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Dr. John La Puma
Many people in this community feel like you just got to buckle down and you'll sleep when you're tired or you have enough money. So now I can go out and spend 4% a year and do the stuff I really want to do. What I would say to that is, are you protecting the body that has to live in that time? Because okay, now you're financially independent, now you're retired early. What has happened to your body in that time? Sacrificing your body and your brain while doing it is leaving your gains on the table.
Podcast Host (Producer/Announcer)
That quote is from Dr. John La Puma. He is a board certified internist who has lectured at Harvard, the University of Chicago and TedMed and is a two times New York Times best selling author. And he joins us to talk about what your job is doing to your health. Because if you're a knowledge worker, you spend most of your day at a desk on on a screen. This episode is about what that's costing you, what's costing you physically, and what to do about it. Welcome to the Afford Anything podcast, the show that knows you can afford anything, not everything. This show covers five pillars. Financial psychology, increasing your income, investing, real estate and entrepreneurship. Acronym Double I Fire. I'm your host, Paula Pant. I trained in economic reporting at Columbia. You are working very, very hard. You're building wealth. But are you protecting the body that has to live so that you can enjoy that wealth? Today we get into the science of what spending your career indoors is doing to your brain, to your sleep and to your long term health. And we talk about exactly what to do about it. Specific things that you can start today. Here to discuss the indoor epidemic faced by knowledge workers, here is Dr. John LiPuma.
Paula Pant
Hi, Dr. LiPuma.
Dr. John La Puma
Hey Paula, thanks for having me.
Paula Pant
Most of the people who are listening to this spend a lot of time indoors. We are knowledge workers. We are office workers. Some people have jobs that allow them to be outdoors, but many, many people don't. What are the top things that they should know about the effect that that's having on their health?
Dr. John La Puma
They should know that they're not alone. That as a people we spend 93% of our time indoors, which our biology simply was not built for. We evolved outside over 200,000 years and in one generation we've moved back in and never left. And that 93% indoors is making us older, sicker, more tired and less productive and less creative than we should be.
Paula Pant
How is it doing that though? Because my inclination would be all right if I'm indoors, that means I'M not getting sunburned, I'm not getting UV radiation, I'm in a climate controlled environment, which means I'm not getting too cold or too hot and all of the associated ailments that come with that.
Dr. John La Puma
Yes, of course. You just described the box that we have put ourselves in. As American workers, we've as a result had not just anxiety and depression and myopia and insomnia and immune deficits and insulin resistance and cognitive dysfunction and attention fatigue, but we've also had impacts on longevity. The idea here is not that indoors is evil, it's not inside we experience toxin and VOC and chronic inflammatory problems that are subtle, that there's emerging evidence for and maybe as, or even more importantly a disruption of our circadian rhythm. So when you described having a climate controlled environment, that's exactly what it is. It's controlled. And our biology has been not just coddled, but seriously disrupted because we don't have natural signals from the environment when we're indoors 93% of the time. Some people never leave their homes in a day. And without the natural signals that our biology evolved to expect, many of our chronic diseases evolve and we get signals that tell our biology we're captive. And that captivity is seriously hurting us. Not just with disease processes, but in the workplace and with teams. Because the inputs that we get inside are primarily screens, screens of all sorts, and telephones. When we get screens and monitors as our companions inside, I think what happens is that we experience something called digital obesity, where just like too much sugar burns out your brain, too many pixels burn out your brain as well. Too much sugar burns out your metabolism, too many pixels burn out your brain. We're simply overwhelmed with pixels that our brain can't metabolize. And we see this in the workplace. We see this with burnout especially. Burnout's not a character flaw or not having enough guts or grit. It's being overwhelmed by pixels where all day you get direct messages, you get slack messages, you get emails, you get texts, you have to keep up with your boss, and then at home you go home and you scroll cat videos to try to escape. That's just more of the Same blue light, 18 or 6 inches away kind of input. Your eyes never get distance, you never experience natural light to change your circadian rhythm and align your biology. I want to tell you more about that. That's the problem that we're captive inside. It's corrupting our biology and hindering, not just hindering, but disrupting and even destroying the protectivity and Creativity of teams.
Paula Pant
So later, as a look into what's going to happen later in this interview, I want to discuss some of the solutions. But before we get to solutions, I want to stay on the problem for a while and I want to fork this discussion of the problem into two different branches. I'd like to learn more about the biology of it.
Dr. John La Puma
Thank you.
Paula Pant
But in addition to that, there's also, you know, logistically, I'm also wondering about the type of work that we, quote, unquote, should be looking for. Because what strikes me, as I hear you talk about the maladies of too much screen time, is that many people aspire to work from home. In fact, some people will negotiate with their bosses to say, hey, can I work from home more often? Yes, but if a person works from home, then necessarily you are actually increasing your screen time, because if you're in the office, you're at least interfacing face to face with colleagues. Whereas if you're at home, the only way that you can perform your work is by staring at a screen.
Dr. John La Puma
Well, I might perspect just a little bit on that. I think that there are many different environments in work that, for example, don't encourage that kind of socialization at work, which is a benefit, and we do want to have benefit. But I think the whole return to work discussion really ought to be a discussion of how to improve the work environment so that we get some of these natural inputs so that we allow people the kind of creativity and productivity that work ought to have. Working inside is a cognitively rich environment, whether it's indoors at the office or it's indoors at home. At home, actually, you could argue that many homes are. Are not as new as many offices and are not quite as sealed up as many offices are. But in both places, what you need are a doorway, not a hiking trail. You need a sky view, not a forest. And in an urban environment, like we are here in New York City, you can get a sky view, which in just a minute, every hour, allows you to rest your eyes, reduce the fatigue in your ciliary muscles, which are around your eyes, fight against myopia, which is 40% in California and 90% in Southeast Asia, including in Asia.
Paula Pant
Myopia is nearsightedness.
Dr. John La Puma
That's right. And I know you were in Singapore not that long ago. And there, there are public health campaigns to allow kids, in fact, encourage parents to allow kids to play outside two hours a day just to forestall myopia. And two hours a day for kids is normal. Although now we don't have that many often, and we can get to this. But the minimum effective dose for adults is actually two hours a week, because most of us, and that's of intentional time in green or blue spaces, because most of us are nowhere near that in using our time effectively. Just to return to your point, whether it's in the home or in the office, there are need to be safeguards built in so that we have natural light, so that we have the ability to have distance, so that we have the ability to interact with greenery in one way or another, and that our work is not confined to. To an indoor box. And that socialization at work is nice, but it's also about work. When you're outside, you're in a social environment. Outside is social. Nature is not the Grand Canyon, the Pacific Ocean, Alaska. Nature is the park down the street. We're walking to it. You meet other people, and that is a good thing for your longevity and your productivity. It's not a secret that productivity and creativity are better when you're taking a walk than when you're having one meeting after another. And that's actually been shown by a study at Stanford, showing that 60% of ideas generated were judged to be better after a walk than those in a meeting, because that walking allows you to use a different part of your brain, which we don't use while we're at work. We use our prefrontal cortex. We use our ability to analyze, our ability to think through concepts, to be logical. When we are outside, we are using our senses, which, as you remember, are touch, listen, see, smell, taste, all in your face. And we engage our parasympathetic nervous system, which is known as our rest or digest nervous system, which allows us to sense things and not react acutely. At work, we're reactive often we have high adrenaline levels, we have high cortisol levels. We are urgent. We have notifications, we have lists, we have texts, we have stuff to do. And it's productive when we're doing it. But the problem is that we're doing it all the time without any natural cues to allow our brains and our bodies to recover. And that's one of the reasons that we have so much burnout, that we have so much exhaustion, that that's kind of the state of the American worker.
Paula Pant
I'm hearing that there's benefit to going, you know, even if you're taking brief respites outside at the park, down the street, or in your own backyard, that there are benefits to that. But what do you do in A situation where the climate is so extreme that that is very uncomfortable. So, for example, as you mentioned, I was just in Singapore. The heat there is so severe.
Dr. John La Puma
Yes.
Paula Pant
My friend refers to the hours between 12 noon and 3pm yes. She calls it the no, no time.
Dr. John La Puma
Of course. And that. We have that in our country, too.
Paula Pant
Yeah.
Dr. John La Puma
Between 10am and 5pm in Phoenix or in Palm Desert or in lots of places that get tremendous heat in the summer. It's unbearable.
Podcast Host (Producer/Announcer)
Right.
Dr. John La Puma
And I'm not talking about being outside in the middle of the day in such extreme. No, no. And in fact, that's why the time that you need to spend in nature needs to be intentional. And in a blue or green space at specific times, the dosage of light, the dosage of green exposure, the dosage of green exercise, movement through a green or blue space is as specific as it is for investing. If someone wants to be financially independent, you could tell them just, we'll save more money. That leaves out a lot of specifics.
Podcast Host (Producer/Announcer)
Right.
Dr. John La Puma
A lot of details. You know, light, for example, has a dosage, a duration, a time of day, an exposure, a location. It's not just get outside more. Because if it was that simple, I wouldn't have needed to write a book.
Paula Pant
So I've heard a lot of people talk about getting sunlight first thing in the morning in order to set your circadian rhythm. I've been hearing about it on the Huberman Lab podcast. We're in Manhattan right now as we record this. To do that not through a window, but to actually get sunlight unfiltered through a window into my retinas. I actually tried it for. But I live in an apartment. I don't have a balcony.
Dr. John La Puma
Sure.
Paula Pant
So it involved in the mornings, putting on a jacket, putting on a beanie and gloves and a scarf and heavy winter boots, and then getting into the elevator, going down to the lobby, and then once I exit the lobby and I look up, all I see are buildings. So then I have to walk all the way to the end of the block, and then that's like the first kind of sliver.
Podcast Host (Producer/Announcer)
And I get.
Paula Pant
Manhattan is sort of an extreme example,
Dr. John La Puma
but most people live in cities.
Paula Pant
Yeah.
Dr. John La Puma
And you're absolutely right. I lived in Chicago for 16 years. I understand bad weather and urban corridors. Let me offer this. You don't have to walk down the block or even do more than stand in your doorway to get a little bit of respite, a little bit of morning light, and morning light, if you can get it. And you have to avoid sunglasses as you Know and contacts are okay. Prescription eyeglasses. Okay. It's the window that filters out the light wavelengths that change your circadian rhythm in your suprachiasmatic nucleus in the back of your brain, that then regulates all the organs in your body and tells you that you're going to have melatonin that night and get to sleep 14 hours later. And gives you deep sleep, the phase of sleep where you actually have you clear the beta amyloid and tau proteins that are accumulate in Alzheimer's and other dementias as well as repair bone, repair and repair muscle and build bone, which happens only during deep sleep. That's why deep sleep is so important. And you only get it in the first couple cycles of sleep, maybe the first third of sleep. And you only optimize it when you get adequate morning light to set your circadian rhythm. That's why that 10 minutes is so important in the morning. And you can do it from your doorway, you can do it from a fire escape. We're in New York City. You can do it from an open window. And yes, it does require extra effort to bundle up and look, but it does a lot of other good things for you, including all the medical things I just mentioned. And that is that it takes you away from your phone the first thing in the morning. It helps your coffee work better because you get an internal boost of cortisol as well as the alertness boost of caffeine and light first. Coffee second, is an easy way to think about, also allows you to not just look at a screen second, but allows you to imagine the world as bigger than whatever the problems you are have imagine the world as bigger than the problems you have in front of you inside your home office, wherever you're looking. And that big view, that view both of distance literally and distance metaphorically is really important because staying inside in our homes and offices often makes our worldview smaller, makes us less of who we are, less of who we can become. And simply looking out and noticing that there are other things going on in the world outside your doorstep and that that reality exists other than the digital reality that we are so used to looking at first thing here not just literally reshapes your eyeball, which elongates when you have myopia, but also reshapes your worldview. So you think that there is more possibility in the world. You think that there is more something else out there. That psychological shift is especially important for listeners like yours who are thinking about retiring early and wanting to do something with that time.
Paula Pant
I think part of the draw towards retiring early, at least anecdotally, from many of the people in this community that I've talked to, is a desire to be outside more, a desire to go on hikes, to garden, to be in nature and experience awe. So I do think there is a draw to it within this community.
Dr. John La Puma
Yes.
Paula Pant
And there is also, simultaneously, there's a bit of a contradiction that in order to get there you have to buckle down and hustle.
Dr. John La Puma
Yeah, sure.
Paula Pant
And that tension, I think, is something that a lot of people grapple, at least anecdotally, you know, from conversations that I've had at meetups, that seems to be a tension that a lot of people really grapple with. Many of the people who are listening, when they wake up early and go to work, they're waking up before the sunrise. So what do you do then? What happens when you're making your coffee and getting in your car and commuting to work at 6am and it's the winter, it's still dark.
Dr. John La Puma
Sure. I do too, actually. I've been getting up at five in the morning because I'm doing this and I have a farm to run. So things happen early. You need, or the people who do that need a double anchor. You need a 10,000 lux light therapy lamp within 6 to 12 inches of your face for 20 minutes or so, depending on the manufacturer. There are different manufacturers and that helps set your circadian rhythm. When it's really dark and you're at 5am, you're looking at your screen. The screen isn't the problem, it's the overwhelmingness of the problem. And then when the sun does come up at 6:30 or 7 or 7:30, whenever it is, wherever you are, you need to go outside to get the wavelengths you missed because it will help cement the circadian rhythm so that you do get the boost of cortisol and that continues. And you want that in the morning, not chronic cortisol elevation during the day and the melatonin made at night, the deep sleep set for later with the muscle repair and bone building and most important, glymphatic system, which is the brain clearing system that helps to take away beta amyloid and tau and the other toxins that have been made during the day. So that double anchor helps people who have to wake up when it's dark. The other thing to know is that outdoor light is actually 25 to 50 times brighter than indoor light. Even on a cloudy day, it's five times more brighter. In this bright TV studio you have here, that's Lovely. Our lux is maybe 450, 400 to 450. Outside it's cloudy. Today it's probably 9,000 lux, 10,000 lux. You can measure this with a light meter, which are free apps or paid apps that are downloads. You can measure it. If you're a photographer, you probably already have a light meter. And it's remarkable because it doesn't seem like. It seems like it's really bright in here.
Paula Pant
Yeah.
Dr. John La Puma
And it seems like it's kind of cloudy outside. So how could it be brighter? It's because of wavelengths that we don't see. And those wavelengths help us know that it's daytime. Hope our bodies adjust to it being daytime. They allow us to continue until it is evening when the sunset is important or the light dimming is important. Too often indoors we have dim light and uncirculated air that's stale. And the toxins emitted from VOCs emitted from everything from cleaners into carpets to paints to fragrances. At sunset, the body begins to cool down. Brain automatically, anciently responds to that signal by lowering your body temperature so that you can sleep. It's not enough time for Times Square. Even though we get that when we're in Times Square, those are pixels and light wavelengths that are telling us wake up, it's time to do stuff. So as long as we avoid getting bright light within an hour of bedtime, then our melatonin is not suppressed. If we do get bright light, those blue wavelengths of light, and within an hour of bedtime, it's much harder to release melatonin. About 80% of melatonin is not released and that suppression lasts for an hour and a half. So it may be harder to get to sleep. Alcohol doesn't help either, by the way. These are natural signals that our body evolved to expect that most people don't get. And that's why the 93% figure is so striking. You wouldn't leave 93% of your portfolio invested in a zero percentage interest account. But that's what we're doing with our biology.
Podcast Host (Producer/Announcer)
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Paula Pant
You talked about the importance of sleep, in particular deep sleep, because that's when the brain flushes a lot of toxins and clears the way.
Dr. John La Puma
That's right.
Paula Pant
What should a person do? Sometimes there's a trade off between sleep and exercise.
Podcast Host (Producer/Announcer)
Right.
Paula Pant
If the only way that you can get exercise in the morning is by waking up early and therefore being a little sleep deprived, maybe you get only five hours of sleep rather than seven.
Podcast Host (Producer/Announcer)
How does a person balance that trade off?
Dr. John La Puma
I think one might try to look at priorities as a whole. You know, we're learning so much about sleep that the evidence is really strong that it drives longevity and well being much more than we had understood previously. All the phases of sleep are important. This non rem slow wave deep sleep has only recently been identified as especially important. The glymphatic system, as you suggest, was identified in 2013. The Nobel was given for it in 2017. It's relatively new information that beta amyloid and tau are flushed out of the brain with the glymphatic system. And when you disrupt that, you accumulate those toxins and they are implicated, as I've said, in Alzheimer's disease. So I was in the gym this morning and I play pickleball four times a week. It's an essential part. I would say that if you are sacrificing these things, and you alluded to this earlier, Paula, when you said that many people in this community feel like you just gotta buckle down and you'll sleep when you're retired.
Paula Pant
You'll sleep when you're retired?
Dr. John La Puma
Yeah, yeah, when you're retired or you have enough money so now I can go out and spend 4% a year and do the stuff I really want to do. What I would say to that is, are you protecting the body that has to live in that time? Because, okay, now you're financially independent now, you're retired early. What has happened to your body in that time that you sacrificed to get there? Because you did sacrifice, and what would happen if you actually took a little better care of your body? You didn't sacrifice sleep or exercise. And you made those the priorities that they are. And that you simply don't realize because the evidence hasn't been obvious until now. And there hasn't been a prescription until now, which I've offered, and that is that both of these processes adequate restorative sleep and many sleeping pills don't give you that because of their interference with deep sleep and adequate exercise, especially movement in green spaces where you have all sorts of other benefits that you don't get in the gym. There's this terrific study published in the British Journal of Medicine this year that showed in 111,000 people tracked for 34 years that the people who did two types of exercise, minimum walking is actually the most effective for longevity. But you have to do something else as well. It isn't enough just to have strength training, which is at 13% reduction in all cause mortality. Walking is beat it at 17%. Tennis and soccer and swimming are all good, but not as good as those. And you have to have two activities to improve all cause mortality. And one of them, the best one, interestingly, is the one that doesn't get you ripped or have a 5k plastered on it. It's simple walking in nature because you get a lot of other benefits. You get the microbial benefits where you inhale phytoncides. Phytoncides are the aromatic chemicals that trees make to communicate and that to defend themselves, part of their immune systems. When we inhale phytoncides, these aromatic chemicals that trees make, alpha pinene, beta pinene, D limonene, not just in Japanese cypress, where the original research was done, but also in citrus trees and in many others. Our own natural killer cell count, which is type of white blood cell that we make that kills cells that have viruses in them in our body and kills cells that have tumor cells that are tumor cells in our body, that activity goes up by 56% and the effect lasts a month. This has been repeated data, both observational and then in the laboratory. And this type of microbial benefit from simply walking outdoors is part of what we get when we're near trees. We get the social aspect that we spoke about, where you meet people. Also good for your longevity. We get the productivity and creativity benefit of walking without the pressure of notifications and direct Messages and buzzing in your pocket. Unless you're walking with your phone like this, like so many of us do, and you risk tripping and falling. A good friend of mine walked up this, was walking up the stairs at the beach in Santa Barbara, where I live. And he was at the top of the stairs. It's 75 stairs. He was at the top of the stairs. He tripped and broke his tibia. And guy is an athlete. I mean, he's awesome physical shape. And he recovered much better than almost anybody else I know. But it still took him four months. When we do that, when we walk
Paula Pant
with our device, with eyes on the device.
Podcast Host (Producer/Announcer)
Yeah.
Dr. John La Puma
Not only are we hurting our distance vision important for resetting. Not just our vision, metaphorically, better vision physically, but we also risk injury. And we're making our world smaller. We're telling ourselves that we don't deserve the outside as an input. We're missing the wavelengths of light. We are missing detecting sound, which is an enormous piece of information. And light and air and sound are all information for your brain. They're information for your body. And they tell your body how your genes should work. About 50% of our genes are governed by this, our circadian rhythm. And genes only make proteins and watch other genes. That's all they do. But the proteins they make and how well they watch other genes depends on the information they're given. It's not just like manufacturing widgets. Genes are responsive to environmental information. And that's the fundamental thesis that we. Our environment is determining our behavior. Environment is 93% inside. And that's hurting us in ways that I think people don't understand but are going to because of discussions like this one. That. That digital obesity is overwhelming. Your brain is giving too many pixels to your brain so that it becomes inured and you're burned out and exhausted for a reason. But it isn't actually your fault. It's your environment's fault. Your body's not broken. Your environment's broken.
Paula Pant
There are people who would say, particularly in the course of a workday, maybe not so much on the evenings or weekends, but in order to get outdoors during a workday, I have to look at my device.
Dr. John La Puma
Yeah, sure.
Paula Pant
That the only way that I can be outside during the workday is by virtue of being outside on my device. Would that be better?
Dr. John La Puma
Because they're keeping track of work.
Paula Pant
Yeah, exactly. Because they're responsible for responding to slack messages or responding to emails or other inputs that come in other inbound.
Dr. John La Puma
You know, a lot of employees don't know they're actually legally allowed to have a break, 10 minutes and every four hours. If the only way you can be outside is to be on your phone, then, I mean, that's kind of an HR thing and ought to be taken up with hr, I think. But let's say that's true. Let's let it go for a second. You know, we actually did a pilot with a corporation in Santa Barbara called Pathpoint where we asked. It was a four week pilot. We had 31 people in it, so it's small. We randomized them to five minutes outside without their device. A house plant on their desk, an office plant, which is impossible to kill, snake plant, and three texts for four weeks. Three texts a week for four weeks that were funny and were about the indoor environment. We tracked the MASLOCK scale for burnout, which is an accepted high standard questionnaire device. And we did before and after interventions. And the least effective, most surprising to me was the house plant, the office plant, because many people are not used to having a plant on their desk and they worried about its health and they tended to over water it. Most plants, by the way, that are hard to kill, indoor plants need six ice cubes every two weeks, six large ice cubes every two weeks for watering. They don't need more. You'll kill it. The most effective was the five minutes outside without their device that we thought because people also reported less back pain, less neck pain, less other, fewer causes for absenteeism as well. We thought that that reset needed to be studied. And I was so surprised by that. As you know, I'm an avid gardener. I run an organic farm. I planted thousands of trees and plants. I'm really interested in how things grow. I love gardening and I thought it would be best for everybody. But I was wrong. What was best was that five minute reset. You are getting other types of information. If you can go outside, if you can't go outside, then you should go to a window, preferably an open window. If you can't go to an open window, you should go to a doorway or a threshold or a fire escape or anything that allows you to see the sky. If you can see the sky, and I've been in Manhattan, you know, we're here now. Yesterday we went out and looked down our 47th Street Hotel corridor and it was a narrow corridor, but I went out to the doorway and I could see the sky at 5 o' clock at night. And it's cool. I mean, the cloud formations were beautiful. You had to look past all the buildings. Yeah, but when you do. You see the sky. If you study it for just a minute, you reset your perspective and you relax your ciliary muscles and you give your brain a reset as well. You allow your brain to focus on something other than traffic or the stuff you have to do when you get upstairs, or the slack messages that are accumulating if you allow yourself to do it. I realize that that might be disruptive for some HR departments, but it's also legally mandated that you get a ten minute break in a four hour set. And if you're not getting that, then that's something to take up with management, because you should. I mean, you need it not just for your biology, but also for your productivity, for your creativity, for your team members. This is actually an essential part of work that I believe we've missed, that actually will improve. And our little burnout study. And I thought about developing it into a business because it has that potential. But I was more interested in why that occurred and I didn't know why it occurred. I wanted to learn the mechanisms behind why people do better when they are outside with specific intentional time in a blue or green space. It turns out, I believe, to be restoration of their circadian rhythm. This whole field in medicine called chronobiology, that's finally getting some oxygen and being away from chronic inflammatory problems and toxins and inputs that are destroying our sleep and our focus and I think impairing both longevity and productivity.
Podcast Host (Producer/Announcer)
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Paula Pant
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Podcast Host (Producer/Announcer)
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Paula Pant
Let's turn the conversation to sleep because you mentioned there are many things that are destroying our sleep, but there are also a number of things that people can do in order to have better sleep. One of the things that you've talked about was sound.
Dr. John La Puma
Yes.
Paula Pant
And you actually described some types of sound that I had never previously heard of. Pink noise.
Dr. John La Puma
Yes.
Podcast Host (Producer/Announcer)
I've never heard of that.
Paula Pant
Brown noise.
Dr. John La Puma
Yes.
Paula Pant
I didn't know noise had other colors.
Dr. John La Puma
Yeah. Isn't that fun?
Podcast Host (Producer/Announcer)
Yeah.
Dr. John La Puma
Yes. Pink and white noise are different frequencies of sound that can help your brain move into a relaxed state. One of my favorite is the noise that you get from gentle rain or from running water at 50 or 60 decibels, which moves your brain from an agitated beta waves to alpha and theta waves. Running water has this magical kind of pink noise sound that many people use from an app or from YouTube. I prefer it from an app because then you're not interrupted by advertisements if you don't have a subscription to YouTube. But it's remarkably calming and allows you to relax. And having that kind of noise also reminds us of what blue spaces can do. There's actually less data about blue spaces being in water or near water than there is for green spaces being in or near green shrubbery or trees or other plants. But I think it needs to be more well studied because so many people have an inherent draw towards water, whether it's moving or not. I mean, lakes and ponds can be just as remarkable. I just went to the 911 memorial here, memorial Museum in New York City, where this, as you know, there's this incredible cascade of moving water down into this what seems like an abyss that is just so perfectly identified as the metaphor for that terrible event. And yet the water has a drumming effect that both echoes the terribleness of that day and also some kind of rhythm that we're missing when we miss, when we simply look at a screen, when we hear only digital noises, when we hear artificial noises and at light at night, we hear a lot of artificial noises. Night, as I told you, I live on a farm, and we hear lots of noises at night. And some of them are car noises because the farm is in a city. By learning what natural noises are at night, you become a little bit more part of the universe. You are less isolated, you are less lonely. Another problem with being inside so much is that loneliness and isolation has the impact of three quarters of a pack of cigarettes. And we're learning that that's a serious cardiovascular risk factor, just like bright light at night is a serious cardiovascular risk factor. The people who get the most bright light between 12:30 in the morning and 6 in the morning, and 40% of us, Paula, go to sleep with a lamp or, or TV on. So you wake up at 3:00am, watch television for 10 minutes. What is your brain supposed to think? Your brain thinks we're awake now. That's not the right message you want to give it at 3am so part of good sleep hygiene is going to sleep with the lights off, knowing that if you need pink noise or white noise or. Or another sound to drum out sounds that are artificial, you can have it. Knowing that some noises are natural and recognizing what those are allows you to use your sense of hearing in a new way. New to most people anyway. Just preparing for sleep is a powerful tool in itself.
Paula Pant
Well, and the research shows that pink noise and brown noise and white noise lowers blood pressure.
Dr. John La Puma
That's right. And lowers cortisol levels and stress monitors as well. In fact, C reactive protein can also drop with those sounds. And C reactive protein is the general marker that we measure in the bloodstream for inflammation, although they're much more specific markers as well. And heart disease is primarily inflammatory, arthritis is primarily inflammatory. Dementia has an inflammatory component to it. So does depression. Chronic inflammation is at the root cause of many common chronic illnesses and reduced longevity as well. But having specific intentional time in nature reduces some of that risk, certainly reduces risk for inflammation. Certainly there are many studies that show that depression, anxiety reduce with targeted with intentional time in green and blue spaces, whether that's forest bathing or gardening. And gardeners, by the way, lifelong gardeners, have 37% less dementia than non gardeners. And there are a lot of interesting reasons for that. It may just be microbial exposure to the helpful bacteria in the soil which improve your own microbiome, maybe the nurturance of a plant which is a life giving kind of force. It may be that gardeners eat more vegetables and fruits than non gardeners because we tend them and raise them and then have them to show. It may be factors we simply don't know of yet. There is a lot in not just understanding the science behind this, but putting the simple practices into practice because it doesn't take very much. As I mentioned, there's the minimum effective dose is 17 minutes a day of intentional time in a green or blue space. It's the only investment I know in your health, the only health and medical modality that costs zero and is immediately accessible to almost everyone.
Paula Pant
You also recommend minimizing blue light right before you sleep and particularly minimizing screen time. Is it sufficient to wear those? I've got a pair of those blue light glasses that I will use when I'm working on my laptop right before bed. Yeah, you know, is that sufficient? Because it's very hard to actually not use a screen for three hours before bed. Because what do you do here? You know, what do you do for those three hours?
Dr. John La Puma
What did they used to do? Yeah, what did people used to do before we had these things?
Paula Pant
Well, the demands have changed.
Dr. John La Puma
The work demands?
Paula Pant
Yeah, the work demands.
Dr. John La Puma
You got to work till 10 o' clock or 11 o'. Clock.
Paula Pant
Yeah, exactly.
Dr. John La Puma
I get that. I mean, I understand what it is to buckle down and to work all the time and maybe not save your vision, your fitness, your body for later. I mean, if that's a choice you're making, okay. But you got to know it's that choice. First of all, you get a lot of benefit if you stop an hour before bedtime. It doesn't have to be three hours. Secondly, blue blocking glasses work only if they actually block the blue wavelengths, and only some of them do. Most of them are. Many of them, anyway, are largely cosmetic. And that's fine for aesthetics. But if you really want it to block the blue wavelengths that are telling your brain it's time to wake up, rather ignore your body biology, let's go to sleep. Enough said. Thirdly, night shift or f lux, Both help. I don't know.
Paula Pant
You're probably familiar with that. Yes. Yes. Those are settings on your computer.
Dr. John La Puma
Yes.
Paula Pant
Yeah.
Dr. John La Puma
Night shift is a setting on your computer. You can and should, in my opinion, also load f lux, which has been around since dos. It's easy. It works in the background. It changes the wavelengths of the light that blue's coming.
Paula Pant
It actually very slowly shifts it.
Podcast Host (Producer/Announcer)
I'd forgotten about that.
Paula Pant
I used to use that. Wow. I should reload it because I used to use that all the time. It's very funny. Once it's really kicked in, it's very funny to try to watch the Simpsons because the Simpsons have such distinct colors that when you see the Simpsons through that blue blocking kind of filter that the f lux will put on your screen, it's so you don't realize how much it changes the color spectrum until you see something that is so defined by color as Homer and Marge Simpson. And then when you see them through that, you realize how much it changes the screen.
Dr. John La Puma
I love that Homer is defined by color. Yes. And yet it's not quite enough as not using that screen at all. Blue light still gets through those. They can't quite stop all of it. It's better, but it still gives your brain the signal that you ought to be awake instead of asleep. So one might try other types of work that improves productivity and creativity and presence, that uses a different part of your brain. With analog tools, you might try journaling. I mean, penmanship takes more motor skills, uses logic and finesse and balance in ways that typing does not and is making a comeback, actually, so are analog journals anyway. And there is something about. And it may be because I wrote my first couple books by hand, but there is something about writing ideas that makes it concrete. I forgot my laptop on the way to New York to see you. So all I had was my phone and this little pad that I bring with me and a pen. And so I began writing down in with the pad, practicing what I preach, drawing arrows to ideas that I wanted to remember later. It felt Very old school. And it is very old school. But it also is in many ways more tangible. When you write something down, you are more likely to remember it than when you type it. And you could say, well, I get an alert for that. And you do. But when you're trying to cool down at night, you're giving your brain the signal that it's time to turn off. When you're maybe drinking tea instead of beer, when you're talking to your partner or to some friend on the phone, when you're looking after a cat or a dog, when you're doing tasks at home, around your home rather than a screen, you are signaling to your body that it's time to rest, which your body actually needs. And that seven hours, optimally for most people, is a central time to give your brain and body recovery. And as we've talked about, cleaning and we haven't talked about, but it's important to consolidating memory and regulating emotion, which you only do in specific phases of sleep. And if you don't get those phases of sleep or if you're awake a lot, if your tracker tells you that you didn't get any of this kind of sleep last night, but you feel okay, so you're going. Trackers are not quite yet at the MacBook level, but they're indicators. And you don't have to track because you might wake up and be kind of wired but tired all day. And that's how most people are. They're wired but tired. Who are in the workplace.
Paula Pant
Yeah.
Dr. John La Puma
And that's what they're missing. They're missing their biology. They're investing 93% of their time in a zero return portfolio.
Paula Pant
Yeah, no, I actually resonate with that. I am wired but tired all day long.
Dr. John La Puma
Yeah. But it's fixable. And the fixable is inexpensive but potent and prescriptive. It's not get outside more, it's be intentional with your time. Have 10 minutes of morning light, hit your retina without your device, without your sunglasses, with your dog, if you have a dog. Great. Meditating if you want. It's taking time away from my messages. How am I supposed to get my emails and texts? Well, you know what? You got to wait 10 minutes. It's going to make you that more productive. And it may affect your sleep, which will be good because you'll get more sleep that night. Have at least one walking meeting a week. That's not a big ask. It's a great place to start. And you know what? You're not sitting across the table from someone, which it isn't for us because we don't have something between us. But often when you're on different sides of a table, you're adversarial. That's a great non negotiating position. We're actually perfectly situated to negotiate something because we're sitting right next to one another.
Paula Pant
Right.
Dr. John La Puma
But when you have a walking meeting, you're walking with someone, they're right by your side, you're improving your oxytocin levels, it feels better.
Paula Pant
But going back to remote work though, yes, if you're remote working, you're not working with people, you're right.
Dr. John La Puma
But if you're having your lunch outside instead of a walking meeting, then you might meet someone in the park, you might meet someone wherever you took your lunch to have outside. And that's actually a good thing. And even if you don't, you're still getting the microbial effect of the air that's powerful. You're still getting distance, you're still getting natural light, which during the day is important for you. And in the middle of the day, that's when you make vitamin D on your arms and legs, when it's warm enough to have your arms and legs out. And it isn't now in March in Manhattan. In the meantime, you need a vitamin D supplement, which you should take with a little healthy fat, peanut butter, almonds or avocados. So you absorb the vitamin D, which is a fat soluble vitamin. And that's just good practice for all multivitamins, especially D, E, A and K, which are the fat soluble vitamins. We want to be able to use our time intentionally in a blue or green space and in the evening by avoiding natural light before bed, at least an hour before bed, and maybe catching a few rays of the sunset, or maybe arranging to meet a friend at a park or down the street, or even at a coffee shop. If your coffee shop route takes you through greenery, then you have just got your 17 minutes minimum effective dose. Because you had 10 minutes in the morning, you had some time out at lunch or in a walking meeting, or both if you're feeling ambitious in a week. And then your evening sunset walk or your evening sunset glimpse or your evening horizon view. You don't need a forest, although those are great. You need a sky view. You don't need to run through a meadow of flowers, although it's wonderful to do that. You need simply to be able to see flowers. This is so radically different for people who are spending 93% of their time indoors. They don't realize that you have more control than you think, that 80% of heart disease is preventable. 50% of depression and anxiety are preventable. 40% of most cancers are preventable because they're environmentally derived. This is powerful medicine, but it has not been prescribed in the way that it can be because the problem has not really been recognized until recently and the prescription not until now.
Paula Pant
You talked earlier about how chronic loneliness has the same impact on our health as smoking 15 cigarettes a day. You said three quarters of a pack of cigarettes a day. One challenge that I often hear from people who do retire is that after retirement, there are often feelings of loneliness because you lose. For people who were not remote workers who did go into an office, there were social bonds there. And when those social bonds get broken, you're no longer in the workforce. Or I guess even if you were a remote worker, you're at least accustomed to talking to people on zoom.
Dr. John La Puma
Sure.
Paula Pant
And then when even that goes away, who is there left to talk to? Maybe you have a spouse or partner, and if so, that's the one person that you can talk to, assuming that they're also retired. And then that's sort of it. And all your friends are still working, so they don't have time for you because they're busy.
Dr. John La Puma
Yeah. I would say, Paula, that fire and your biology have to be deployed together. That those people have missed the opportunity to optimize their biology while they were working, and they haven't taken good enough care of themselves to be able to pivot and understand that what they've worked so hard for puts their body and brain in an impaired cognitive position. That's a fixable problem while you are working. For those people who are retired, who are lonely now, there are many opportunities to be as ambitious as you have been in work that are social and for some people, they're philanthropy and on boards and in community efforts. Some people, as you well know, start second or third careers. For me, I have a couple of things. I have a farm where I interact with a lot of people who come and go and want to be part of it or are part of it, or vendors and people who teach me things and athletics. We haven't really talked about green exercise, but it's the best way, the easiest way to get the kind of both exposure that you need to nature to improve your biology and to correct some of these sleep and focus and mood and immune and insulin sensitivity problems or resistance problems and to improve your body so you can try to recoup some of what you lost Working so hard to get to where you are. And I like sports that are not just in the gym, not just for the reduced all cause mortality benefits, but for the social benefits. And I alluded to pickleball before, which is the fastest growing sport in America, where you have to be polite to people when you introduce yourself, you click paddles at the end. You may be fiercely competitive during the game, which is perfectly fine if that's how the game is structured for you. 4. Because very few people play singles and most people play doubles, unlike tennis, that automatically gets you in the club. And besides, pickleball is something you can learn within 20 minutes and have fun with, literally. It doesn't have to be pickleball, but there should be a sport. Sports teach you all kinds of things about teamwork which you also may not have learned while working this hard to get to where you are. Where it was all like 16 hours or 18 hours a day and you're just killing it to make your team better and to reach that financial goal, which is cool. But then is your body prepared for it? Usually not. That damage is cumulative and it doesn't need to be. So yes, loneliness is a real thing. If you're retired and you're isolated and you stay inside. And that's another reason to escape the box that we have put ourselves in. Escape captivity because you no longer have to be wired, but tired. You can be refreshed and engaged and productive and creative in retirement in new ways, not just in athletics, but in contributing to your community. Because sometimes that's been missed along the way. And community, Dan Buettner points us out in Blue Zones is one of the things that all those people with optimum longevity and optimum quality of life has as a root, foundational theorem and practice. Community does make the world go round. It is a powerful way to experience the world that is not just about me and us and what you and I can do, but what the world we live in. And that's not, you know, a very. Not something that's in the air very much in our increasingly polarized society and where there's stranger danger walking down the street. Most people are good unless you're able to meet them, usually during an activity. We have had a honey bottling at my farm where people come and bottle honey. It's remarkable. People have no idea how bees make honey or where we got it or what the comb is. And they learn so much and they talk to other people doing the same thing. Activities reduce loneliness. That's an easy entry. And green Exercise. Exercise in green space not only carries the microbial benefits and the light benefits and the horizon benefits, but also gives you the physical benefits the same exercise outdoors is 20% less perceived exertion than that exercise indoors.
Paula Pant
Meaning you're working out just as hard, but you don't feel like you're working out just as hard.
Dr. John La Puma
Exactly. That's because you're getting all these other inputs. That's powerful. You could do 20% more just by being outside. And as I've said, the simplest activity, walking, is the premier activity for reduction all cause mortality. And when you combine that with another activity, the gym and walking, strength training and walking, you get 19% reduction in cause mortality in this huge study I cited earlier. So just like working to accumulate wealth and doing it really early so you don't have to answer to anybody else is an admirable goal. I like that goal. But sacrificing your body and your brain while doing it is leaving your gains on the table. It's counterproductive. It hurts you, doesn't help you. You think it helps you because you feel good. Your bank account's going up, but you pay for it. You pay for it in people that I see every day. My patients have arthritis, they can't move, never mind playing pickleball. They have cardiovascular disease. That's significant. And I've cited easy ways to improve that risk. There are so many payments down the line that come to bear. But the most damaging for many people is the mental health aspects of it. The depression, the anxiety, the feeling of isolated that I'm just in this alone and all I have to do is burst out. And they don't understand that the world actually has biological cues for their brain and body that will make them more productive, more creative, more of who they really are if they can sample some of the hundreds of ideas that are about intentional time in green or blue spaces that you can and should use not just to optimize your biology, but to protect your productivity and protect what you're building and protect your body, the body you're going to have when you are retired. This is really powerful medicine, I think, and a root cause. The indoor epidemic is a root cause of the problem that's just not been recognized. But the fix is remarkably simple and intentional.
Paula Pant
You've mentioned several times as we've been talking about the importance of looking at the horizon. One thing I want to draw out and sort of make clear are the benefits specifically of. Of looking at a longer distance. You know, since so much of the time when we're looking at our screens. A screen is relatively close, and so our eyes are fixed on something that's relatively close. Can you elaborate on that?
Dr. John La Puma
Yes. So when our eyes are fixed on something relatively close, our screen here, you know, what is that? Eight inches from me or a monitor here, 24 inches.
Paula Pant
Mm.
Dr. John La Puma
To compensate for that near work, it's called your eye, when that near work is excessive, elongates, it changes the shape of the eye in an abnormal way. So that you need distance glasses or contacts or eye drops. You need glasses or eye drops to correct the nearsightedness that develops over time. Glasses or eye drops. That doesn't sound like a big deal, but 5% of myopia is high myopia, which is a condition in which your eye deteriorates and your vision gradually is destroyed, sometimes rarely developing into blindness, but often developing into other eye problems that are significant and severe and don't respond to glasses or eye drops. So we want to avoid that high myopia, which is only 1 out of 20 people who have myopia. But since so many of us do, it is really important to give your eyes a break. If you look at the horizon, five minutes an hour, instead of one minute an hour, which is necessary for the cognitive reset and the ciliary muscle reset. Just one minute an hour going to a window, looking at the distance, studying the clouds if you can, hearing the wind, watching the birds. That helps during work, if you're trying to stall myopia, or in some cases actually reverse it, and that's rare, but it does happen. You need five minutes an hour in Singapore, two hours a day so kids can play is a public health campaign. It's been that way for at least eight years because it's so significant in Singapore, and the Public Health Ministry recognizes as such, this is a message to parents that their kids need to be off devices during that time. And what's the best model for kids? It's their parents being outside. What are their parents doing outside now? They're looking at their phones. What should they be doing? They should be flying a kite. They should be throwing a Frisbee. They should be walking with kids. They should be playing outside. They should be on a jungle gym. They should be socializing with other kids. They should have a dog along. If they don't have a dog along, they can make friends with somebody else's dog if it's available. The point is that parents are the best models for kids. And unless kids see this from parents, they too are going to be on Their device outside. And that's destroying kids upbringing. You know, some kids spend less time outside than prisoners in maximum security prisons. And that's not something we want to do to our kids. And we only get around that by modeling this ourselves for our children. And distance outside allows us to do that. It allows us to see the sky and get those wavelengths which again, 25 to 50 times brighter than inside, even though we can't see it. Tell our brains, hey, we're awake during the day. Let's be alert, let's enjoy this. Let's have an internal boost, not a caffeine boost.
Paula Pant
Hmm.
Dr. John La Puma
Let's understand that we're making vitamin D if our arms and legs are bare between 11 and 2, especially activating the form inactive form of vitamin D. That's the shorthand for making vitamin D. Distance allows us to, in the right quantities, improve our vision, fight myopia and see something greater than we are, get cortisol stimulation for our brain, which we need, and allows us to socialize because we're outside and get the microbial benefits of the air as well.
Paula Pant
You know, it strikes me, as I hear you talk, that before there were screens, there were books and textbooks. I'm thinking back to my childhood. You know, before there was a lot of screen time. There was academically, of course, I was always looking at textbooks. I was a big, big reader as a kid. Recreationally, I would sit outside, I'm still not looking at their head. This is pre screens.
Dr. John La Puma
But you're getting that benefit anyway. You're getting the wavelengths that you're telling your brain you're awake. I mean, this isn't really about being perfect, Paula. It's about absorbing any benefits we can. Because we're so closeted, we're so much in our little cubicles, we haven't had the idea we need to break out. So reading outside is perfect. Reading a book outside is even better. I too grew up with lots of books. I was always in the library. I wasn't as good as you. I was always in the library reading books during summers when I was a kid, I read six books a week. I love reading now. I do read outside occasionally, but I'm more likely to be physically active. I'm more likely to be working on my farm or I'm more likely to be playing pickleball, or I'm more likely to be walking my dog or on the beach. I'm more likely to have an activity because it engages me more. I'm lucky so I can do that. But if I wasn't able to. I would read more outside and I love that you did that. You can picnic outside. This is as simple as taking any activity that you're doing inside and try it outside, as long as it doesn't involve a screen. Then you get the benefits of simply being outdoors passively, which by the way, has remarkable benefits for longevity. Even living near within 500 meters of a green space, of a dense vegetated space improves the fraying of telomeres, which are the end caps on chromosomes, which is part of how aging is tracked for each cells. By two and a half years, you get two and a half years biologically younger, biologically better aged, simply by living near a green space rather than in urban space, which is tough for those of us in the middle of Manhattan right now. But we might get those benefits by being passively engaged in green space. Even near green space improves your longevity, right?
Paula Pant
So even micro green spaces, even having just a couple of trees or houseplants, yes, something is better than nothing.
Dr. John La Puma
Absolutely. That houseplant on your table, the wind that ruffles your curtains, the dog by your feet, the lettuce in your salad are all indicators that there's a bigger world out there. And they are good bridges to the outside because somebody grew that lettuce. Your dog probably wants to go outside because the wind that ruffles the curtains is more interesting outside than it is inside and has sound associated with it and scent often. And those are cues to your brain that outdoor engagement is not just awaiting for you, but needed by your biology, a cue that many of your listeners are missing. And yet it's so available to them, they simply have to stack it. It's part of a longevity stack, it's part of a productivity stack, but you don't have to pay for it like you do supplements. You don't have to pay for it like you might red light machines. You don't have to pay an investment advisor. You have to pay yourself. And you ought to pay yourself first anyway, in my opinion, because you want to get paid on the front end and the back end. What most people, most investors, most particularly people interested in retiring early, are missing is that payment both on the front end and they're definitely not going to pay it on the back end, even though that feels like it.
Paula Pant
You know, I think the challenge is that often in these discussions, productivity and wellness are pitted as opposites or pitted as mutually exclusive. The framework seems to be that a person can either hustle or be healthy, but not both simultaneously. And we see that when we hear
Podcast Host (Producer/Announcer)
people who are starting a side hustle,
Paula Pant
for example, they have their nine to five, but then they also have their five to nine.
Dr. John La Puma
Sure.
Paula Pant
Or another iteration of that is some people in particularly demanding careers are working. Something that's common In Asia, the 9, 9 6, culture, 9am to 9pm, six days a week. There's a framing of these two concepts being pitted as opposites. But you actually, you told us a story in your book that I really liked of a woman. I think she was a med student. She was approaching finals week. It was a very stressful time. And she actually began right before bed taking baths with Epsom salts. She put kind of some sort of a lamp, some kind of a special lamp that she was using. And, you know, she began incorporating those practices and her performance actually improved because her sleep was more effective. It was more, you know, like every hour of sleep was more efficient sleep because it was deeper sleep.
Dr. John La Puma
Exactly.
Paula Pant
And so because of that deeper sleep, she was better rested, which meant that she actually was getting a performance boost. What I liked about that story was that it broke the framework of productivity and health being mutually exclusive because it illustrated how better health actually led to higher productivity.
Dr. John La Puma
That's right. Her sleep then became more restorative. We often miss that with sleeping pills, with alcohol, with trying to cram seven hours of sleep into four. And there are rare people who do get four hours of sleep and are just fine and super productive. But that's a genetic variant and, and rare restorative sleep is magic. But I don't think of this as wellness. I think of it as biology and science and as a way to actually help people like your community achieve their goals in intentional ways. That's why the minimum effective dose is so surprising and why so many of us are not getting it. And how easy it is to get that sleep hygiene routine where she took a bath with Epsom salts and read by a special light. And she often read a book, a physical analog book that all tells your biology. It's okay to cool down now, to get the sleep that you really need so we can be better tomorrow. Too many of us are missing that. This does come under the broad. I mean, my publisher is called Wellness Imprints. And yet I think of this evidence based approach as truly scientific in the kind of way that cardiology and infectious disease and epidemiology really have mastered. And this is just the first part of the scientific iteration of what we need to study. This is emerging evidence. I read 2200 studies. I bet there are another 2200 this year. Because this field is growing so quickly. I think that when I was young, I often felt the same way. You know, I did an internal medicine internship in residency. I worked as a hospitalist for a year. I had a very conventional practice for a little while. I know what it's like to stay up all night to work. It seemed like it was, in fact, it was required in my 20s and in my 30s. And yet I found a way to pivot so that I could work on my own health, then teach other people how to do that themselves. And that's what this book tries to do. That's why Indirect Epidemic as a book is so important, because it teaches people that there are many possibilities. It doesn't all look one way. What there is to do outside is more than you imagined, and it's good for not just you, but also your kids, your family.
Paula Pant
Well, thank you so much.
Dr. John La Puma
Thank you.
Paula Pant
Where can people find you if they'd like to learn more?
Dr. John La Puma
Learn more@indoororepidemic.com I'm also on LinkedInLapuma and my own website is drjohnlapuma.com.
Paula Pant
thank you.
Podcast Host (Producer/Announcer)
Dr. John La Puma. What are three key takeaways that we got from this conversation? Key takeaway number one. Burnout is not a problem with willpower. It is a problem of biology. You're not burned out because you're weak or you lack grit. You're burned out because your brain is processing more digital input than our brains were ever designed to handle. Dr. LiPuma calls this digital obesity. So he compares it to, like, how too much sugar overloads your metabolism. In that same way, too many pixels overload your brain. And the fix is not to try to push through it any more than
Paula Pant
it is to push through too much sugar.
Podcast Host (Producer/Announcer)
The fix is to step outside, touch grass.
Dr. John La Puma
Burnout's not a character flaw or not having enough guts or grit. It's being overwhelmed by pixels. Just like too much sugar burns out your brain, too many pixels burn out your brain as well. Too much sugar burns out your metabolism. Too many pixels burn out your brain. We're simply overwhelmed with pixels that our brain can't metabolize.
Podcast Host (Producer/Announcer)
That is the first key takeaway key takeaway number two. The minimum effective dose is smaller than you think. You don't need to take some expensive vacation in order to get the benefits of nature. You don't need to go on a hiking trip. The research puts the minimum effective dose at just two hours a week in a green or blue space. So on average, 17 minutes a day, even if you're a very busy high achiever. 17 minutes a day or two hours a week. That is doable.
Dr. John La Puma
The minimum effective dose for adults is actually two hours a week of intentional time in green or blue spaces, because most of us are nowhere near that light, for example, has a dosage, a duration, a time of day, an exposure, a location. It's not just get outside more, because if it was that simple, I wouldn't have needed to write a book.
Podcast Host (Producer/Announcer)
That's the second key takeaway. Finally, key takeaway number three Better sleep is a performance strategy. Most knowledge workers treat sleep as the sacrifice that they need to make in order to get more done. In fact, it often can be a flex to talk about how little you slept or you know, you stayed up burning the midnight oil. Dr. Lipuma flips that. He says deep sleep and that's the kind that you get in the first few hours of the night. That's when your brain flushes toxic proteins that are linked to Alzheimer's. That's when you repair muscle. It's where you build bone, and it's the single biggest lever for performance. And in order to get better deep sleep, look at light first thing in
Dr. John La Puma
the morning, the melatonin made at night, the deep sleep set for later with the muscle repair and bone building and most important, glymphatic system, which is the brain clearing system that helps to take away beta amyloid and tau and the other toxins that have been made during the day. You clear the beta amyloid and tau proteins that accumulate in Alzheimer's and other dementias and you only optimize it when you get adequate morning light to set your circadian rhythm. That's why that 10 minutes is so important in the morning.
Podcast Host (Producer/Announcer)
Those are three key takeaways from this conversation with Dr. John La Puma. Thank you so much for being part of the Afford Anything community. We have a newsletter. It's completely free and worth every penny and it's@affordanything.com newsletter that's affordanything.com newsletter come sign up. You will love what we have in store. For the past couple of weeks we've been launching our rental property course that is now closed, so we will not be sending any emails about that until the fall. So from this point forward we will be sharing insights in this weekly thing that we do. It's called three Things Monday. We were doing that prior to the launch. You'll get an email every Monday with three things that we don't talk about on the podcast Observations about money, about retirement, about the way people handle or think about their finances. Observations about what's happening in the wider world around us. That's three things. Monday you can get that for free at affordanything.com Newsletter thank you again for being part of this community. If you enjoyed today's episode, please share this episode with friends, family, neighbors, colleagues. It's the single most important thing you can do to spread the message of FI r e. Please open up your favorite podcast playing app, hit the follow button so you don't miss any of our amazing upcoming episodes. And while you're there, please leave us up to a five star review. And thank you again for being part of this community. I'm Paula Pant. This is the Afford Anything podcast and I'll meet you in the next episode.
Host: Paula Pant
Guest: Dr. John La Puma, Board-Certified Internist & NYT Bestselling Author
Date: May 29, 2026
This episode explores the significant, often overlooked, impact that spending the majority of our lives indoors—especially as knowledge workers—has on physical and mental health, productivity, and longevity. Host Paula Pant speaks with Dr. John La Puma, an expert in lifestyle medicine, who uncovers the biological costs of the "indoor epidemic," breaks down how our environments affect our brains and bodies, and offers practical, evidence-based strategies to reclaim wellness—without sacrificing productivity or ambition. The conversation is especially relevant for listeners charting their own work and financial freedom paths, showing that investing in your health is inseparable from investing in your future.
Extent of the Problem:
Biological Misalignment:
Digital Overload and Burnout:
Social and Environmental Drawbacks:
Circadian Rhythm Disruption:
Physical and Mental Health Impacts:
Vision and Eye Health:
Minimum Effective Dose of Nature:
Light and Sleep Hygiene:
Get 10 minutes of unfiltered morning light exposure soon after waking—set your circadian rhythm and improve sleep quality. (14:29, 18:42)
For early risers or those in low-light environments: use a 10,000 lux therapy lamp and supplement with sunlight once available. (19:46)
Avoid bright or blue light (including screens) at least an hour before bed to not suppress melatonin. Blue-blocking glasses and color-shifting apps (Night Shift, f.lux) help but aren't complete solutions. (50:52, 51:33)
"Blue blocking glasses work only if they actually block the blue wavelengths, and only some of them do. ... It's better, but it still gives your brain the signal that you ought to be awake instead of asleep." – Dr. John La Puma (51:33)
Movement in Nature:
Walking in green spaces dramatically reduces all-cause mortality—more effective than gym-only routines.
Incorporate "walking meetings" or lunchtime walks for creativity, relaxation, and social contact. (09:03, 58:11)
"The simplest activity, walking, is the premier activity for reduction all cause mortality. And when you combine that with another activity ... you get 19% reduction in cause mortality in this huge study." – Dr. John La Puma (67:06)
Restoring Social Connections:
Soundscapes for Sleep:
Pink, brown, and white noise promote relaxation and lower blood pressure, cortisol, and inflammation. (44:12)
Natural sounds (rain, water, wind) work better than digital artificial noise.
"Pink and white noise are different frequencies of sound that can help your brain move into a relaxed state. ... Running water has this magical kind of pink noise sound ... remarkably calming." – Dr. John La Puma (44:25)
Restorative Sleep as a Performance Tool:
Deep sleep flushes brain toxins associated with Alzheimer's, repairs muscle/bone, consolidates memory, and regulates emotion. (27:54, 86:35)
Prioritize sleep and exercise—don't trade one for the other; the costs accumulate and reduce quality of life post-retirement. (28:14, 29:28)
"Are you protecting the body that has to live in that time? ... What would happen if you actually took a little better care of your body? You didn't sacrifice sleep or exercise." – Dr. John La Puma (29:28)
Health and productivity are not mutually exclusive—they reinforce each other.
Optimizing biology enhances cognitive performance, creativity, and wealth-building capacity. (79:10)
"What I liked about that story was that it broke the framework of productivity and health being mutually exclusive because it illustrated how better health actually led to higher productivity." – Paula Pant (80:18)
Burnout is an Environmental and Biological Issue, Not a Willpower Problem
Digital overload is akin to metabolic overload from sugar; the antidote is time in real, physical environments that our biology expects. (84:25)
Tiny Doses of Nature Have Outsized Effects
Just 2 hours a week—17 minutes a day—in green or blue spaces confer profound cognitive and physical health benefits.
Restorative Sleep is a Superpower for Productivity and Longevity
Deep sleep, set up by proper light exposure and nature, is critical for brain health, memory, and performance. (86:35)
By prioritizing intentional moments outdoors, rethinking the boundaries of productivity, and taking small but science-based steps to respect your biology, you can both enjoy your accumulated wealth and live long enough—healthily—to truly spend it.