Adam Alter (6:38)

Thanks for having me, Mike.

Mike Carruthers (6:40)

So what is that feeling of being stuck? I mean, everybody's felt it, but what actually is it?

Adam Alter (6:46)

Yeah, it's a good question. And, you know, there's the kind of stuck that we all felt early in the pandemic, where you may have wanted to travel, but government regulations meant that you couldn't. There was nothing much you could do about that. I don't think that's particularly psychologically interesting or worth exploring. It's just the way the world works. Some things you want, you can't have. But then there's the kind of stuckness that I actually found in my research is much more common, which is the kind of stuckness that is to some extent within your control, where if you behave the right way, act the right way, learn the right things, do the right things, think the right way, you are likely to move in the direction of getting unstuck. And that's true about all sorts of different things. It's true about what you do at work, what you do at home, your relationships, creative tasks. You know, it's true across a whole lot of different domains. And so that's the kind of stuckness that I'm really interested in, the kind that you can act on.

Mike Carruthers (7:39)

When I think about somebody being stuck or when I'm stuck, it's like stuck in a job or stuck on a project, like you're writing something and you get a writer's block or you can't think of what to say next. I guess there's a lot of ways to get stuck doing research.

Adam Alter (7:56)

One of the things I did early on was I wanted to understand the various species of stuckness and so I sent out a survey to hundreds and hundreds of people. Some of them were very, very talented, experienced. Some were struggling in all sorts of different ways. But all of them were stuck in at least one respect. And the stuckness varies. For some, it's financial. For some, it's creativity based. For some, it's relationships, interpersonal things. You know, it's, it's, it's a pretty diverse concept, but there are a lot of commonalities that unite these different instances of being stuck.

Mike Carruthers (8:27)

And then how do you get unstuck? What, what is the process of becoming unstuck from whatever you're stuck in?

Adam Alter (8:35)

We're extremely good at being physically stuck and getting unstuck. We're sort of well engineered for that in a biological and evolutionary sense. So if you stick a human in a position where he or she is physically entrapped, we marshal all sorts of resources. And every now and again you'll read these stories of what is known as hysterical strength, which is where people lift cars to remove themselves from difficult situations, physical entrapment. But unfortunately, the same instincts that make us so effective at dealing with those circumstances actually paralyze us when we're emotionally or psychologically stuck. So the first thing you've got to do when you feel stuck is to really deal with those emotional responses. And there are a number of things you can do. One of the sort of paradoxical things is to often slow down at the beginning. So your body will tell you and your brain will tell you to speed up, to act, to do anything, to get unstuck. But without planning a proper strategy, you're going to fail. And so very often the first thing you need to do is to slow down, to exhale, to sort of remove some of the pressure that will immediately feel as though it's upon you. Once you've done that, you can start to form some strategies for getting unstuck. You can simplify the problem. There are a whole lot of different ways of doing that you can also. One, I think, very useful thing when you're trying to come up with new ideas for something, if you're trying to come up with creative solutions, for example, is to dial down how creative or novel the idea needs to be. So a lot of us seek something that's truly, wholly, radically original and that's really paralyzing. And actually there's very little true originality in the world. And the best place to begin is to just tweak existing things that exist in the world. This is often a matter of taking two existing ideas and recombining them in novel ways, which is known as recombination.

Mike Carruthers (10:19)

And so how would give me an example of doing that?

Adam Alter (10:23)

One of the really good examples of this is Bob Dylan. When you ask a lot of really great, talented musicians who is the most original voice or the most original songwriter of the 20th century, it's surprising that a lot of them say Bob Dylan is that person. Maybe it's not surprising, but what's surprising is how much they agree on that. But when you actually look at the origin of Dylan's songwriting and the basis for his early music, a lot of it ended up being small tweaks on existing ideas. You know, he'd met certain musicians, particularly folk musicians, in the early part of his career in the 60s, and those folk musicians influenced him in ways that were. Were profound. And when he was later asked about the influence of those musicians on his work, he said, oh, absolutely. I tweaked what they had done. I recombined what they had done with some of what I'd heard in rock and roll. And I had created this kind of newish version that was really a recombination of existing ideas. And you find this in all sorts of different areas. From the outside, these people might look like true originals, but in fact, when you look more closely, you find that there's a sort of recombination of these existing ideas to form a sort of novel version of whatever those existing ideas were.

Mike Carruthers (11:39)

And do you think that's. Do you think it's deliberate, they're actually thinking what you're saying?

Adam Alter (11:45)

No, I actually don't. I think most of the time what happens is it's not purposeful. And I think creativity for a lot of people is kind of mystical. You know, we're not very purposeful about it. It's a difficult thing to be creative. And by definition, that's true. Because if it were easy, you'd be following the herd, and what you were doing wouldn't be particularly novel or interesting. But it turns out, with creativity, as with many things, once you understand it, you realize there are some very deliberate algorithmic strategies that help you be more creative. And one of them is exactly this. This process of recombining. One of my favorite examples of this is a woman named Arlene Harris who has made a business of combining existing ideas in new ways. She basically took the cell phone industry in about 2007, 2008, which was essentially designed for young adults. You know, if you think about the original iPhone, it was really, really hard for older adults to use, it was very different from what they'd been used to. They couldn't type very easily. A lot of them complained about what it was like to use the iPhone. And Harris came in and said, well, look, we've got this product that's tremendously successful for young adults. We have older adults who want some versions of that, but they also want some versions of old phones, of traditional phones, of flip phones, phones with buttons. And she created a sort of hybrid in a phone known as the Jitterbug, and ended up selling that business for a billion dollars. So what she basically did there was she said, yeah, this is not novel, it's not new, it's not sexy, it's not original. But what it is, it's taking an existing market and an existing product, finding a new market that wants something slightly different, and bolting these concepts together to form something that is tremendously successful but isn't really in any sense completely radically original.

Mike Carruthers (13:33)

If it's not deliberate, but it's not accidental, what is it?

Adam Alter (13:38)

Well, I think some people stumble on this, right? And it's interesting. When you're in the business of creativity, whether it's art, music, writing, doesn't really matter the genre you're in, you naturally hoover up information. You hoover up the different strategies that other people in your field use, and without even realizing it, you become a sort of accidental plagiarist. And when you ask people, where did these ideas come from? Naturally, those ideas, whatever their latest idea is, is going to be the product of everything they've ever consumed before. But humans are really bad at pinpointing the origin of new ideas and really the origin of pretty much anything that they think of. And so when you try to backward engineer what we do, when we do new things, a lot of what we're doing is just taking whatever we've been exposed to, creating a sort of Frankenstein's monster out of it, and that's what our original product ends up being. But once you understand that insight, it's incredibly valuable when you're stuck, because it turns the mystical process of creativity into something quite deliberate and algorithmic. And I think a lot of people who understand this have become much more successful and generative as a result of that.

Mike Carruthers (14:51)

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Peter Attia (16:52)

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Mike Carruthers (17:22)

So Adam, I'd like to talk to you about some principles of stuckness that I think a lot of people believe. I also believe and that when you're stuck, this would be number one. When you're stuck, one of the best things to do is talk to other people. Because when you're stuck inside your own head and can't think of any new ideas, go get some from somebody else.

Adam Alter (17:48)

I think that's on its face. That's excellent advice. The thing that most of us do instinctively though is we ask the wrong people. Our friends, colleagues who are trusted. They tend to be people who are a lot like us demographically, in background, in attitude and values. And, you know, there are really three kinds of people you can get advice from. You can get advice from people who are who you really like, who you trust, who are often a mirror image of yourself in certain important ways. And the simpatico that you feel with them, the connection you feel with them is a good thing in every respect, except if you're trying to find something new and creative and different and to get unstuck so you can start with them. But you also have to think of the other two kinds of people. One of those is known as a non redundant person. This is just someone whose ideas are different from your own. They don't have to be wildly different or in opposition, but they're just different in some respect. There's a lot of evidence, for example, that in the creation of TV shows, there's some work that was done on the TV show Doctor who, which is the longest running TV show of all time. It began in the, I think the 50s or 60s, that when the team that was working on each episode of Doctor who involved people who didn't know each other or who'd never worked together or who were otherwise non redundant. In other words, they had different backgrounds. Those episodes were rated by fans of the show as by far the most innovative, interesting and memorable. You're looking for people who are non redundant, but then the third thing you're looking for is to go even one step further, and that's to find deliberate black sheep. These are people who go against the grain. And Pixar has a number of executives who use this approach. So they'll assemble a team of writers, of artists, of cartoonists and so on, and then they'll go out and find someone who disagrees with the way that team is functioning and they'll bring them in and they'll say, all right, cat amongst the pigeons, be our agent of chaos and tell us what we should be doing completely differently. It's been really, really effective. In fact, a lot of their Academy Awards have come on the back of these films that have been created with the help of this black sheep, someone who's talented but basically disagrees with the rest of the team.

Mike Carruthers (19:50)

So the next thing I wanted to ask you about is in my conversations with people about creativity, I think you said earlier on in our conversation that one thing you need to do is maybe slow down a little bit. And yet I find that if you're stuck, you need to move, you need to build some Momentum. And often creative experts will say that the way to be creative is not to try to think of a big idea, but start coming up with lots of ideas. Creative people come up with lots of ideas. They're always firing on new ideas. But it sounded like what you said in the beginning was, no, no, wait, slow down.

Adam Alter (20:34)

That's a really important clarification point. That essentially, before you begin, you want to slow down, you want to take a pause. And that could be for all sorts of different reasons. And there are some great examples of, for example, athletes who are stuck in the process of some sort of competitive sport, and they pause, they take a beat before they do anything, and then they find that they perform much more effectively. One classic example of this is the soccer player Lonel Messi, I think the greatest player of all time. He spends the first five, roughly three to five minutes of every match he plays ambling around the center of the field, watching all the other players and not really committing to the game. And what he's effectively doing there is he's taking those few minutes to calm down emotionally because he gets quite anxious, but also he's taking that time to develop a strategy that will be useful for the remaining 85 minutes. And so what what you're suggesting about, you know, if you're in a creative pursuit and arguably the game of soccer, there are a million different things you could do. You have to be creative, you do want to have lots of different ideas, you want to try lots of different things. And by pausing for those few minutes, he's setting himself up to be able to do that. So I think you're right that after that pause, you want to basically do something, anything. And by definition, you're not stuck if you're moving. And so to move, even if it's not exactly in the right direction you want to be going in, is quite valuable because it unsticks you. It gets you oriented in the right direction. One of my favorite examples of this is Jeff Tweedy, the frontman for Wilco, and he's also a writer. He talks about the process of writing books and also the process of writing songs. And he says it's difficult. Most people who are very good at this say that it's difficult. And what he does is he'll wake up in the morning and he'll sort of pour out. This is how he describes it. He says, I'm going to pour out all my bad ideas. And so what he's doing is he's not writing stuff that's great, necessarily. A lot of it won't be used. But he kind of, I don't know, oils the gears and moves in the right direction by just pouring out the bad stuff that's sitting at the top. That's how he thinks of it. And then all the good stuff that's underneath, that's a couple of layers below, is then free to emerge. But you have to go through that process first of pouring out all the bad stuff, all the stuff that's not particularly interesting.

Mike Carruthers (22:52)

I also wonder. My observation, anyway, is that it's kind of human nature to get stuck, that we're kind of wired that way because if we always feel like we're not stuck, then you're probably not gonna get ahead. That I may say I'm stuck in my job. There are a lot of people who would love to be stuck. Like, I'm stuck. It's just that things haven't maybe changed a lot, but things are fine. You just, like, it's human nature to want to do something else.

Adam Alter (23:24)

I think that's right. I think one of the most profound insights about stuckness is that every single person is, in at least one respect, stuck. It doesn't take many people, it doesn't take most people very long to think of an instance or an area of their lives in which they feel a little bit stuck, at least a little bit stuck. I ran a survey that I had mentioned on hundreds and hundreds of people around the world, and within about 10 seconds, almost all of them could come up with an area of their lives in which they felt, to some extent, stuck. And what's really interesting about being stuck is that it also feels lonely, despite the fact that it's this universal human experience. And that loneliness, that sense that you're alone in that process, is very isolating. And so you have this weird paradox where people say, I'm stuck. Everyone else says they're stuck, but we all feel isolated in that process. But I think you're right. I think stuckness is absolutely inevitable.

Mike Carruthers (24:19)

And I wonder if, because it's inevitable that you feel stuck, that a lot of people might sabotage or ruin a good thing because just because they feel stuck, even though things are fine, objectively speaking, you have this internal stuckness that makes you do things, maybe you shouldn't. That screw everything up.

Adam Alter (24:40)

Yeah, I think that's a really profound and important insight that.

Mike Carruthers (24:43)

Well, thank you.

Adam Alter (24:45)

Yeah, sure. So when you're subjectively stuck, that doesn't mean you're stuck in a sense that requires activation or action or anything in particular. It might just require just Resting with that stuckness. That's part of what I meant by this, the psychological response of feeling like you have to do something. It's really important to pause. And part of that process of pausing and taking a beat is to say, do I need to act? And if I do, in which direction should that action be pointed? And very often the answer is no, you don't need to act. You can sit with that for a little while, as uncomfortable as it may be, and it might resolve itself. And if it doesn't, then you've given it a bit more time and you probably learned something more about that experience of stuckness from that time, which will make you more effective in dealing with it later on. So I think that pause that beat at the beginning before you do anything is really, really critical in marshaling your resources in a productive direction.

Mike Carruthers (25:42)

It seems as if a lot of this has to do with how you look at being stuck, that life is not just this free flowing river, that everything goes your way. Every day you will come upon times when you're stuck and then you'll get unstuck and move on, get unstuck and then get stuck again. I mean, it's just kind of the way life goes.

Adam Alter (26:03)

It's very much a cultural thing how we think of stuckness and of change in general. So in the west, in the United States, in Australia, where I'm originally from, in Canada, in the uk, we tend to think of things as being fairly consistent across time. And when they change, we find that a little bit surprising. Even though we say change is inevitable in the east, in East Asia in particular, in Japan, Korea, China, that's the opposite. They anticipate things changing. So one of the studies I did was I gave people a pattern of days where there had been either sun or rain for three days in a row. And then I said, tell me what's going to happen on day four. Now in the US we say things like, oh, it's a sort of warm streak and it's a warm period. And so the fourth day is probably going to be sunny as well. Or if it's rainy, we're in the middle of a rainy patch, it's probably going to be rainy. In East Asia, people say, oh, no, changes are around the corner. If it's been three days of rain, tomorrow is going to be sunny. So East Asians tend to be better prepared for change and therefore for getting unstuck and for seeing that stuckness is just sort of a part of life. You will always be experiencing change, whereas you're right in the west, we see it as a journey, and stuckness is this sort of frustrating thing that intervenes and makes that journey more complicated than we'd like it to be. And so I think when you can change your mindset and adopt the sort of Eastern way of seeing change as inevitable and as just a necessary part of life that you should always be anticipating, you're much better at coping with that.

Mike Carruthers (27:35)

Well, this is some great insight to file away for the next time I or anybody is feeling stuck. And what I really like is the fact that feeling, that sense of stuckness that is so isolating is actually universal and everybody feels it. Comfort in Numbers I've been talking to Adam Alter. He's a professor of marketing at NYU Stern School of Business and he is author of a book called Anatomy of a How to Get Unstuck when It Matters Most. And there's a link to that book in the show notes. Thanks Adam. Thanks for being here.

Adam Alter (28:08)

Thank you very much. I appreciate it.

Mike Carruthers (28:11)

We talk a lot about health on something you should know and I guess it motivates me. I mean I'm not a nut about it, but I try to take care of my health. I want to preserve my mobility and strength as I get older. And I recently started taking this supplement. Maybe you've heard about it. It's called Mitopure. Mitopure is a precise dose of something called Urolithin A that supports your health by encouraging cellular renewal. Since I started taking it, I can tell I have more energy and I notice I recover faster after I exercise. I did some research on this too. There's some real science here that supports what I'm saying and so does my experience. Mitopure is the only Urolithin A supplement on the market that is clinically proven to target the effects of age related cellular decline and Mitopure is shown to deliver double digit increases in muscle strength and endurance without a change in exercise. From my own experience, I have more energy and strength and just overall feel better every day. And who doesn't want that? And I'm not just recommending it to you. On this podcast I tell friends and other people I know about it because of how it makes me feel. Now Timeline is the company behind Mitopure and timeline is offering 10% off your order of Mitopure. Go to timeline.com something that's T I M E L I N E.com/something I am a big fan of Shopify. They have been a longtime sponsor here and Shopify is the commerce platform behind millions of businesses and they should be behind yours too, because they get it right. If you run a business, you know, as I do, that there are so many details that need your attention, it can be overwhelming. Finding the right tool that can handle a lot of those details and simplify the selling process, well, that's a game changer and it makes your life easy and helps you sell more, which is what Shopify does. Shopify handles 10% of all e commerce in the US from household names like Mattel and Gymshark. If Mattel and Gymshark are using Shopify as their commerce platform along with millions of other businesses, shouldn't you be too? Shopify gets you up and running with your own design studio. They've got hundreds of ready to use templates to build a beautiful online store and AI tools that write product descriptions, page headlines, and even enhance your product photography. If you've ever tried to build an online store, this has got to sound pretty tempting. Turn your big business ideas into With Shopify on your side, sign up for your $1 per month trial and start selling today at shopify.com sysk go to shopify.com sysk shopify.com sysk Generally, I think people hope to live a long and healthy life. And the advice to do that has typically been to eat right, get enough sleep, stay active, and exercise and see your doctor. All of which is probably great advice, but it's a little vague and it's pretty old advice. It's been around for a long time and it turns out there are other things we can do and other technologies we can use to see how we're doing beyond just eating right and exercising. Here to discuss this next level of health and longevity is Peter Attia. He is a medical doctor who serves on the editorial board for the journal Aging. He is host of a podcast called the Drive, one of the most popular podcasts covering the topics of health, medicine and longevity. And he is the author of a monster bestselling book called the Science and Art of longevity. Hey, Dr. Attia, welcome. Thanks for coming on something you should know.

Peter Attia (32:27)

Thank you so much for having me.

Mike Carruthers (32:28)

You bet. So I think most people know that if you're gonna live a long and happy life, your best bet is to eat right, exercise, get some sleep, cut out your stress. So how is what you're talking about different than that pretty generic advice?

Peter Attia (32:44)

Well, I mean, I think it comes down to probably specificity, right? Just like I think everybody knows if you, you know, have cancer, you need chemotherapy. But the, the Details are probably what matters a lot more. Right. And what separates, you know, me, who's not a medical oncologist from someone who is, is knowing when to use that chemotherapy, which chemotherapy to use, how to cycle it, what doses to use, what biomarkers to be looking at to make sure you're not giving too much or too little, how to monitor somebody when they're in remission. It's the nuance that matters. And so you're absolutely right. I mean, I think certainly throughout our medical education, it wasn't, you know, lost on anybody that exercise was good for you. But, you know, when was the last time a doctor asked you what your VO2 max was, or what your zone 2 was, or what your almi was? And even if they knew to ask those things, that they know what the metrics were, what they were going to hold you up to as a standard, and more importantly, how do you get to the place where you want to be?

Mike Carruthers (33:40)

And so what are those things? If my doctor asked me, I wouldn't know what he was talking about. Can you explain those?

Adam Alter (33:47)

Yeah.

Peter Attia (33:48)

So those are just kind of a few examples of things that I think are really good signal integrators of things that we understand are beneficial. So we know that exercise is good for us, but the question is, how good is it for us? And one of the ways I think that's easiest to explain this is to look at what an outcome is that reflects a lot of exercise and compare that to say, an outcome that we know is bad. So we know that smoking is bad. Right. I don't think there's any ambiguity about that. So how would we explain how bad smoking is? Well, one way to do it is to use a mathematical and statistical tool called the Cox proportional hazard, which spits out something called a hazard ratio. And it basically integrates the effect of smoking over a person's lifetime and says this is the risk. And when you do that, you come up with an answer that says, and I'm just making this up, I mean, these are actual numbers. But I'm just saying, like directionally, let's assume you take somebody who smoked, you know, got a 20 pack, your smoke history. So they smoked a pack a day for 20 years, they're 50 years old. You compare that to a 50 year old who's never smoked, but otherwise is the same. What's the difference in risk? And the difference in risk is about a 40% increase in all cause mortality, meaning there's a 40% chance greater that that person is going to die. The smoker in that year than the non smoker. That's what that integral function is doing. And we can do the same thing on the positive side. So we can look at muscle mass. So ALMI stands for Appendicular Lean Mass Index. And it, as its name suggests, is a way to tabulate the total muscle mass you have in your arms and legs. And that's a reflection of how much you do. It's a reflection of how much exercise you do. Similarly, we can look at something called a VO2 max, which is a measure of the peak amount of oxygen your muscles can utilize when you're either on a treadmill or on a bike. It's an exercise test you do, and that's obviously important because it's a reflection of how much you exercise. It's a way to capture the volume of exercise a person does. And when you compare the hazard ratios of people who have high versus low VO2 max muscle mass or muscle strength, you see that the risk multiplier is so much greater than 1.4. That's what it means to have a 40% increase in risk. We're talking about 2, 3, 4, even 5x risk multipliers.

Mike Carruthers (36:22)

Right? But most people aren't going to get down to that level of specificity because what, what, how would it change anything? I mean, you exercise, you exercise. If you don't, you don't. I mean, how much?

Peter Attia (36:35)

Well, it's not hard to do any of these things, right? So a VO2 max test, you don't need a doctor to do it. Anybody can just google VO2 max test near me, and you could go and get one of these tests. It probably costs 100 bucks, maybe 120 bucks. You go and get the test, which means they put you on a treadmill or a bike, and they basically just push you until you can't go anymore. And it spits out that number, and then that number tells you where you rank. So for your sex and for your age, you will get a percentile. And you then decide, do you, do you, do you want to be at the 50th percentile? Do you want to be at the 20th percentile, if that's what it spits out, or do you want to be in the top, you know, 25 percentile or even the top two and a half percentile? There's, there's no limit to the predictive power of this metric in terms of your lifespan. In fact, there is no metric that is more highly associated with longer life than a high VO2 max. So knowing it is the first step and then understanding how you can train it to get better is the second step.

Mike Carruthers (37:33)

So how does that work? If you have the test and then you take that number and say it's too low and you want it to be higher, how do you get it higher?

Peter Attia (37:43)

So it depends on which number we're talking about. But if we're talking about VO2 max, then the name of the game is obviously more training geared towards that. So to train VO2 max, I describe it to people. It's your, your cardiorespiratory fitness is kind of represented by the area of a triangle. And the. So picture a triangle sitting standing up on a table. The base of the triangle is your aerobic efficiency. We measure that in something called Zone 2. The height of the triangle is your VO2 max. So the greatest area of a triangle would have the widest base and the highest point. And as a general rule, what we want people doing is spending 80% of their total cardio training time at low intensity, which we call zone two. We can talk about what that means in a minute and then 20% of that time at higher intensity towards that VO2 max. And the easiest way to do that, and the way we have our patients do it is doing four minute intervals with one to one rest and recovery. So that would mean after a brief warmup, you might do four minutes of pushing yourself to about as hard as you can push yourself in that four minutes. Now, you're not going all out because obviously all out effort is only going to last 10 to 20 seconds. But this is a really significant effort, such that at the end of four minutes you're absolutely gassed and you need four minutes of passive recovery. So if you were doing this on a track, for example, and you were running, you would just walk very slowly for four minutes to recover. If you were on a stationary bike or on a regular bike, you'd pedal really, really slowly. And just doing, gosh, five of those intervals a week in one session would probably be sufficient for most people to significantly raise their VO2 max.

Mike Carruthers (39:27)

But isn't this sounds very like this is for real high end athletes. I mean, we're in a culture where it's difficult to get people to walk around the block after dinner. I mean, what you're talking about is way beyond what most people would even think of doing, perhaps.

Peter Attia (39:44)

But I guess, you know, I'd say two things about that, right? So. So first is there, you know, it's all relative to where you're starting. So to your Point, if we're talking to someone who does zero exercise, you know for whom, if you could get them to go out and walk after dinner, that's a big win. The good news is they don't have to do that much to still get a big benef benefit. You'll still get about a 50% reduction in all cause mortality, meaning at any point in time, if you look out the following year, you can reduce your rate of dying by 50% if you go from zero exercise a week to three hours of exercise a week. But again, it's got to be strenuous exercise. But the other point I'd say is it depends what problem we're optimizing for. I suppose. So, you know, I'm trying to optimize for a problem which says how do I maximize health span and lifespan? And I guess the question is, why wouldn't that be challenging? I mean, if the answer were all you have to do is drink kombucha and meditate for 10 minutes a day, don't you think people would have done that already?

Mike Carruthers (40:50)

Probably. But there also seems to be this kind of fatalistic. When your number's up, your number's up, and I do the best I can and you know, all this, you know, I'd rather be happy and not, you know, be in the gym 20 hours a week. I'd rather live my life. So I guess it really depends on what you. What's important to you.

Peter Attia (41:10)

Yeah. I think it's also important to understand that while that might be true when you're 30, that same attitude is going to reduce the quality of your life when you're older. And I agree that I don't think most people. I think if most people felt that they had to choose between quality and quantity of life, they would choose quality. What I think people maybe don't realize is that that's a false choice. Virtually everything you're doing to increase quality of life is also increasing quantity of life. There are very few exceptions to that rule. So all this exercise that we're talking about, it's true that the metric by which we measure the outcome is length of life. What's much more complicated to measure, because it's subjective, is quality of life. And this is actually the single most important thing. I write about this as something called the marginal decade of life. The marginal decade of life is your last decade of life. By definition, everyone will have a marginal decade. No one knows the day they enter their marginal decade, of course, but most people sort of realize it when they're Getting close to the end of it. For most people, the marginal decade is not necessarily a pleasant time. Their body's sort of broken down, they're. They're in pain. They can't really enjoy the things that they enjoyed when they were younger. They tend to become quite passive in life. They're not really participating. They're mostly spectating. And obviously there are many exceptions to that. And those are probably the people that stand out to us when we think about what we want to be when we're older. But unfortunately, most people who end up having a great marginal decade usually get there on the basis of great genetics and a bit of luck. What I'm arguing is actually we have to train for that. That has to become the purpose. Because if you train to have a wonderful, you know, marginal decade, in other words, to be 80 years old, but actually function like a healthy and fit 60 year old, well, first of all, that for most people is the single most desirable thing. But also it implies that everything that comes before it is also great. So just like it. You know, just like someone who shoots a bow and arrow, which happens to be sort of one of my favorite pastimes. If that person can be very accurate at 80, 90, or 100 yards, and that's where they're practicing well, by definition, they're very good at 30 and 40 yards.

Mike Carruthers (43:44)

So when, if you do what you're talking about and really get very specific about what's optimum for you, how much longer, how much better are you going to live? I mean, it sounds like a lot of effort. So what's the payoff for all that effort? Generally speaking.

Peter Attia (44:02)

I think the payoff is at every point in time you're able to enjoy the things that you enjoy, whether they be cognitive or physical. It's important to remember exercise is not only sort of the most potent tool we have at extending lifespan, that is living longer, it's also the most potent tool we have at improving cognitive performance. In fact, it's probably the single highest ROI tool a person would have at minimizing the risk of dementia and neurodegenerative disease. So to me, that is the payoff, right? The payoff is that I'm reducing my risk of the diseases that would most frighten me, and I'm increasing my ability to participate in all of the activities that matter to me and, you know, will one day matter to me as I get older and my kids get older and I have grandkids and I want to be able to do the things with my grandkids that I so enjoy doing with my kids today.

Mike Carruthers (44:58)

When you look at the landscape, in fact, I just was just reading this article about how Alzheimer's disease and dementia is just exploding in many states, and they attribute it to lifestyle and diet in large part. And I've always thought that people, if you tell them you need to exercise more and eat better and sleep better and all this, no one goes, oh, really? I didn't know that. Everybody knows that they choose not to do it. And I wonder why, why, knowing how important it is, is this apathy to do what's necessary to lead a long and healthy life?

Peter Attia (45:35)

There's probably two different reasons I could think of off the top of my head, right? So the first has to do with a lack of clarity around what that risk is. So I think when people say, yeah, you need to exercise to protect your brain, that seems a little vague. I think if people understood the magnitude of the benefit, that might be, you know, 10% of it. But I think the real issue here is the discounting problem, right? This is a hyperbolic discounting problem. And it's the same reason that it's really hard to get someone who's 25 years old to save for retirement. You know, if you're, if you're making $50,000 a year, you know, you're getting roughly $1,000 a week in your paycheck. Let's just say it's even $50,000 after taxes. So you've got $1,000 in your paycheck after your taxes are deducted. And, you know, a financial advisor might say, hey, look, you know, if you could, if you could set aside 25 of that and. Or 20% of that $200 a week, it's really going to move the needle when you're 60 or 65. And he's looking and he's thinking, well, okay, I sort of understand that, but it feels really abstract because I'm 25 right now, and that extra $200 a week would give me an extra two nights of going out for dinner. And I really enjoy that because I get to be with my friends. I'm not, you know, there's no value to be. There's no value judgment in that statement. It's simply a question of prioritizing.

Mike Carruthers (46:59)

Yeah, I think you're right on there. I think that's exactly it. That it's just like saving for the future. It's like, I can do that later. I don't need to do it now because I don't feel anything that needs Fixing, So why should I bother?

Peter Attia (47:13)

Yes, And I actually think it's even harder than the analogy I gave, because the analogy I gave, when you put the $200 away for the future, it doesn't take you any additional time. And it's not physically hard when I'm asking a patient to spend an hour a day or sometimes more exercising. It's an opportunity cost of time that's coming at the expense of something else.

Mike Carruthers (47:42)

So talk about diet, because there's been so much contradictory information, what you should, shouldn't eat, and. And so what, when the dust all settles, what say you?

Peter Attia (47:55)

We don't actually know as much about nutrition as we'd like to. We know much more about exercise than we know about nutrition. It's much easier to study exercise than it is nutrition. Nutrition is the messiest field of all of health. And it's. But what do we know? Well, we know that energy balance matters. We know that when an individual consumes significantly more energy than they're able to put to work, they store it. They store the excess. And that's an amazing feature of our evolution. Our capacity to do that, by the way, sets us aside from many of the other species that we parted ways from millions of years ago and even hundreds of thousands of years ago. From an evolutionary perspective, that's what allowed our brains to become so big, was this capacity to store energy in the form of fat. So this worked really well for us up until 150 years ago. But of course, now, in an environment of excess food where you're not going to starve, this sort of working against us. So really, that's rule number one, right? Is, you know, you don't want to be overnourished, which is, I guess, a kind way of saying you don't want to be carrying around too much excess fat, especially when it gets out of the subcutaneous places where it was designed to be stored and leaking into places like around the organs in the liver, around the heart, around the kidneys. These are the really dangerous places to store fat. And that's really where overnutrition causes harm.

Mike Carruthers (49:27)

I don't know how you get younger people to appreciate what the benefits will be in doing what you're talking about or what the problems will be if you don't exercise, if you don't eat right. It's those things show up later in life, but, boy, they do show up.

Peter Attia (49:44)

Let's look at the most extreme example of that. Once you reach the age of 65, if you fall and break your hip, your one year mortality, meaning the probability that you're going to be dead within 12 months of that injury is 15 to 30%. And a big part of that is yes, a certain subset of people die in the short term as a result of that injury, but many more people die as a result of never getting active again. And they'll, they can, they can die very quickly.

Mike Carruthers (50:12)

That's a pretty high number.

Peter Attia (50:14)

It is. And that's why again, we really talk a lot about why do you want to be lifting weights, why do you want to be doing cardio? I mean, why do you know. Accidental falls are the greatest source of accidental death for people above the age of 70. It's an enormous cause of mortality. It's not very sexy. Nobody really wants to talk about it, but the fatality is so high from a broken hip or femur that it is effectively. And again, I gave you data for all comers over 65. When you start looking at that at 75, 85, at some point a broken hip just becomes fatal. And there's no greater way to strengthen your bones than to lift heavy weights. That is the signal to tell a bone to increase density.

Mike Carruthers (51:00)

I really like your perspective on all of this. It's a different way of looking at the whole issue of diet and exercise. It's probably why your book is sold a zillion copies and your podcast doing so well. Because of your insight into this, I've been speaking with Peter Attia. He is a medical doctor, he's host of the podcast called the Drive. And the name of his big monster best selling book is Outlive the Science and Art of Longevity. And there's a link to that book at Amazon in the show notes. Appreciate it. Thanks for coming by Peter.

Peter Attia (51:31)

Thank you very much. Appreciate sitting down with you.

Mike Carruthers (51:37)

If someone in your car has motion sickness, there are a few important things to remember. First of all, it's a good idea to have some ginger handy. Ginger tea or ginger chews can be as effective as over the counter remedies for motion sickness. And peppermint helps too. And there are some things you can do to lessen the severity of motion sickness. For example, look off into the distance and focus on a steady point. That can really help keep your head as still as possible. Sudden head movements can make things worse. And if the front seats are taken, the middle seat in the back of the car is best because the more you can see in front of you, the better. Those motion sickness wristbands can really help people too. And if you don't have one Handy. Applying pressure with your thumb on the inner arm just above the wrist crease seems to help and that is something you should know more than anything. We rely on word of mouth to get to get the word out about this podcast and to grow our audience. And we would really appreciate your help. So please tell someone you know about this podcast and recommend they listen. I'm Mike Kerr Brothers. Thanks for listening today to something you should know.

Peter Attia (52:56)

I'm Amy Nicholson, the film critic for the LA Times. And I'm Paul Scheer, an actor, writer and director. You might know me from the League Veep or my non eligible for Academy Award role in Twisters. We love movies and we come at them from different perspectives.

Mike Carruthers (53:11)

Yeah, like Amy thinks that you know.

Peter Attia (53:13)

Joe Pesci was miscast in Goodfellas and I don't.

Mike Carruthers (53:16)

He's too old.

Peter Attia (53:17)

Let's not forget that Paul thinks that Dune 2 is overrated. It is. Anyway, despite this, we come together to.

Adam Alter (53:25)

Host Unspooled, a podcast where we talk.

Mike Carruthers (53:26)

About good movies, critical hits, fan favorites.

Peter Attia (53:29)

Must sees, and in case you missed ems, we're talking Parasite, the Home Alone, from Grease to the Dark Knight. We've done deep dives on popcorn flicks. We've talked about why Independence Day deserves a second look. And we've talked about horror movies, some that you've never even heard of, like Ganja and Hess. So if you love movies like we do, come along on our cinematic adventure. Listen to Unspooled wherever you get your podcasts and don't forget to hit the follow button.

Mike Carruthers (53:59)

Do you love Disney? Do you love top 10 lists? Then you are going to love our.

Adam Alter (54:03)

Hit podcast, Disney Countdown.

Mike Carruthers (54:05)

I'm Megan, the magical Millennial.

Peter Attia (54:07)

And I'm the dapper Danielle.

Mike Carruthers (54:08)

On every episode of our fun and family friendly show, we count down our.

Peter Attia (54:12)

Top 10 lists of all things Disney.

Mike Carruthers (54:14)

The parks, the movies, the music, the food, the lore. There is nothing we don't cover on our show.

Peter Attia (54:20)

We are famous for rabbit holes, Disney themed games, and fun facts you didn't know you needed. I had Danielle and Megan record some.

Mike Carruthers (54:29)

Answers to seemingly meaningless questions.

Peter Attia (54:31)

I asked Danielle what insect song is typically higher pitched in hotter temperatures and.

Mike Carruthers (54:37)

Lower pitched in cooler temperatures. You got this.

Peter Attia (54:39)

No, I didn't.

Mike Carruthers (54:39)

Don't believe that about a wish coming true. Well, I didn't either.

Peter Attia (54:44)

Of course, I'm just a cicada.

Mike Carruthers (54:47)

I'm crying. I'm so sorry, Jimmy.

Adam Alter (54:50)

You win that one.

Peter Attia (54:51)

So if you're looking for a healthy dose of Disney magic, check out Disney Countdown. Wherever you get your podcasts.