The Dr. Josh Axe Show

Episode: Are Barefoot Shoes Good For You? | Guest: Mark Sisson

Release Date: September 4, 2025

Overview

Dr. Josh Axe sits down with Mark Sisson—founder of Primal Kitchen and barefoot shoe company Paluva—for a candid and science-based discussion on movement, injury prevention, fitness longevity, and the profound effect of foot health on overall well-being. The conversation flows from the pitfalls of modern exercise practices and running culture, to hormonal health, and lands squarely on why going barefoot (or wearing barefoot-style shoes) could be the missing link in your health journey. Sisson, now 71 and extraordinarily fit, shares practical wisdom for strong, pain-free living across the decades.

Key Discussion Points

1. The Myth of Exercise for Weight Loss

• Running Isn’t the Answer:
  • “Exercise is a horrible way to lose weight. Running in particular, it’s a horrible weight loss strategy for most people.”
    — Mark Sisson (00:30)
• Diet as the Primary Driver:
  Sisson asserts that body composition is “probably 80% diet.” Achieving metabolic flexibility—burning fat efficiently at rest and during activity—is the “holy grail of weight loss.” (12:35)

2. Movement for Longevity: The Minimum Effective Dose

• Functional Fitness, Not Volume:
  Sisson attributes his vitality to a “decathlon” of fitness skills (deadlift, sprints, balance, planks, etc.) rather than chasing volume or intensity.
  “What’s the minimum effective dose of exercise that I need to achieve my result? Not what’s the most I can do, bust my ass, leave the gym exhausted.” — Mark Sisson (07:45)
• Focus on Intuition:
  Training should be intuitive and responsive to the body’s signals, not dictated by rigid programs. “Some days I get to the gym… and I’m literally two or three sets into a workout, like, you know, today is not my day to train.”
  — Mark Sisson (11:25)

3. Avoiding and Healing Injuries

• Listening to Your Body:
  Both Axe and Sisson recount their injuries rooted in “pushing past warning signs,” especially in competitive, high-volume exercise environments like CrossFit (06:52).
• Lessons Learned:
  “I am where I am today because of not just what I did and how I did it, but also the mistakes I made and the learnings that I had from those mistakes.” — Mark Sisson (07:45)

4. Hormones, Aging, and Diet

• Optimizing, Not Replacing at First:
  Sisson honestly discusses his decision to use testosterone replacement therapy (TRT) in his mid-60s, advocating instead for maximizing natural hormone health as long as possible through lifestyle and diet. “Put [hormone replacement] off as long as you can, use herbs, even use things like peptides, let’s do some things to put it off.” — Dr. Axe (19:37)
• Food as Hormone Medicine:
  They touch on ancient approaches (e.g., Chinese medicine) that prioritize food for hormone optimization (16:42).

5. The Barefoot Revolution: Foot Health and Full-Body Impact

• Why Feet Matter:
  Shoes disconnect us from vital feedback loops. “Feet need to feel the ground. Feet need to feel what’s underneath so that… the brain has all the information it needs on how to orchestrate the entire kinetic chain.” — Mark Sisson (21:40)
• Shoe Design Flaws:
  Modern shoes with thick cushioning, high heel-to-toe drop, and narrow toe boxes cause compensation and injury up the kinetic chain (hips, knees, back).
• Barefoot vs. Barefoot-Style Shoes:
  Sisson and Axe extol the design of Paluva shoes for proper ground feel, toe splay, and just enough cushioning for modern environments.
  “The way that these have been designed are just kind of extraordinary.” — Dr. Axe (21:40)
  “We create a shoe that has these individual toe slots that allows for ground feel—just enough padding, just enough.” — Mark Sisson (21:40)

Notable Segment

Benefits of Barefoot or Minimalist Shoes [34:38–40:06]:

• Restores natural movement and communication with the ground
• Strengthens glute activation (“Great toe, great ass” — gym saying via Sisson)
• Strengthens foot and toe muscles, reducing injury risk
• Improves balance, stability, and potentially brain function (Sisson: “I want to do an experiment with pre-dementia people… barefoot or minimalist footwear to see if there’s any connection there.” — 36:22)

Practitioner Myth-Busting: Orthotics

• Orthotics “just put a band-aid on one of the problems and then forced it further up the kinetic chain.”
  — Mark Sisson (27:41)
• Instead, let foot muscles strengthen via natural or barefoot-style use

6. Practical Advice for Listeners

• Start by going barefoot as much as feasible, especially at home or while training
• Gradually adapt to minimalist (barefoot) shoes—adaptation may take about two weeks (54:39)
• Focus on walks, strength training, and sprints for overall health, not chronic running
• Add balance and grip strength moves (e.g., slackline, planks, hanging from bars) to supplement fitness

Notable Quotes & Memorable Moments

• “If you can’t feel the ground, there’s a lack of communication there… that’s now going to disrupt your knees, your hips, your low back, all the way up through your entire spine.”
  — Dr. Axe (06:06, 24:59)
• “Once you’ve achieved this metabolic flexibility then the minimum effective dose of exercise becomes: walk a lot, as much as you can...go to the gym twice a week and lift weights…once a week, sprint.”
  — Mark Sisson (12:35)
• “Feet are just hands that we developed in a different way.”
  — Mark Sisson (42:41)
• “50% of runners get injured every year. Like, that’s worse than the NFL. The so-called high tech running shoes… haven’t altered that one iota.”
  — Mark Sisson (29:26)
• “I think the most comfortable shoe you’ve ever worn. Within a couple of days, you go, oh my God, like, I can’t believe how dexterous my toes are and how great this feels.”
  — Mark Sisson (54:32)

Timestamps of Important Segments

• 00:30 – Sisson: “Exercise is a horrible way to lose weight.”
• 04:23 – Origins of Sisson’s fitness philosophy and consistency
• 07:45 – On learning from injuries; play, joy, and the minimum effective dose
• 12:35 – Why running (and most exercise) is ineffective for weight loss
• 19:01 – Sisson on starting testosterone replacement therapy
• 21:40 – In-depth on barefoot shoes, design insights, and their impact
• 27:41 – Dangers of orthotics and artificial foot support
• 34:38–40:06 – Direct discussion of barefoot benefits, practical applications, and stability drills
• 45:36 – Sisson’s history with cycling shoes and the invention of the triathlon “brick”
• 47:15 – Why walking is the secret longevity exercise
• 51:17 – The ancestral health model and connection to modern well-being
• 54:32 – Final thoughts: adaptation to barefoot shoes and their benefits

Summary Table: Actionable Takeaways

| Area | Key Tip | Supporting Segment | |---------------------------|----------------------------------------------------|-------------------------| | Weight Loss | Focus on diet and metabolic flexibility | 12:35 | | Exercise | Walk daily, lift heavy things 2x/week, sprint 1x | 12:35, 47:15 | | Injury Prevention | Heed your body’s warning signs, train intuitively | 04:53, 07:45 | | Foot Health | Go barefoot or use barefoot-style shoes often | 21:40, 34:38 | | Hormonal Health | Prioritize food and movement before HRT | 16:42, 19:37 | | Longevity & Stability | Add balance & grip-strength work; strengthen feet | 42:37–43:48 |

Final Thoughts

This episode is a call to rethink conventional wisdom around fitness, injury, and especially foot health. Sisson’s blend of ancestral wisdom, scientific rigor, and personal experience offers listeners a robust, actionable blueprint for greater vitality—starting from the ground up.

“Your feet are your foundation. Start taking care of them.”
— Dr. Axe (34:40)

Note: All timestamps are approximate and based on available transcript segments.