby, you’d better train EVERY part of your body.

 — Bruce Lee

Lee’s study of all aspects of physical training led him to experiment with different fitness modalities, including barbell training, isometrics, plyometrics, circuit training, running, and stretching.

His practice of these diverse modalities all had a single goal: becoming a better martial artist.

While Lee only chose exercises that would help him improve as a fighter, because martial arts require the full spectrum of physical capabilities (strength, power, speed, endurance, and flexibility), Lee systematically trained all these capabilities; he didn’t specialize.

Below, we’ll look at the main components of his physical training:

Weightlifting

Thanks to his research and his own experience, Lee developed a deep appreciation for physical strength and believed it was the foundation of all other physical capacities. If you get stronger, you can move faster, with more power, for longer periods of time.

And the most effective and efficient way to get stronger is through resistance training.

In the early part of his training career, Lee used isometrics to build strength. Then he discovered the effectiveness of barbell training and began to pump iron.

While Lee’s weightlifting programming evolved throughout his life, if you look at his programming as a whole, five key elements emerge:

Compound Movements: One of the principles of Jeet Kune Do was economy of motion — using the shortest and most direct path to achieve the desired outcome and minimizing wasted movement and energy.

Thus when Lee chose an exercise for a workout, he looked for ones that could give him the most bang for his buck, like compound lifts, which work several muscle groups concurrently, promoting overall strength and power. Lee was a fan of squats, clean and presses, bench presses, and rows, feeling that these movements not only had high ROI for building strength, but also achieved the harmony between muscle groups that was essential for optimal power generation in martial arts.

Low Volume: While many sources claim that Lee used extremely high repetitions, John Little’s extensive review of Lee’s workout records showed that he typically employed a moderate rep range of 8-12 reps per set for most exercises. The exception was leg training, where he did favor higher repetitions and aimed for 12-20 reps per set.

Lee also kept the volume of his workouts low, doing only 1-2 sets per exercise. Lee was doing Mike Mentzer’s Heavy Duty program before Mike Mentzer.

Progressive Overload: Lee firmly believed in the overload principle and consistently strove to increase the demands on his body for continuous improvement. Depending on his fitness goals at the time, he’d try to achieve progressive overload by adding weight, increasing repetitions, or reducing his workout time.

Focus on Velocity: Lee prioritized speed and power because they often distinguished a great fighter from an average one. He understood that power is the ability to express strength quickly. To that end, he often incorporated velocity work into his weight training. Instead of using slow, controlled movements, Lee would make the concentric part of the lift quick and explosive.

Minimalist Approach: Another principle of Jeet Kune Do was simplicity, and this was reflected in Lee’s continual refinement of his weightlifting programs; he worked to eliminate unnecessary exercises to optimize results from minimal work. If you look at the evolution of Lee’s weightlifting workouts, they got shorter and shorter; he went from doing hour-and-a-half long workouts with a bunch of exercises to a workout with just a few movements that could be done in less than 30 minutes. By focusing on an effective selection of compound lifts, done at low volume, he got the results he wanted in short, intense workouts.

While Lee’s barbell-training workouts evolved over time, he eventually settled on a program in which he did a 20-minute session 3X a week (Tuesdays, Thursdays, and Saturdays) that often looked like this:

• Clean and press: 2 sets of 8 reps
• Squat: 2 sets of 12 reps
• Barbell pullover: 2 sets of 8 reps
• Bench press: 2 sets of 6 reps
• Good mornings: 2 sets of 8 reps
• Barbell curl: 2 sets of 8 reps

In addition to general weight training, one area of his body that Bruce Lee took time to do special exercises for was his forearms; we’ll be dedicating a whole post to his forearm-training routine down the road.

Cardio

Lee caught the jogging bug in the 1970s. He thought running was an effective and safe way to improve his stamina and endurance. He’d jog two to six miles on Mondays, Wednesdays, and Fridays and would always have a pair of sneakers with him so he could get a run in even when he was away from home.

Lee incorporated the progressive overload principle into his running by increasing his speed or distance. He was also an early practitioner of the “heavy hands” method of aerobic activity and would hold light dumbbells or wear ankle weights while running.

Lee would sometimes supplement the running he did for cardiovascular health by cycling or jumping rope on Tuesdays, Thursdays, and Saturdays.

Stretching

You’ve likely seen pictures of Lee displaying his phenomenal flexibility with one of his high kicks. That flexibility came from his commitment to daily stretching. Upon rising and before he got out of bed, he would do his “Wake-Up Routine” — a set of six stretches and body activation exercises:

• Full-body stretch: 5 times, maintaining stretch 3 seconds, rest 2 seconds
• Arch back: 5 times
• Leg tensing: 12 times, 3 seconds tensing, 2 seconds rest
• Abdominal tensing: 10 times, 3 seconds tensing, 2 seconds rest
• Sit-up, touch toes: 5 times
• Bent-leg raises: 5 times

Later in the morning, Lee would spend 15 to 20 minutes on a full stretching routine. He even created special equipment that would allow him to progressively overload his stretches.

Here’s an example of what one of his stretching sessions would look like:

• Seated straight leg stretch
• Side stretch
• Hurdle stretch
• Seated groin stretch/butterfly stretch
• Thigh stretch/standing quad stretch
• Front pulley stretch. This stretch required a pulley and rope set-up. While standing, Lee would place one foot in a strap connected to a rope and then pull on the rope, which would raise the leg into a stretched position.)
• Side pulley stretch. Same as front pulley stretch but the leg was placed in a side kick position.)

Besides his dedicated stretching sessions, Lee would stretch throughout the day. While he was reading, he often propped his leg up on a table or desk so he could get in some stretching while he developed his mind.

Core Work

Lee believed that the abdomen was the “center or generator” of the body because it was the place in the body that coordinates all its parts and contributes to both punching and kicking power. Consequently, Lee trained his abs every day. The result was a powerful core and a tight, trim, 26-inch waist.

In addition to the famous dragon flag exercise, which Lee popularized, he did numerous other exercises for his stomach and waist. Here’s an example of one of the daily ab routines Lee did:

• Sit-ups: 4 sets of 20
• Side bend: 4 sets of 15 to 20. Lee would hold dumbbells in his hands to increase the intensity of this movement.
• Leg raises: 4 sets of 20
• Twists: 4 sets of 50. To perform this movement, Lee would hold a stick across his shoulders, bend forward at the hips and twist right, aiming the left stick end toward his right foot. After returning to the upright position, he would then twist left to bring the right stick end toward his left foot.
• Frog kicks: 4 sets of 20. Lee performed this exercise by hanging from a pull-up bar and raising his knees up to touch his chest.

Punching and Kicking 

Of course, martial arts training was part of Lee’s physical regimen. He’d alternate days where he’d work on combative leg moves with days he’d focus on arms and hands. He often aimed to do 500 punches a day and threw some of these punches while holding light weights. He’d focus on speed and endurance with his kicking and punching sessions, but would also train power by incorporating work with a heavy bag.

Below is a kicking and punching routine that Lee used in 1970:

Kicking

• Side kick: left and right
• Hook kick: left and right
• Spin kick: left and right
• Rear front thrust: left and right
• Heel kick: left and right

Punching

• Jab: speed bag, foam pad, top and bottom bag
• Cross: speed bag, foam pad, top and bottom bag
• Hook: speed bag, foam pad, top and bottom bag
• Overhand cross: speed bag, foam pad, heavy bag
• Combinations: heavy bag, top and bottom speed bag

An Example of Bruce Lee’s Training Routine

Lee trained throughout the day, nearly every day. He did several hours of daily exercise, scheduled into morning, afternoon, and evening sessions that were each focused on training a particular modality.

What he did during those sessions evolved over time, according to what he had learned in his studies, the particular movie he was next to star in, and his personal goals.

But to give you an idea of how he brought together the above elements and incorporated them into his daily routine, here is an example of one of his training schedules from 1970:

Monday

• 7 AM to 8 AM: Ab work and Flexibility
• 12 PM to 1 PM: Run
• 5:30 PM to 6:30 PM: Punching

Tuesday

• 7 AM to 8 AM: Ab work and Flexibility
• 12 PM to 1 PM: Resistance Training
• 5:30 PM to 6:30 PM: Kicking

Wednesday

• 7 AM to 8 AM: Ab work and Flexibility
• 12 PM to 1 PM: Run
• 5:30 PM to 6:30 PM: Punching

Thursday

• 7 AM to 8 AM: Ab work and Flexibility
• 12 PM to 1 PM: Resistance Training
• 5:30 PM to 6:30 PM: Kicking

Friday

• 7 AM to 8 AM: Ab work and Flexibility
• 12 PM to 1 PM: Run
• 5:30 PM to 6:30 PM: Punching

Saturday

• 7 AM to 8 AM: Ab work and Flexibility
• 12 PM to 1 PM: Resistance Training
• 5:30 PM to 6:30 PM: Kicking

Sunday

• Off

The Overarching Secret of the Jeet Kune Do Way to Physical Fitness: Self-Expression

 Absorb what is useful; reject what is useless, and add what is specifically your own.

—Bruce Lee

Perhaps the most important component of Bruce Lee’s approach to physical training is that he made it uniquely his own.

Each practitioner of Jeet Kune Do is encouraged to develop his own “personal style” within its framework. For Lee, both fighting specifically, and physical training generally, was not some rote habit you went through the motions with and rotely checked off your to-do list each day. Instead, movement was something you put “emotional content” and “passionate meaning” into. For Lee, physicality was existential.

To reach the heights of his potential, Lee created ever-changing training protocols that were suited to him and his personal goals. He didn’t follow cookie cutter programs. He didn’t follow exactly what the experts told him he was supposed to do.

He experimented. He acted. He felt into his training until he had discovered his personal training style — his way to “fully express the human body.”

Source:

Bruce Lee: The Art of Expressing the Human Body by John Little

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Note: This is a rebroadcast.

Kelly Starrett, a doctor of physical therapy, has trained professional athletes, Olympians, and military special operators, helping them unlock peak performance. But as he approached his fifties, he started to see cracks appearing in the health of the folks around him. What had worked for his peers in their 20s and 30s, wasn’t working anymore; they were gaining weight, having surgeries, and just didn’t feel good.

So he and his wife and fellow trainer, Juliet, decided to write a book — Built to Move: The Ten Essential Habits to Help You Move Freely and Live Fully — that took all that they’ve learned from training elite performers and distilled it into the foundational practices that everyone, at every age, can use to develop lasting mobility, durability, and all-around health. Today on the show, Kelly unpacks some of those essential physical habits, sharing the “vital signs” — tests that will help you assess how you’re doing in that area — as well as daily practices that will help you strengthen and improve that capacity.

Resources Related to the Podcast

• Kelly’s previous appearance on the AoM podcast — Episode #213: Undoing the Damage of Chronic Sitting
• AoM article on the Sitting-Rising Test
• AoM Article: 7 Simple Exercises That Undo the Damage of Sitting (including the Couch Stretch)
• AoM article on foam rolling
• AoM Article: The Benefits of Hanging for Strength and Mobility
• AoM Article: 12 Balance Exercises You Can Do on a 2×4
• AoM Podcast #638: How Changing Your Breathing Can Change Your Life
• AoM Podcast #678: Physical Benchmarks Every Man Should Meet, At Every Age
• Muscles and Meridians: The Manipulation of Shape by Phillip Beach
• Video of Kelly demonstrating the Couch Stretch
• Video of Kelly demonstrating the squat test
• Video of 90/90 sit/stretch
• Video of Chris Hinshaw demonstrating the Old Man Balance Test
• Get yourself a pull-up bar
• The SlackBlock
• Kelly’s article on fixing shoulder pain, including a video on the Shoulder Spin-Up

Connect With Kelly Starrett

• The Ready State website, including the Built to Move book page
• The Ready State on IG
• Kelly on Twitter

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Read the Transcript

Brett McKay: Brett McKay here and welcome to another edition of The Art of Manliness podcast. Kelly Starrett, a Doctor of Physical Therapy, has trained professional athletes, Olympians and military special operators, helping them unlock peak performance. But as he approached his 50s, he started to see cracks appearing in the health of the folks around him. What had worked for his peers in their 20s and 30s wasn’t working anymore. They were gaining weight, having surgeries, and just didn’t feel good. So he and his wife and fellow trainer, Juliet, decided to write a book Built to Move: The Ten Essential Habits to Help You Move Freely and Live Fully. They took all they’ve learned from training elite performers and distilled it into the foundational practices that everyone at every age can use to develop lasting mobility, durability, and all around health. Today on the show, Kelly unpacks some of those essential physical habits, sharing the vital signs, test that will help you assess how you’re doing in that area, as well as daily practices that will help you strengthen and improve that capacity. After the show’s over, check out our show notes at aom.is/builttomove.

Alright, Kelly Starrett, welcome back to the show.

Kelly Starrett: It is great to be here, my friend.

Brett McKay: So you’ve spent your career helping professional athletes, members of the military achieve elite performance, and I think a lot of people, they probably know you for the book you wrote, and it’s been almost a decade ago, Supple Leopard, which is just this bible of different movements and things you can do to help you move better so you can perform better. Your new book is Built to Move: The Ten Essential Habits to Help You Move Freely and Live Fully. This book is focused less on things like setting PRs and more on just what are the building blocks of feeling good and being vital overall over your whole lifetime. And in the book you talk about 10 physical practices and then each practice has a test or some metrics that you call vital signs to see how you’re doing with that habit.

And this book really resonated with me. We were talking before the podcast, I turned 40 recently. And in my 30s, I was really… I’m power lifting. That was my thing, and I still do it, but what’s interesting is when I was 35, 36, I could just go hard all the time and recover really fast. About two years ago, injuries started popping up and it was like tendon stuff, just overuse my… Your knee hurts and then your hips are achy. And then in 40, it’s the same thing. And now my shift has been moving away from performance, right? Trying to deadlift more and more and more weight to, I just wanna be durable. I just don’t wanna hurt when I get up off of… Out of a chair. And it’s funny, I was rereading Aristotle, his book on Rhetoric, and he goes on this tangent about fitness and health and beauty and it’s really poignant.

He said this, he says, “For a man in his prime,” and he thought a man in his prime was like thirties to maybe 40. He says, “For a man in his prime, beauty is fitness for the exertion of warfare together with a pleasant, but at the same time formidable appearance.” And I can relate to that when you’re in your 20s and 30s, you just wanna look Jack, you wanna be strong, whatever. Then he says, “For an old man, beauty and fitness is to be strong enough for such exertion as necessary and to be free from pain through escaping the ravages of old age.” And that one, I resonate with Aristotle on that one. I wanna be free from pain, but just strong enough to do what I gotta do throughout the day.

Kelly Starrett: Yeah. Here… Here’s what’s really crazy about that, is that we’re starting to see a generation of young athletes who follow these principles in the book because they found that it really does enhance the short game. And what you’re seeing is, and what we’re appreciating now is that when we are working with young athletes who are making millions of dollars, they realize that if they can control their sleep and their minimum ranges of motion, some of these pieces in here, they actually can extend their career. So it means… Means a lot of money to them. And then what ends up happening is that universally, the athletes we work with actually realize they can go harder and they’re actually capable of more. And remember, this is a laboratory. So what I’m transferring that to myself now is, you mean I can get to Friday night and feel like I’m not just smoked, that in the afternoons I can get home from my job and actually be more present for my partner and my kids.

Okay, I’m in. And when my friends say, “Hey, we’re going for a pickup bike ride, or basketball game,” I feel like I’m not gonna injure myself to do that. So these 10 behaviors, we chose these 10 because they’re the hinges that open the biggest doors. And simultaneously, if you are not interested in exercise, you don’t identify with power lifting, you don’t identify with diet culture. We realize that there’s a lot you can do to begin to have a conversation with your body, so you don’t end up just sort of devastated by accident. You took a fall, your bone densities… I mean, just realizing that the long game is the short game and to what your point is, you don’t have to feel wretched. And we really haven’t empowered people so if we use an example, pain is a great example of oftentimes the sort of the fulcrum or the catalyst that initiates a lot of conversations with people about their bodies. “This pain won’t go away. It used to just go away. I just ignore it or take some ibuprofen for few days and it went away.”

And suddenly people are realizing, Hey, I’m living with this thing all the time. Is this who I am now? Like, should your hips hurt? So couple of things. One is that I want everyone to hear pain is a request for change. Unless you have a clear mechanism of injury, or you’ve got something occult going on, like a fever or an infection, something obvious. Or your pain is interrupting your ability to occupy your role in your family or do your job, those things are medical problems. They’re medical emergencies. I want you to go get help. Everything else is typical, which means what we’ve said to a generation of people is that pain is a medical problem. So until you’re ready to go talk to a doctor or a physical therapist about it, it’s not serious, or you should just live with it.

And what we set up people to do is just to go ahead and self-soothe it any way they want with bourbon, with THC, with whatever thing could make themselves feel better. And what we’re trying to do here is say, Hey look, if we’re gonna untangle complexity around pain, we need to make sure that you’re eating enough protein and micronutrients, that you’re sleeping and that you’re moving. And then we can also say, Well, hey, these tools that we’ve discovered over the last 15 years to help restore your position and make you bench more, well they can be redeployed for you and your family when someone’s achilles hurts or their knee hurts. And we realize that we have this real rich tapestry of options that I can drop into my household without having to engage with a physician, without being an expert, and I can start to make myself feel better and ultimately use that as a catalyst to transform how I’m interacting in my world.

Brett McKay: Okay, so these 10 essential habits, they’re great for, if you’re a young athlete who’s keyed in on performance, it’ll help you with that. But even if you’re not interested in that, you just wanna feel good and vital throughout the day, it’s gonna work for you too. Alright, let’s talk about some of these. You lay out 10 tests and then with each test or marker habits you can do on a daily basis to help you improve that. The first one you talk about is the sit and rise test. What is this test and why do you think it’s important?

Kelly Starrett: Oh, isn’t that great? So this is a test that has been well validated to show all cause mortality and all cause morbidity. If you struggle to sit crisscross applesauce on the floor and then stand up from that position without putting a knee down or putting a hand down, like you can’t just pop up and down like every 5-year-old, right? Ask your kids to do this, they’ll crush it because it’s not about strength. But what you’ll see is, holy moly, I’m stiff, and that stiffness, I can’t access my power, I can’t access my shapes, and that means that I have fewer movement choices. So I’m like, here, get up and down off the ground holding this baby. And you’re like, I can’t, I have to hold the baby with two hands and now I gotta put the baby down. What you start to see is that it has these follow along implications.

The number one reason people end up in nursing homes, they can’t get up and down off the ground independently. And what’s notable, I think is one of the things that we know is if we were trying to launch a business, save for retirement, train for the world championships, we set a goal and we work backwards from that goal, but we do not engage in that thinking towards our own health and behaviors. So if we know that we have this simple idea that really is a nice predictor of how you’re gonna fare as you get older and stiffer and weaker, theoretically, none of those things have to be true by the way. Then why don’t we one, put it on your radar and show you that, hey, if you got it, no problem. Good, keep doing what you’re doing. But if this was trickier than you thought or you couldn’t do it, let’s pay attention to that, because the first order of business for all of our interventions is exposure.

So the first thing that we’re saying is if you are struggling to get up and then off the ground, well what we want you to do is start spending some time on the ground while you’re watching TV every night. Isn’t that simple and reasonable? Sit cross-legged, sit 90/90, kneel. It doesn’t matter, but if we know that getting up and off the ground ends up being a nice predictor of how well and affluently you can move through the world because you have more hip range of motion, you can play better pickleball, you can deadlift better, what you’ll see is if your lifestyle is working for you, you’ll ace this test. If your lifestyle is introducing what we call a session cost, which is a concept we use when we’re looking at how gnarly the session was the day before. So you and I go and do some crazy deadlift workout, and the next day I’m crippled and you’re not. I paid a higher session cost for that, right? My force was down, things hurt, I couldn’t do it again. Well, we can start applying that session cost idea towards what’s going on with my day-to-day living, my movement fluency, the workouts I’m doing, and is that costing me in terms of this sort of third party validation test, which is show me you have some hip range of motion.

Brett McKay: Yeah. Okay. So you lay out the test, it’s really simple. So everyone can do this right now, they’re listening to us. You just sit on the floor and then get up off the floor and what you do…

Kelly Starrett: Cross-legged. Cross-legged.

Brett McKay: Yeah, cross-legged, cross-legged, right. And you start off, you give yourself a score of 10 and then you subtract a point. If you do one of the following, brace yourself with your hand to the wall, place a hand on the ground touching your knee of the floor, supporting yourself on the side of your legs, losing your balance. And if you do that, you subtract. If you have a low score, it means like, well you got room for improvement.

Kelly Starrett: That’s right. And that’s the right word.

Brett McKay: Yeah.

Kelly Starrett: You got room for more improvement. It’s not bad.

Brett McKay: No.

Kelly Starrett: You got room for improvement.

Brett McKay: I think that’s a good point you made about most people go to nursing homes because they can’t get up off the ground, right? Because like as soon as you can’t move independently, you’re gonna need 24/7 support care there. And it just usually starts going downhill from there. And you hear about… When you hear about like an older elderly person, they fall down, they break a hip, you think, oh man, this is bad. They’re probably not gonna be around much longer.

Kelly Starrett: Not to be Mac Cobb here, but one of the greatest predictors of the gnarliest things that can happen to you is to break a hip after 70. The research is a… Like you die within five… I mean, it’s so bad. And you have to understand exactly what you’re saying. I suddenly lost my mobility. I can’t feed myself, I can’t move, I’m bedridden, I lose my muscle mass, I lose my conditioning, I lose my bone density, I lose my… And then my brain starts to go and my social connections start to go. One of the things that we’re, I think obsessed with in this culture is like all the hard science, like deadlift more or wattage, poundage but all of the ancillary things that happen by being in a community start to go away if your world gets smaller.

One of the things that’s nice about a lot of these behaviors in the book, like eating as a family, is that we are trying to strengthen our social bonds. What we found in COVID was that holy moly, the brain is a social organ. It needs other brains to actually work and be a brain. And what we know is that we need stronger families, stronger households that are more connected to each other and more connected to their neighbors and their community at writ large. And some of those easy ways are to eat together and to go walk around and nod your head at your jerk neighbor. I mean it really, it’s transformative. So what you’re seeing is when we start making inadvertent choices from lack of choice because we don’t realize we’re doing certain things, it starts to take away a lot of our movement choice, which ultimately has implications in the kinds of society we find ourselves in our 50s, 60s and 70s, 80s, a 100, you’re gonna be a 100-years-old. 54% of kids who are in the fifth grade right now are gonna be 105.

Brett McKay: And so there’s… As you said, to improve on this test, the thing you gotta do is just sit on the floor more and there’s no…

Kelly Starrett: That would be a great start. Right. That’s a…

Brett McKay: Yeah, and there’s no specific way you have to sit, you can do crisscross applesauce. I like… My favorite one is the 90/90 sitting, where you kind of put your hips to the side, that feels really good.

Kelly Starrett: Yeah. You are working on an internal rotation there. And there’s a great writer osteopath, I think, and his name is Phillip Beach and he wrote a book called Muscles and Meridians and it really is like functional embryology… I just wanted to throw it out there because I’m a physio and I had to have a bunch of embryology and if I’d had this book, I’d been stoked on it, I would’ve understood it more effectively. But he believes that one of the ways the body tunes itself is that we spend time on the floor. It actually opens up our pelvic floors. It restores motion in your low back, it loads tissues, it loads your hamstrings, it keeps your hip range of motion good so you have more movement choice. It’s one of the ways that our bodies have engaged with the environment for two and a half million years.

Look, I’m not pint… Like I live in a cool mid-century modern house, I love it. But we have to appreciate that just a few hundred years ago, we did a lot more sitting on the ground, toileting on the ground, eating on the ground, building fires, and hanging on the ground. So it’s almost like we know intuitively that, okay, if… This is one of the things that actually helps the body work better. Well it’s pretty easy for you to watch TV at night and sit on the ground for 30 minutes. Just sit on the ground for a little bit and you’ll see that… You’re like, oh, there’s my roller or maybe I’ll roll my calves out. But exposing yourself to these bigger ranges of motion and fidgeting around, you’ll see aggregates. And we start to stack these behaviors, these behaviors start to compound. And if you get 30 minutes of sitting on the ground seven days a week, you’re starting to spend a lot of time in these fundamental positions that do things like improve your squat, improve your ability to run up the hill, right? Make your back feel better, make your knees feel better, etcetera, etcetera.

Brett McKay: Alright, let’s talk about the next vital sign, which is breathing. When you have an assessment, the breathe pull test, what’s going on there?

Kelly Starrett: The body oxygen level test. So I think breathing’s had its moment, right? Wim Hof gets everyone going. Laird Hamilton, we have Patrick McKeown of Oxygen Advantage. There’s so many great systems and it’s not like the yogis have been talking about this forever, but what we discovered was, there was a lot of low hanging fruit in terms of improving people’s VO2 max and mechanical ventilation. So this is why this matters. If you come to me as a physical therapist, you’re like, “Kelly, I have back pain.” There’s three things we’re gonna talk about day one, no matter what. We’re gonna talk about your sleep, because if you’re not sleeping that eight hours, it’s really difficult for me to figure out is it your brain or is it your body? What’s happening here? Number two, I’m gonna make you walk a lot, because I need you to de-congest your system, your lymphatic system, which is the sewage of your body, is built into your musculature. And if you move your musculature, you move your sewers. If you don’t move your musculature, the drains block up. And if you’ve ever seen a gross sink, that’s your body. If you don’t move, that backed up sink, you have to flush that stuff and that’s all done through movement.

So moving and then we’re gonna talk about breathing. And what we’re gonna see is if the first motion of the trunk, everyone is obsessed with it’s okay to round your back when you deadlift. Of course your spine’s supposed to flex and rotate and twist, but the first movement of the spine is breathing. And what we find is that, it’s a nice indicator of sort of vitality in terms of you can find positions that allow you to ventilate more so it improves your VO2 max, but breathing more effectively does things like opens up your upper back so and you put your arms over your head, makes your low back feel better, allows you to create more intraabdominal pressure when you lift.

And as we found out in the last 10 years of really monkeying with breathing, that when we got people more CO2 tolerant, which is what the body oxygen level test does, it allows people to access more hemoglobin. So one of the things we found, believe it or not, is that people who had COVID and smoked, that was a bad deal to have those things, but they were more comfortable with lower body oxygen levels in their body. And the reason was is that they were smoking so much that their CO2 levels were really high and had set their brains at being very comfortable with these lower oxygen levels. Obviously that’s a problem if you can’t breathe. But from a performance standpoint, what we found is people whose brains were more comfortable running higher CO2 levels, those people are actually able to strip off more oxygen off the hemoglobin. So the body oxygen level test is just a simple way of you being aware of how good you are at utilizing what’s available to you.

Brett McKay: And so you just hold your breath for as long as you can. You want… I guess you aim for 30 to 40 seconds.

Kelly Starrett: You exhale.

Brett McKay: Okay, yeah, you exhale then hold your…

Kelly Starrett: Just take a breath, exhale and then see how long you can go, because it turns out you got plenty oxygen on board to hold your breath for two minutes, three minutes, four minutes, five minutes. What you don’t have is a brain that is gonna tolerate the skyrocketing CO2 levels. So your drive to breathe is actually the rising CO2 level. And what we find is now… Because we’ve been doing this long enough with our athletes, is that now we’re seeing athletes be able to breathe nose only, push 90% of their max heart rate, they’re much more efficient, they don’t have to burn the sugar. But also what we find is, man, if we’re gonna talk about your neck pain and your jaw pain, we need to talk about your breathing. And getting you to breathe through your nose, getting you to not breathe only up in your neck like you’re being chased by cocaine bear, those things really end up making a difference in terms of how your brain perceives you in your environment and the effectiveness of not yanking on your neck every single time you take a breath. Imagine this, you’re on the Peloton bike and you’re rounded and you wanna go faster. If I say get into a position where you can take a bigger breath, you’ll automatically organize your body in a way where you have better access to your ventilation and better access to your diaphragm. And those shapes can be applied to work, to holding my kid, to rocking, to whatever I wanna do.

Brett McKay: And yeah, the practice that you recommend, you just said it there, just start breathing through your nose only throughout the day.

Kelly Starrett: That’s one of the practices. Super simple. Tape your mouth shut at night. That’s become very common. But we also have some breathing drills you can do. And here’s one of the things that I want people to understand, is that I think we’ve become habituated to thinking about all of our health behaviors have to occur in these one-hour blocks. That’s weird. No one has time to go to a one-hour balance class or one-hour breathing class, or one-hour mobility class. If you do anything, I want you to go to the gym. I want you to go to your garage and lift heavy weights. That’s what I want you to do. But I want you to bury and hide the reps, everything else. So we do a lot of this breathing stuff on our warm-ups, on our daily walks, during… While we’re spinning up on the bike. It’s so easy to integrate these things into your life.

Brett McKay: So the next vital sign is about your hips, and this one really spoke to me because my hips have been really achy lately. And so the assessment you have for this is the couch stretch. So tell us about this test and what is the couch stretch.

Kelly Starrett: If you had to pin me down and say, “Kelly, what is the one thing I should do from a one-on-one mobilization?” I am obsessed with you being able to take your hip into extension. So if you imagine a lunge position, lunge shape, that’s hip extension. So standing up from a squat is extending your hip, but actually taking your hip into extension is the magic. And what we find is that the way we train the session cost of our day-to-day lives, we see that people are pretty ineffective at having good full hip extension and having control in that hip extension. So what we’re seeing here’s though, there’s a lot of knee pain and a lot of back pain that’s a symptom of not being able to extend your spine or extend your hip. So your knee behind butt is really the magic. It’s not knees over toes, it’s can you get this knee behind your butt. And the couch stretch, if you’ve never done it before, you should Google couch stretch, we invented it so that we could get people doing it while they’re watching TV. And basically you start on the ground, this is the full couch, you put your knees up against the wall, your back is away from the wall, and you put your shin in the corner where the wall meets the floor. So your foot is pointing towards the ceiling and you’re kneeling away from the wall, and then you bring your other foot up into a lunge, so it looks like sort of exaggerated run shape, except your leg is bent up.

Then all I want you to do is squeeze your butt, take five breaths, can you raise yourself higher, yourself more torso upright, take five breaths and squeeze your butt, and then ultimately can you go straight up and down? And what we find is people really struggle because their quads are so stiff, hip is stuff, their butts turn off. That’s one of the reasons now why you’re running and wobbling your back and your hamstrings are stiff all the time because they’re doing all the work that your glutes should be doing. So if we can get people to improve this, it’s amazing how many things start to feel better.

Brett McKay: And then the daily practice for that test, you just do the test, like you just do the couch stretch every day?

Kelly Starrett: You could. We also throw in some isometrics, show you where you can spend some time the end of your day or during the day. Just put your hip into extension a little bit while you’re washing dishes, while you’re hanging out, squeeze your butt, just do some isometrics, hold that for 30 seconds. We also realize that this is a great place to do some soft tissue mobilization, so you can get on the ground while you’re watching TV, roll out your quads, roll out your hips, and you’ll see that those systems start to improve.

Brett McKay: We’re gonna take quick break for a word from our sponsors.

And now back to the show. Let’s talk about shoulders, another problem that a lot of guys experience as they get older. Shoulder is a weird thing. It’s incredible. It’s got this amazing range of motion, but it can get jacked up really bad. What are the most common shoulder problems you see in the regular Joe athletes you come across?

Kelly Starrett: Well, what’s interesting is, think about it this way, you have the brain, which is the most complex structure in the known universe, seriously, it is, attached to a structure that is equally as sophisticated. So this brain body thing we’ll walk around in is the most extraordinary structure in the known universe. And your shoulder, let’s just start by saying, is designed to last 100 years easily. So when you suddenly throw an error signal and your shoulder hurts, we want you to understand that, A, that’s not typical. It’s a request for change. Well, what change are we talking about? Well, no one on the planet connects range of motion to pain. And there could be a lot of things. Nothing could change. You could have incomplete range of motion, shoulders don’t hurt. All of a sudden you have a baby, you’re sleep-deprived, you have a deadline at work, you smash a bunch of pizza, you drink some beer, [chuckle] it doesn’t matter, whatever the stressors are, and your shoulder starts hurting, and you’re like, “What happened?” Nothing happened except your brain became much more sensitive to your lack of tissue quality or your inability to express normal range of motion.

So what we have here is a really important system. I think most people can recognize or wrap their heads around that. If we were gonna talk about your lower back health, we really should be talking about what’s going on with your pelvis and your leg too. It’s weird how you have big muscles that attach from your spine to your leg and no one looks at how well your leg moves. So if your leg doesn’t move well on your body, it can be yanking, it could be tensioning, it could just be putting mechanical input into your lower spine. So that’s why we look at the spine, the pelvis in the leg as a system. Well, there’s the same system upstream, it’s your neck, it’s your thoracic spine, your chest and your shoulder. They make a trifecta of positions. So if I wanna improve your neck pain, I gotta look at your shoulder range of motion. If I wanna look at your shoulder range motion, I also need to look at how well your thoracic spine works. Remember I told you already, we’re moving in that direction ’cause we’re getting you to take big breaths and you breathe in your upper back? Well, what we’re doing here is we’ve got some simple tests for you around some key range of motion positions and some isometrics that are easy to get you started on untangling what feels like a complicated system. It’s not that complicated.

Brett McKay: Yeah, you got two tests. My favorite was the one where you lay on the floor on your back and then you see how far you can get your arm back, basically.

Kelly Starrett: Yeah, basically it’s an I, Y and T, but really in that situation, or if you’re just… Elbows are out to your side at 90 degrees and you flex the back of your hand to the ground, we’re looking at how much force you can create there. And what you see is if you’re struggling to get to that position, you’re weak in that position. Well, welcome to your rotator cuff. And a lot of times, your rotator cuff, or rotator cup, depending on which patient is telling you about their shoulder pain, the rotator cuff is this sort of non-specific idea that I have muscles that help rotate my shoulders. Well, we look at a lot of rotation capacity with our athletes, and what we see is that when you lack fundamental range of motion in your body, specifically in your shoulders, can’t put my arms over my head, can’t achieve some of these fundamental shapes, your force production starts to go down, which means that when you approach some of these positions at high speed, like playing golf, that can be a problem because you see a lot of inhibited musculature, a lot of force production, like it’s taken away and now you’re just hanging on your tissues.

Brett McKay: Any daily practices that people can do to help their shoulder health?

Kelly Starrett: Oh yeah.

Brett McKay: There’s a lot, but I mean, what’s one or two that you’d recommend, like, “Do these and you’ll be good?”

Kelly Starrett: Yeah, it’s interesting, if we look at our movement traditions, everyone listening has probably gone to a yoga class once. And when you’re in there, you’re like, “Holy crap, these people love Downward Dog. Why is Downward Dog so important?” And you do so much Downward Dog. Downward Dog, Downward Dog. Well, Downward Dog is an overhead position. So if there’s one thing you could do is at least once a day, put your arms over your head. Hanging from a door jamb, put your arms over your head, take some breaths. If you have a pull-up bar, which you should have in your house, hang from your pull-up bar. I cannot tell you how hanging will fundamentally change your life. Hang with different grips. You don’t even have to hang with your feet all the way off the ground, put a pull-up bar in your kids’ doorway, but it’s secretly for you. We have a pegboard in our garage, we’ve got pull-up bars outside, inside the house, in our garage, and just hanging will transform your shoulder function, and transform your upper back. If you’re getting that hump in your upper back and neck, hanging is the solution.

What I would direct you to is some kind of shoulder motion every day. And if you did something like Sun Salutation, cool. That would cover it. But also, if you’re really interested in taking the next step, on our site, we have something… And even if you Google “Kelly Starrett shoulder spin-up,” you will come up, and it’s a quick five-minute routine that touches a whole lot of spine shoulder positions. You don’t need any equipment. I use it for all my elite athletes, I teach it to all our teams, and it’s just like daily vitamins for your shoulder, even if you’re not gonna load your shoulder, even if it’s a lower leg day.

Brett McKay: Right. So you’re big of the squat, and that’s one of your tests. Why is being able to get down into a full squat important for human durability?

Kelly Starrett: Isn’t that interesting? We look at squatting as exercise, not squatting as movement choice. Lower yourself down off a cliff or a ledge, you’re gonna have to squat all the way down. One of the things that happens is obviously getting up and down off the ground is useful there, but it’s one of the ways where we can start to expose the tissues of the body to their full range. So taking the knee and flexing it all the way, taking the ankle and flexing it all the way. Letting your back round in that bottom position is really important to normalize the motion of the back. In yoga, for example, they call it Malasana, and they’re like, “It’s a pelvic floor mobilization.” Well, it turns out your pelvis and your femurs are connected directly to the connective tissue of your pelvis. This is why when you get kicked in the nuts, you feel a stomach ache. So what we’re seeing here is that when we restore how people’s hips move, it changes the connective tissue muscular systems and restores it to, again, native range. But also what we start to see is, man, you’re gonna have better choice, you’re gonna be able to move more effectively, and you’ll see things like your wattage improve on the bike.

Brett McKay: And the test is simple as get down to a full squat, you want ass-to-grass.

Kelly Starrett: That’s right.

Brett McKay: That’s it.

Kelly Starrett: I want ass-to-grass. Ideally, you can do that with your feet straight, but you can even turn your feet out to do that ’cause you may not have the ankle range. But if you fall over and can’t get into a full squat, man, that says a lot about you not having full access to the miracles of your body. Again, we’re not arguing about squat technique, I’m talking about getting up and down off the ground or taking a poo or having waiting for a bus. So this is very much one of those use it or lose it shapes. But the research is clear that people that toilet on ground, sleep on the ground, they engage in a lot more squatting-like behaviors, and lo and behold, we see less osteoarthritis, we see less hip disease, we see less lumbar disease. It’s almost like if we just use our bodies and just touch the ranges once a while, tell our brains it’s safe to be here, we see things like skiing or snowboarding improve.

Brett McKay: In the practice of that, just squat more. Like that’s something you can do throughout the day. I do that. After I read that chapter, I was like, “I’m gonna start squatting more.” I’ve been squatting…

Kelly Starrett: It’s easy.

Brett McKay: During this interview. Like when you were talking, I was squatting.

Kelly Starrett: Oh I love it.

Brett McKay: Yeah.

Kelly Starrett: That’s what I think is remarkable. There’s a lot of opportunities for you to move in a more complete way, and this is what every physical therapist, surgeon, orthopedist on the planet says your hip should be able to do. And if you take all of the range of motion books and you’re like, “What should the ankle be able to do? It should flex this much. How much should the knee flex? How much should the hip flex? What should happen to the lumbar spine?” And then you put them in a blender and shake it up, all those things together end up being a squat.

Brett McKay: Yeah, my goal is to be like one of those 80-year-old ladies in Southeast Asia that are just still squatting, I wanna be doing that.

Kelly Starrett: What’s so cool about that is, actually, it’s a really reasonable goal. So anyone who’s starting this… For some people, it’s gonna be a brutal awakening. You’re like, “Oh, I thought I was super fit. I’m doing Peloton and I do my quarter squats and I look good naked, but I can’t move very well.” And we’ve certainly seen a hinge move towards movement culture. And one of the things that I want everyone to hear is that muscles and tissues are like obedient dogs, and there’s no reason… Yes, it’s gonna be harder to maintain your muscle mass as you get older, but there’s no reason you have to lose your range of motion ever at any age. So one of the things you can absolutely do your whole life is actually have access to your range of motion, ’cause you can imagine if your elbows got stiff, all of a sudden you’re like, “Well, that’s not a big deal. I just can’t feed myself anymore.” You know what I mean? That’s crazy. If your life depended on getting up and down, then you would be really good at getting up and down. I was just in Japan with some friends and we were staying at this cool mountain hotel as we were doing some backcountry skiing, and one of our friends got sick and I was like, “Hey, I really should not spend a few days in this room with this sick guy. Do you guys have any other rooms?” And they were like, “We don’t.”

And then we were like, “This hotel is huge. What do you mean you don’t have any rooms?” They didn’t have any White person rooms, Western rooms. What they had was traditional Japanese rooms. But the Americans who’ve been there before haven’t been able to use those rooms because you sleep on the ground on a futon because the table is set for you to kneel and sit cross-legged, because the shower is built for you to squat and sit in. The whole thing was organized around a person being able to move through the environment. Even the controls for the room were set up at sitting height. So I was like, “Oh, no problem, I got it,” and they were like, “Really? You can do it? Look at you, you’re a huge guy,” and I was like, “It’s no problem. Trust me, I can squat.”

Brett McKay: Okay, so squatting is one. The next test to talk about is the old man balance test. What is this one?

Kelly Starrett: We have this friend named Chris Hinshaw, who is an incredible coach, and he tried to come up with a test where he could beat his kids at, and this challenge is all about balance. And one of the things that we know is that fall risk in the elderly is gnarly, but when we started working on foot strength and foot capacity and balance in our athletes, worked it into games, made ’em spend more time on one leg pressing, single-leg deadlifts, things like that, man, their athleticism went through the roof. And so what we realized is that we needed some better ways to challenge people’s range of motion and their balancing control just day-to-day, little micro-balances, because think about it, someone falls in your family like, Go to this balance class because your balance got so bad and I have to go get formal training? That’s crazy. Look, here’s a simple test for everyone, it’s called the SOLEC. Ready for it? Standing one leg, eyes closed. Stand on one leg, don’t put your foot down for 20 seconds. I bet you’re gonna be shocked at what happens when I take away your eyes. And what turns out is that if your feet are stiff, if your feet are always in foot coffins, shoes, if your feet aren’t strong, you’re really gonna struggle. If you don’t have good anchor range of motion, it’s gonna be difficult for you.

And what we’re trying to do is just bring this awareness of balance and play should be happening in sports. So if you’re riding mountain bikes and playing soccer and pickleball and you’re moving your body, chances are this will not be a problem for you. But for a lot of people who are not doing those things, you’re gonna be shocked at how bad your balance is, and it’s only gonna get worse unless we play with it. So the old man balance test is really simple. Every time you put your shoes and socks on, do it one leg at a time. So stand on your left leg, put your right sock on, don’t put your foot down, put your shoe on, tie it, don’t put your foot down. You’re gonna have to reach down and grab it, you’re gonna have to balance. And so every single time you put your shoes and socks on, you can practice a little bit of one or two minutes of balance, and I guarantee you it’s gonna kick your butt.

Brett McKay: Yeah, and then you talk about it, your house, you have different just balance things you can do. Maybe you put like… You just could put like a 2 x 4 in your house and just walk accross.

Kelly Starrett: Oh, nailed it. How about this? You can put a broomstick down and just balance on the broomstick. But I’m a huge fan of having a dynamic work environment. Well, I want choice. I wanna be able to perch against a bar stool, I wanna stand, I wanna… But on the ground, I have a bunch of balance stuff, so I just do this while I’m at work. If I’m on calls, I’m standing on a thing called a SlackBlock, which is like a portable slack line in your house. It’s tiny. It doesn’t take you many space. And I’m standing on one leg, balancing on the SlackBlock while I’m talking on the phone. And so I get so many hours every week of working on my balance. Does it improve my biking? Yes. Does it improve my skiing? Yes. Does it improve my lifting? Yes.

Brett McKay: Another practice you talk about is just standing more, walking more, moving more throughout the day. If you have a desk job, it doesn’t have to be that you’re in a chair eight hours. There’s different ways you can work, right?

Kelly Starrett: Yes. And if you… Look, I don’t talk about this much, but I had the great pleasure of working with a former US President. I’ve worked with and supported a couple of presidents, and this one president was a pretty prolific book writer, but could not write at a standing desk. So what we had to do was create an environment for this former president to get more movement at the desk because he felt like his best writing happened when he was still. And so that meant we needed to make sure that we were introducing a place to put his foot and a chair that wiggled more, and what I want you to realize is that we didn’t come up with this arbitrarily. Harvard defines sedentary lifestyle as sitting more than six hours a day. That’s an aggregate, that’s all your sitting. That means driving in the car, picking up your kid, it’s all of that. So what we’re trying to do is not battle our physiology, but it turns out…

So right now, I’m talking to you at a standing desk, but I’m actually perching on a bar stool. So I’ve got my foot on the ground, I’ve got one foot up, and in this position, because I’m perching and I’m not sitting, I’m actually above this thing called one-and-a-half metabolic equivalence, which is how much energy my body is using to just function in the background, but the sedentariness is that falling below that one-and-a-half. So sitting in most chairs, you fall below one-and-a-half, and that’s what we’re trying to not do. I need you to accumulate enough non-exercise activity that you actually fall asleep.

One of the things that we found was that a lot of people who are working out weren’t actually moving, still didn’t actually get enough sleep or find that they had enough sleep pressure. What we found was that working with Delta Force, of all the technology that they had access to, they had their guys walk 12,000 to 15,000 steps a day in addition to their training, and it knocked down all their insomnia problems. It really started to make everything better. So if you wanna adapt better to your training, you wanna fall asleep faster, you wanna feel better, you need to look at how much your total movement is, and conversely, how to limit your total sedentary time.

Brett McKay: And this does a lot of things, it’s gonna clear out your system, you talked about that earlier, motions lotion, so you’re gonna move and not feel achy. And then, yeah, I think the sleep component is really important, I’ve noticed that as well, when I move more, I have the best sleep. The best sleep of my life was when Kate and I went to Italy for, I don’t know, she was doing some of school thing. Went to Italy, you walk around Rome all day.

Kelly Starrett: You walk 20,000, 30,000 steps a day.

Brett McKay: Yeah, probably. Yeah, it was insane the amount we walked. And I remember, we got to the hotel, just laid down, we were like, “Oh, we’re just taking a nap,” and we were… It was like 15 hours later…

Kelly Starrett: Kids come back from summer camp and they’re just exhausted and sunburned, that’s the game, but for adults. And you just really nailed it. And what I want people to understand is we can come at this any way you want, but one of the ways that’s important to me is that it’s a hidden calorie burner in my day. So I love dessert, I love ice cream, I love cookies. I’m never gonna turn those things down, ever. If they’re combined, it’s even better, but when we wrote ‘Deskbound,’ my wife found a little conversion, a little calculator, and if she just stood and didn’t sit at her desk during her work day, in the course of a year it was 100,000 calories. I outweigh her by almost 100 pounds, that’s 170,000 extra calories I’d burn every year, that’s like 35 marathons, and all I have to do is just not sit while I’m working. I’m talking about perching, fidget, messing around, walk a little bit. And notice that we didn’t say, “You have to get 10,000 steps,” we saw that all of the benefits really start to kick in at 6,000 to 8,000 steps, which is really reasonable if you just start throwing in short walks after your meals, you take a call, you go for a little stroll in your neighborhood. It’s easy to get 6,000 to 8,000 steps. But the average adult gets less than 3,000, so it’s difficult for me to be sensitive to your foot pain and your Achilles and your junky tissues, if you’re not moving more during the day, which means you just have to be more conscious of it.

Brett McKay: And this is important, this daily movement is important, particularly for those who are… I just said exercising regularly, ’cause they’re thinking, I’m good, I got my hour of cardio in and I got my hour of weight training in, but you’re…

Kelly Starrett: Yeah, smashed it.

Brett McKay: You’re probably still sedentary.

Kelly Starrett: That’s right.

Brett McKay: Yeah.

Kelly Starrett: And if you’ve ever flown on an airplane and look down and you’re like, “Why do my ankles… I have cankles, what’s up my ankles are swollen.” That’s what we’re talking about. Your lymphatic system is backing up because you didn’t move your muscles, you ended up collecting fluid in your ankles, that is edema. But really what’s happening there is that it’s a failure of… It’s why… If you ever go in the hospital, they’re like, pump your legs, do calf pumps. Here are these things, we don’t want you to get a DVT. That deep vein thrombosis happens because people are sedentary in the hospital and they’re so freaked out about it, they hire a physical therapist to come in to tell you to wiggle your feet.

Brett McKay: Okay. So we talked about movement, can you get your steps in, don’t sit down all day, you don’t have to stand up all day, but just move around. You mentioned sleep, if you’re having problems sleeping, moving a lot will help you sleep. Nutrition, what role does nutrition… You’re a physical therapist, and one of the first things you ask is, what are you eating? What role does nutrition play in recovery and just our ability to move well?

Kelly Starrett: Nutrition for better or for worse, become identity politics for so many people, and it’s an identity, and it’s a hobby, and it’s a sport. And it’s a full contact sport. If you get on the Internet and talk about your diet. Universally, what we can start to say is everyone on the planet has protein minimums, you should get this amount of protein, and a really reasonable amount for everyone is 0.7 grams per pound of body weight, which turns out, if you’re sedentary, that’s probably enough. But if you’re over 50 or you’re exercising or trying to change your body composition, it probably is a little bit closer to 1 gram per pound body weight. So you’re keto. Cool. You’re carnivore, cool. You’re paleo, cool. You’re Whole30 cool. You’re vegan or vegetarian, cool, just show me you get this much protein.

And what we find is if you’re trying to change your body composition or you’re trying to recover, but you don’t have the building blocks on hand to do that, you’re not gonna see the gains you want, either way for body composition or otherwise. But the other part of that is that based on some really good data, we find that people don’t get enough micro-nutrients. There is not a single study in the world that says improving your fiber intake doesn’t improve your health. The easiest way to do that is actually eat fruits and vegetables, and so what we found is based on one of our friends, EC Synkowski, her company is OptimizeMe nutrition. She has something called the 800-gram challenge, and every single day, she challenges people to eat 800 grams of fruits and vegetables, and you’re like, “I don’t like vegetables,” cool, you eat fruits.

I don’t eat apples. Cool, you do eat berries and rutabaga. I don’t really care. But it turns out when we get more micronutrients in, all the polyphenols, all the vitamins, all the minerals, you can do that with four big apples a day. But when we get into people’s diets, and we’re trying to talk about soft tissue health and connective tissue health, and brain, health whatever it is, glow, gut health turns out fiber and micronutrients and protein make the basis. For people who are trying to lose weight, when we ask them to eat more and expand their choices, it’s the first time in their life, they’re like, “Holy shit, I had to eat so much to meet these minimums?” We’re like, “Yeah, welcome to it.” A pound of cherries is 230 calories. Go ahead and OD. Let me know what happens. What you’re gonna see is there’s so much food available to… We don’t wanna be restrictive anymore, we want people to hit this baseline.

Brett McKay: If you ate a pound of cherries I think you’d be on the toilet.

Kelly Starrett: It’s an illustrative point. Eat a pound of melon. Eat four apples, you know, what I mean. It really is… And you’re suddenly, I’m like, yeah, you know, the other day, I went to Trader Joe’s got myself up a flat of blackberries, they were just gorgeous, and I ate the entire thing, it was like 400 grams, 350-400 grams, almost half of my micronutrients for the day, and it was 230 calories.

Brett McKay: Yeah. It’s not like…

Kelly Starrett: I love cookies. One cookie from Starbucks is like 350 calories. So what we get is all of this benefit where I’m full, I’m getting all these nutrients. Somehow we demonize fruit. That was ridiculous, where like fruit is sugar. What a bunch of horse crap that is. It’s not the bananas and apples that are the problem. If you eat more micronutrients and fruits and vegetables, you’re gonna protein, your body will start to turn the lights back on.

Brett McKay: So this is great, and then at the end of the book, you have a schedule for people to follow if they’re trying to figure out how can I incorporate all this stuff in my day-to-day. And as you said, you don’t have to make time. Like, I’m gonna do an hour of my built to move routine, no it’s like…

Kelly Starrett: Yeah, no.

Brett McKay: Just you wake up, I’m gonna do this thing, I’m gonna get my steps in, whenever I’m taking a break or on the phone, I’m gonna walk around. I’m gonna get down in the squat, you can just do this stuff as… Like health shouldn’t be a block on your schedule, it should just be a part of your day.

Kelly Starrett: Yeah, what we’ve found is when we handed this thing to our world champion athletes, they were always viewing it through the lens of I wanna go faster, I don’t wanna do it more often, and they found blind spots that enable them to work harder. And when we applied it and gave this to non-exercisers, like we have some publishers who work with us in the UK who are not exercisers and who love pork pies. They were like, “Just reading this, changed my framework and how I perceived the world around me, and it changed me in making different subtle choices,” that all compound over time to really make radical changes where you can feel better and again, work harder and show up and feel fresher. That’s really the game.

Brett McKay: Well, Kelly, this has been a great conversation. Where can people go to learn more about the book and your work?

Kelly Starrett: Go to builttomove.com. We’ve got… Actually, when the book comes out, we’ve got a 21-day Built To Move challenge, it’s free. And it’s basically a video a day just kind of supporting some of these ideas, just to bring you through, you could aim your friends at it. We are @thereadystate on all our socials, and if you are interested in more about how to assess your body more completely, we’ve got the app and everything else.

Brett McKay: Fantastic. Well, Kelly Starrett, thanks for your time. It’s been a pleasure.

Kelly Starrett: Always a pleasure. Keep putting out the good word, my friend.

Brett McKay: Thank you, sir. My guest today was Kelly Starrett. He’s the co-author of the book, Built To Move. It’s available on amazon.com and book stores everywhere. You can find more information about his work at his website at thereadystate.com. Also check at our show notes at aom.is/builttomove, where you can find links to resources, where we delve deeper into this topic.

Well, that wraps up another edition of The AOM Podcast, make sure to check on our website at artofmanliness.com, where you can find our podcast archives, as well as thousands of articles written over the years about pretty much anything you can think of. And if you’d like to enjoy ad-free episodes of The AOM Podcast, you can do so on Stitcher Premium. Head over to stitcherpremium.com, sign up, use code manliness at check out for a free month trial. Once you’re signed up, download the Stitcher app on Android or iOS and you can start enjoying ad-free episodes of the AOM podcast. And if you haven’t done so already, I’d appreciate if you take one minute to give us a review on Apple Podcast on Spotify, helps out a lot. And if you’ve done that already, thank you. Please consider sharing the show with a friend or family member you think would get something out of it. As always, thank you for the continued support. Until next time, it’s Brett McKay reminding you to not only listen to the AOM podcast, but put what you’ve heard into action.

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I’ve done the traditional barbell squat my whole life. It’s a great exercise for overall lower-body strength. I’ve also experimented with other squat variations: the front squat, the goblet squat, the belt squat.

This year I’ve been doing a squat that’s become my favorite ever: the Hatfield squat.

I love this exercise. I originally switched to it because long-standing problems with cranky shoulders and knee pain were making the traditional barbell squat uncomfortable. The Hatfield squat has made squatting fun and productive again after years of frustration trying to make the barbell squat work for me. What’s also great about the Hatfield Squat is that it’s an excellent movement for quad hypertrophy, which lines up nicely with my new fitness goal of getting more ripped. It’s been a game-changer in my training.

If you’ve had trouble with barbell squatting or are looking for a different squat variation to mix into your programming, here’s everything you need to know about the Hatfield squat.

What Is the Hatfield Squat and What Are Its Benefits?

The Hatfield squat, named after powerlifting legend Dr. Fred Hatfield, aka Dr. Squat, is a back squat variation that requires a safety squat bar, which is a type of barbell that looks sort of like an ox yoke.

When you do the Hatfield squat, you place the safety squat bar on your back. Then, instead of holding on to the safety squat bar with your hands, you rest your hands on an additional barbell or a set of handles that have been placed at navel level on the barbell rack. As you descend into the squat, you keep your hands on the support in front of you, using it to maintain your balance and an upright torso.

This increases the stability of the exercise, allowing the Hatfield squat to offer some unique benefits:

Great for quad hypertrophy. If you’re looking to grow legs as big as tree trunks, the Hatfield squat can be a helpful tool. Its increased stability allows you to overload your quads more than a traditional squat. Instead of focusing on keeping your balance during the squat, you can just focus on the movement, which means you can be a bit more aggressive in adding reps or weight.

Great for squatting around injuries. The most significant benefit that the Hatfield squat has given me is that it has allowed me to squat heavy again despite the niggling physical issues I’ve had on and off for years.

Because I have shoulder tendonitis due to bench pressing and struggle with shoulder flexibility (despite the amount of time I’ve worked on developing this capacity), the bar position on the traditional low-bar squat just exacerbated my shoulder pain. Because you use a safety bar with the Hatfield squat, you don’t have to use your hands to hold the bar on your back. It completely removes the stress on your shoulders.

The Hatfield squat has also allowed me to work around some pain I’ve had behind my knee since 2020. The pain only happens during the descent part of a traditional barbell squat. I still don’t know what the source of the pain is despite talking to an orthopedic surgeon and getting an MRI done. I reckon it’s some sort of overuse injury on a tendon back there. But at any rate, the increased stability of the Hatfield squat allows me to squat heavy and below parallel without any pain behind my knee.

People with lower back issues have also found the Hatfield squat helpful for squatting without exacerbating their injury.

Due to the Hatfield squat’s pain reduction ability, I’ve also been calling them “Midlife Man Squats.”

It is a great accessory lift for the barbell squat. You don’t have to replace the traditional barbell squat completely with the Hatfield squat. Instead, you can use the Hatfield squat as an accessory lift in your barbell programming. On deadlift day, you could do the Hatfield squat for 3 sets of 8-12 reps for hypertrophy and increased work capacity.

Or you could use the Hatfield squat for overload training to build strength and confidence in hoisting heavier weights, doing 3 sets of 3 reps with weight that is heavier than you typically lift on the traditional barbell squat.

Here’s a hypothetical barbell program that would incorporate the Hatfield squat:

Lower Body Day A

• Squat 3 x 5 (squat is the main lower body lift)
• Rack pulls 3 x 5 (rack pulls are the accessory lift for the deadlift)
• Good mornings 3 x 10

Lower Body Day B

• Deadlift 1 x 5 (deadlift is the main lower body lift)
• Hatfield squat 3 x 8-12 (Hatfield squat is the accessory lift for the squat)
• Lunges 3 x 12

How to Perform the Hatfield Squat

The Hatfield squat is pretty dang easy to perform. You just need to get the right set-up.

Equipment Needed:

• Safety squat bar (SSB)
• Barbell or handles

Place the handles or barbell on the squat rack at about belly height.

Get under the safety squat bar and unrack it.

Keep your hands lightly on the handles or bar in front of you. You’re not using the handles/auxiliary barbell to assist in pulling yourself up. You’re just using them to maintain your stability throughout the lift.

Squat with an upright torso. The Hatfield squat should be done with an upright torso. You don’t need to bend over like you do on a low-bar squat.

Lower yourself until slightly below parallel and then rise back up. Remember, just use the handles for stability. Do not use the handles to pull yourself up.

Like I said at the beginning, the Hatfield squat has been a game-changer for me. It’s allowed me to keep squatting without any pain. If you’ve struggled with incorporating the barbell squat into your workout due to pain, try the Hatfield squat. I think you’ll probably like it as much as I do.

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You probably think of the health effects of sunlight as a mixed bag. On the one hand, sun exposure helps your body make vitamin D. But on the other, it can cause skin cancer.

To get around this conundrum, dermatologists frequently recommend avoiding sun exposure when you can, slathering on sunscreen when you can’t, and taking a vitamin D supplement to make up for the lack of sunlight in your life.

Yet in seeking to solve one problem, this advice may open up many others and be contributing to ill health in the West.

Today on the show, Rowan Jacobsen, a science journalist who has spent years investigating the health impacts of sunlight, will unpack the underappreciated benefits of sun exposure, and that, crucially, they’re not primarily a function of the production of vitamin D and can’t be replaced with a pill. We talk about what else is at work in ultraviolet radiation’s positive effects on blood pressure, autoimmune diseases, insulin resistance, mood, and more. We also get into how to weigh these benefits against the risk of skin cancer, why health officials in Australia, which has the highest rate of skin cancer in the world, have changed their recommendations around sun exposure, and if there’s a role sunscreen should still play in your routine.

Resources Related to the Podcast

• Rowan’s article in Outside magazine: Is Sunscreen the New Margarine? 
• Rowan’s article in the Atlantic: Against Sunscreen Absolutism
• AoM Article: Why You Should Become a Sun Worshipper
• Dermatologist Richard Weller’s TED talk: Could the Sun Be Good for Your Heart?
• Australian recommendations on sun exposure 

Connect With Rowan Jacobson

• Rowan’s website

Listen to the Podcast! (And don’t forget to leave us a review!)

Listen to the episode on a separate page.

Download this episode.

Subscribe to the podcast in the media player of your choice.

Read the Transcript

Brett McKay: Brett McKay here, and welcome to another edition of the Art of Manliness podcast. You probably think of the health effects of sunlight as a mixed bag. On the one hand, sun exposure helps your body make vitamin D, but on the other, it can cause skin cancer. To get around this conundrum, dermatologists frequently recommend avoiding sun exposure when you can, slathering on sunscreen when you can’t, and taking a vitamin D supplement to make up for the lack of sunlight in your life. Yet, in seeking to solve one problem, this advice may open up many others and be contributing to ill health in the West.

Today on the show, Rowan Jacobsen, a science journalist who spent years investigating the health impacts of sunlight, will unpack the underappreciated benefits of sun exposure and that, crucially, they’re not primarily a function of the production of vitamin D and can’t be replaced with a pill. We talk about what else is at work, and ultraviolet radiation’s positive effects on blood pressure, autoimmune diseases, insulin resistance, mood, and more. We also get into how to weigh these benefits against the risk of skin cancer, why health officials in Australia, which has the highest rate of skin cancer in the world, have changed the recommendations around sun exposure, and if there’s a role sunscreen should still play in your routine. After the show’s over, check out our show notes at aom.is/sunlight. Rowan Jacobsen, welcome to the show.

Rowan Jacobsen: Hi, Brett. Thanks for having me.

Brett McKay: So you are a journalist, and for the past few years, you’ve been researching and writing about the benefits of sunlight to our health, and how the injunction to religiously slather on sunscreen might be causing unintended health consequences. Let’s talk about the health benefits of sunlight. I’m sure listeners have heard and know that sun exposure increases vitamin D levels in the body. How does that happen? What is it about sunlight that causes vitamin D levels to go up?

Rowan Jacobsen: Yeah, it’s kind of this interesting phenomenon where we really are photosynthesizing. We don’t do it like a plant does it, but we are synthesizing these compounds with the help of photons from the sun. So the way it works, so I guess for starters, vitamin D is a hormone that is used for all kinds of different reasons in the body. Like it’s kind of misnamed as a vitamin ’cause it’s not like the other vitamins, which are these little things that you get in food. It’s a hormone that we use for lots of different things and it’s essential to health and we mostly make it in our skin. And the way that evolution worked this process out is that it makes these molecules that are similar to cholesterol, they’re sterols, it makes these molecules that are like a couple of chemical processes, chemical steps away from becoming vitamin D and that’s as close as we can make on our own.

And we do that in the skin, and then what we rely on the sunlight to do is the sun hits those molecules, breaks open one of the little chemical bonds between the molecules so that that molecule can then change its form into a different form, which is vitamin D or actually pre-vitamin D. And then that molecule goes into the body and gets transformed into the type of vitamin D that we use after going through the liver and sometimes the kidneys too. So it’s this incredibly complicated process, but the upshot is that there’s this one step that we need sunlight to break open the bond for us so that we can change that molecule into something else.

Brett McKay: So I know sunlight is made up of different types of UV radiation, including UVA radiation and UVB radiation. Is there a specific type of radiation that causes that reaction?

Rowan Jacobsen: Yeah, for vitamin D, it’s all the UVB, which is particularly a narrow wavelength of UVB, about like 295 to 310, 315 nanometers. So yeah, there’s UVA, UVB, UVC. UVC gets filtered out by the atmosphere entirely, which is a good thing ’cause otherwise it would be really deadly. UVB is that next wavelength and then UVA has a very different size wavelength to it. And so we get both UVA and UVB on our skin. UVB is the one that can hit those molecules and break apart that bond and make vitamin D.

Brett McKay: What does our body do with vitamin D once it’s turned into vitamin D?

Rowan Jacobsen: So, most famously, it’s essential for bone mineralization. And this was discovered way back when kids were getting rickets in like… During the Industrial Revolution, suddenly, people who had always been outside farming were in these cities. The cities were really sooty, so even if you were outside in the city, you weren’t really getting any sunlight and the kids were working in factories. So suddenly, all the kids were getting rickets, which is when your bones are soft, too soft. They don’t get hard enough ’cause they don’t have enough calcium in them, and then you get these bowed legs. It’s bad. You don’t want to get rickets for sure. But a lot of kids were in the Industrial Revolution suddenly. And they figured out that that was because they weren’t getting proper bone mineralization.

They weren’t getting that calcium into their bones. And vitamin D does that. And that discovery was a huge health step forward because we were able to pretty much eliminate rickets famously because of cod liver oil. So cod liver oil is a good source of vitamin D. So they started giving the kids cod liver oil and that gave them just enough D to not get rickets. They also started putting babies in the sun. You know, like there’s these crazy photos from back in the day of these little cages hanging out the windows of tenement buildings, and you would put your baby in that cage for a little while just to get a little sunlight on the baby.

Brett McKay: That’s interesting. So people hear that, okay, I just need vitamin D. I don’t want to sit out in the sun ’cause I don’t want to get a sunburn. I don’t have time for that. I don’t want to get skin cancer. So I’ll just take a vitamin D supplement and that will take care of me and I’ll get all these benefits that come from vitamin D, one of them is just bone mineralization. And then there’s been these other health benefits that have been associated with vitamin D. So if you have elevated vitamin D levels, you have better metabolism, you reduce your cancer rates, things like that. So yeah, why not just take the vitamin D supplement?

Rowan Jacobsen: Yeah, right. And this is the message and the advice we’ve been receiving from dermatologists for a couple of decades now, is like, we know that sun exposure causes skin cancer. We know that it makes vitamin D, we know we need vitamin D. But no problem, avoid all sun exposure, and yeah, your body won’t make enough vitamin D, but you just take vitamin D pills to make up for that, and problem solved. So that was this overly simplistic understanding for a while. But to test it, what you have to do is do these trials where you get a lot of people so that you have some statistical power to get randomness out of there, and give half the people vitamin D pills and the other half just get a placebo and see what happens. And so now, some huge, huge trials have been done, multiple years, tens of thousands of people involved in the trials. And we have extremely strong definitive evidence that those vitamin D supplements do not help to improve any disease.

Just they totally failed in a way that… You know, science rarely gets results that are so definitive. Like there’s no question. They didn’t improve a single condition. Which was really surprising, because like you say, people who have high levels of vitamin D in their blood have lower rates of pretty much every disease you can think of. So we really did think, oh, vitamin D is not just for bones, it must be essential for all these other things in the human body and for preventing all these other diseases. So then these supplement trials, when they failed, then everyone had to kind of go back to the drawing board and say like, now wait a minute, how can it be that people who have naturally high levels of D in their blood have lower rates of all these diseases but if you artificially raise people’s amount of D in their blood with supplements, it doesn’t do anything? And you probably, you already know the answer.

Brett McKay: Right. Well, yeah, it’s the sunlight that’s doing it. Vitamin D is just a marker that you’re getting a sufficient amount of sunlight.

Rowan Jacobsen: Right, exactly. So it wasn’t causative, it was just correlation. The people with the lower rates of disease had a higher D because they were getting sun exposure, but now we know it wasn’t the D that was causing the lower rates of disease. It was something else about sun exposure.

Brett McKay: Okay. So people probably heard this idea that vitamin D improves a bunch of health conditions, but it turns out it’s not the vitamin D. There are other things going on, other pathways with the sunlight itself that creates those health effects. And we’re gonna talk about how the sunlight can improve those different facets of our health. That’s not to say that vitamin D is not important. You can get it from the sun or from a supplement. And as you said, we need vitamin D so we don’t get things like rickets. You don’t want rickets. So we need vitamin D for that.

Rowan Jacobsen: Yeah. And vitamin D is probably important in other ways. Like pretty much every cell in our body has vitamin D receptors in it, so they’re there for a reason. Like our cells are all doing things with D, but we only need so much probably. So you don’t wanna be vitamin D deficient. But this idea that really cranking up your level of D was gonna somehow chase all these diseases out of your body, that has turned out to be false. So D is important, but you probably get enough through sunlight, most of us. But it depends, like it depends where you’re living. So yeah, that’s only part of it. So could there be other things that sunlight is doing for you?

And now we have quite a bit of evidence that, yes, it turns out there’s dozens of different processes and pathways that are triggered by sunlight hitting skin that have lots and lots of different effects on the human body, and we’re really just learning about them. So this is the impasse. So now, the dermatologists are gonna have to readdress this whole formula that they gave to people. Like, don’t worry about the D, get the D through the supplement. Because it doesn’t work, and all those health benefits that we’re chasing, probably you need actual sunlight for that.

Brett McKay: Well, let’s talk about some of these health benefits that people are starting to see there’s a connection to sunlight. One of them is blood pressure. There’s a connection between increased amounts of sunlight exposure and decreased blood pressure. And there’s a guy, it’s a dermatologist who found this connection, a guy named Richard Weller. Tell us about him. What’s the connection between sunlight and blood pressure?

Rowan Jacobsen: So he’s a fascinating guy, a dermatologist in Scotland, but he does work in Ethiopia every year and has for decades. And he started questioning the conventional wisdom on sun exposure and vitamin D after doing all this work in Ethiopia. Where Ethiopia, like huge amount of sun ’cause it’s in the tropical zone, in the equatorial zone and it’s up at like 6,000 feet. So it gets a huge amount of sunlight. And he says he never treated a skin cancer there, never saw any ’cause he was treating people with very dark skin and they just weren’t coming down with skin cancers. So that was the first step where he started questioning some of the conventional wisdom. But then in terms of blood pressure that we had known for a long time in these observational studies that people living in areas that got more sun exposure had lower blood pressure. Like high latitudes, where you don’t get as much sunlight, higher blood pressure.

And everyone had sort said like, well, it’s probably just temperature, because your blood pressure is definitely lower in warmer temperature areas. So everyone kind of like chalked it up to temperature. But then, back, I don’t know, in the early 2000s, I think it was, some scientists discovered that… Actually it was earlier than that, scientists discovered that nitric oxide, which is a very simple molecule, is actually a really important signaling molecule in the body, and that nitric oxide will cause the muscles in blood vessels to relax and to dilate. So nitric oxide is a really potent vasodilator, so it will expand those blood vessels and lower blood pressure. And that was, a guy won a Nobel Prize for that back in the ’90s I think. But what people only realized more recently and what Richard Weller’s research helped to show was that our skin actually has these huge stores of nitrates in them, which is sort of a precursor to nitric oxide.

And when sunlight hits skin, it breaks up those nitrates into nitric oxide and sends them into the body and lowers blood pressure. And he did these experiments on his grad students. Like first they showed it in mice and they’re like, huh, it works. And then he did experiments on grad students where he shone UVA. He wanted to prove it wasn’t vitamin D that was responsible for this ’cause everybody chalks up everything about sunlight to vitamin D. So he used UVA instead of UVB ’cause UVA light does not create vitamin D. So he took his grad students and shone UVA light on their arms and he also put foil, like metal foil on half the students so that they were getting the heat of the UVA but not the actual beams of the UVA ’cause he wanted to prove that it wasn’t just heat either, ’cause we know heat can lower blood pressure.

And sure enough, the students who got the actual raise of UVA light, their blood pressure went down more than the students who just got the heat. And they’ve since done other studies looking at huge chunks of people in both the US and UK. And yeah, it’s now very clear that sun hitting skin produces nitric oxide, which lowers your blood pressure. And blood pressure is the number one risk factor for lost years of life and mortality worldwide. So anything that lowers blood pressure can be a pretty big deal.

Brett McKay: And that’s a cheap intervention. It’s free.

Rowan Jacobsen: Yeah, it is. It’s free. You know, it’s a cost benefit ratio ’cause when you’re exposing yourself to light, you are raising your risk of skin cancer. But skin cancer kills very few people. It’s a very, very small factor in mortality, and blood pressure and all the cardiovascular related diseases is number one cause of mortality in the world. So yeah, it’s probably a very good benefit for the risk.

Brett McKay: Yeah, we’re gonna talk more about the real risk of skin cancer later, but with these blood pressure experiments, it was UVA radiation that produces nitric oxide?

Rowan Jacobsen: Yeah, well, so he used UVA ’cause he wanted to prove it wasn’t related to vitamin D. But since then, I think they’ve found that UVB does it too. Like all the UV produces nitric oxide. So yeah, so the blood pressure lowering effect is, and I don’t even like dividing it up too much ’cause anytime we start to boil it down to this sort of human created simplicity, it reminds me of like fat carbs of protein. It’s like this human construct that turns out to be much simpler than the real thing.

Brett McKay: So sunlight can reduce blood pressure. There’s also been research showing that sunlight can strengthen immune function or improve immune function. Can you tell us about that research?

Rowan Jacobsen: Yeah, and that’s really fascinating to me. And that research was one of the main reasons the Australian authorities decided to revise their sun exposure recommendations. But this is, again, is something that’s been known for a while. We’ve got 20 or 30 years of research on this and it’s just… In science, department A is not necessarily talking to department B. So the immunologists were way down this path of researching sunlight’s effect on the immune system, and the dermatologists were just not ever getting the message on the other side of the campus. But anyway, so what we know is that we have a lot of immune cells in our skin, which makes sense ’cause the skin is the first barrier to the outer world. So the skin is constantly dealing with pathogens and cuts and all kinds of assaults to the body. So there’s constant immune action happening in the skin. And UV is another sort of minor assault that we get every day, that we’ve been getting every day for as long as humans have been humans.

So the skin has evolved to deal with it. So it gets a little dose of UV and then it heals that damage and healing that damage is basically an anti-inflammatory response. So the UV is a tiny bit of inflammation and it triggers an anti-inflammatory response in the skin. All these immune cells get created, they reduce inflammation, but then what’s really interesting, which is a more recent discovery, is those cells then migrate from the skin into the body through the lymph nodes and reduce inflammation throughout the body. So it’s the systemic anti-inflammatory response that’s triggered by a little bit of UV. And that’s important, because one thing we’re learning more and more is that a lot of the classic diseases of modern civilization have roots in inflammation. Like we sort of have a lot of chronic inflammation going on all the time. So something, and again, like you said before, a free intervention that can reduce inflammation could be a fantastic health benefit.

Brett McKay: And I feel like we intuitively understood this maybe a century ago. I love reading these old history books, biographies, and there’s always this instance where some famous guy gets sick as a kid and the doctor’s like, “Well, you need to take them out to the desert,” or “Go to the the ocean side and get lots of sun, because you got tuberculosis and that will help heal you.” And I think that just spending time in the sun probably did a lot that helped strengthen their immune system.

Rowan Jacobsen: Yeah, exactly. There was this whole age of heliotherapy where, like you said, tuberculosis, rickets of course, and some other diseases, psoriasis. People would be sent out into the sun, or they’d be sent up into the mountains in Switzerland to cure these diseases. And it worked. They didn’t quite understand why it worked, but it was somewhat successful. So sun was definitely considered by the leading doctors to be a benefit to health. And then that all started to flip in the ’30s and ’40s as everyone realized, they discovered the mechanisms by which UV can cause skin cancer. And then slowly, decade by decade, the message, that sort of the drumbeat got stronger and stronger, stay out of the sun so you don’t get skin cancer. And we’re kind of at this like peak moment of that.

Brett McKay: Another way sunlight can improve your immune function, you know, vitamin D, again, vitamin D plays a role in your immune system. If you get sunlight, you’re gonna increase your levels of vitamin D, which also contributes to your immune system.

Rowan Jacobsen: Exactly. And yeah, that’s an important point. All of these pathways are probably way more complicated than we think. It’s not gonna be one very simple step by step, like this, to this, to this. A whole lot of stuff happens when sun hits skin, and all these signaling molecules and hormones, they don’t necessarily just do one thing. In different situations they’ll do different things. You’ve got this very complex effect happening with nitric oxide, which can also be anti… It can be used to kill pathogens. So you’ve got nitric oxide, you’ve got vitamin D, you’ve got these direct effects on immune cells.

And one of the other things, like vitamin D, we’re all told to take vitamin D pills, that’s because everybody thought there was just one type of vitamin D, and most dermatologists today still think that. But one of the things we’ve learned in the past 10 years is that there are more probably like 20 different, slightly different versions of vitamin D that the body makes with sunlight. And they all have slightly different side chains on these molecules, but they all do slightly different things and we really don’t understand how that works. But we do know that a bunch of those non-canonical types of vitamin D, you can’t replace those with a pill that is going into the stomach and then to the liver. It just doesn’t work. It will not make these other flavors of vitamin D.

Brett McKay: Related to the immune system, there’s also been research showing that sunlight exposure can help with autoimmune diseases. So this is when your immune system goes haywire and starts attacking your body. So things like psoriasis is an autoimmune disease, arthritis, rheumatoid arthritis, MS is another disease like that. But sunlight seems to help with those conditions.

Rowan Jacobsen: Yeah, for sure. Again, it’s that anti-inflammatory effect. And it’s really strong with MS, which is a disease where the body’s immune system starts attacking the sheaths around the nerves that protect the nerves so that signals can be sent, electrical signals can be sent. The body mistakes the little sheaths around those nerves for an invader and starts attacking them. It’s just this classic but like overreaction of the immune system. And sun exposure really effectively slows down that process for MS. Like you look at the observational studies based on latitude and sun exposure and people living at high latitudes have usually several times the risk of MS compared to people living at lower latitudes. And prevalence is higher in winter than in summer, and it’s also, you can even track it with birth month where people born in spring, at the end of like a long winter, have higher rates than people born in early fall.

Same thing for psoriasis, type 1 diabetes, like you said, and some other autoimmune diseases. And there’s some clinical trials going on right now where they’re tracking this. Because basically this has mostly been observational studies, so you really, in order to prove it, to really have like the gold standard of evidence, you need to have some clinical trials where you’ve shown that it works. But we do know from some early clinical trials that just a little bit of narrow band UVB therapy, so using a light that only shines UVB in this very narrow wavelength that doesn’t cause skin cancer, it reduces all the biomarkers of inflammation in the blood of these patients that have MS and other things. So yeah, it looks good so far for that.

Brett McKay: That’s really interesting. What about insulin resistance, does sunlight affect that? That’s a big problem these days.

Rowan Jacobsen: Huge. Huge. Yeah. Insulin resistance, diabetes, all the… Like the metabolic syndrome stuff, where your body’s not metabolizing very actively, it’s just sort of slowed down, getting a little groggy and your cells aren’t accepting… They’re resisting insulin. Yes, sunlight has been shown in studies of both mice and observational studies of people to have a pretty solid impact on reducing risk of diabetes and insulin resistance. And in terms of why, like it’s probably some of those same things we’ve been talking about. I think there’s probably an inflammatory component to diabetes and insulin resistance as well, and so this probably reduces that a little bit. But then the other part of it, and I think you can apply this to a lot of things we’ve been talking about, if you wanna like pull back and think about big picture, there’s this really fascinating study a few years ago that looked at all the genes in the human body and when they were being expressed.

So then when they were being cranked up and when they were being kind of turned off, in terms of like month of the year. And what they found was that about a third of the genes in the body have a seasonal component. So they’re either being cranked up in summer or in winter. And generally, what they saw was that the inflammatory genes were being cranked up in winter and anti in summer. So winter, like evolutionary, the theory would be that in winter that’s when flu and all these other infectious diseases are on the rampage. We’re spending a lot of time cooped up together in spaces where we’re more likely to share diseases with each other. Summer is a low disease time, so it makes sense in winter to crank up your inflammatory genes to deal with all these pathogens and to basically try to just survive winter.

 And then summer, things are good, you’re out in the open air, you can reduce all that inflammation. But of course the signal for that is, one of them is sun hitting skin, sun hitting skin and sun hitting retinas. So if we are living our lives indoors and aren’t getting exposure outside, our bodies might be in a sense thinking that it’s biological winter all the time. So they’re acting like it’s biological winter, so they’re staying in this inflammatory state. So that would be the theory underlying why this would be the case, but it’s just a theory right now.

Brett McKay: We’re gonna take a quick break for a word from our sponsors. And now back to the show.

What about sun exposure and its connection to sleep and mood?

Rowan Jacobsen: That one is for sure, like no question and nobody even argues with this one. And it’s through different mechanisms. It’s probably partly through the skin, but a lot of it is through the eyes. But yeah, we know for sure that getting that hit of light in the morning is what sets your circadian rhythm, sets your biological clock, tells you that it’s morning, it’s time to crank up your system and be really active and high functioning. So if you’re outside in the morning and you’re getting a lot of bright light, then that melatonin that your body makes that’s for sleeping at night will quickly get reduced and you’ll get alert for your day, and then also you’re on the schedule where at night the body will know to turn up the melatonin so that you sleep well.

And when you don’t get that strong, diurnal change in light, then your circadian rhythms can get messed up. And you can’t get it being indoors, it’s interesting. I didn’t start paying attention to this until I was reading some of these researchers who specialize in this stuff. But even a cloudy day outside is way brighter than with your lights on indoors. Not even close, by like 50 times, 100 times, in terms of lumens. So you really need to be outside to get that signal that tells your body to wake up and sort of crank up the whole system and then the opposite at night.

Brett McKay: And the connection to the mood, people probably are aware of seasonal affective disorder. It happens during the winter. There’s less sunlight exposure, so people kind of get in the funk. You’re probably familiar with this, you live in Vermont.

Rowan Jacobsen: Totally.

Brett McKay: Vermont falls and winter. I remember we lived in Vermont, my wife and I, shortly after I graduated from law school, we were there in the fall. And I remember it was like 4 o’clock in the afternoon, it’s dark. I’m like, what? It’s 4 o’clock. Why is it…

Rowan Jacobsen: Yeah, it’s depressing.

Brett McKay: It got depressing.

Rowan Jacobsen: It does. And you can fight it, right? You go out, you ski, you do whatever you can to embrace the day. But it’s still, it’s not that natural an environment for human beings at some level. So you got to figure out ways to get around that. And yeah, people do. Yeah, their hormones are strongly affected by that. So again, you kind of go into hibernation mode. It’s kind of like what we were talking about earlier. All that darkness is a signal to the body to just shut down and endure. ‘Cause normally, in winter, food is often tight. Like before all our modern conveniences, you really did want to sort of put the system on minimal mode until things got better. So I think we still are dealing with that. So the best thing and the way to fight it is either, like you can have artificial lights that are bright enough that they can affect that SAD, or you go outside as much as possible or you go on vacation.

Brett McKay: Yeah. So yeah, I saw some research that sunlight can increase levels of serotonin, which is a feel good neurotransmitter, releases endorphins that can also help you feel high and euphoric.

Rowan Jacobsen: Totally.

Brett McKay: I mean, if anyone’s been to the beach or on a hot sunny day, you just feel good, you just feel so groovy whenever you catch some rays.

Rowan Jacobsen: Yeah, and it’s direct, like your skin and brain are producing endorphins, are producing dopamine. Dermatologists talk about how unfortunate it is that people get addicted to sunlight because of these things, but it’s like, well, there’s a reason. Your body isn’t just making those on a whim, there’s a reason. So you don’t want to get too much, but you do want to at least pay attention to those natural signals that we have.

Brett McKay: Okay, so I think we’ve talked a lot about the health benefits of sunlight. Increases vitamin D, but vitamin D, what we talked about is not necessarily connected to all these other health benefits, like reduced blood pressure, reduced metabolic syndrome, etcetera. That is from sunlight itself. Vitamin D is just a marker that you’re getting enough sunlight. And people might be hearing this thing, oh, okay, yeah, I’ll grant you that there’s all these health benefits that come with sunlight, but we know for a fact that it frequently causes skin cancer. So why risk the exposure to get those benefits? Just put on the sunscreen.

And that’s the stance, we’ve talked about this throughout this conversation, that’s the stance the American Academy of Dermatology has taken, which says you should apply sunscreen every day on skin not covered by clothing if you will be outside. And I think this is interesting ’cause I’m 41, so if you’re my age, sunscreen really wasn’t a big thing when I was growing up. Maybe my mom would say, “Well, you’re gonna go to the water park all day, put on some sunscreen.” But I don’t remember putting sunscreen on that much when I was a kid. So when did this message to always wear sunscreen arise? What was behind it?

Rowan Jacobsen: Yeah, and so what was behind it was simply that one fact that we know that UV exposure triggers skin cancer, raises your risk of skin cancer. So based on that one thing is why we’ve been told to, continually to keep reducing our amount of sun exposure to basically zero now. Or let me add, skin cancer, also wrinkles, sunspots, like there’s this cosmetic stuff, the cosmetic damage that UV causes as well. But in terms of health, then skin cancer is the one thing that you have to worry about. And yeah, it’s interesting that the message has gotten more and more strident with each decade. And people have been using more and more sunscreen with each decade. But skin cancer rates are higher than ever. So the etiology is probably more complicated than they think, but it is definitely very well established that sun exposure causes skin cancer.

But in terms of what you wanna do about it, it’s not clear that a little bit of sun exposure is really that problematic. And there’s quite good evidence that there are more benefits than risks for that small amount of sun exposure. So then it’s a question of like, where do you set the… You know, the pendulum’s swung way far, as far as it could in one direction where, I don’t know, if you look at a lot of the recommendations in popular magazines and newspapers, the dermatologists are literally saying, even in winter, on a cloudy day, if you’re gonna be indoors all day, still put on sunscreen. There’s no science behind that. They’re just trying to get people into the habit of doing it. And I think the worry is that people aren’t very good at following directions. So if you want them to put on any sunscreen, you gotta tell them to put on a lot all of the time and hope that they’ll listen to you one out of every three times or something.

Brett McKay: In your articles, you talked about that the conversation about skin cancer is a lot nuanced. I think people hear cancer and they just think, okay, cancer equals death automatically. And they probably think melanoma when they think skin cancer. But there’s different types of skin cancer. Melanoma is the worst one you could get. But the stuff that’s often caused by sun damage, it’s like basal cell carcinoma. Those are actually pretty treatable. Like you can actually just go to a dermatologist and it’s like an outpatient surgery.

Rowan Jacobsen: Yeah, that’s correct. There’s three different kinds of cancers that are the main ones, basal cell carcinoma, squamous cell carcinoma, and melanoma. And basal cell carcinoma is by far the most common cancer in the world. It’s probably more common than every other cancer put together. That’s the one, you know, you always see these public service warnings, like one in every three people will get skin cancer. And that’s what they’re talking about, is basal cell carcinoma. It doesn’t actually really have any health impacts 99.9% of the time. That’s the one, yeah, you go in, you get a cutoff, you’re done. So in a way, it would be better if it wasn’t called cancer, ’cause like you were saying, that word really scares people. Richard Weller, the dermatologist we mentioned, he actually told me that when one of his patients comes in and he diagnoses a BCC on them, he then says, “Congratulations ’cause your life expectancy just went up.”

And what that means, that doesn’t mean BCCs are actually good for you. It means the people who are getting BCCs tend to be quite healthy, because it’s like your dad who’s playing golf in Florida every day. He’s getting sun exposure, he’s getting a lot of exercise, he’s getting BCCs, but he’s quite healthy. So yeah, Richard Weller says he cuts a lot of BCCs off a lot of very healthy old people. SCCs, squamous cell carcinomas, are a little bit more to worry about than BCCs. But again, usually it’s just cut it off, outpatient procedure, that’s it. Melanoma is the one that kills people and that’s the one you need to worry about, but it’s much, much less common than the other two. It’s like 1 to 2% of skin cancers are melanoma, and the rest are BCCs and SCCs. So there’s a little bit of a bait and switch that you see in the public messaging where people will say, skin cancer is incredibly common, one out of three people will get it.

And then they’ll say, melanoma kills 10% of the people who get it. And if you don’t look carefully, you’ll think that skin cancer is both extremely common and extremely deadly, but it’s not. There are some that are extremely common and are no big deal and there’s one, melanoma, that can be deadly, but it’s uncommon. And BCCs, definitely caused by sun exposure. The more sun exposure you get, the more BCCs you’ll get. Melanoma, it’s a different story. It’s not as simple as just chronic sun exposure. Melanoma tends to turn up in people who get intermittent sun exposure. People who have pale skin and basically go to Cancún on vacation and get fried, that’s kind of like the perfect formula for melanoma. And worst thing of all, probably for you and me, it’s mostly associated with sunburns in childhood and adolescence, so.

Brett McKay: I had some sunburns, some really bad ones.

Rowan Jacobsen: Me too. I grew up in Florida. And so a 13-year-old kid growing up in Florida is gonna get a fair amount of sun.

Brett McKay: Yeah, I had one, I had a few where like your skin just peels like paper.

Rowan Jacobsen: Yeah.

Brett McKay: It hurt. But then when it peels, that was kind of satisfying.

Rowan Jacobsen: And it’s just so weird. It’s kind of fun. But it’s not good for you. They definitely, like every researcher I’ve talked to across the board says, just don’t burn. Burns are bad.

Brett McKay: So one of the arguments you’re making in your articles and in your research is that this sunscreen absolutism that we have in the United States, where it’s like you gotta apply sunscreen, even if you just go outside for a little bit, just all the time, even in winter time. What it’s doing, yeah, we might be staving off these skin cancers like basal cell carcinoma, but those, it’s not gonna kill you. You can get just the surgery to take it off, but we’re missing out on those other health benefits that come from sun exposure. ‘Cause when you block the sun with sunscreen, you’re missing out on the vitamin D production, the reduction in blood pressure, immune system improvement, etcetera.

Rowan Jacobsen: Yeah, possibly. It depends on the sunscreen. And this is one of the interesting nuances here I think, is back when sunscreen was SPF 15 or whatever, it doesn’t block 100%. It blocks maybe like 90%. So there’s still about 10% getting through. And so maybe, like on a day at the beach, that might have actually been the perfect formula, where that sunscreen was letting you get a great amount of UV but was still preventing you from getting burned. So now of course we’ve got SPF 50 or even SPF 100 sunscreens, and the advice is even on a cloudy winter day, put it on. So there’s this real push to make sure that people never, never get any photons hitting their skin. So that’s probably gonna have to change. But I actually think sunscreen can be an ally in making sure you do get the right amount of sun. ‘Cause if it gets you outside without burning, it could actually be a benefit.

Brett McKay: Something you mentioned in one of your articles, this sunscreen absolutism. The dermatologists, they don’t discriminate on your melanin level. So even if you’re Black or Hispanic, where you have a lot of melanin and you don’t burn as easily, they still say, yeah, you gotta wear a SPF 50 sunscreen. And you’re like, well, that doesn’t make sense.

Rowan Jacobsen: Right. And this is the thing that’s gonna have to change I think, and I think probably pretty soon. That advice to always put on heavy duty sunscreen every day, indoors or outdoors, that’s probably not a bad recommendation for people with the very palest skin. Like people who have red hair, freckles, who evolved, their ancestors came from places at very high latitudes that were getting very little sunlight and kind of evolved skin to harvest whatever light they could get. Like people who never tan always burn, that advice makes sense for them, but not for everyone else. And the world is mostly populated by everyone else.

So people with really dark skin, on the other end of the spectrum, basically do not get skin cancers from sun exposure, do not have any of these risks. But also have, because they have more natural sunscreen basically, need more sun in order to produce vitamin D and some of these other compounds. So for them, the recommendations make no sense. And then there’s a bunch of people in the middle who have maybe more of like a Mediterranean skin tone, an Asian skin tone, who have a little bit more risk of skin cancer than people with super dark skin, but really very little. And also probably have a lot to gain from moderate sun exposure. And you don’t need, that’s the other thing we should probably talk about, you don’t need too much to get some of these benefits.

Brett McKay: We’ll talk about the daily recommended dose of sunlight here in a bit. So in America we have a very, you call it sunscreen absolutism. No matter what, how you spend your time, whether indoors or outdoors, whether you’re pale, dark, wear sunscreen, health officials in Australia have taken a different tack, they’ve gotten more nuanced with sunscreen use. And this is interesting ’cause Australia is a place that has notoriously high levels of UV exposure and skin cancer, but health officials in Australia are saying maybe you don’t use sunscreen all the time. So what are they recommending?

Rowan Jacobsen: Yeah, and it’s so funny, because probably the last place on earth, you would expect to be the first place to take the plunge on changing the recommendations would have been Australia. ‘Cause as you say, their skin cancer numbers are off the charts, the highest in the world, like more than twice as high as US or UK. And it’s because they have predominantly pale skin population in an extremely sunny place. So it’s a really bad match. So they get tons of skin cancer, but they also have some of the longest lived people on the planet. So right there, it tells you that maybe like sun exposure isn’t so bad for you, even if you do have pale skin.

So Australia, I think the reason that they ended up being the first ones to change, to go away from the zero sun policy is because they’ve had to deal with this. Like melanoma and skin cancer is in their face every day, they’ve had to like process it the most. So maybe they’re a little less scared of it in a sense. And I think it was more obvious to them, ’cause they do a lot of research on it. They have a lot of the top skin cancer researchers in the world. And they can see that a lot of people were clearly getting more harm than benefit from this zero sun policy. They’re also saying that there was a lot more vitamin D deficiency in Australia than they would ever expect for such a sunny place.

So they actually started worrying that people had taken the message to heart maybe too much. So they wanted to change their messaging so that it was no longer this one size fits all message that should only have applied to people with super pale skin. And they kind of broke up their messaging into three groups, people with pale skin, people with dark skin, and then people in the middle, and different recommendations for each one. Pale skin, yeah, still use your sunscreen all the time pretty much. But when the sun’s not so bright, try to at least get outside with sunscreen on to get whatever… They were focusing on D, but they know it’s this other stuff too, to get whatever sun you can.

Middle group, get small amounts, still use sunscreen anytime the sun is pretty bright. But yeah, work the edges of the day, the edges of the season and make sure you are getting some direct exposure. And then people with dark skin, they basically said like, you just should focus on getting lots of sun. You don’t need sunscreen except when you’re gonna be outside for an extended period on a bright day. So that was quite controversial. And they caught a little bit of hell for it, but I think they’ll turn out to be the first penguin in the water and then all the other penguins will start to join them.

Brett McKay: Are you seeing a shift happen amongst American dermatologists yet?

Rowan Jacobsen: No. So far, none. UK, yes. UK is starting to shift a little bit, Europe a little bit. America is gonna be last on this for whatever reason. It’s just kind of how we do things, I think.

Brett McKay: Yeah. So let’s talk about how we can get sun exposure without increasing the risk of skin cancer. ‘Cause some people might hear this news that, okay, sunlight is great for you. I’m just gonna get sun all the time and never wear sunscreen. That’s not what these health officials in Australia are advocating for. So based on the conversations you’ve had and the research you’ve done, how can we get sun exposure and get all these health benefits without increasing our chances of getting different types of skin cancer?

Rowan Jacobsen: Yeah. And this, I’m quite sympathetic with the dermatologists because, yeah, you tell people that 10 minutes of sun is good for them, and sure enough some of them will go out there and get six hours of sun. ‘Cause they’re like, if a little’s good, then a lot’s better, right? So that is definitely something worth worrying about. But I feel like you just have to give the straight information, right? And then hopefully it’s clear enough that people can follow it. So Australia, when they put out their new position statement, they actually have all these tables in the back. It’s worth looking at that document that they created.

And the tables show for places with different UV indexes, so that’s gonna depend on where you are in the globe and what season it is and the day, right? For your skin type and UV index, how many minutes of exposed sunlight do you need to get a healthy vitamin D dose? So those will translate to the US too. So those are worth checking out. But what it comes down to is, for most people on most days, you’re either gonna get it just walking about your day, or you can get it with 10 minutes or to 20 minutes of focused exposure.

Brett McKay: Yeah. And if you have darker skin, you might have to extend the amount of time you’re out there getting that sun exposure to get the benefits.

Rowan Jacobsen: Quite a bit. And the other part of it, though, is that in higher latitude places, like here in Vermont, we don’t get any UVB. All the UVB is filtered by the atmosphere like November through March, probably. There’s just too much atmosphere that the sun is coming through at that low angle. So we don’t get any UVB for four months of the year. And you can save, your body will save it up a little bit, but that’s where you see a lot of vitamin D deficiencies, is at higher latitude, colder places.

Brett McKay: All right. So those Australian tables are a good place to check to see how much sun exposure you should get each day and in each season, ’cause it’s gonna differ, and then when to use sunscreen. But in general, what are some good general guidelines for using sunscreen? Because you’re not… I mean, even though you’re against sunscreen absolutism, you’re not against sunscreen altogether. So when should people put on sunscreen?

Rowan Jacobsen: Anytime you think you might be out long enough to get a burn, and as I think you and I can both attest to, it’s easier to get a burn than you think. Like you think, oh, I’m not gonna get burned, and then you get burned. It’s easy to just get a little more than you think you’re gonna get. So it makes sense to play it cautious and use it anytime you know you’re gonna be out for a while. And unless it’s like, you know, if it’s winter, that’s a whole different deal.

Brett McKay: Yeah, all the dermatologists you’ve talked to who are sort of pro getting sunlight and not using sunscreen all the time, they all agreed you do not want to get sunburned. Like you want to avoid sunburn as much as possible ’cause that’s what caused all those problems.

Rowan Jacobsen: Yeah, that’s just your skin cells dying and freaking out, and yeah.

Brett McKay: Yeah. So for me, I work from home. I typically don’t wear sunscreen at all ’cause I’ll just go outside, get some sun when I’m doing my early morning walks, doing chores and errands. I will wear sunscreen when I’m gonna be out for a long time, especially if I’m gonna be at altitude. So like my wife and I just went backpacking, I slather on the sunscreen. It’s so easy to get sunburned when you’re up in the mountains at 10,000, 11,000, 12,000 feet, ’cause you don’t have the atmosphere filtering the radiation.

Rowan Jacobsen: Yeah, for sure.

Brett McKay: So constantly applying sunscreen then and then when I’m skiing, ’cause like the sun reflects off the snow, and it’s easy to get sunburned. And it’s hard there ’cause you think it’s cold, so you really can’t feel anything, but you go in and your cheeks are red, and you’re like, ah, didn’t put on enough sunscreen.

Rowan Jacobsen: Yeah, for sure. Yeah, totally. All those things. And yeah, also anytime it’s gonna help you get outside, because one of the criticisms that people get in these observational studies where it’s like, oh, these people who are getting all the sun exposure are healthier in all these ways, and they have better longevity, blah, blah, blah. And one criticism will be, well, but how can you tell it’s the sun exposure? Maybe there’s just things about being outside, they’re exercising. Like, in those studies, you always try to control for exercise, so you’re comparing people who are exercising the same amount. But still, there could be other things about being outside that are just good for you. So, I don’t see the problem in that if the answer is get outside, right? So if sunscreen is gonna help you spend less time indoors, then I think it’s all to the better.

Brett McKay: Is anyone exploring, I don’t know, special sunscreens or ways people can get the benefits of sunlight without raising their risk of skin cancer?

Rowan Jacobsen: What people are doing is there’s a lot of experiments using these narrowband UVB lamps that a couple of companies are making now. I think this is gonna become a big deal. So they were first used for psoriasis treatment I think, and they just produce a very narrow band of UV, somewhere around like 300, 310 nanometers. It’s been used in psoriasis patients for a long time, decades, and we know it does not cause skin cancer. It’s not the type of wavelength that damages DNA. But it does produce vitamin D, and it also seems to have these good immunological effects.

Like psoriasis is an autoimmune disease where your skin is being attacked by the immune system, and it definitely has an excellent effect on psoriasis. It seems to work for MS. It even worked for COVID, it seems like, maybe. So I think you’re gonna see a lot more people using UVB, so then there’s not even an issue with skin cancer. But I’m still not convinced that you get all the benefits from UVB lamps that you would get from sunlight.

Brett McKay: Here’s a controversial question. Tanning beds. Can you get the benefits of sunlight from a tanning bed?

Rowan Jacobsen: Yeah, that’s an interesting one. I don’t know the answer yet. That’s why I’m working on a book about all this. It’ll be out in a couple of years by the time I’ve done all the research, written the manuscript, and then gone through the production process. But I’ll definitely have a chapter on tanning beds in there. Right now, I don’t know enough. I do know, like tanning beds do raise your risk of skin cancer, so dermatologists are strongly anti-tanning bed. But they do definitely give you some of the benefits, especially the endorphins, for sure. They give you that hit of feeling good. They will improve your vitamin D a little bit. But again, because it’s not the same as sunlight, I’m somewhat skeptical of them, but I don’t know enough to say whether they’re just plain bad or whether they might have a use.

Brett McKay: Yeah, a few years ago here in Oklahoma, we had a winter where it was just gray every day for like two months. And I was getting pretty depressed. I was getting some seasonal affective disorder. I got brown skin. I’m swarthy. So I need a lot of sunlight to get the benefits. And my wife said, you should just go to a tanning bed. And I’m like, tan? I’ve never done that before. That’s like what they do on Jersey Shore. Like I’m not gonna… And so I did it, I did like the least amount. So I did the least amount of time. I think it was just like two minutes. I mean, it was really short. And I felt better afterwards.

Rowan Jacobsen: Totally, yeah. I have friends who do it, and same thing.

Brett McKay: Yeah, I’d be interested to see if instead of tanning bed salons, you have UVB light salons, where you stand in front of a UVB light instead of going to a tanning bed to get the health benefits of sunlight.

Rowan Jacobsen: Yeah, I’m curious too. And I suspect that the tanning beds are gonna go in that direction, whether it’s more than just the UVB or just the UVB. But I bet they’re gonna try to curate their wavelengths a little bit to try to maximize the good and avoid the bad. That’s just a guess.

Brett McKay: Well, Rowan, this has been a great conversation. Is there someplace people can go to learn more about your work?

Rowan Jacobsen: For me, it would be rowanjacobsen.com.

Brett McKay: Rowanjacobsen.com. And then look out for the book you’ve got coming out.

Rowan Jacobsen: Yeah, In Defense of Sunlight, 2026.

Brett McKay: 2026.

Rowan Jacobsen: I think that’s safe. Safe prediction.

Brett McKay: And in the meantime, if you’re listening, go out and get some sun. You’re a plant. That’s one of the cool takeaways. I forget, like we’re little plants. We need water and we need sun. So get some sun.

Rowan Jacobsen: We photosynthesize, yeah.

Brett McKay: Yeah. Well, Rowan Jacobsen, thanks for your time. It’s been a pleasure.

Rowan Jacobsen: Thanks. It was great being here.

Brett McKay: My guest today was Rowan Jacobsen. You can find more information about his work at his website, rowanjacobsen.com. Also check out our show notes at aom.is/sunlight, where you can find links to resources, and we delve deeper into this topic.

Well, that wraps up another edition of the AOM podcast. Make sure to check out our website at artofmanliness.com where you can find our podcast archives. And while you’re there, sign up for our newsletter. We got a daily option, and a weekly option. They’re both free. It’s the best way to stay on top of what’s going on at AOM. And if you haven’t done so already, I’d appreciate it if you take one minute to give us a rating on Apple Podcast or Spotify. It helps out a lot. And if you’ve done that already, thank you. Please consider sharing the show with a friend or family member who you think would get something out of it. As always, thank you for the continued support. Until next time, this is Brett McKay, reminding you to not only listen to AOM podcast, but put what you’ve heard into action.

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Note: This is a rebroadcast.

When men think about optimizing their hormones, they tend only to think about raising their testosterone. But while increasing T can be important, an ideal health profile also means having testosterone that’s in balance with your other hormones as well.

Today on the show, Dr. Kyle Gillett joins me to discuss both of those prongs of all-around hormone optimization. We start with a quick overview of the different hormones that affect male health. We then get into what qualifies as low testosterone and how to accurately test yours. We also discuss what causes low testosterone in individual men, and how its decline in the general male population may be linked to both birth control and the world wars. In the second half of our conversation, we discuss how to both raise testosterone and get rid of excess estrogen, including the use of some effective supplements you may never have heard of. We then get into the risks and benefits of taking TRT, before ending our discussion with what young men can do to prepare for a lifetime of optimal T and hormonal health.

Resources Related to the Podcast

• AoM series on testosterone, including How I Doubled My Testosterone Levels Naturally
• AoM Podcast #761: How Testosterone Makes Men, Men
• AoM Podcast #878: The Fitness Supplements That Actually Work 

Connect With Dr. Kyle Gillett

• Kyle on IG
• Gillett Health Podcast on Spotify and Apple
• Gillett Health on YouTube
• Gillett Health website

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Read the Transcript

Brett McKay: Brett McKay here and welcome to another edition of The Art of Manliness Podcast. When men think about optimizing their hormones, they tend only to think about raising their testosterone, but while increasing T can be important, an ideal health profile also means having testosterone that’s in balance with your other hormones as well. Today in the show, Dr. Kyle Gillette joins me to discuss both of those prongs of all around hormone optimization. We start with a quick overview of the different hormones that affect male health. We then get into what qualifies as low testosterone and how to accurately test yours. We also discuss what causes low testosterone in individual men and how it’s decline in the general male population may be linked to both birth control and the world wars. In the second half of our conversation, we discuss how to both raise testosterone and get rid of excess estrogen, including the use of some effective supplements you may never heard of. We then get into the risk and benefits of taking TRT before ending our discussion with what young men can do to prepare for a lifetime of optimal T in hormonal health. After the show is over checkout our show notes at aom.is/optimalt.

All right, Dr. Kyle Gillette, welcome to the show.

Dr. Kyle Gillette: Thank you. My pleasure.

Brett McKay: So you are a medical doctor. You do family practice, you specialize in obesity but also hormone optimization, helping people have healthy hormones so they live a flourishing life. And today I’d like to talk about hormones, particularly male hormones. I think when most people think about male hormone optimization, they think about testosterone and which is obvious why you do that. And we’re gonna dig deep into testosterone today. But are there other hormones that affect male health that people often overlook?

Dr. Kyle Gillette: There certainly are. So even testosterone in and of itself, there’s nothing unique about it compared to other androgens. There’s just one androgen receptor. Testosterone just happens to be the most well-known androgen. So there’s DHEA, which is a very weak androgen. It’s produced by the adrenal glands, which are small glands above the kidney. There’s DHT, which is dihydrotestosterone. This is a very strong androgen. You don’t have as much of it as testosterone, but it’s vitally important for what’s called secondary sexual characteristic development, like the deepening of the voice, growing facial hair, those secondary sexual characteristics which are vital.

Brett McKay: And also I think people often overlook estrogen plays a role in male health.

Dr. Kyle Gillette: Certainly, testosterone aromatizes and directly converts to estrogen. So the way to think about estrogen is the more estrogen the better for your health because it prevents things like heart attacks at a correct ratio to where you feel good.

Brett McKay: Okay, so we gotta have some estrogen in there at the right balance. And then there’s another hormone called SHBG. What does that do?

Dr. Kyle Gillette: So SHBG is also known as androgen binding globulin. It’s a protein, it’s made in many places, the liver makes most of it, but the testes also make some of it. And SHBG stands for sex hormone binding globulin, it most strongly binds DHT and then it binds testosterone, relatively strongly, DHEA weaker than that. And then estradiol, which is your main estrogen, even weaker than that. So think of this as regulating all of the hormones and keeping them more stable. The higher the SHBG, the more stable the level will be. Men produce a lot of testosterone during sleep. So the level is generally much higher in the morning. But if you have a very low SHBG you’ll crash and you can actually have deficient levels of testosterone in the evening routinely. But normal levels in the morning if you don’t have enough SHBG, the most common cause of an SHBG deficiency is insulin resistance, which is often due to too many calories or too many carbohydrates and sugar.

Brett McKay: So what’s interesting about all those hormones is they interact with each other. It’s a complex system so if you raise the level on one, one might go down or up. So I think a lot of guys they get too focused on, well I gotta increase this one thing or reduce this one thing. Well, if you do that you’re gonna have these cascading effects that might not be optimal.

Dr. Kyle Gillette: Correct. I actually heard an advertisement from a TRT clinic this morning and it said new studies shows that men with low testosterone are more prone to cardiovascular disease and early death and diseases of aging. And I thought to myself, this is odd because they are implying that you need testosterone replacement to prevent this. But of course that is a logical fallacy because just replacing the testosterone without figuring out what’s actually causing it in the first place, not that TRT is wrong, but you need to figure out what the cause of it is and then address it.

Brett McKay: Okay. And I hope we can talk about TRT ’cause I know a lot of guys are thinking about doing it or maybe they are doing it and they might have questions about that. Let’s talk about testosterone. So there’s two ways to measure testosterone or two measurements of testosterone that I read about. One is total testosterone and free testosterone. So first, what’s the difference between the two and as a clinician is there a particular number you focus on?

Dr. Kyle Gillette: Yeah, so total testosterone is a total amount of testosterone, whether it’s bound or unbound, when testosterones bound it in general does not bind the androgen receptor, which is on the X chromosome. And total testosterone includes a testosterone bound to albumin, which is the main protein in the blood and also SHBG which we talked about earlier. But free testosterone or any free androgen is what is going to be what is actually binding to the receptor. And then it takes it into the nucleus of the cell and then it binds to DNA to cause what’s called gene transcription. So the androgen receptor gene that’s on the X chromosome is then mostly activated by free testosterone. Oddly enough, sometimes I make the analogy of plumbing. So you have a pipe that’s your bloodstream that takes testosterone everywhere and then you have different types of cells. For example, a muscle cell or a brain cell or a germ cell in the testicle or a somatic cell in the testicle, which we don’t have to get into. But anyway, the free testosterone level can be very different in the bloodstream, which is where we measure it on a blood test versus inside the cell. So it is possible to have symptoms of low testosterone because you don’t have enough androgen in the cell but have a normal level in the blood. It’s rare but it’s possible.

And the opposite is possible, to have a low level in the blood but still have enough inside the cell that’s free to be causing normal gene transcription.

Brett McKay: Okay. So just to recap there, total testosterone is made up of bound and unbound testosterone. Bound testosterone could be bound to albumin or SHBG. And then when it’s bound to those things it can’t attach to the antigen receptor in the cell and so it can’t be… Can’t effect have those changes on the cell. Free testosterone, unbound testosterone is free testosterone. So as a clinician, when you do a blood test on a patient, what number is more important to you? Which one are you gonna be focusing on more? Is it the free or the total?

Dr. Kyle Gillette: I think both are equally important. For athletic purposes, for muscle building purposes. Usually that’s more correlated with free testosterone level. However, symptoms and how you feel is usually correlated more with total. Insurance companies and academic societies usually put more weight into total testosterone, partly because free testosterones are often measured inaccurately so often it’s more accurate to calculate your free testosterone using your total testosterone and your SHBG and then you estimate what your free testosterone is. Some societies say low testosterone is often best treated if you one, have symptoms. And then two, also have a testosterone below about 400. That’s what the urologists say. Most other societies go by 300 and I tend to agree with the level of 400 with a caveat if you have significant symptoms and with a second caveat, if you cannot improve that naturally in any way after identifying the root cause.

Brett McKay: Okay. I wanna dig more into diagnosing low testosterone because there’s lots of commercials out there. You just mentioned one or these businesses popping up where you can just go in, get a blood test and like, hey, you got low T, here’s testosterone and maybe they don’t. So you mentioned two things you look at to diagnose low testosterone, you’re gonna do blood work and if it’s below 400, coupled with if the patient is reporting symptoms of low testosterone, we’ll talk about the symptoms of low testosterone here in a bit, but let’s talk about blood work. ‘Cause I think a lot of guys out there, they think it’s a panacea, if you just take a test, you take the test and it says, oh well, your T is at 400. They’re like, well I got low T. Why isn’t one blood test alone sufficient to diagnose low testosterone?

Dr. Kyle Gillette: Yeah, in general testosterone levels can have what’s called outliers. It’s the statistical phenomenon. But it’s especially true of testosterone where you could check it one time and your testosterone that morning could be low because the last two nights you’ve had poor sleep and poor diet and other lifestyle factors. Males that are generally seeking a TRT prescription know those very well because there’s various things that you can do to artificially make your testosterone level look low that morning. So in general, the recommendation is to recheck it two to three times after a good night of sleep and normal diet and whatever you’re doing normally not after you’ve dieted down to 7% body fat to do an ultramarathon or body building show, then your testosterone is certainly going to be low. But when you’re at a healthy body fat and there’s not an artificial something else that is going to make your testosterone look low. There’s a runner, his name is Nick Bare and he also is doing a body building show and I saw that he got his total testosterone checked and he’s a healthy guy. I’m not sure what his baseline testosterone is and his total testosterone was right at 100 before his body building show.

So that was obviously secondary to the caloric deficit. That wouldn’t necessarily count as a testosterone reading that you could put stock in assessing TRT or not. But for most people they probably won’t be in a scenario like that. But it is important to get at least two readings. If you’ve been sick before, then maybe just postpone the blood test by a week. That way you get an accurate reading.

Brett McKay: Let’s move on to the symptoms. So you do the blood test, what symptoms are you looking for to diagnose low testosterone?

Dr. Kyle Gillette: Yeah, could be through any system. So it could be anything from depression, anxiety to low libido is certainly classic. Low muscle mass is not really one that we look for. Testosterone levels that are naturally produced are not as correlated as people would think with body composition and muscle mass and athletic performance. So it’s not uncommon to see a pretty high level athlete have a total testosterone of let’s say 450 and let’s say someone that has very low muscle mass and maybe even 20%, 22% body fats have a total testosterone of 1000 and there’s not as much correlation. But other things that you would look for seriously is, for example, erectile dysfunction, sexual health in general, sperm production. So if there’s a patient that is having even sub-fertility, just a little bit of trouble getting pregnant, that individual should certainly have a test of his testosterone as well.

Brett McKay: So with low libido, how does a guy know if he has low libido? Because that seems like it’d be pretty subjective.

Dr. Kyle Gillette: Yeah, libido obviously has a lot of psychosocial factors as well. It’s usually taken at a patient’s word and a lot of times when you’re testing these patients, you’ve known the patients for a while, sometimes you haven’t. But if they’re telling you that it’s low relative to what it usually is and no other factors have changed, for example, you know they’ve been married to the same person for five years, they’re not actively going through problems in the marriage, there’s not something else that would be affecting the libido. So that would usually come up in the social history. When you do a history and physical on a patient, it is important to dig into the social history to make sure there’s not something else that is affecting the libido.

Brett McKay: So besides the low libido, maybe the lack of drive, what are the consequences of suboptimal male hormone levels like chronically? Is it gonna affect your cardiovascular system? Is it gonna affect cancer? Does it affect things like that?

Dr. Kyle Gillette: It will. If someone is significantly hypogonadal for a long time, they’re at much higher risk of osteoporosis, which leads to bone fractures and even mortality as well. They’re at higher risk of neurodegenerative disease, likely largely due to low estrogen. If you don’t have a lot of testosterone, you’re probably not converting a lot of it to estrogen and if you’re not doing that then you’re also at risk of cardiovascular disease. Estrogen is very cardioprotective and helps with the production of good cholesterol to help take cholesterol out of the plaque. So they’ve done studies and you look at one group of people that have true hypogonadism, which is generally two levels under 264 or so, and then one group you give TRT and then one group you don’t give TRT, you would think that the group that you give TRT would’ve a shorter lifespan ’cause androgens do cause excess production of “bad cholesterol.” They do increase a particle called ApoB, which is the most important one to watch for cardiovascular risk. But the group that you give TRT actually has less heart attacks and strokes.

Brett McKay: Right, because what you were saying before, the testosterone creates estrogen and then the estrogen protects the heart. So let’s talk about the causes of low testosterone. What can be behind low T?

Dr. Kyle Gillette: Most commonly, metabolic syndrome. So excess calories, excess carbs, insulin resistance, high fasting insulin leads to the liver not producing SHBG. So you might be producing a decent amount of testosterone but it’s being metabolized so fast that it’s difficult to use. That’s most common. The second most common I think is sleep apnea or obstructive sleep apnea. Obviously that kind of goes hand in hand with metabolic syndrome but often it goes hand in hand with PTSD. I saw a study on young men that had just gotten out of the military and they had been diagnosed with PTSD and they tested them all for sleep apnea and something like 80% of them had sleep apnea and they were all under under a BMI of 25. So there’s certainly a lot of stress component as well. The limbic system includes places like the hypothalamus and the amygdala and downstream to that is the hippocampus and the amygdala, downstream of those is the hypothalamus and that’s some of the places of the brain that are involved in sleep regulation and breathing.

So the theory is that apneic episodes don’t just come from having a huge neck and excess body fat, but there are other factors like trauma at play. And when you have a patient with severe sleep apnea, they have a score called a AHI score and if that score is very high, like 100 or 200, you almost always see deficient testosterone levels.

Brett McKay: Okay, so having metabolic syndrome, being overweight, sleep apnea, any other causes of low testosterone?

Dr. Kyle Gillette: Yeah, so theoretically xenoestrogens could be a cause of low testosterone. These are things like phthalates. These are also things like bisphenol A, also known as BPA, you might see BPA free on water bottles from time to time. These do bind various estrogen receptors and are likely suppressive. By suppressive, I just mean they shut down the production of the hormones that lead to testosterone production to some degree. Heat damage is also kind of an honorable mention. Some people might be familiar with what varicose veins are. Varicocele is where there’s varicose veins in the scrotum and some people with varicocele can have venous cooling very well. The testes wanna be about 91 to 92 degrees where the body is 98.6 degrees. So if you can’t keep your testes at 91 or 92, then you’re going to have less testosterone production and less sperm production. And in the more severe cases you’ll have atrophy, which is shrinking because, think about them as factories. If you’re not using the factory, they start to shut down.

Brett McKay: And besides these lifestyle factors and environmental factors, you could also have just an issue with your pituitary system, right? You might have a tumor or something in pituitary gland that’s dysregulating the release of hormones.

Dr. Kyle Gillette: Correct. I suppose that would be likely one of the more common less modifiable risk factors. There’s not a lot that you can do about that. You can take supplements like vitamin B6 or like vitamin E, but a lot of times pituitary microadenomas or even macroadenomas, basically it’s a small tumor in the brainstem. The pituitary gland is where you make a lot of different hormones like growth hormone and like LH and FSH. But LH is the main hormone that’s produced there that leads to testosterone release. So there’s two different types of hypogonadism. There’s primary and secondary. So primary is where the testes are not functioning. And then secondary, think about it, it’s two steps instead of one step. So the LH can be low in secondary hypogonadism and if your LH is very low and a hormone like prolactin or IGF-1 is very high, then that might be a sign of a pituitary micro adenoma. In which case you need MRI.

Brett McKay: And LH, that’s Luteinizing Hormone, correct?

Dr. Kyle Gillette: Correct. LH is Luteinizing Hormone. FSH is follicle stimulating hormone. They do crosstalk to some degree, but LH mostly helps with testosterone production and mostly binds to the Leydig cell in the testicle. And FSH mostly binds in the seminiferous tubules and helps with spermatogenesis.

Brett McKay: So I mean listeners have probably heard reports that T levels in men have been declining in the past few decades. Do we know what’s causing this sort of general decline? Is it just all these lifestyle, like people are getting fatter, there’s not sleeping, they’re stressed, and the stuff in the environment is that kind of what we’ve decided is the cause of the lower T levels?

Dr. Kyle Gillette: The various causes that we’ve already discussed are likely the primary causes of what is causing declining testosterone levels. But I think there is another factor, and a lot of that has to do with what I’d call epigenetic drift. Some people might call it natural selection, I might call it unnatural selection, where individuals with higher testosterone levels are no longer being selected for as early. And also a lot of individuals are having kids later on in life, for example, in their 30s or even 40s, when you might have very different maternal and paternal hormone profiles. That’s one of the reasons why I recommend if men are taking medications like Finasteride or Dutasteride, that they stop their Finasteride 90 days before attempting conception and they stop Dutasteride, depending on what dose they are, usually six months before conception. By the way, spermatogenesis takes about 60 days or two months. That way they have enough time to wash out before they start producing the sperm in the germ cells so that they wouldn’t pass down any epigenetic changes to potential offspring.

Brett McKay: Okay, so maybe this is… The idea is that… Again, this is theoretical, right? The testosterone increases aggression and risk taking behaviors and that’s not as adaptive in our safe high tech modern landscape. So men with lower testosterone might be more successful these days and women choose those men for their partners and then when they have children, the men pass down his genes and then his children have lower testosterone too. And that just perpetuates, just lower testosterone in the male population overall. Also, this idea of selection, I’ve heard that, I read this somewhere, correct me if I’m wrong on this, that women on birth control, they’re not attracted to higher testosterone men. Is that true?

Dr. Kyle Gillette: Yeah, that is one of the major players of what I would call unnatural selection. Another interesting unnatural selection, I suppose, if you look at, not very recently, but the World Wars, certainly in World War I and World War II or in the Korean War or Vietnam War, but especially wars that… Even if a war has a draft, the individual that has higher testosterone and also more sensitive androgen receptors, so this is probably true throughout all of human history, you would… And this obviously cannot be proven scientifically, but theoretically that individual would be more likely to volunteer to go to the front line or to very risky positions. And if that male passes away at age 18 or age 19, then that is likely a fecundity rate of zero. So no offspring from that individual and then you start to have genetic drift.

Brett McKay: Okay, so again, this is theoretical, what you’re saying is that men with very high testosterone, they’re gonna take more risk and in doing so, that may take them out of the gene pool by taking those risks. And there’s more opportunity for that sort of risk taking during big global conflicts like the world wars, right? More high T men die, they lose the chance to reproduce and pass on their genes. And then that just contributes to the declining testosterone in men in general. And that’s gonna have echoes through the generations. And on top of that, we have selection factors going on in the mating market as well.

Dr. Kyle Gillette: Yes. And it’s not like it’s an be all end all. All or nothing. You select for high testosterone or you select for low testosterone. There’s a lot more psychosocial factors at play, but we are certainly seeing that there’s likely a decline in testosterone even a bit more than could be accounted for by just metabolic syndrome and sleep apnea. Maybe things like heat damage to the testicle, maybe things like xenoestrogens are playing some part in this, but we’ll probably never know. But it’s very fun to speculate about it.

Brett McKay: Well, the heat damage to the testicle, what would… Causes like keeping your laptop on your lap, sitting down a lot, would that cause heat damage?

Dr. Kyle Gillette: Probably not significantly enough, but if you already had a Varicocele and you already spent an hour in the jacuzzi, keeping your really hot laptop and phone directly over your scrotum is certainly not gonna help. I suppose someone could prove this at some point. They’ve actually done a lot of studies where they look at the scrotal temperature and they’ve randomized two groups of usually, college students and one group they have wear basically like a sock around their scrotum that has something really warm in it. So they warm up the scrotum artificially to 98 degrees instead of 91 or 92 degrees. And in the individuals that don’t have varicocele, they can still overcome that heat damage because their venous pooling mechanism is so good at buffering that heat damage. So that did not affect their testosterone production and it did not affect their spermatogenesis. However, in individuals that already have impaired venous cooling, for example, with varicocele or varicose veins then it did.

Brett McKay: We’re gonna take a quick break for a word from our sponsors. And now back to the show. Let’s talk about optimal levels of testosterone. So below 400, and if you’re experiencing low testosterone symptoms, that’s not good. Is there an optimal level, as like a level that guys should reach for or is it gonna differ from man to man?

Dr. Kyle Gillette: It certainly differs, but that’s kind of an easy answer. So I’ll get into it more than that. A lot of times people have told me that I say individualized, I say that word a lot because health is individualized. We are all unique, we have different genetics, we have different epigenetics and we have different growth and development past that as well. But for most men, an optimal testosterone level is between about 500 and as high as you can go naturally. So there is some individuals with a total testosterone of 1500, they almost always have really high SHBG. So a lot of times their free testosterones only 20 or 25, between about 550 and whatever you can produce top in endogenously naturally without medication.

Brett McKay: But you also said it could be lower. I mean you mentioned there are athletes who are at 450 and they’re healthy. So if you get a blood test and it’s below 500 a little bit, you probably… I mean, I guess you shouldn’t worry too much about it if you’re not experiencing any symptoms.

Dr. Kyle Gillette: Correct.

Brett McKay: Okay, that’s good to know. So let’s say a patient comes to you reporting symptoms of low T, you do a series of blood tests that show yeah, that your T levels are low, they’re below 400. What’s your first line of attack in helping this patient get his T levels up?

Dr. Kyle Gillette: First thing to look at would be LH and FSH. If those are really low, then I’m worried about the pituitary or the brain. If those are really high, then I’m worried about the health of the testicles. If they’re in between, then I look for another pathology like diabetes, metabolic syndrome, insulin resistance, sleep apnea, etcetera. I also look at prolactin and IGF-1, make sure you assess their tumor risk. And then I also look at estradiol. If it’s a very high estradiol, then estradiol is likely what is suppressing the production of LH from the pituitary. So you have estradiol, which is your main estrogen, which is causing less testosterone production. And in that case, I look at things like alcohol consumption that can up-regulate aromatase or consumption of excess calories or fat that can up-regulate aromatase, which converts testosterone to estrogen by the way. So those are the first things.

Brett McKay: Beyond that, what are you looking at?

Dr. Kyle Gillette: Beyond that, I’d like to, if pertinent, do an exam, make sure, especially if this individual is developing, if they’re an adolescent or whatnot, you need to make sure that they’re through all the tanner stages. Basically tanner stages one to five, five is done, when you’re essentially adult growth and development to make sure that they don’t have some unusual or unlikely syndrome. And then after that I’d like to look at their fasting insulin, their A1C, see if there’s something that I can correct. I look at their cortisol. If their cortisol is high, then there’s a lot of lifestyle factors and also supplements that can help control cortisol like Ashwagandha or Emodin. I look at their prolactin. So if their prolactin is just a little bit high, then maybe I do start them on some Vitamin B6 or some Vitamin E. If their estrogen is high, maybe I start them on some Calcium D-glucarate that helps with estrogen glucuronidation and metabolism. It basically helps you excrete it through your stool and then repeat labs in one, two, maybe even three months and see if we can improve those things along with, as always, diet and exercise.

Brett McKay: Okay. So it sounds like the first line of attack, if it’s not a pituitary problem, you’re gonna be primarily doing lifestyle changes, right? Quitting drinking, getting better sleep, diet, exercise to help get that insulin sensitivity back online. So yeah, lifestyle stuff would be the first line of attack and then will it take maybe one to two months before you start seeing results from that?

Dr. Kyle Gillette: Yeah, often it does. A lot of times you feel better the first week and a lot of times your testosterone production recovers very quickly. But occasionally, I use medications as well. So some people utilize a short course of HCG, which essentially binds the LH receptor, takes the place of LH and occasionally, I’ll utilize very short courses. By very short, I mean, a week or maybe two weeks of selective estrogen receptor modifiers or sometimes longer in the right patient, especially very young patients that you’re trying to stimulate endogenous production, these are often patients that desire fertility within the near to mid near future.

Brett McKay: Besides diet, exercise, sleep, managing stress, you mentioned a few supplements that you recommend men taking to optimize male hormones. Are there ones that you recommend for just any guy who… Maybe they don’t have any problems with testosterone but they just want to feel good? Are there ones that you like and that are safe?

Dr. Kyle Gillette: Creatine 5g-10g a day would be a great start. L-carnitine would be a consideration, especially if they’re interested in athletic performance optimization or body composition optimization, L-carnitine would be reasonable. Consider checking a TMAO to make sure that it doesn’t convert to that in too high of a rate. Another reasonable addition if someone has high estradiol would be Calcium D-glucarate to make sure that they’re binding up extra estrogen and excreting it.

Brett McKay: I’ve heard that Boron can impact testosterone. How does boron increase T levels?

Dr. Kyle Gillette: Boron works okay for people with really high SHBGs. It increases free testosterone by decreasing SHBG. The effect wears off to some degree if you take Boron for a very long period of time. If you have very low levels or you’re insufficient or deficient in Boron, it works extremely well and a lot of people consume Dates or Raisins because they tend to be relatively high in Boron.

Brett McKay: There’s another something I’ve been hearing about lately, Tongkat ali, I think that’s how you pronounce it. What’s going on with that one?

Dr. Kyle Gillette: Tongkat ali is also known as Longjack. So Tongkat’s active ingredients are Eurypeptides, one of which is Eurycomanone. And Tongkat is helpful because it upregulates a couple different enzymes in the steroidogenesis pathway. There’s been plenty of human study on it, with mixed results and it looks like the cause of the mixed results is, sometimes people have great activity of those enzymes. So that’s not the rate limiting step in testosterone production. So think of it as a signal, think of your testicles as a factory. Tongkat is a signal to that factory to ramp up production, but if your factory is already operating at maximum capacity or it’s limited by something else, then that’s not going to improve your testosterone level. Tongkat works on very similar enzymes that are also upregulated by insulin and IGF-1. So in general, if you’re in a caloric deficit or if you’re trying to lose weight or body fat, Tongkat will work better. If you have a low fasting insulin or a lower end IGF-1, Tongkat will also likely work better. And I’ve seen this anecdotally as well.

Brett McKay: A couple years ago, I remember ZMA was a big supplement that was pushed for increasing testosterone levels. Anything to that?

Dr. Kyle Gillette: ZMA is very reasonable to add if you have a low alk phos. So if you look at your CMP, which is your metabolic panel, there’ll be an enzyme called alkaline phosphatase. Alkaline phosphatase along with GGT are two intracellular enzymes. And the lower these two are the more likely you are to have insufficient levels of Zinc and magnesium. That’s why when I have input to various companies designing a supplement to optimize testosterone, I almost always put in Zinc, Magnesium and Vitamin D. You just wanna make sure these aren’t the right limiting step. Think about trying to optimize your testosterone is like trying to get into a fraternity. You’re not just making best friends with one of the people and then just hoping that nobody else will blackball you. You wanna make sure that you address each individual because if you… Let’s say you forget your Vitamin D and forget your Zinc, you’re deficient in Zinc, you’re deficient in Vitamin D, those two things will hold you back.

Brett McKay: Once you start down this path of increasing your testosterone or getting them optimized, is there any benefit to getting them higher? So let’s say you started off at 400, you had low T symptoms and then through lifestyle changes and maybe taking some supplements, you bump it up to like a 700. Are you gonna get any more benefit from testosterone by getting it up to 800 or 900?

Dr. Kyle Gillette: Past about 600, there’s little to no benefit, other than bragging rights.

Brett McKay: At what point would you have a patient go on testosterone replacement therapy?

Dr. Kyle Gillette: At any point when the risks outweigh the benefits and they understand both the risks and the benefits in their own terms.

Brett McKay: So what are the risk of TRT?

Dr. Kyle Gillette: Yeah, one of the risks is it causes more fluid retention and swelling. One of the risks is if you hyper convert to estrogen, estrogen will then bind to the liver and cause more SHBG and platelet production. And if your platelets go very high past a certain point, we know that people on oral estrogen, the blood clot risk is associated with how high their platelets and SHBG go. It’s likely the same for TRT. So if you go on TRT and you go into a huge bulk and you start consuming a bunch of alcohol and your platelets skyrocket, then it is gonna increase your blood clot risk. So TRT is not in and of itself going to improve health, it’s just going to be a tool to help you achieve a lot of your goals. Another risk of testosterone is if people have heard of medications called statins. Those work by decreasing the activity of an enzyme called HMG-CoA reductase. Any androgen including testosterone increases the activity of this enzyme. So often people’s cholesterol and it’s not actually cholesterol, they are lipoproteins, but people’s “bad cholesterol” gets worse. That’s why we watch that ApoB number very closely because we know that ApoB is the particle that is going to lead to plaque formation in areas like the coronary artery.

Brett McKay: And I guess the benefits of TRT is that you’ll mitigate those symptoms of low testosterone?

Dr. Kyle Gillette: Correct. And there’s of course other benefits as well like the benefits of estrogen, that we discussed earlier, being it’s cardioprotective benefit. And one of the main benefits of testosterone in a lot of individuals that I see start is they might have a… Let’s say they have an A1C of 5.7 or 5.8, which is technically pre-diabetes. You’re very unlikely to get diabetes on testosterone compared to if you are not on TRT. So a lot of individuals, perhaps they’re, I wouldn’t say doomed, but very likely to get diabetes and TRT can make a huge difference, especially when combined with other insulin sensitizing medications to prevent that.

Brett McKay: Do you keep people on TRT indefinitely? Is it like once you start to keep doing it or are there periods where you’re like, “Well, we’re gonna take you off and see what happens” or well how does that work?

Dr. Kyle Gillette: Most individuals are on indefinitely, but not everyone. Occasionally there’ll be a patient that is profoundly hypogonadal and the benefit of testosterone at that time is just huge. Let’s say it’s a patient who has a BMI of 40 and they weigh 400 pounds and they also don’t have a huge amount of lean body mass to lose in proportion. Everybody who weighs 400 pounds is gonna have a lot of lean body mass, but just less relative to your average person and they wanna maintain as much of that as possible. They need that tool in order to exercise, even if it’s somewhat of a placebo tool, that still helps. So if it gets them having a very healthy lifestyle, they go on that medication, perhaps they go on another medication like a GLP-1 for a short period of time and then they don’t really know what their baseline testosterone is. So maybe after two years they’ve learned those lifestyle interventions. They very slowly are ready to come off of every medication and then you can use a medication like HCG to help restore natural production. Perhaps one week of a medication like Enclomiphene or Novedex or even Raloxifene. And then you see what their natural production capability is. You give them a few weeks and perhaps they restore to a total testosterone of 600s, which is likely quite good in that situation or perhaps they go down to 100s again.

But a lot of people would want that chance to go back to producing their testosterone naturally. And in some cases it does work. I would say 90% of people that start on testosterone are going to remain on it indefinitely. But I would also say that 90% of people that go on testosterone can very likely regain at least their previous level of testosterone if they were to want to come off.

Brett McKay: Well, here’s a question. With female hormone therapy, you might start taking it during menopause to help with symptoms, but at a certain point, once menopause is over, I think you’re supposed to get off those hormones. Does something like that happen for men? I mean, you might do TRT throughout your 50s and 60s and then at a certain point you’re in your 70s and you’re like, Well I don’t need to do this anymore. Or are there 80-year-old or 90-year-old guys taking TRT?

Dr. Kyle Gillette: There are 80 or 90-year-old guys taking TRT. Occasionally, you’ll do a dose adjustment. It just kind of depends on the situation, but a lot of times when males reach that age, they are less likely to have as much benefit and they are more likely to have slightly more harm. So it’s a moving target over time where you get out the scale and you’re weighing the risks and the benefits and at that point when a patient’s already on TRT, you also weigh the risks of how difficult it would be to come off, which is not extremely difficult. But it is difficult because there’s medication regimens that you have to go with and even with those medications often there is a short period of time when you don’t feel great.

Brett McKay: So we’ve been talking about optimizing male hormones in grown men, but let’s say we got some dads and moms out there listening and they’ve got boys who are about to start or are in the middle of puberty. What can they do for their sons? What can young guys do to make sure they set themselves up for a lifetime of male hormone optimization?

Dr. Kyle Gillette: First and foremost, no huge dirty bulk in early adolescence. What I mean by that is, I mean, let’s say there’s somebody that’s trying to put on weight for football or whatever other reason, can’t think of any reasons where it would be worth it, but they’re putting on weight and also putting on fat. Adipose tissue in fat, adipose tissue is fat, that is going to increase the conversion to estrogen and estrogen is gonna close the growth plates of the bone. So that’s gonna prevent you from reaching full stature, both in height and other areas of your skeletal developments as well. So that’s a great initial recommendation. Thinking about gut health and fiber consumption is also very important. That’s gonna prevent, again from over, it’s called intrahepatic circulation of estrogen. Estrogen is not necessarily the enemy. In fact, a little bit of estrogen is neat to what’s called priming the pituitary in order to fully kickstart adolescence.

And that’s one of the reasons why boys with very high body masses have higher estrogens. The pituitary gets primed too early and something called precocious puberty is happening, which is too early of puberty. So that’s another thing to consider. In addition to that, you wanna have a reasonable balance between cardiovascular exercise and resistance training. You certainly want to do both because adolescents can be thought of as your free endogenous steroids of, I’ll say cycle, just because people understand it. But your free endogenous steroid boost where you know you are going to be one, super sensitive to all the androgens that are released, probably most people remember puberty and you’ll also be having a lot of androgen around, regardless of what you do, even if your health hasn’t been great. So when that endogenous steroid burst happens, that is the perfect time to take advantage of those lifestyle tools to build up very high bone mineral density and very high lean body mass without putting on excess body fat.

Brett McKay: I imagine young people getting plenty of sleep is important too.

Dr. Kyle Gillette: Yes, extremely important. And that might be one of the most common causes of suboptimal hormone profiles in adolescents.

Brett McKay: What about supplementation? Is supplementation something you encourage in young people to optimize their hormones or is you just focus on the diet and exercise?

Dr. Kyle Gillette: With the oversight of a doctor, I do encourage supplementation, if it makes sense. For example, let’s say there’s a young person and they get a stool test and the beta-glucuronidase enzyme is very high. We know that that individual is just recycling their estrogen over and over again, that makes something like a Calcium D-glucarate or with the oversight of the doctor maybe even a very low dose of an aromatase inhibitor, a very reasonable addition. And then if you get blood tests, you can actually check the hormones to make sure that they’re increasing at the correct rates, that your DHT is optimal, your testosterone’s optimal, your estradiol is optimal, your IGF-1 is optimal, and then you can tweak a supplement. Supplements are just like medications, they have pharmacologic effects so they have an effect on the body and the body metabolizes them.

So things like Creatine can be very reasonable. Creatine does not affect the development of the kidneys. I did a podcast with my good friend James O’Hara recently. We get a lot of questions from pediatricians because the AAP, which is a society of pediatricians, still recommends no Creatine supplementation whatsoever up to the age of 18. So not even, not even a 17-year-old. So I just kind of thought that was… And it’s been 15 years. So they’re gonna update their recommendation within the next couple years whenever they have a joint meeting. But that’s definitely a vestige of times past when we thought that Creatine was harmful to healthy kidneys. You just check a Cystatin C because Creatine makes your creatinine blood marker look abnormally high. Falsely high. So Creatine can make sense in a lot of kids as well. And then if there is a kid that has really low insulin IGF-1, sometimes Tongkat makes sense in that individual.

And then in some kids that do have optimal hormone profiles, let’s say there’s an athlete and he’s developing or she’s developing and they have very high testosterone, very high IGF-1, that’s great, you know that Myostatin levels are gonna be really high after you have that burst of androgen during adolescence. Myostatin is gonna stop the muscle from developing and cause you to start putting more fat into the tissue. I think that Myostatin inhibitors, week ones like Fortetropin, which comes from fertilized egg yolks or Epicatechin. CocoaVia is a good source of Epicatechin. Different cocoa powders have a lot of Epicatechin. Green tea has EGCG, which is another Epicatechin. Basically, those take down the levels of Myostatin. Those are also very reasonable to take for the right patient.

Brett McKay: What about, should parents be sweating about xenoestrogens in their kids? Like, make sure they get certain types of deodorants or cosmetic products and avoiding plastics?

Dr. Kyle Gillette: Bisphenol A and phthalates. Yes. That’s kind of where I personally draw the line, where if you are worried about every single thing, we live in an unnatural environment, more so than ever. So those are usually the ones that I say to avoid. If you live in an area that more likely has contaminants and microplastics, a lot of times I do recommend testing your water. There are a lot of services that do this. I personally used MyTapScore to test both the water, from the tap and the water through my Berkey filter. If you have young children. And that seems like a very reasonable time to use a water filter if you don’t know what the contents of your water is. And then as far as foods, of course, avoiding ultra processed foods, I think, it was ultra processed mac and cheese that got a bad name for having high phthalates. I assume they fixed that by now, but I actually don’t know. So a lot of times it’s the same recommendations as any other whole food diet. And then know your sources, try to avoid contaminants at very high levels and use the Pareto principle, try to do right most of the time and you’ll get most the benefit even if you’re just doing it some of the time.

Brett McKay: Well Kyle, this has been a great conversation. Where can people go to learn more about your work?

Dr. Kyle Gillette: My hub is on Instagram, kylegillettmd, and it’s Gillett Health on all other platforms. I do have a podcast that we fairly recently have, I guess, gotten pretty good audio and video of, but that’s on YouTube, Spotify and Apple Podcasts. We have a clinically, I guess, a clinical grade podcast. And then we have a layman’s podcast that we’re gonna call After Hours, which should provide good entertainment.

Brett McKay: Fantastic. Well, Dr. Kyle Gillett, thanks for your time. It’s been a pleasure.

Dr. Kyle Gillette: Thank you.

Brett McKay: My guest today was Dr. Kyle Gillett. You can find more information about his work at his website, gilletthealth.com. Also, check out his podcast, Gillett Health podcast and check out our show notes at aom.is/optimalt where you’ll find links to resources where we delve deeper into this topic.

Well, that wraps up another edition of The AOM podcast. Make sure to check out our website at artofmanliness.com, where you can find our podcast archives as well as thousands of articles that we’ve written over the years about pretty much anything you think of. And if you’d like to enjoy ad-free episodes of the AOM podcast, you can do so on Stitcher Premium. Head over to stitcherpremium.com, sign up, use code MANLINESS at checkout for a free month trial. Once you’re signed up, download the Stitcher app on Android or iOS and you can start enjoying ad-free episodes of the AOM podcast. And if you haven’t done so already, I’d appreciate if you take one minute to give us a review on Apple podcast or Spotify, it helps out a lot, and if you’ve done already, thank you. Please consider sharing the show with a friend or family member who you think could get something out of it. As always, thank you for the continued support. And until next time, it’s Brett McKay, reminding you to not only listen to the AOM podcast, but put what you’ve heard into action.

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Since March, I’ve been waking up earlier.

Before that time, I’d typically go to bed at 11 p.m. and naturally wake up between 7:00 and 7:30 a.m.

Then, for some reason, regardless of what time I went to bed, I started spontaneously waking up between 5:30 and 6 a.m. Consequently, I moved my bedtime earlier, too.

I’m not sure why the shift happened; maybe it’s my circadian rhythm changing in middle age.

When I first started waking up early, I didn’t know what to do with myself. I mostly read and took care of admin work before the rest of the family woke up.

But then at the start of May, I decided to take a two-mile walk right after I woke up at the buttcrack of dawn. Why? I don’t know. It was something to do mostly. Also, I knew I needed to walk more. I’ve got a pretty dang sedentary job as a blogger/podcaster. I’m on my butt reading, writing, and answering emails for hours every day.

I’ve had plenty of guests on the podcast who talked about the research on just how bad being sedentary is for your health — even if you make time for regular, strenuous exercise every day like I have for over 15 years. An hour of dedicated exercise each day can’t make up for sitting on your butt for the rest of your waking hours.

So, I figured I’d use my newfound time in the morning to move more and get my steps in.

I had zero expectations or specific health goals when I started the daily walking habit.

But I could soon tell from both personal observation and the fitness trackers I use (the Oura ring and the Apple Watch) that it was creating some positive changes in my health.

Here’s what happened after doing a month of my morning walk routine:

My daily steps increased.My daughter Scout likes to check my Apple Watch stats each night when I tuck her in. Back in March, she looked at my daily steps and saw that they were consistently in the 4k to 5k range. “Dad, you really don’t move much during the day,” she’d observe. “You’re kind of a lump.

Convicted!

Ever since I’ve started walking every morning, I usually get 12k to 15k steps a day. Much better. The boost hasn’t come from my morning walk alone; that habit has also had the unintended benefit of getting me moving more in general. I’ll intermittently take 10-minute walking breaks during the day just because I like how it feels to walk. I also get the Scout vote of approval each night when she looks at my watch.

Winning!

My resting heart rate dropped. Resting heart rate has been shown to be a good indicator of overall fitness and cardiovascular health. A lower resting heart rate means your heart is working more efficiently. Higher resting heart rates have been associated with cardiovascular disease.

A normal resting heart rate for adults is between 60 and 100. Well-trained athletes have a resting heart rate closer to 40.

Before I started walking in the morning, my resting heart rate was usually between 60 and 55. Not terrible.

But after a month of daily walking, my resting heart rate started hovering around 45 — closer to elite athlete level. And I got there just by leisurely walking for 35 minutes every morning.

My heart rate variability increased. Heart rate variability (HRV) is the variation in time intervals between consecutive heartbeats, reflecting the autonomic nervous system’s regulation of the heart. You actually want a lot of variation in your heart rate. High HRV indicates a healthy balance between the sympathetic (fight or flight) and parasympathetic (rest and digest) systems. Individuals with a high HRV are less stressed and more resilient physically and emotionally. You’re able to perform better physically and mentally when your HRV is high.

Low HRV indicates that your body is under stress due to factors like fatigue, dehydration, overwork, or illness.

Physical exercise, like walking, lowers your HRV by enhancing the parasympathetic (rest and digest) activity of your nervous system. Physical activity also helps your body manage overall stress levels and improves blood flow, two factors that contribute to a lower HRV as well.

Before I started walking every morning, my HRV hovered between 36 ms and 40 ms — not great. Now it’s hovering between 45 and 55 ms. An improvement!

My V02 max improved. VO2 max, or maximal oxygen uptake, is the maximum rate at which your body can consume oxygen during intense exercise. It’s a key indicator of cardiovascular fitness and aerobic endurance. Higher VO2 max values indicate a greater ability of the heart, lungs, and muscles to utilize oxygen, reflecting better overall fitness and endurance levels.

You can improve V02 Max through consistent HIIT or steady-state cardio. The only cardio I’ve been doing this past month is walking every morning.

According to my Apple Watch, at the start of May, my estimated V02 max (emphasis on estimated; I’d need to take an actual V02 max test to get an accurate measurement) was 38.5. Today it’s 42. It’s only a small change, and there’s still a lot of room for improvement, but taking a stroll each morning seems to have helped!

I sleep better at night. While I’m still waking up earlier than I used to, my sleep overallhas improved since starting the morning walk habit.

According to my Oura ring, I fall asleep faster and have more deep sleep and REM sleep. During deep sleep, your body releases hormones to help you grow and recover, and your brain flushes out toxins. REM sleep is when we dream, and as we’ve discussed on the podcast, our brain uses dreams to consolidate memories and make sense of all the stuff we experience during waking time.

I reckon the morning walk has improved my sleep in two ways. First, walking is a great way to build up your sleep pressure. Physical activity helps create adenosine in your brain, which makes you sleepy. The more adenosine you’ve built up during the day, the sleepier you feel at bedtime. When it’s 10 p.m., I’m ready to hit the hay, and as soon as my head hits the pillow, I’m out.

The early morning walks have also likely helped my sleep thanks to the exposure it provides to early morning sunlight.Exposure to sunlight helps regulate our circadian rhythm. Research suggests exposing yourself to sunlight first thing in the morning can get your circadian rhythm in a good groove so that you’re ready to go to sleep when you go to bed and experience better quality sleep when you are sleeping.

I’m in a better mood. We’ve talked about how physical activity is the antidote to both anxiety and depression. It’s all thanks to the endorphins that are released when you move your body.

I’ve noticed an improvement in my mood. I just feel better when I get my morning walks in.

I’ve lost some weight. From January to March, I did a short bulk to go from 185 to 200 pounds. In April, I started cutting calories to get my summer shred on. The goal was to get back down to 187 pounds. Why 187? I feel and look good at that weight. In April, I was able to lower my weight by five pounds by just reducing calories each week. In May, I continued to lower my calories slightly each week, but added in my daily walks. I was able to drop the remaining 10 pounds in just four weeks, and I never felt starved because my calories didn’t get crazy low. Combining calorie restriction with increased energy expenditure from walking turbocharged my weight loss.

Lower heart rate, increased HRV, improved V02 max, deeper sleep, better mood, and reduced body weight.

Solvitur ambulando. It is solved by walking. Damn straight.

I can’t recommend taking a daily walk enough. Two miles takes me about 35 minutes. With just 35 minutes a day, I was able to make some pretty significant improvements in my health in just a month. A small change in your daily routine will net you an outsized number of benefits.

If you haven’t started a regular exercise routine because you feel like you don’t have the time or because you think you have to do a really hard, strenuous workout to get any benefit from exercise, try going for a two-mile walk each day.

Don’t have time or aren’t ready for two miles? Then just do a mile. Something is always better than nothing.

Think you’ll be bored? Listen to a podcast (might I suggest AoM’s?). Improve your mind as you gently but significantly improve your body.

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Walk into any commercial gym, or even a hotel fitness center, and you’ll probably see a cable machine and/or a functional trainer.

A cable machine features two weight stacks connected by a cross-beam. The weights in each stack can be adjusted by the user and are lifted through a system of pulleys and cables that travel up and down a track.

A functional trainer sports a similar system, but is more compact in design, with the weight stacks sitting closer together. Most functional trainers also have a pull-up bar between the two weight stacks. 

Cable machines/functional trainers are pretty dang versatile. While a downside of weight-training machines is that they lock you into one position, a cable machine allows for movements that are more dynamic and exercise your balance and stability more than other machines. And with one machine, you can do multiple strength-training exercises and use movements that effectively isolate muscle groups and work them from a variety of angles. It’s possible to use cable machines/functional trainers to get an effective full-body workout.

This advantage is particularly beneficial when you’re traveling. Most hotel gyms are pretty basic: it’s typically a small, poorly lit room with limited equipment. But they do often offer a functional trainer, which means you can get in a good all-around strength training session while you’re on the road.

To learn a full-body cable workout that can be used either at regular or hotel gyms, I turned to Chris Contois, my physical therapist at Vitality Therapy and Performance here in Tulsa, OK. He’s also a competitive bodybuilder and has been doing some bodybuilding programming for me the past year.

Chris created a simple upper body/lower body split that can be done with a cable machine or a functional trainer. He noted that in the last two hotels he’s stayed in, the functional trainer had fixed handles; you couldn’t swap out attachments and put on a rope handle, for example. So he designed this functional trainer workout assuming you might only have fixed handles available.



Also, one of the downsides of functional trainers is that they’re not great for training legs. While you can do some leg exercises with a functional trainer, your options are limited. If you feel like you need a bit more lower body work, Chris recommends adding some plyos or some bodyweight movements, like air squats.

Upper Body/Lower Body Cable Workout

For a full-body workout, do all the exercises for both the upper and lower body, resting 90 seconds to two minutes in between each set.

Upper Body

• Mid Back. Mid-Handle Position Single Arm Mid Row: 4 sets x 8-12 reps
• Upper Chest. High-Handle Position Cable Crossovers: 4 x 10-15 
• Lats. High-Handle Position Half Kneeling Underhand Pulldown: 4 x 10-15 (video shows an overhand grip, just switch to underhand)
• Mid/Lower Chest. Mid-Handle Position Single Arm Chest Press: 4 x 8-12 
• Shoulders. Low-Handle Position Cable Laterals: 4 x 10-15
• Biceps. Low-Handle Position Single Arm Cable Curl: 4 x 10-15 
• Triceps. Low-Handle Position Single Arm Behind Head Tricep Extension: 4 x 8-12 
• Abs. Mid-Handle Position Rotational Chop: 4 x 10 

Lower Body 

• Quads. Low-Handle Position Cable Goblet Squats: 4 sets x 10-15 reps
• Glutes and Hamstrings. Low-Handle Position Cable Pull Throughs: 4 x 12-15 
• Quads and Glutes. Low-Handle Position Split Stance Lunge: 4 x 8-10 
• Hamstring and Low Back. Low-Handle Position Cable Romanian Deadlift: 4 x 8-10
• Outer Leg. Low-Handle Position Hip Abduction: 3 x 10-12
• Inner Leg. Low-Handle Position Hip Adduction: 3 x 10-12

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When you have a license to kill, you’ve got to keep yourself in tip-top shape.

So what did James Bond do for his workout? 

From the James Bond novels, we know that 007 liked to do all sorts of physical activities that could count as exercise: boxing, judo, swimming, and skiing. He was also a golfer, so he got some activity in that way.

As a Commander in the Royal Navy Reserve, Bond likely incorporated some of the calisthenics he learned from the military into his workout routine. It’s possible that he even drew inspiration from the Cold War HIIT workout, 5BX. 

You can see these influences in the workout 007 does in From Russia With Love. In that novel (one of the 5 best books in the Bond canon), Fleming describes a short calisthenics routine that his secret agent does that’s capped off with a “James Bond shower”:

There was only one way to deal with boredom — kick oneself out of it. Bond went down on his hands and did twenty slow press-ups, lingering over each one so that his muscles had no rest. When his arms could stand the pain no longer, he rolled over on his back and, with his hands at his sides, did the straight leg-lift until his stomach muscles screamed. He got to his feet and, after touching his toes twenty times, went over to arm and chest exercises combined with deep breathing until he was dizzy. Panting with the exertion, he went into the big white-tiled bathroom and stood in the glass shower cabinet under very hot and then cold hissing water for five minutes. 

A pretty quick and straightforward bodyweight workout, that we’ve illustrated for reference above. With one adaptation: Bond scholars and aficionados have never figured out exactly what Fleming meant by “arm and chest exercises.” We substituted chair dips; they work both the arms and chest. You can imagine in your own arm and chest exercise if you’d like. Performing that portion of the workout, and all the rest of them, in a tux with a pistol and martini glass on hand is optional, but highly encouraged if you’re an operative training to face the unique challenges of international espionage. 

Illustrated by Ted Slampyak

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When you’re lifting weights, you might be thinking about setting a new PR or doing your curls for the girls.

But throughout history, philosophers have thought about physical fitness on a deeper level and considered how exercise shapes not only the body, but also the mind and the soul.

My guest today, Joe Lombardo, is a strength enthusiast who follows in this tradition and has explored the philosophy of bodily exercise in his writing. Today on the show, Joe and I discuss several different ways the philosophy of strength has been expressed over time.

We begin our conversation with how the ancient Greeks thought of physical training as a way to develop personal as well as social virtues, and why they thought you were an “idiot,” in their particular sense of the word, if you didn’t take care of your body. We then discuss early Christianity’s relationship with physical exercise and the development of the muscular Christianity movement in the 19th century. We end our conversation by looking at the philosophy of physicality espoused by the Japanese writer Yukio Mishima, and what he had to say as to how strength training moves us out of the life of the night and towards the light of the sun.

Resources Related to the Podcast

• “The Soft American” by JFK
• AoM podcast and article on the La Sierra P.E. program
• AoM Article: When Christianity Was Muscular 
• The Greek Way by Edith Hamilton
• Yukio Mishima
• Sun and Steel by Yukio Mishima
• Joe’s writings on Quillette
• Joe’s writings at the European Conservative 

Connect With Joe Lombardo

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Do you sometimes walk to another room in your house to get something, but then can’t remember what it was you wanted? Do you sometimes forget about an appointment or struggle to remember someone’s name?

You may have chalked these lapses in memory up to getting older. And age can indeed play a role in the diminishing power of memory. But as my guest will tell us, there are other factors at play as well.

Charan Ranganath is a neuroscientist, a psychologist, and the author of Why We Remember: Unlocking Memory’s Power to Hold on to What Matters. Today on the show, Charan explains how factors like how we direct our attention, take photos, and move through something called “event boundaries” all affect our memory, and how our current context in life impacts which memories we’re able to recall from the past. We also talk about how to reverse engineer these factors to improve your memory.

Resources Related to the Podcast

• AoM Article: 10 Ways to Improve Your Memory
• AoM Podcast #546: How to Get a Memory Like a Steel Trap
• AoM Podcast #750: The Surprising Benefits of Forgetting
• Reminiscence bump

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• Charan’s website
• Charan on IG
• Charan’s faculty page

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Brett McKay: Brett McKay here and welcome to another edition of the Art of Manliness podcast. Do you sometimes walk into another room in your house to get something, but then can’t remember what it was you wanted? Do you sometimes forget about an appointment or struggle to remember someone’s name? You may have chalked these lapses in memory up to getting older. And age can indeed play a role in the diminishing power of memory. But as my guest will tell us, there are other factors at play as well. Charan Ranganath is a neuroscientist, psychologist, and the author of Why We Remember, Unlocking Memory’s Power to Hold on to What Matters. Today on the show, Charan explains how factors like how we direct our attention, take photos, and move through something called event boundaries all affect our memory, and how our current context in life impacts which memories we’re able to recall from the past. We also talk about how to reverse engineer these factors to improve your memory. After the show’s over, check out our show notes at awim.is/memory. Charan Ranganath, welcome to the show.

Charan Raghunath: Thank you very much, Brett. Great to be here.

Brett McKay: So you are a neuroscientist and you’ve spent your career, 20 plus years, researching memory. And we’re gonna talk today about why we remember some things, why we forget other stuff and what we can do to improve our memory. But after I read your book, one of the big takeaways I got from it was that memory is more than just an archive of our past, that actually memory shapes our day-to-day lives. So how does memory influence our lives beyond just being able to recall events?

Charan Raghunath: So one just very kind of simple example would be let’s say you wake up in a hotel room, your first question as you wake up as you’re a little disoriented and probably without even thinking about it you’re having this moment of, where am I? And just to situate yourself in time and space, it’s like you can look around you know where you are in the room, but, where is this room? It could be in like a prison somewhere or it could be in like a resort, who knows, and so you have to rely on memory just to get to that point to dig you out of that hole and tell you exactly where you are. So let’s take a slightly more complex example now like let’s say for instance you are trying to choose which restaurant you wanna go to and you have like a usual restaurant that’s pretty good but then lately they changed the menu and, you know, the last time you went there you had a terrible meal.

Brett McKay: So you can use memory to basically say, you know what, I’m going to go to someplace different this time. And then we can take something like a big choice. So I decided to go into research in cognitive neuroscience, but my training was in clinical psychology. And I actually had the chance to do a clinical internship in which I could have been on a career path to make lots of money in a clinical career. And when I look back on that decision, what I asked myself was essentially, what are the kinds of moments that I feel most comfortable in, that I’m happiest about? When I thought about the instances in which I was in the clinic, I thought, okay, I have to be dressed up well. I have to be there early in the morning. I have to be on when people say there’s a lot of pressure because if I don’t get things right, bad things can happen.

Charan Raghunath: Versus the times that I could remember from being in research where I was like staying up late, drinking beers and eating pizza in the lab while we were working late for a conference or something like that. And the people that I hung out with in the lab versus the more kind of formal environment in the clinic. And it was just a no-brainer. And so these hard life decisions are very very complicated we’re making them based on insufficient information and so we rely on memory to give us that data that we need to make these decisions about our future.

Brett McKay: And as we’ll see in this conversation too, memory is connected to a lot of other things in our lives that we might not think are connected to memory. The ability to imagine things, that’s connected to memory. How we situate ourselves, not only in place, like that example you gave, you wake up in a hotel room, you’re like, “Where the heck am I?” But also in time. But let’s get to this question. I think a lot of people might have this. Why do we remember some things, but not others? And then the follow-up question is, what can that answer tell us about how memory works?

Charan Raghunath: When we look at the design of the brain, what you see over and over and over again, whatever system you look at, is that the brain is optimizing to make the most of a little bit of information. And so what I mean by that is if we see the world, we’re not literally looking at everything. We’re only grabbing little bits and pieces of the world with our eyes by just moving our eyes and focusing in different places and then assembling that into a meaningful picture. So we know that even our ability to perceive the world is limited and our ability to hold things in attention is limited. So what makes things memorable and what makes things grab our attention, there’s a high relationship between them. They’re often things that are biologically important. So something that you’ll probably find this, I imagine yourself, Brett, if you look back on things in your life, you probably remember the first things that will come to mind will be the highs and lows, right?

Things that are very emotionally, there were exciting or times where you were scared or times where you felt intense desire. And these are biologically important moments where there are chemicals in the brain that promote plasticity that are released during these moments. So that right off the bat tells you something about why some events are memorable is because they’re biologically important. Other events that would be also important would be things that are new or things that are surprising. So we often remember these events that really surprise us because they stick out. And some of that is related to a phenomenon I’ll get into with regards to interference. But some of it is also when we’re surprised or when we’re in a brand new place that we’ve never been to before. Again, there’s these release of neuromodulators, these chemicals in our brain that promote plasticity. So those are some of the key factors. And another key factor, as I mentioned is the fact that memories compete with each other.

And this is a phenomenon called interference. So I think intuitively, we might think of memory as being like I store a bunch of files in my hard disk. And more or less, if I store 10 files or if I store 20 files, it doesn’t make a difference. But that’s not how memory works. In human memory, the memories are competing with each other. And so if I’m trying to remember, Brett, let’s say, your name, I meet you sometime in person. We go into the real world as opposed to the virtual world. I meet you, we have a beer or something like that. Then later on, I meet someone named Britt. Well, remembering Britt is going to be complicated because I’ve just learned about Brett and there’s going to be this interference between them. So the way that memories can survive that competition is if there’s something distinctive that makes this memory different from something else.

So if I had something about your name and I could tie it with something interesting about you that I learned and make that all into one big story, for instance, then now all of a sudden you’re very, very different from Britt because Britt is just sound that I heard. And this is the way in which memories can stick around is if we’re attending to something that allows us to capture what’s unique about this moment in time. So the sights, the sounds, the smells, emotions, something that you think about that’s unique.

Brett McKay: Does our brain store memories in a specific part of the brain?

Charan Raghunath: Well, this is a very tough question to answer because essentially it comes down to what is the memory. And so there’s many different ways memory can be manifest. One is your ability to just know, call upon facts, general knowledge that you have about the world. And that’s called semantic memory. And then there’s your ability to remember specific events in your life, like episodic memory. So, I know that Def Leppard was a British metal band that played very melodic songs in the 1980s, but that’s different than my memory for seeing them in the round during the Hysteria tour, which was a little bit after they had peaked. But nonetheless, that’s an episodic memory from one point in time. And so those kinds of memories differ from each other. Now, the hippocampus is an area of the brain that’s known to be very important for forming new episodic memories. And it doesn’t do it by itself, but what it does is it ties together all of these different parts of the brain that are processing the different kinds of aspects of the semantics of your world. Does that make sense? Am I kind of getting too…

Brett McKay: No, that’s making sense so far, yeah.

Charan Raghunath: Yeah. So a lot of what people think of when they think of the memory loss, for instance, that you see in the earliest stages of Alzheimer’s disease, that’s related in part to the loss of the hippocampus, because what happens is people start to lose this ability to form new episodic memories. They still have knowledge of who they are, all the people they know in those early stages, but they lose this ability to form new episodic memories. And so that’s why the hippocampus is such a big player in memories, ’cause it plays this role in just arbitrarily saying, in some ways, the hippocampus, I mean, if we were to pretend the hippocampus is a person instead of a brain area, you could say, well, it’s being deliberately dumb. It’s not thinking about why things should go together. It’s just saying, “Hey, I happened to see Brett in the pub while the song was playing in the background all at the same moment in time.” And that’s what the memory is. It’s just this random coincidence of factors.

Brett McKay: Okay, so the hippocampus is involved in episodic memories.

Charan Raghunath: Mm-hmm.

Brett McKay: Something that you’ve researched a lot and found, and it’s been groundbreaking, is the role the prefrontal cortex plays in memory. People might be familiar with the idea that the prefrontal cortex can be used as short-term memory, it’s sort of used as… The analogy is the prefrontal cortex is like RAM. It’s like working memory. So if you need to temporarily remember something, prefrontal cortex can take that for longer-term memories. You go to the hippocampus. What your research has found is no, the prefrontal cortex actually plays a bigger role in those long-term memories. What role does the prefrontal cortex play?

Charan Raghunath: Yeah, I think that I’m really glad you brought up that RAM analogy because I think that was very popular for a long time in psychology that we used to think of humans as being like computers in this very kind of straightforward way, but we’re not. What the prefrontal cortex seems to be about is it’s kind of a, again, I’m gonna use these analogies just to keep things simple, although I hope people with a more scientific background won’t get mad at me for this. But a lot of people use the term executive to describe what the prefrontal cortex does. And what that means is, you know, an executive who’s running a company really has no useful skills. You’re not gonna trust them with the accounting. You’re not gonna trust them to like handle the mailroom or anything like that. But their job is really to oversee everything coordinated towards a common goal.

And that’s what the prefrontal cortex is all about. So for a long time, people used to think, oh, the prefrontal cortex doesn’t do anything because people could lose a prefrontal cortex and they would still walk and talk and have all the knowledge they did before, but they couldn’t function in the real world because they had no ability to use that information to get their goals achieved. And so you brought up this idea of short-term memory. And so part of the idea of being able to hold a phone number, say, in short-term memory, like if I give you a phone number or if I say, “Hey, here’s your temporary password. I need you to reset it so that you can get back into your bank account.” You’re keeping that information in mind. But to do that, you have to keep yourself from being distracted. There’s a kid crying in the background or maybe you’re getting a text alert on your phone and you have to suppress those distractions to focus on what’s relevant.

And that’s where the prefrontal cortex comes in. But that same ability is also what allows you to be present in the moment and focus on what’s important, like where I put my keys or where I put my phone, as opposed to the things that may be less important but could grab your attention, like the sound of a dog barking or a kettle whistling or something. Things that you need to take care of, but they’re not necessarily related to these other long-term goals.

Brett McKay: And so this idea that the prefrontal cortex directs our attention to stuff that we wanna remember. And if we’re distracted, we might not remember that thing. That explains like why we forget, like, where did I put my keys? Where did I put my wallet? Because you just, you weren’t, your prefrontal cortex kind of checked out when you just dropped them on the counter and you weren’t paying attention. So it was just like, “Yeah, we’re not gonna remember that.”

Charan Raghunath: That’s exactly right. Yeah, yeah, that’s exactly right. And so, and sometimes what happens is our prefrontal cortex isn’t checking out, but it’s actually, sometimes we intentionally do it. We switch from one task to another. We’ll go, “Oh, yeah,” I’m gonna be like, I’m walking in the door, I’ve got my keys, but then I just decide habitually to check my email or something. And so the prefrontal cortex is saying, “Okay, let’s shift gears. Now my goal is to check email.” And so the next time when you go back to your keys, you’re already a step behind because your prefrontal cortex has to use all these resources just to shift back from the email task back to whatever it was you were doing when you opened the door. And so as a result, our resources become too depleted, spread too thin, and we can’t focus in on what we need. So sometimes the prefrontal cortex is there, but we misdirect it because we have bad habits.

Brett McKay: Right. Or it could just be overwhelmed I think you highlighted some research how constantly using social media that can inhibit memory because your prefrontal cortex has got all this information just… You’re blasting it and it then it can’t remember stuff you actually wanna remember.

Charan Raghunath: That’s exactly right. Yeah. So you can be blasted both by switching between these things. And again, a lot of this is under our control, so to speak, meaning that we don’t have to check social media all the time. Like right now, if I was being sloppy, I would be checking social media in between points in our conversation, which would be horrible for my ability to remember our conversation later on, which is why I turned off all my alerts and I went into focus mode for this conversation because otherwise I’d be having this conversation and then somebody would say, “Hey, what did you do today?” And I’d be like, “I was on this amazing podcast, but I can’t remember anything about it.”

Brett McKay: Yeah. And this might explain like why as you get older, I mean, there’s a couple of things going on as you get older, why your memory feels like it’s not as sharp. But I just think as you get older into your 30s and your 40s and your 50s, you have a lot more going on in your life, a lot more stuff to keep track of, keeping track of your kid’s schedule, your work schedule, things that need to be done on the house. And so, yeah, you’re probably gonna forget that your glasses are on top of your head because you got so much going on.

Charan Raghunath: That’s a very good point. So as we get older, there’s a bunch of things that happen. So one is, that we have a lot of stresses, we have a lot of pressures, and we have a lot of competing things and deadlines and so forth. And so when we’re under stress, the natural response of the brain is to down-regulate the prefrontal cortex. You wanna go into more of a responsive mode rather than a mode of planning and deliberation. And so we’re now compromised because of that stress. But then on top of it, as we get older, on average, the prefrontal cortex shrinks a little bit. It’s not functioning as efficiently as it should. And then we’re maybe having some health issues. Maybe we just got over a bout of COVID. Maybe you’re not sleeping as well as you used to. And so all of these factors can compromise the frontal cortex even more. So one of the things I think a lot about is how modern life is just optimized to deplete our mental resources and put us in the state of perpetual amnesia.

Brett McKay: Okay, so the prefrontal cortex plays a role in memory by directing where we place our attention. And then when we don’t give something sufficient attention, we can’t remember it. So, if we got a lot going on in our lives, we tend to be forgetful because there’s just too many things to pay attention to. It overwhelms the prefrontal cortex. And then when you’re multitasking, you’re task switching a lot, you can’t give any one task enough attention to remember what’s going on with it and do it well. And then all these things, it can cause stress and that can deplete the strength of the prefrontal cortex as well as other things like lack of sleep. Something related to this is how the use of smartphone cameras affects how we remember an experience. What does the research say there?

Charan Raghunath: So, on average, the research shows pretty significantly that when we use cameras to document our lives, we actually have a paradoxically lower memory for those events. And I think people have this intuitive idea that if I take a picture of this event, I will remember it. And in theory, that could be true. But what often happens is people don’t go back to the pictures, right, ’cause we collect gobs and gobs of pictures and then on top of it, we’re mindlessly documenting these things. And you can see this with the rise of Instagram walls everywhere, right? So it becomes no longer about the experience, but about the picture. And so what happens is, is that people tend to have a poor memory for these experiences when they’ve been focused on taking the pictures and posting them now it doesn’t have to be that way so you could be more selective in the way that you take pictures and use the camera as a tool for grounding you in the moment and say, “What’s really going on here? What’s interesting here?” And then selectively take pictures that are planting cues in your mind for later on being able to remember them. Because that’s what a lot of memory is, is if you have the right cues, some distinctive thing that you’re seeing or smelling or hearing, that’s what allows you to go back and revisit that moment. And so we can be mindful about picture taking.

One study found that if people are in that kind of condition, you can actually improve memory. Another way you can do it is by actually going back to those pictures. So we can think of, like, an Instagram story or a Snapchat post as being a metaphor for how photos actually have this amnesia quality, where you post something, and then two days, it disappears. And this is what I think we often do with our photos. But if you actually. One of the things I do like is what’s called Facebook memories, where they put on a photo that you haven’t seen in years, but you posted it a while back, and that’s now a cue to recall that memory.

And the act of recalling that memory now makes it more accessible later on, so that way you can remember it again. So the act of remembering makes it more memorable.

Brett McKay: Okay, so if you’re going to take pictures, I think going back to what we were saying about the role of the prefrontal cortex in memory, if you’re just focused on taking the perfect picture and thinking, “Oh, this would be great for Instagram, and what are my friends gonna think about?” The way you’re directing your attention, you’re putting it on the picture taking itself. I mean, you’re not really present. You’re not there. And because of that, you’re not gonna remember the experience as much. But you could, if you direct your attention differently, even while taking a picture, that can enhance your memory if you wanted to.

Charan Raghunath: Yes, I would say that if you… You can use your prefrontal cortex. Say, if my goal is to have a memorable experience, I can actually, first of all, think about what’s in front of me, think about the sights and the sounds and the smells and so forth, and immerse myself in it. Immerse myself in this moment. But then when I do take pictures, you can actually ask yourself, what would be a good reminder of this moment? What are the points in this moment that I want to remember? What are the points in this moment that I don’t want to document? I think lots of times we just take pictures without ever even thinking, is this the memory that I want to be calling back? Because ultimately, once we start taking these pictures, those pictures will have a disproportionate effect on what we remember. So how many times have you taken a vacation and you take pictures, and the events that you remember later on are those events that you photographed and the ones that you didn’t photograph get thrown to the side? Has this ever happened to you?

Brett McKay: Yeah, no, for sure.

Charan Raghunath: So, yeah, so that’s I think part of it is the camera can be a tool. And again, if you use your frontal cortex to say, “What do I want out of this experience?” The camera can be a tool to get it, as opposed to a distraction that just takes you away from what you want.

Brett McKay: So going back to this idea of episodic memory, this is sort of remembering events in our lives that happened to us. Why is it that we have a harder time with episodic memory as we get older? So I think we mentioned some things, right? You have just a lot going on in your life. There’s stress. Your prefrontal cortex shrinks as you get older. But, I mean, I’ve noticed this in my own life, and I think you talk about this in the book. I can remember stuff from when I was middle school through age 30. Like, very vividly. I remember college. I remember traveling internationally. I remember high school football. But then after age 30ish, things are kind of like… I kind of remember doing that, but it’s not as in much detail as those teenage years. What’s going on there?

Charan Raghunath: Well, this is something that’s very, very common. In fact, memory researchers have a name for it, which is the reminiscence bump. And the idea behind the reminiscence bump is that if you just plot the number of memories that people will report if you ask them about different times of their lives, and you just make a little graph out of it, there’s a big bump in the graph from the years between the ages of 18 to 30, and there’s a number of reasons for that. And one big reason is that that’s when our sense of who we are is actually emerging. And so the experiences that we have during that time period are very tied to our sense of identity. And that’s the time when we’re forming our tastes in music in food, and we’re finding the friendships that help define us and so forth.

And so we tend to call upon those memories more as a result. And as I was saying, the memories that you call upon the most will be strengthened each time you call upon them.

Brett McKay: Another theory as to why we remember more from our youth is that memory is enhanced when we encounter something novel. And when we’re young, we’ve got a lot of novel things. There’s a lot of first, we do a lot of new things. And so when the brain encounters that, its memory camera is like, “Oh, hey, this is novel. This might be important. We’re going to take a lot of footage of this.” So then when you look back on it, there’s a lot of memory footage to unspool. But as adults we tend to get into a routine, we experience less novelty. Each day, I mean, even year, is just a lot like the last one. So the memory camera just, like, turns off. It’s like, “Well, I’ve seen this before. No need to capture it.”

So when we look back, there’s not a lot of memory footage to unspool. So if you want more memories in adulthood, you’re gonna have to do more novel things. More memorable things. We’re going to take a quick break for a word from our sponsors.

And now back to the show. How can understanding how episodic memory works help us understand why it is when we go into the kitchen for something, we forget why we went into the kitchen. What’s going on there?

Charan Raghunath: This is one of my favorite topics and actually something that we’re studying a lot in my lab right now. Even though our lives are continuous, what happens is we tend to remember our lives as a series of events. Like, I went to the kitchen, I went to someone’s 21st birthday party, blah, blah, blah. And so what we think happens is that as we go about our day, you’re creating a little story in your head. That’s okay. So my job right now is to talk to Brett and answer this question. I’m keeping your question in mind. I’m thinking of all these ways of answering it. But then we move on to another question, and I flush that information out. I focus on the new question you’re asking.

And that time, when I pivot from question one to question two is what we would call an event boundary. It means that one event is over, another has begun. And what we can see when we scan people’s brains is at those moments, there’s almost a tectonic shift in the patterns of brain activity, where you see this change in patterns as people’s story about the world changes in a moment.

And so what’s interesting is, is that even the act of just moving from one room to another can give you that. So if I take a few steps right now, if I were just stand up, take a few steps to my right, I’d be in my room. And then one more step, and I’m crossing into the hallway. And even though it’s just another step, I would psychologically feel like I’m in a new place. And that change in your spatial context is enough to create an event boundary. And because context is so important for memory, that is episodic memories are so tied to a time and a place that in the time it takes me to go to the kitchen, now I’ve shifted across two or three rooms. And now when I go back and try to remember why I went to the kitchen, I have to engage in this act of mental time travel to recall what I was doing back in that time period when I was in my room.

Brett McKay: And that’s why it’s often helpful if you go back to the room you were in originally, you’ll remember why you went to the kitchen.

Charan Raghunath: That’s right. Yeah, that’s right. So then what happens is, for me personally, I’ll go to the kitchen, I’ll say, “Oh, what was I here for?” Then I’ll just grab some food and eat it. And then I come back to my office, and I’m like, “Oh, my God, I left my phone in there.” I realized, okay, over the course of the past year, I probably consumed thousands of calories because of these damn event boundaries.

Brett McKay: As I read about that idea about event boundaries, it made me wonder if this can help explain. Whenever I read stuff on a digital device, like my smartphone with the Kindle app, I don’t remember as much as when I’m reading from a paperback book.

And I think it’s it could be because when you’re on a device, it could be on the Kindle app, and then immediately I can swipe over to Instagram or my email. That event boundary when I’m reading on my phone, it’s just really porous. I’m switching back and forth between events, so I’m. I’m remembering less about each. But with a book, like a paperback book, there’s a clear event boundary in its pages. When I’m reading, I’m reading. I’m just in the book, it’s just one event.

And I’ve noticed that whenever I read a paperback book, I remember it more. I can find things, and I can remember where some quote that I highlighted is. I know which part of the book it’s in, but I don’t have that experience when I’m reading on the Kindle app.

Charan Raghunath: Yeah. So there’s definitely physical aspects of holding a book that are different than the way we interact with a Kindle, for instance. And so that can lead our reading experience change, which is going to change memorability. So one of the things that you mentioned is just the fact that if you’re using a device that has more than just a reading app on it, it’s just so tempting to think of other things. So, when you pick up that device, your brain is considering all the possible tasks you could do on that device. And so it’s almost like you’re at a buffet.

I don’t know about you, but if I ever go to a buffet, I’m eating one thing, but I’m thinking about all the other things I could be eating, right? So, again, I’m never really there. And with a book, on the other hand, you have no choice. You’re sort of stuck with it.

And also with a book, there’s a way in which there’s a spatial sense of where the plot is, because, essentially, there’s a physical place for each word on this book. But on the screen, it’s a little different, because every page appears on the same screen, so it gives you a little bit more distinctiveness.

And all these factors put together, I believe, make it easier. I think you brought this up in your example. If I’m reading page 100, I often have to think back to what happened in page 70 in order to be able to understand what’s happening in page 100, and that’s easier to do, I think. At least it feels more natural with a physical book because it’s on a different page.

So I can think about it in a way that actually takes me back to a different place in a different time. And what we found is that actually there’s a little burst of activity and a pattern of activity in the hippocampus that tells us that people are mentally time traveling back at these points where you can make a connection between the current part of a story and a previous part of the story.

Brett McKay: That’s really interesting.

Charan Raghunath: And so I think that act of being able to link things together and build them into a bigger narrative is just mentally easier with a physical book.

Brett McKay: Okay. So if you feel like your brains kind of like, “I’m not remembering as much,” few things you can do there. Don’t blast your prefrontal cortex as much. Maybe turn off the fire hose of social media. Don’t tasks switch so much? Take care of your prefrontal cortex. Sleep, reduce stress, eat right. That can help out a lot.

I thought it was really interesting. You have this chapter about the role that imagination plays in memory. What’s the connection between the two?

Charan Raghunath: So, I loved writing this chapter. It was just so much fun because it allowed me. One of the things about writing this book that was so much fun is I got to take a beginner’s mind and start to look at things that I’d seen and different things that I had read and put it together in a new way. And so there’s a very old idea going back to a researcher named Bartlett in 1930, where he argued that we don’t replay the past, but we really create what he called an imaginative construction. And by that, he means that we don’t play the past. We actually imagine how the past could have been. It’s like, instead of replaying it, we stage a play in our mind of how it could have gone out.

And so we do get some details, but then we use imagination to fill in the blanks and add meaning to our past. And likewise, he suggested this. And then, in neuroscience, this idea really took off about 15 years ago, that we actually use memory to supplement imagination. That is, when we imagine things, they’re not coming out of thin air. They’re based on this combination of all these semantic knowledge that we have and then all these little episodic memories, these random bits of experience that we’ve had at different moments in our life that allow us to anticipate and imagine things that have never happened before. And it’s sort of the root of creativity.

Brett McKay: So this raises an interesting question. If memory is us just imagining how things might have gone, how do we know if what we’re remembering actually happened, that we’re not just imagining it?

Charan Raghunath: This is one of the coolest things about science, when somebody comes up with a problem that nobody had previously realized was a problem. And so my old advisor, Marcia Johnson, just came out with this as a young researcher in the seventies. She just said, “How do we tell the difference between imagination and things that we’ve actually experienced, because it’s all in our heads. A memory for something that happened and a memory for something we just thought about are both just mental experiences.”

And so the way that we have to do it is, again, surprise. You have to use your prefrontal cortex to do a little bit of extra detective work. And so what that involves is saying, “Okay, when I remember this thing, what are the bits and pieces that are coming to mind? Are they things that I can see or are they things that I can hear? Or something that gives me some grounding in that past event? Or is it just stuff that I thought about?” So, I don’t know about you, but for me, I have these issues where I ask myself, did I send that email? Or did I just think about sending the email? Did I take my medicine today? Or did I just think about it and then get distracted?

And I have to actually ask myself, okay, can I feel myself pushing the send button? Can I visualize myself or can I taste like putting the medicine in my mouth and drinking the water? And if so, do I bring back a sense of today versus some other day? And so those kinds of sensory experiences ground us in things that we’ve actually experienced in the real world, but the information that we think about could very easily be imagined.

Brett McKay: And then also, whenever we’re doing that imagining memory thing going on, like, other stuff might mix in as we’re trying to recall a memory of our childhood, there might be something that we picked up, like we read a book or something or we saw a movie, and we unintentionally spliced that into the childhood memory, and it might turn into something that it actually… That’s not how it happened.

Charan Raghunath: Yeah. And often, I mean, we need this because it’s this less is more principle that we’re using schemas as the scaffold for our episodic memories so we don’t have to keep rebuilding our memories from scratch. If I went to a cafe every Monday and met up with a different friend, if I formed a blank memory of that every time, I would be wasting enormous amounts of resources when instead, I could just take all my knowledge about what generally happens in cafes and then tack onto that the specific details of what I did this week versus what I did last week.

Now, the problem is that our schemas allow us to fill in those blanks, but sometimes we fill them in incorrectly. And then what’s worse is when we recall those events and we fill in the blanks incorrectly. Now, that new information can creep into our old memory because the memories get transformed every time we recall them. And so that’s why often people’s, when they tell the story of something that happened in their childhood over and over and over again, or your parents probably do this, what happens is that they get more and more of these little errors that start accumulating.

Brett McKay: Does this idea explain why sometimes people confess to crimes they didn’t commit?

Charan Raghunath: Yes, because what you can typically do in these interrogation situations, and there’s actually manuals that… There’s a manual called The Read Manual that talks about an interrogation method, which relies on this, where what they do is they ask a person to… So, first of all, you start off with somebody who’s an authority figure, like a police person. You put the defendant under stress, and then you give them some misinformation, like somebody else has ratted you out. We already know that you did this. So now there’s a little bit of a seed of doubt planted in the person’s mind, and they’re stressed out, so they’re not applying this kind of critical thinking that the prefrontal cortex would normally let them do.

And then you ask them, “Okay, well, if you don’t remember, just imagine how it could have played out.” And so now they think about it, and if they have a vivid imagination, they might actually be able to come up with a very vivid mental picture of how the crime could have played out. And the next day you ask them, and now they remember something, but they don’t remember what happened. They remember what they imagined. And so if you do this across multiple days while a person is stressed out, sleep deprived, in case of it’s some interrogation of somebody abroad, like what the CIA does with their enhanced interrogation tactics, maybe they’re being tortured. And so as a result of all this, people can develop quite a rich false memory for things that never happened.

And this has been simulated in the lab by Julia Shaw and Elizabeth Loftus, and this has been shown to happen in real life.

Brett McKay: Okay, so memory can be squidgy because our imagination plays a role in recalling memory. Here’s another thing I’ve noticed in my life, and it goes to the squidginess of memory. Sometimes you’re talking to a friend, and you’d be talking about when you were in high school or in college, and you say something like, “Oh, yeah, I remember you were really for the war in Iraq. And I remember how adamant you were.” And the person, your friend says, “Actually, no, I wasn’t I mean, I might have said some things, but I actually wasn’t.” You’re like, “No. You seem pretty adamant about that at the time.” Do we sometimes change our memories in order to match how we see ourselves today? So maybe we thought something in the past, but then our politics has changed or our beliefs have changed, but we update the way we remember things so that it matches how we think of ourselves today. Does that make sense, what I’m asking?

Charan Raghunath: Absolutely. And the answer is yes. So our ability to recall anything in a given moment is based on who we are and how we feel and our mental context at a given moment. So just as if you hear the right song or if you’re in the right place, you can access a memory for a particular moment that matched up with that. It can kind of send you back in time. Likewise, when we’re searching for information, the goals that we have and the beliefs that we carry with us affect what we can pull out and what we can’t.

So it can be something like more unconscious. So, for instance, it could be something along the lines of you’re having a fight with your partner, and so now all of a sudden, you pull up all these things recently that they did to piss you off, and it’s just so easy to come up with them. Then you make up, and then a week later, you can’t remember what you even thought about, let alone all those other memories that popped up.

  And so what changed was your mental context, this emotion, this intense emotion that you felt. And this also works for beliefs, too. So we have certain beliefs, and we tend to find memories that are consistent with our beliefs. If my belief is the past used to be great, and I was so cool when I was in high school, then I’ll remember all these great things that happened in high school, but I won’t remember all the negative things that happened in high school.

And then finally, we view the world through a particular perspective, and so we can actually access other information. We change this perspective. So, for instance, two people who are members of different political parties might watch the same presidential debate and come away with memories of completely different experiences of who won and who lost based on little one liners and so forth and the talking points that they selectively remember.

But people can switch perspectives and, say, well, what if I was instead of being a Republican? What if I was a Democrat or vice versa? They can start to pull up these exceptions that they might have normally missed. Just like you can probably pull up information about the positive aspects of your relationship with your partner when you’re not fighting with them.

Brett McKay: Okay, so that’s interesting. So how do you manage that? Are there any tips on how to make sure you’re remembering things correctly and you’re not messing things up just so it updates and matches your current state?

Charan Raghunath: Yes. I think one factor to keep in mind is just, first of all, how much you’re going to search for information in memory that confirms your beliefs. So on average, people tend to think of them, recall memories that are more positive and that make themselves look better than they really were. So if I recall some experience from some time in my life, I might actually think of it, think of an experience that’s going to be more positive, but I’ll also remember myself in a way that’s maybe been more of a positive role than it actually transpired.

So being aware of these biases, I think, is the first step. Another step is allowing ourselves the time to think critically. And again, what often happens is we’re under stress. You shut down the prefrontal cortex, you move on to the next thing very quickly, and it makes us very susceptible to misinformation. It makes us very susceptible to manipulation. But likewise, I think one thing we can do to help ourselves is surround ourselves by diverse perspectives and give ourselves a chance to remember things from other perspectives and think that maybe the way I see the world now is just one view of how the world could be.

Brett McKay: What’s one thing that people can start doing today to get more out of their memory?

Charan Raghunath: Oh, so much. What I would say is, probably the one thing that I would say is be comfortable with discomfort. And what I mean by that, and I don’t mean like that necessarily. Be a man. Man up. I know we’re in the Art of Manliness, but what I do mean is that I think we often assume that memory should be effortless. Things should just easily come to mind, and we should be able to memorize things easily.

And you look at the kid who gets straight A’s and you’re like, “Oh, that person’s smart. That person’s doing great in school.” But really the person who’s getting straight A’s is not learning. In theory, if you’re learning, it means that you’re actually struggling and you’re failing to recall things sometimes, and that you can get the most learning by pushing yourself and exposing the weaknesses in your memory so that you can then capture those weaknesses and fix them.

Likewise, if you want to be more creative, you need to expose yourself to sources of memories that are very idiosyncratic and weird. If you just kind of expose yourself to gobs and gobs of the same media, whether it’s reading material or music or people who you interact with, and they’re all from the same demographic group, same culture, same beliefs, you might as well be ChatGPT. You’re not going to be that creative or interesting. And if you want to be accurate and you don’t want to be remembering things in a way that’s basically making you susceptible for manipulation, you need to surround yourself with sources of information and people who have different beliefs, again, so that you can really constantly challenge yourself to challenge your view of how the past transpired.

And all of those things can be uncomfortable, but they can also be sources of curiosity. And curiosity is a major driver of learning and has enormous effects on the brain, as we’ve shown in our lab.

Brett McKay: Well, Charan, this has been a great conversation. Where can people go to learn more about the book and your work?

Charan Raghunath: Well, you can definitely read my book Why We Remember. You can also go to my website, charanranganath.com, to get on our mailing list for more information. And you can find me on Instagram, where we post periodically, including some tips about memory from time to time. And that’s @thememorydoc.

Brett McKay: Fantastic. Well, Charan Ranganath, thanks so much for your time. It’s been a pleasure.

Charan Raghunath: Thanks for having me, Brett. This has been fun.

Brett McKay: My guest here is Charan Ranganath. He’s the author of the book Why We Remember. It’s available on Amazon.com and bookstores everywhere. You can find more information about his work at his website, charanranganath.com. Also check out our show notes at aom.is/memory where you find links to resources where we delve deeper into this topic.

Well, that wraps up another edition of the AOM podcast. Make sure to check out our website at artofmanliness.com where you find our podcast archives. And while you’re there, sign up for a newsletter. We got a daily and a weekly option. They’re both free. It’s the best way to stay on top of what’s going on at AOM. And if you haven’t done so already, I’d appreciate if you take one minute to give us a review on Apple podcast or Spotify. It helps out a lot. And if you’ve done that already, thank you. Please consider sharing the show with a friend or family member who you think would get something out of it. As always, thank you for the continued support. Until next time, it’s Brett McKay reminding you not to only listen to AOM podcast but put what you’ve heard into action.

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