Longevity Simplified: Howard Luks, MD on optimizing lifestyle to extend healthspan and lifespan.

Howard Luks, MD talks about his mp nonsense approach to optimizing your lifestyle in order to extend your health span as well as lifespan. 

You can find Howard on twitter/X @hjluks
And on his excellent website at https://www.howardluksmd.com/
You can order/gift his book on amazon.com https://www.amazon.com/dp/B0B195C17T

We talk in depth about exercise, to include strength training and cardio, to include zone 2 cardio. 

We discuss the importance of diet, and how there are many healthy dietary patterns you can choose from. 

We talk sleep, stress management, and most importantly, investing your time in the things we know move the needle, as opposed to focusing on minutiae that may not matter. 

Don't miss the forrest of longevity for a single tree. 

Transcript

[00:00:00] Jerry Teixeira: I was excited to sit down and talk to Howard Lux recently. Uh, Howard is an md, he's an orthopedic surgeon and he also is a avid researcher and writer about longevity. Now, Howard has recently published a book called Longevity Simplified, and what I love about his book, and one of the primary reasons I wanted to talk to him is, as the name implies, he has simplified the actionable steps that a person can take to optimize for longevity, and that's gonna address cardiovascular fitness, musculoskeletal fitness.

And the thing about Howard being a orthopedic surgeon is he's seen firsthand how your musculoskeletal health. Impacts your longevity, your healthspan and your lifespan. And so I think that he and I first met on Twitter and saw a lot of things eye to eye, uh, based on that. And it's because I also think that your strength, your musculoskeletal health play a vital role in aging successfully.

And not just aging successfully, but navigating life and living successfully. And at a high level in general. Uh, I highly encourage you to check out the book Longevity Simplified. This is the book that I would suggest you gift to someone if you want to give them a roadmap to improving their health without getting too, um, deep in the weeds.

When it comes to the science, there's not a lot of, uh, overly technical talk. It's not dumbed down by any means. Um, but it's something that I think most people will be able to read the book. They'll be able to understand all the concepts, and they'll be able to institute them, uh, quickly and easily. And it definitely can make a difference.

There's no fluff, there's no filler outstanding book. Um, Please enjoy my interview with Howard Luxe.

All right. I'm excited today to be interviewing Howard Luxe. And, uh, Howard is is a doctor that I stumbled upon on Twitter, not sure exactly how, um, but his content, uh, kind of stood out to me right away. Um, at that point he was working on a new book, which had not, uh, been released yet. Um, but his content is very, um, based in sound science as far as from what I've seen from reading the book.

Um, but what it stood out to me about it was the fact that it is something you can read, you can apply with, with absolute minimal barriers to entry. Um, it focuses on the big levers that you can pull to help optimize lifestyle for the purposes of trying to age as well as possible, extending health span and hopefully lifespan.

Um, so, uh, I'd like to start with you explaining, I mean, yes, you're a doctor, but what, what brought you to medicine? And then from there, what brought you into your pursuit of, you know, health span longevity and then wanting to distill that and bring it, you know, to, to an audience.

[00:03:03] Howard Luks: Thanks, Jerry. It's a pleasure to be with you. You know, I think our, uh, methods, uh, are very similar, right? You preach the same on the strength building side, right? I can teach you to do this, uh, without expensive equipment, uh, and any, and any craziness, uh, that we've all, uh, unfortunately, unfortunately wasted a lot of money on in our, in our past decades.

Um, so again, I'm happy to be here with you. Why did I become a doctor? Um, I didn't graduate college as a physician. I graduated as a chemist. Um, tried that, didn't like it. Um, got a master's degree for one of the jobs I was, uh, performing, and it was in basic medical sciences exposed to a lot of medical students.

I figured, what the hell? Um, and so I transitioned, uh, and applied to medical school based on my, uh, athletic endeavors. Uh, and the number of times that I saw my orthopedist, which was frequently more than I saw my pediatrician, uh, or orthopedics, was a natural space for me. Uh, I was an athlete. I thought I understood the athlete mindset.

Um, and at least early on I figured, all right, something's broken, surgery, fix it. Uh, as you know, uh, I've changed with regards to that. Um, The longevity space. You know, how do you know physicians are not trained in longevity? We're not trained in managing health span. We're not necessarily trained in managing the whole person.

Um, so that, that came about, uh, quite a number of years ago. Uh, shortly after I had, uh, uh, after we had our second child, um, we were outmaneuvered and outweighed. Uh, so, uh, a lot more effort. Uh, had to be, uh, given it home, which didn't leave me time just for my running, my cycling and everything else. I hadn't had a chance to put to build my gym out in my basement yet.

So I gained weight. Um, one day I happened to have some abdominal pain. So I saw a radiologist in the hallway and they threw me on the ultrasound table and they ultrasounded me. They said, ah, you're fine. Your gallbladder's great. It's just a little fat in your liver. So they brushed it off. 'cause back then, you know, it wasn't termed, uh, it wasn't termed fatty liver diseases or, or non-alcoholic fatty liver.

Uh, so I started reading, uh, and everything that I read, uh, wasn't good. You know, it talked about metabolic health, et cetera, and I didn't really even know what metabolic health was at that point. And there certainly wasn't a focus on it in this space. Um, there wasn't even a social space at that point either, so I just started to read more that brought me to insulin resistance, uh, and that that brought me into the dementia world, uh, the world of cardiac disease and more.

Um, and for me, uh, in order for me to learn something, I have to write about it. It. So, yeah, after doing a lot of research, I started to write these articles. I put the articles up on my website. Um, I had them closed for a while, private. Uh, and I started to open them up and pretty soon they started to become quite popular.

Uh, many people started to reach out. You should write a book. The, then, then the pandemic came, and I had the time to do that. Um, but how do I use this in my everyday world? Um, I guess around the same time that, uh, my own health started to deteriorate, uh, you started to notice trends. Um, a lot of the people in front of me were on the same three medications, right?

Um, a lot of them were suffering from the same diseases. Uh, And I was starting to connect all the dots on my own, in my own research, right? That everything, uh, most of the diseases that we're gonna die from have a common root cause. Um, and in many respects, that's, that is metabolic dysfunction. Um, and the root cause of that is poor mitochondrial function, poor energy partitioning, poor mitochondrial flexibility.

These are just, uh, just some of the terms that folks will encounter when they research this. Um, and then I started to think, you know, maybe there's a connection between what I'm seeing, uh, in the office and all these orthopedic issues. And it turns out there was, right. We know that tendon tears are more common in people with a.

Poor metabolic health. We know that osteoarthritis is more common. We know that osteoporosis is worse and more common. Um, so there are a lot of downstream consequences to poor metabolic health, not only for our brain, our heart, our kidneys, the liver, our pancreas, et cetera, but for our musculoskeletal system as a whole.

So I started to incorporate what I was reading into what I was sharing with patients. Um, and that's a very tough messaging proposition, right? How do you communicate this to your patients? You, you can't just say, eat less sugar and walk more. Um, that doesn't incentivize many. Um, and this had a lot to do with how I crafted the message in my book too, because if people understand the why, Why does this work?

Why does this improve my ability to age better and healthier longer? Um, then they'll frequently engage 'cause something clicks in their, in their mind. Um, so when I started to connect the dots, uh, I started to notice that more and more patients bought in. Uh, and they went on this journey with me. And some of those were some of the greatest successes that I had in my office, right?

I didn't touch them with a scalpel. But, um, not only did I, I change their lives, um, I improved their lifespan, their health span, and more often than not, probably the health span and lifespan of those in their family. 'cause they bring everyone along with them on their journey, right? Right. If they're gonna be walking, so is the rest of the family, uh, if they're gonna be working out in the basement, so is the rest of the family.

Um, so that became really, uh, One of the ma major, um, benefits or bonuses to being a physician and to be, to being, to engaging people, uh, about the person centric or entire, uh, person holistic approach to my little part of the orthopedic surgery 

[00:10:23] Jerry Teixeira: world. That, that was probably, I would imagine a surprise to some patients, right?

Because you, you go to your family doctor or, or your primary care and you think of that person's being more of the doctor over your, your general health. Um, and then you go to an orthopedist and it's, well, this is a specialist, so you know, somebody's going in, Hey Doc, I think I need surgery. You know what?

What's my m r? I say, and then, you know, I'm sure some people were like expecting you to come back and say, well, this is the procedure. And instead it's like, well, here, here's the exercise prescription and here's, uh, so, you know, I could, I could imagine that there was some shock there. Um, but what you just said brings up something that I've noticed or, or came to the conclusion of over the years is that the treatment methods for many common, um, conditions when it comes to connective tissue, seem to be changing or have changed.

And, and that's one of the things I, I loved about your stuff early on is, you know, you, you have articles and people can go to your website, check 'em out, we'll put, um, show notes for them. Uh, but you have articles talking about, Hey, you may not need surgery for, you know, th this particular injury, there's a rehabilitation, maybe the right choice in, in more cases than we used to think.

Uh, and so if you could maybe 'cause you, you're the expert in this area, um, you know, loading our, our body, loading our connective tissues is how we strengthen them. So when an injury, depending on severity, uh, once some maybe initial inflammation and pain is subsided, subsided enough, um, people need to get back to loading, uh, to promote healing.

But they need to do it in a manner where it's, it's progressive but not too much, not too quickly, and not at too, too high of an intensity so that the body can actually adapt to this loading and the tendons can, can basically heal. Um, and, and the portions that can't heal because sometimes they can't, new, new tissues are formed around it.

You, you regain integrity and strength of the tendon. Can you maybe just touch on, you know, 'cause I think a lot of people when it comes to those connective tissue injuries, they, they think rest, ice, ibuprofen, and then surgery, right? They don't always realize that it's, it's load that you need. 

[00:12:36] Howard Luks: Right. Much more, much more involved.

So first to go back to, to the last statement, these are very challenging co. Conversations in, in the office. Um, and surprisingly many people are open to it, so they'll talk about longevity. They, they'll take my suggestions to heart. Uh, they'll do some lab tests. Uh, I may refer them out to an expert. Um, so more and more, again, if you explain the why and the how and how this is interconnected, you'll, you'll, you'll typically generate buy-in.

Uh, you may annoy a few people too, but that's okay. Uh, it's all part of the learning process. So, um, in my world, I'm predominantly a runner. Um, a very average cyclist. I was a decent runner in my days, but I never podium. But still, I would run some crazy, uh, trail races. Um, and I just enjoyed finishing them and not having anything broken.

Yeah, but in running and training for distance, uh, it is really clear mo in most runners and cyclists, et cetera, most injuries are training errors, right? It's, we were poor at, at managing load. Uh, we didn't understand recovery. We didn't understand rest. We didn't respect our need to do so. Um, and I'm guilty of this as well, uh, especially in my older years.

Um, the faster that I wrapped my loads, the more likely I am to be injured. Um, I have a post on my website about deconditioning at rest. Um, and there are very few injuries that require absolute rest, um, stress fractures and others, uh, come to mind. But most soft tissue injuries don't. They do require a change in load management, perhaps a change in the type of load that's being applied.

Um, perhaps they need a few days just to calm down if a tendon is really hot, but deconditioning occurs very rapidly, um, it will surprise you, uh, at how rapidly it, it does occur. Um, for example, you know, I think, you know, I had Covid about six weeks ago, and I was vaccinated only about four days prior to Covid.

So my inflammation had started to react to the vaccine, not enough to prevent me from getting sick. Then I got sick, so I got a double hit. Um, and even after I cleared the virus, uh, the effects of me were brutal. Uh, Tachycardia, shortness of breath, et cetera. So I didn't run or cycle for six weeks. Uh, and I started up at the end of last week, you know, running one mile, uh, cycling for 20 minutes.

Um, and I could feel it, you know, not only in my breathing and my heart rate, uh, but I'm sore. Um, and it'd be very easy for me if I tried to get back to my normal schedule from six weeks ago. It'd be very easy to me, uh, to injure something. Um, so, uh, paying attention to load is very critical on avoiding these overuse injuries and in managing your return from these overuse injuries.

Uh, also important is time course and consideration for recovery. Once you have an entrenched case of Achilles tendinopathy or hamre tendinopathy, you're in for an eight to 10 month course or longer. Um, and understanding how to adjust your activities, uh, accordingly is just of paramount importance. But you're absolutely correct.

Um, most injuries do not require at absolute rest, um, and they shouldn't be rested. Uh, we use too many braces and too many boots on people. Um, and the consequences of those can be significant when you try to get back out there and get active again. 

[00:17:14] Jerry Teixeira: Okay, so shifting gears a little bit. I well, we're actually going back to what we were talking about previously.

Um, so you bringing your framework to patients, um, in the office. And then that's the same framework that ultimately ended up forming the foundation for your book. So can you describe, um, what the steps, what the key areas, and I think there's seven if I'm remembering correctly from the book. Um, but, but can you just run over what you found are the key areas that you try to get patients to focus on?

And then in your experience, is there one or another? Like have you found that, okay, these are the areas, let's focus on this one first, let, let's get a win here, and then expand. Or how, how have you found instituting those, uh, tends to work best for you? Yeah. 

[00:18:09] Howard Luks: Um, it can be a challenge. I mean, in our Twitter bubble, right?

You know, most of us are active. We're out there doing it, we're doing something, we're running, we're working out. Uh, so it's hard to imagine how people don't like it. But the vast majority of people don't exercises work. It's painful, it's sweaty, it's annoying, it's uncomfortable. Um, and you know, that's something to, to be avoided.

Uh, and so we have to work with people, uh, and work with what they're comfortable doing. And if we give them, uh, a goalpost that's too far afield, uh, too far downfield, and the goals are too lofty, then when they fail, that's a miserable experience. Right? Right. Um, so, uh, and that's not going to bring them back to exercise, uh, or many healthy lifestyle choices.

Um, so I like, you know, my biggest lever for people. Is exercise. Um, and when I say exercise, I emphasize movement. Um, we can't escape the fact, you know, there's a lot of, a lot of Twitter circles where you have to do h i t, you have to be on an assault bike. You have to be killing yourself. You have to do sprints.

You don't right? If you want to, great. If you wanna top off the cardiac benefit and the longevity benefit, fantastic. I'm glad you enjoy it. I enjoy it. So we'll do it. But everyone doesn't need to do it all cause mortality, right? Dying from any cause. Uh, your chance of dying from any, any cause goes down dramatically if you walk as little as six to 8,000 steps a day.

So I want people to try and make their day a little harder. I try and impress upon them not to park at the spot that's closest to their, to their office or to their home if they park on the street. Embrace that walk. You don't have to walk a straight line from your car to the front door as well. Same thing at the supermarket.

Park at the furthest spot away. Enjoy the walk. Um, by the end of the day, you're gonna get five, 6,000 steps in. You know, if you're at work and there's a staircase up, you know, you can walk down three and up two. Um, it shouldn't be a challenge, and the more you do it, the easier that it will become. Um, I talk about exercise snacks, uh, on my website.

There's nothing wrong with getting up and doing five squats or pacing around your office if you're on a Zoom call. You don't have to have your butt stuck to your chair the entire time. Um, and slowly but surely, those, those movement patterns, uh, become a habit, um, and often will extend to a walk after dinner or after lunch, et cetera.

Eating, eating, eating is important, food is important. Um, we need the energy, right? We need a t p for everything. Um, but energy partitioning and how our body derives it, where it derives its energy from, from which source, glycogen, uh, or fat, um, is something we call metabolic flexibility. Um, we can create a lot more energy from burning fat, but in people with metabolic disease, we tend to prefer burning glucose and we lose the ability to burn fat even at very low effort.

Um, so again, just like we can go down down many rabbit, rabbit holes in the exercise space, we could do the same at food. Um, am I a fan of strict elimination diets? No. Um, as a matter of fact, I've tried many just to see what it was like. I tried keto. Uh, I actually didn't mind it, but my cholesterol shot through the roof, so I stopped that.

Um, you know, I've tried purely plant-based. Um, now I'm mostly plants, but I, I enjoy a steak and chicken and fish just like everyone else. So I try to emphasize, uh, whole food, real food. Um, you know, uh, our foods are highly obesogenic. Um, I don't think we realize how large the, uh, food engineering departments and big food companies are.

They know precisely the mix and food that's gonna make us want to eat more. They know the smell. It's gonna want us. To eat, eat, eat more. When you wash out all the fiber, unfortunately you also wash out a lot of the nutrients and you wash out the substances and these foods that are going to bring satiety or that feeling of feeling, you know, that feeling of being full.

So with a low satiety index and, uh, and that, you know, smell and taste, that, that ke keeps bringing you back. Um, it's very easy, uh, to put on extra weight. Um, so, uh, again, I push real foods. Um, it doesn't matter whether they're meat and vegetables. Uh, I implore people, if you're on keto, please watch your A P O B or your L D L particle number.

It is important. Uh, it does have a role in cardiac disease causation, uh, Although you'll get yelled at because I 

[00:24:18] Jerry Teixeira: said that. No, I, I, I, for, for the people that don't know. So I've, I've been low carb for, geez, 2010, so going on almost 13 years for the vast majority of that time, I ate plenty of plants. Uh, I, I did have a period where I went strict carnivore for almost seven months, and I did that.

At first I thought it was super crazy. Um, but I kept reading, you know, anecdotes of course, but I kept reading people that had skin conditions and autoimmune conditions, right? Anywhere finding that they, they saw improvements and I thought, well, I'll try anything for a couple months. I, I'm, I know that's not a long enough course of time to really matter in the grand scheme of things.

And so I thought, let me try this to see if it helps resolve my skin issues. And lo and behold, it did. Um, but when I, even when I did it, I did a video where I said, Hey, I don't, there's no data or anything to make me think that this is. The best diet for human longevity. I'm, I'm doing this because I have this condition and I'm trying to find a solution for this, uh, without having to throw steroid creams on my, on my skin, you know, for the rest of my life.

And so whether it was digestive based, whatever the issue was, and I was obese at one point, I ate so much processed food. It was the standard American diet. I think it maybe was still remnants of, of that, something with my digestive system. But once I eliminated everything except for that very limited pellet of foods, uh, the condition resolved.

I was able to titrate plant foods back in. I did them kind of like one at a time. And then after, uh, several months, nothing was bothering me. So I just kind of opened the floodgates. And I eat plenty of vegetables and plants now. Um, even when I was carnivore, um, I still did quite a bit of seafood and I never was, I guess, truly strict.

'cause I still cooked with olive oil. I, for whatever reason, I never developed a taste for. Globs of fat and tallow and all that. I, you know, I even rib eyes, I, I know it's heresy, but I trim the fat off a lot of the fat, stuff like that. So, um, so yes, I still am lower on the carbohydrate spectrum, although these days it, it's about 80 grams or sometimes even a little higher per day.

So it's not terribly low. Um, right. Not, not that, you know, don't wanna make the show about me or anything, but I, I thought, and that's one of the things that I thought appealed to me with your, your content is okay. My, my labs are good and, and they've been good. Um, I think my high L D L C was like 91 at, at that time.

I'm actually due for labs again. I was gonna go get 'em drawn last week and I got sick so I delayed it. 'cause obviously my c r p's gonna be up, you know, you're, you're sick, like you're, your blood work's not gonna be representative of your healthy state. So I'll go back for labs probably next week and I'm the type of person where I am willing to change my approach to diet.

Based on my, my biomarkers. Um, and, and I like that you've always, you know, had a, a general guidelines and then a tailored approach like, Hey, your labs look good. Keep, keep doing what you're doing. Right? Oh, hey, right. This is a potentially a concern with your labs. You might wanna talk to your doctor.

Consider lowering, lowering rape ob, for example. Um, I'm not a, a lipidologist and in within a low carb community, I know there's people that tell me, don't str don't worry about your rape ob don't worry about your L D L C. But I've got kids and the way I kind of look at it is if all my other biomarkers are are good and I can make a small change dietarily and my a O B goes down, there's no negative.

So it's not like I have to no longer, I mean, I don't have to go eat 300 grams of carbs a day. That's not, you know what I mean? So like I can still follow the dietary framework that I feel the best with. Which is, you know, the moderate to low carb framework. And I can still say, well, I, I eat a little more fish, use a little more olive oil, lower my ap o b I'm not using Tao.

I don't use as much butter as I used to. I don't know, like, I guess I don't, there's no, there's no benefit to like, Hey, let me get my a o B higher, like that I, that I can, you know what I mean? No. So I, and I don't, 

[00:28:32] Howard Luks: and somewhere it is a badge of honor, unfortunately. Um, but, but I think, you know, that's the proper message.

You know, what works for one person isn't gonna work for everyone else. Um, and we shouldn't force our dietary habits on, on others. Um, and we shouldn't come at them if they question the dogma. Um, that's firmly out there. Um, yeah. And. Unfortunately, there are a lot of people now in that A A P O B uh, space who are rolling the dice on the biggest wager their life, right?

Um, so, you know, I want to get, I'll steer us off here. Yeah. Um, you know, you'll find a diet that works for you. Uh, hopefully it's real food. Um, a little more veggie than meat, but just enjoy it. Look, it needs to be sustainable. None of these are quick fixes, right? So, so whatever you do has to work for you with the, where you can buy them, how much that you can afford, what you like to have, how many mouths you have to feed, et cetera.

There are many, many considerations that go into this, right? So, another thing, sleep. Right. There are zero physiological processes in our body that are not adversely affected by lack of sleep. So we are chronically undersleep population. Um, chronically poor sleep leads to increased risk of dementia, of cognitive decline, cardiac disease, hypertension, insulin resistance, and all downstream con consequences of that.

Um, so, you know, we have all these folks who optimize their exercise and they optimize their eating patterns, but they don't optimize their sleep schedule. Um, you know, there's nothing wrong with going to sleep at nine or 10 o'clock at night. Uh, yeah, it's, we really do need seven hours of sleep. Um, some people say eight, um, in the seven camp.

Uh, Based on what I've read, not upon my own research. Um, and you just feel better. I mean, everyone knows how crappy they feel after a poor night's sleep. Um, just because you may get used to that doesn't mean that you're handling it well. Um, the internal effects are extraordinary. Your brain goes through these, uh, cycles, uh, at, at night, highly repetitive, highly reproducible cycles.

Um, sleep is a very active process for our brain. So we park our short-term memories and an to long term, we clear out all the garbage, right? We have garbage cells, these glial cells, um, in our brain that can clear out the garbage in between the neurons if given enough time to do so. Um, That system can get all messed up if it doesn't have enough cycles.

Um, we go through many hormone cycles at night, right where the hormones, uh, spike at night and then diminish. Uh, it's all part of a circadian rhythm and biological clock. Um, so it's very important to allow our brain, uh, to get to that place where it can readjust and recharge itself. As an aside, uh, I think it's really important, you know, your wake up cycle too.

Uh, you wanna get your face in the sun, uh, without sunglasses for a few minutes in the morning. Uh, you have a pineal gland, uh, right behind your eyes. Uh, it starts to spout out these hormones that wakes your brain up and lets you know the day's beginning. Um, You know, uh, I think a really important and underestimated, uh, benefit to achieve health span, uh, is having a sense of purpose, uh, and having friends.

Yeah. Right? What's getting you outta bed in the morning? There has to be something to get you outta bed. There has to be someone, uh, that, uh, who, who's thinking about wants to get you outta bed, uh, or drives you outta bed. 

[00:33:13] Jerry Teixeira: Well, the, the retirement poorly phrased, that's kinda like the retirement trap, right?

Where people retire and they lose their sense. They, they've tied their identity to their profession. Absolutely. Um, or, or, or the friends at work or whatever. So they, they stop going to the workplace and their health. It happened to my mom. I mean, my mother's a perfect example. She was a hairdresser. She retired.

Her health immediately started to tank. Um, and, and so I think that is ties into your point, people when they retire, for a lot of people work is what gives them a sense of purpose. You know, and then they lose that, right? But also leaving the house, like you mentioned, for some physical activity to go to work, they lose that.

So, so I think it's great. Probably multifactorial and that, that retirement age where it, it's, you know, you're skating on thin ice if you don't have a plan to transition away from retirement into something else to make, you want to get up and, and, and, and, and live, you know? 

[00:34:10] Howard Luks: Absolutely. Well, look, you know, we can't escape the fact that as we age, we lose abilities.

Um, but we gain others. There's some, some great books that are written about this, right? It's fluid intelligence that drives us when we're young. Um, uh, and uh, that's the accumulated knowledge and the knowledge that we got from the books and our strengths and our ability to work all day and all night as surgeons and whoever.

Um, but those abilities fail. Uh, I have a lot of friends saying, you know, God, you know, I'm just killed by surgery now. I, you know, I'm exhausted. Um, what should I do to train for that? Like, you can't, right? It's, it's just gonna go away. Um, but we gain, it's called crystal in knowledge as we get older because now we know how to synthesize all this knowledge that we have in our data banks.

Um, and we combine that with our real life experience and we can turn that into truly meaningful and actionable knowledge to share with people. So, uh, it's sort of accepting the changes that are going to occur with aging. And our ability to start to share the crystal knowledge that we have. That's to a large degree, why I still write, why I do podcasts, why I wrote a book, and why I'm planning on another.

[00:35:47] Jerry Teixeira: So, okay. So you talked about the two types of intelligence, um, and I think that to, to people probably makes some intuitive sense, um, because it seems like as we get later in years to, you know, the, the grandparent age, so my oldest is 16, so I'm not, I'm not quite there yet, but it seems like there is a, they seem to make better teachers and they seem to be better at passing on knowledge and helping to guide, correct.

Uh, future generations, maybe a little more patient. Um, and, and what I've found, uh, I'm 43, so again, I'm not old, but I've, I really enjoy teaching people, um, what I've learned or my cumulative experience. I find gra, you know, A satisfaction in that, that when I was younger, I, I didn't really care about. Um, so I, I definitely think that there is some intuitive truth.

Again, 

[00:36:40] Howard Luks: it's all good. One second.

[00:36:50] Jerry Teixeira: No, it's, sorry, two dogs. I've got two myself. So, um, but yeah, I, I think to, to your point, understanding that that change happens can help you not have a midlife crisis, uh, when you start having the skills that maybe helped you earlier in your career, whatever that happens to be, when they're not as sharp as they were.

Okay, now how do I make the most of how I'm transitioning, uh, to, to maintain my sense of purpose? So if you were known as, you know, the, the big time surgeon and you're, and you're, and you're doing back to back surgeries or these marathon surgeries, whatever the case is, and those things are starting to wipe you out and you can't.

Maintain them without it taking a toll on you. Uh, I think at a certain point, if, if you know that that is an inevitable part of transitioning into this later stage in life, um, then you can do that successfully and still find immense gratification. I, I'm sure there's, you know, like in your case, writing a book.

So I'm sure there's surgeons that, Hey, I, I love to teach now. Uh, I like to help influence the, the younger, maybe, maybe they're publishing papers at, at a faster rate, um, contributing to the body of literature. So whatever, whatever your, your area of interest is. I think understanding that this change takes place and making sure that you're addressing, maintaining a sense of purpose, um, is important.

And then the one that I think is, is also key and, and it really interests me because in the social media age, we have friends in a different way than we traditionally had friends. So I have people that I've met through social media that I'm like, man, I really like this person. We, we see eye to eye on a lot of things.

We have really good conversations, but I've never seen him in person. So I, I, I wonder how much the, the, when you look at, um, populations that have exceptional longevity, when you look around the world, they're having friends, gets them outta the house, they're social, they go visit these people, they walk. So I wonder how much of it is the physical activity at later age that happens as a part of these friendships and how much is attributed to the friendships themselves helping add to your sense of purpose?

While I've gotta wake up to converse with so-and-so, I've got, I've got people to live for, you know, so to me, I don't know how to, how to separate those two things. And it's like, I really enjoy awesome. I've got people that I wanna interact with online. I learned from this person. I, you know, we, we, so I, I feel like though, to me, intuitively, those relationships.

Have to matter. Like the, you know, it's, I know people often say, well, it's not real life. It's, it's Twitter, but it is real life. 'cause real life is changing with the advent of technology. Um, so have you, have you thought about that at all? Like, you know, how you balance your, your in-person relationships versus those that you've maybe, um, you know, ma made online?

[00:39:42] Howard Luks: Yeah, so a lot of my online relationships have turned into very important, uh, real life relationships. Um, and that was always fascinating. You know, I've been on Twitter since 2008 or oh nine, I think. Um, uh, two of the businesses that, uh, one that I founded, um, I met two guys through Twitter. We met in San Diego and you know, we went from there.

Um, so. My online friendships, uh, have been very important. Uh, but it's my real life relationships that, uh, I derive most satisfaction from. Um, you know, rather it's just, you know, a quick drink, a coffee, a quick snack, you know, a run. Um, you know, I used to run alone and only ran alone. Um, now I'm sort of half and half, uh, and I, I really enjoy running with some people.

Um, uh, others not so much, but it's okay. Uh, but yeah, you know, whether it's the fact that you're walking with friends or, uh, that you're exercising your, you know, your cognitive strength, um, pulling facts from the depth of your memory. Or just its lower stress. Uh, I don't know. Um, I don't think anyone knows.

Um, but, and like this longevity talk, it's not just one thing. There's no single path that's gonna work. Um, but it's an extremely important, uh, aspect of healthy aging 'cause, 'cause longevity really is, um, an epidemic. Um, and we've lost a lot of meaningful relationships, uh, through the years. Or we just text instead of picking up a phone or driving to their house, you know, walk into their house to their neighbor.

Um, those are meaningful moments. Uh, and I think they have a far more significant impact on us than, than 

[00:42:05] Jerry Teixeira: we imagine. Yeah. It, the technology for all of its, you know, all for all the good that it does, um, has, it's a double-edged sword and there's a dark side to it. And I, I think, like you talked about, we, we make more connections than ever, but maybe less deep and less meaningful, um, than Right.

They once were, uh, reduced physical activity. I, I think at the end of the day, when you look at a lot of the advice throughout your book, it's can essentially be boiled down to replacing that which technology has removed from, from our daily lives, right? We, we used to have to walk a lot. We used to have to do a lot of moderate to low intensity physical activity just, just to survive.

Right? We no longer have to do that. Um, and so it, when you look at the, whether it's the Okinawa winds, the Greeks, even if you look at these hunter gatherer populations who seem to have very robust metabolic health, uh, their physical activity levels are, are super high, but they're not, yes. They're not high intensity.

They're not running 26, you know, they're walking 10 miles a day or, or, or rowing canoes and Right. So I think. I, I used to, when I was younger, up until the last, probably the last like five, six years, especially about 2015, I used to just lift. And then for the cardiovascular health, I thought, okay, well this metabolic Metcon style conditioning, I'll just do some real high intensity weightlifting, get my heart rate cranked up for 20 minutes and I'm good.

And then when I started really looking at humans as this, and we are, we're this creature that I, I think we're either tops or close to tops on the planet for endurance capacity. And so I started realizing like, you know, my training, my lifestyle, I don't walk anywhere. I'm been driving everywhere. You know, uh, I, I do lift, I do exercise plenty, but I realize like I'm not, I'm not doing this movement, this, this endurance-based movement that we've evolved for.

And I started realizing that all the exercise I'm doing, while yes, it's strengthening my musculoskeletal system, and yes, it's good for me, it's all. Glycolytic, the energy system I'm using is all, you know, the creatine, phosphate, glycolytic energy system. So I have this aerobic energy system that I'm virtually is untouched.

But as I started digging into this, I realized it's worse than that because it's not just that it's not developed, it's that I'm overdeveloping the other energy systems in relation to, to this one. So, um, and, and I, I definitely wanted to talk to you about this topic. It's one of the, one of the main reasons I wanted to talk to you, because I think most people, the average person, especially number one, get up, get active, get moving.

That's the most important thing. Whatever the heck it looks like, if you're at a CrossFit box, if you're whatever you're doing, great. Keep doing it. I, I, you know, but I think that most people don't view walking as exercise. They don't view, I never did until recently. You know, and, and for most people, and you know, we can talk about, they've maybe heard of heart rate zones they see on their Apple watch there, there's a reason to spend time in different heart rate zones.

And so I think once you're like, cool, I've gotta get up. I've gotta get active. Great. You're active now. Once you're no longer sedentary up, moving around, like what's the benefit of zone one, zone two and, because I think a lot of people, they start exercising, they fly right past those two zones and everything's 3, 4, 5, 3, 4, 5.

And so it's, it's not a complicated concept. And we, you know, the biology, if you really wanna dig into it, which you don't have to, can be complicated, but the premise behind it I is, is pretty straightforward. It's pretty simple. Um, so if you could maybe just briefly talk about what those zones represent, energy system wise, and why it's important to train the different zones, especially, you know, one and two, and you mentioned mitochondrial health, um, being kind of, you know, foundational for healthy aging.

And so if you could kind of just tie that together. Um, I, I know it can be a complicated, but, but I know that the zone two, you see it all over Twitter. Zone two is zone two. So I think with the way you distilled your 

[00:46:14] Howard Luks: book, right, it got, it got overplayed, right? Um, and it just became a catch phrase. Uh, and it's very poorly understood.

You know, I get pulled into a lot conversations on Twitter about low heart rate training. Um, and it really is very, very poorly understood. So, yeah. So if, you know, the best trained endurance athletes in the world, um, are trained, uh, such that the vast majority of their training is low heart rate. And believe it or not, it's zone one because zone two, when you're that fit is a significant effort, right?

If you can put out 250, 300 watts in zone two, you're working really hard. And in these Sam Milan and others who teach, you know, the world, these world class cyclists and triathletes are very clear. They don't want their racers, um, doing much in the upper zone. Why? What are the benefits? Um, most of us are fat oxidation deficient.

You can call it aerobic deficiency syndrome as it's coined, um, by maffetone, uh, and, and, and, and, and others. But what's happening is we're fat oxidation deficient. So energy partitioning, where do we derive e energy from? You eat, you digest, it breaks down, it goes into your blood. Um, in the ideal world, our mitochondria.

Uh, our cells are processing fat for energy. It comes with lower oxidative stress. It comes with, uh, lower inflammatory burden, uh, less reactive oxygen species because we're not pushing hard. Um, as with h i t, less cardiac strain, less of a recovery burden, less of an injury burden. So those are some of the reasons why we don't wanna do too much exercise, too high a rate exercise back to the mi, the mitochondria or mitochondria prefer to burn fat.

It's more efficient. Um, they should burn fat up to a certain point. Your lactic acid threshold. Uh, the first, uh, the first threat, first threshold where we're slowly building our lactate because we are, we have a little glycolysis. Going on to burning glucose, but we're preferentially burning fat, uh, to make energy as we, our energy demands increase fat.

Oxidation can't keep pace, oxygen supply can't keep pace, and we switch over to glycolysis, um, which does not require o oxygen. And in the ideal world, we don't switch over fully to glycolysis until we're running, until we're cycling at a decent clip or swimming at a decent clip or hiking hard uphill. But what's happening now is the vast majority of people have very poor metabolic health.

And as you mentioned, they're flying through, um, this energy partitioning. Immediately upon being active. So these folks are in glycolysis walking, uh, in glycolysis, going upstairs. How do we know? Um, we can test 'em, uh, we can do ventilatory testing on them. Um, we can do lactate testing on it. Uh, and I've done this in the office.

Uh, I brought my lactate meter to work and I'll have people with resting lactate levels of two milli mole, 1.8 milli mole, not 1.8 to 2.1 Milli mole is where most people start their tran transition from zone two to zone three. As you pointed out, many runners, even when they start running, by the time you leave the trailhead, your heart rate is 160 and you've left zone one and two behind.

Uh, and you're in three, heading into four. Why Phil Maton and others, you know, would say you have aerobic deficiency syndrome. You're just blowing right through these zones because you do not have a well equipped aerobic or fat oxidation system or engine. Uh, what are the consequences of that? Well, you're gonna start to run out of energy 'cause you're just blowing through your glycogen.

Um, two, as I said, more reactive oxygen species, more of an inflammatory burden post-exercise. Um, higher recovery needs a higher cardiac strain depending on your health that may be important, um, and a higher risk of injury. So what's the importance of wanting to build up your zone one and two, or ability to oxidize fat?

First of all, your health. Right. If you're not capable of burning fat, you have that poor metabolic flexibility, inability to burn fat, your mitochondria not functioning well, that leaves you very high risk of developing, or you have insulin resistance and you probably have hypertension. You have a increased risk, uh, of dementia.

There's a reason why we, we, we call dementia type three diabetes because it is an energy par partitioning problem. So about 30 to 40% of cases of dementia could probably be avoided by improving our metabolic health. So let's say you are a runner and you wanna improve, or cyclist, you wanna improve your ability, uh, to, uh, run further, uh, run at a pace where you're less tired, um, where your energy needs are less, et cetera.

Um, By stressing, uh, zone one and two running, which may not be running initially. It may be walk runs and just walks. You will build resilience, you'll build capacity, you'll build endurance in your running, and you'll build your endurance as a runner and be able to run longer. Um, and that would be reflected if you te you tested as lower lactate at the same pace.

So before I started all of this many years ago, I would run at a certain pace on my average run, a hundred fifty eight, a hundred sixty. You know, I was up around my second lactate acid threshold, uh, and I was a little outta breath. And when I got back to the car, I felt tired if I ran long. Um, so I spent years doing low heart rate training.

Um, and at first I was 12 minute miles, 11 and a half minute miles. It was awful. Um, But I got that down and it keeps going down, and some of 'em are more gifted. Uh, luckily some have gotten it a lot lower than I have, but I can come off a trail now running nine and a half minute miles. I could run 12 miles.

So there's no end, uh, zone creep where, um, I'm creeping up in from zone two to three. There's no heart rate creep or drift, uh, where my heart rate is slowly in, in increasing. That's, that's where I'm at. I get, and I get into my car, uh, and I feel great, and I get home and I get outta my car and I feel great.

So, you know, the, the burden on my recovery is markedly diminished. Um, and the health benefits are indisputable. And again, if you wanna build your running performance, fantastic. You know, do some sprints at the end of a long run. Do some hill repeats. Do you know, a threshold run once a week? Um, but do it intelligently and don't dismiss the, the importance of building your ability to oxidize 

[00:55:05] Jerry Teixeira: facts.

Yeah, I, I think the important thing there, you touched on, even in some runners, it's going to be a brisk walk is gonna be one zone, one zone two. So that means that if, if someone's listening to this, and they're most people, for most people you say, okay, well there's health benefits to, there's mitochondrial health benefits.

Um, to me, doing this type of training, how do I know if I'm, you know, zone two for most people, if you just go on a brisk walk, you know, not, not a light stroll, but a brisk walk, you're, you're there. I mean, that's pretty much it. You do that for 30 minutes. Um, and, and that's giving you time. That's gonna help, at least for a while, um, that's gonna help condition that energy system.

And so I think for most people it doesn't have to be, you know, it's almost like there's this voodoo to, to zone two and it's like, no, just go on a brisk walk for most people. Even if it, even if you're a fairly fit person, that, so maybe you're at the low, at the lower end of zone two, maybe you're even zone one.

And, and, and maybe just a little bit of zone two from what I'm seeing, zone one, zone two, the crossover. It's, it's all good. Anytime you spend in that type of light, physical activity is hugely beneficial. So, 'cause 'cause I, I was fairly confused, I mean, without lactate testing and, and you know, most people are not gonna buy meters and, and break their skin and test their blood and all that.

Um, and when I first started, okay, I got, I'm gonna try to do some more, you know, zone two to build this aerobic base coming from a history of, of neglecting it. I, I would set out on a jog and I mean, I was. I used to run and I'd go on a jog and I'd see people jogging super slow and I was like, is loser over here?

Like, like boring. What are you doing? I'm like, how can you do that? It's so boring, you know? Um, and so, but once I understood, I was like, I smarter than me. You know? So I, but I, I would, to your point, you made, I, I would have to run so slow, right? And I still do. I mean, like you mentioned, 12 and a half, 13 minute miles, it's like a trott.

Uh, but right. I, I've done it where I've gone for 45 minutes or an hour, and you're right, you're not tired afterwards, you stop running and you're like, oh, let me make dinner. Let me, yeah, you're fine. You feel good. Like you, you, I mean, you exercised, you did, and you feel good, but you, you're not fatigued. Um, so, so it's the, the difference in reduced recovery times for that type of training are, are, are readily apparent.

Um, but I think the barrier to it, it, it needs to be demystified. For most people, if you just leave the house, take your dogs, go on a brisk walk, uh, very light jog, if that, uh, and if you have some kind of monitor where you can check your heart rate, you know, for, for the individual it will vary. But, you know, heart rate of one 10, even your zone one ish, you know, one 20, zone two, depending on your conditioning level, you don't, it doesn't need to get very high.

And so the activity doesn't need to be, doesn't need to be very intense. And like you mentioned for a lot of people, and this was my case, running was too much. I had to run, walk, run, walk, run, walk. I ended up just buying a bike for the house. Um, and part of that was just because I have kids, I can't always just go leave the house when I want to go on a run.

Right. Um, I, I have to work my exercise around my family. So wake up, hop on the bike, watch Netflix, um, which I know is, is supposedly terrible. Nobody should be watching tv. We should all just be working. Um, But I, I will, I, I'm like, oh, a new, new Lord of the Ring series or whatever, and, you know, 45 minutes, right?

Goes by pretty quick. My kids are asleep, right? Very fast. Right? And so, so for me, the bike has helped, but that's kind of where I'm at. If, if I go on a run now, I still get some heart rate creep after about 25 minutes. Um, so I'm working to try to eliminate that. Uh, and, and for, for people who don't know, that just means you take off and you're at for, let's say it's a 1 29 ish heart rate, and you go, okay, I'm good.

And so you're running at like 12 minute miles or whatever, and then you, you go three miles in, all of a sudden you see your heart rate go up 10 beats per minute o over a, a two to three minute period. And so that's the point where now even at the same effort, you're, you're, you're out of that zone, right?

And your heart rate's creeped up. So what I've been doing is as soon as I see my heart rate start to creep up, I just pack it in. And that, that's the end of that session. Um, so or you'll Yeah, exactly. Exactly. If, if I have time, I. I don't have No, I get it. It's been, it's happening at around 30 minutes, so I'm pretty much like, okay, if I'm on a run, that's, that's about the end of it.

I, I head back home, um, on the bike, it's easy 'cause I could just notch it down a little bit and, you know, right. Keep, keep my heart rate where I want it. Um, but yeah, I think that was a, 

[00:59:43] Howard Luks: it's much easier to make the transition to low high rate exercise on a bike than it is. Yeah, yeah. It could, it'll be much, much less 

[00:59:52] Jerry Teixeira: frustrating.

Yeah. It, it, it really is. That's why I ultimately went with a bike. 'cause I was like, geez man, I, I, I, I literally have to like trott, it's like a shuffle and it, it, like the shuffle is so unnatural. You late, your shin, shin shins, your legs, you know, it's, it's not a good movement pattern. And so I was like, okay, this, but, you know, I, I 

[01:00:12] Howard Luks: did that.

You know, as I said, when I, I'm running at the same pace now. Well, pre Covid, um, uh, pre six weeks ago, COVID, I'm running at the same pace now that. My heart rate was 1 55, 1 58. It's now 1 22 to 1 

[01:00:31] Jerry Teixeira: 26. Right at at the same speed. At the same speed, so that at the same pace. So that's how you can tell, because then, then, you know, people are gonna say, okay, cool.

I, I can do this. Right? Like most parents, my kids, we bought bikes. I'm gonna go ride some bikes. I mean, you can make it a, you can make your zone one zone two leisure type activity. It doesn't have to be absolutely. You out on the trail, you know, or, or, or whatever away from your family. You, you can, you can bring them along.

I actually take my youngest to the park and there's a park near the house where it's just teaming with kids. There's always tons of kids. And so, you know, if we go to an a, not busy park, my kid wants me to play with him when we go to this particular park, I'm invisible. He just wants to play with the other kids.

And, and the, it's set up where there's a, a circular sidewalk around this. It's not huge, but I mean, it's enough. I can just s huff, I can do a super slow run. So I'll take the kid to play and I'll just run around in a circle and watch him, you know, run around the equipment basically. Yeah. I'll run for 40 minutes and then I'll just take him and, and then we'll go grab, you know, something to eat, go home.

Uh, but, but I'm turning fun time at the park into some time that I can, I can get a little, you know, that low intensity physical activity. Absolutely. So, I, I just wanna make sure people understand that it, you don't have to be a runner, quote unquote. You don't have to be a cyclist as a regular person, especially if you have poor mitochondrial health.

You can totally do this type of activity, you know, work it into your, into your daily life. Be that, like I do a bike watching tv. Uh, my kid will be watching the other day. We watched Avengers and I'm on the bike and he's next to me. You know, he doesn't care that I'm on the bike. Like, it doesn't matter, you know, I mean, he's old enough.

He's not on my lap or watching TV anyways, so, so Right. It's totally fine. Um, so one, one of the things that I, I wanted to make sure I talked to you about, and I, I liked your book because it, it's definitely the book that you can, you can buy and you can gift to people who you want to improve their health.

Who are not interested in the health and longevity space. There, there's no buzz words. It's, it's written, it's written super, super plainly. So like, if I bought it from my dad, if I bought it for, they would understand it, right? They don't need to ask what things mean. The terms that you use are clearly explained and defined.

Um, but one, one of the things is there's, there's not a section on like, you know, longevity exogenous molecules and supplements and that kind of stuff. Uh, so I, I wanted to get your reasoning, and I'm, I'm pretty sure I know what it is, but, but get your reasoning why you decided not to go into that, into that, um, you know, that, that space or, or, or even touch on that aspect of longevity.

Uh, like I said, I think I know why, but

[01:03:17] Howard Luks: yeah, so because I wanted to focus on simple. Actionable steps that work and that you can start, uh, employing today. Um, you know, longevity science with regards to molecules, it's pretty unsettled, right? You know, for every per person who says, you know, you should eat low protein, you'll find two that says you shouldn't, you should eat high protein.

Then you'll, you know, find people who said, you know, you should eat, eat revera. Um, well, it turns out that that data was inaccurate and it's not gonna help you. Um, you know, certain online folks started taking metformin, uh, they stopped taking it, but somehow that didn't get to the audience. So there's a, I run into a lot of people who are still taking metformin.

Because so and so take it is taking it. Yet that study, you know, that's currently being funded and done, uh, isn't out yet. Um, you know, a lot of people are talking about rapamycin, um, and some people are, have bought in. They're all in on this. Uh, again, the research isn't out there yet. We don't know the dose, we don't know the frequency, we don't know the long-term downside effects of, uh, of it.

So we're not gonna find longevity as of right now in a pill bottle, uh, or on a shelf. Um, it's just not plainly available. Uh, and we don't know a lot of the consequences of, of some of the very powerful agents that some people are, are taking. Um, So I, I didn't wanna touch on that subject because there's just too little that's known.

Um, and too many people will too often reach for the pill instead of go out on a walk. So I wanted to keep the message, uh, 

[01:05:37] Jerry Teixeira: pretty simple. Well, the, the thing that, um, with, so you mentioned like metformin. The thing that was interesting to me about that when, that, there's a study that came out that showed that metformin use, uh, could impair adaptations to exercise.

So maybe it's making your exercise less beneficial. Uh, so the thing that I found interesting and, and I'll, you know, there's a well-known longevity expert, um, published, well credentialed and all that. And this individual, even though they, they, you would think like they know what to do, they have a hard time.

Uh, applying, you know, they don't exercise enough, they don't sleep well enough. They're like, when you listen to them tell you what they do, you're like, make, you're not even doing the, like, e even people that know better, it's like they, they go outta their way to try not to exercise, to like, you know. Right.

So, so I, I, they're 

[01:06:31] Howard Luks: not doing steps 1, 2, 3, and four, so, you know, they're not ready for the rapamycin. Right. Um, and, and, and, 

[01:06:40] Jerry Teixeira: oh, go ahead. No, go ahead. The thing that I, the thing that kind of stood out to me is almost all of these molecules that are supposed to, you know, enhance human longevity, they share common pathways, mechanistically with exercise, with CalWork restriction with these other things.

So it also stands to reason that, that the better your metabolic health and the more you employ the, the proven thing, so the better you sleep, you exercise, you eat. The healthier you are, the less advantageous it seems that these types of things are going to be. So the people that are the most interested in optimizing for longevity are probably the very people that will get the smallest potential benefit from any of those things.

Assuming those things, you know, assuming there's one that says, oh, this really works. You know, Metformin, for example, I looked into it and I was like, right, well, I like, why would I take this? I already, my body already does all this efficiently, you know? Right. Um, so, so yeah, 

[01:07:40] Howard Luks: no, you're right. There are, you know, there are three huge levers.

You know, again, I think that the biggest one is exercise. The second, uh, is nutrition. And when I say exercise, I mean movement and strength, uh, training or muscle mass maintenance. Uh, the second is nutrition and food, uh, uh, and the third is sleep. And unless you're pulling. All those triggers, those three triggers as hard as you can, and working them, you know, the additional benefit of rapamycin, uh, or metformin is gonna be very low.

Uh, and if you're not doing the first three, it might be even lower. We just don't know. Yeah. 

[01:08:30] Jerry Teixeira: So one other, one other question that I wanted to, wanted to pose to you, um, because I think it's, it's beneficial in light of, you just got over recently having a Covid case. Uh, I, I also had it a few years ago, and then I just had my, my daughter, I had to pick her up early from school.

She was sick. I got sick, my son got sick. Everybody was throwing up. It was like a, a five, six day thing. Uh, I mean, it, it, it was pretty bad. It felt like crap. Um, I. But one of the things that I've changed my stance on, you know, when I was younger, if I got sick, I was trying to get back to exercise as quick as I could, and now having a little, little larger knowledge base, um, but also having better, having better equipment to, to kind of monitor my health with.

Uh, and you don't have to have anything fancy, but, but I do have an Apple watch. I sleep with it, and it gives you your, your sleeping heart rate. And so what I observed is I was sick, I started to feel better, but my, my sleeping and resting heart rates are like five to seven beats per minute, higher a, a week, you know, out of being sick, out of already feeling better.

And so seeing that, I, I go, okay, well, I'm gonna start out with lighter exercise. I'm zone one, zone two E Even my, my resistance training, I'm taking longer rest periods and I'm, I'm. Giving myself basically a lower intensity session, uh, with my strength training this week. And so today's the first day my, my heart rate's starting to dip back down.

You having had covid and, and being an athlete, having been sick in the past, like what, what is your advice to people? Like how do you approach number one training when dealing with sickness, but then once you're on the other side of the sickness and you think, uh, I feel good, how do you, um, titrate your, your, how do you suggest people titrate their training back in?

[01:10:24] Howard Luks: Yeah. Um, so it's, uh, excuse me. It's all good.

Sorry. So that's a great question. Um, and it's not easy to answer. After having Covid recently, I'd looked for hard and fast answers and they don't exist. Um, one key principle is go back slowly, especially with flu and covid, uh, because these, like whatever one attributes to a post covid syndrome, it's also a Postviral syndrome, uh, including the flu, uh, which can knock you back on your ass for a few months, uh, easily in some cases.

I know people like me in my own, in my own run of circle who had covid, and within a week to 10 days they were running, tolerating it well, we watched their heart rates. Everything was fine. Um, I think it was a little early to get back into it, but you know, every parameter, uh, that they were willing to monitor looked okay.

So for me, um, I was like, you. My aggressing heart rate was 20 beats above normal for the first two weeks. Uh, my respirate, my, my respiration rate was high. My H R V was in, was in a cesspool. Um, so it was very clear that my body was telling me, don't do this. Um, I decided to look deeper, so I got some blood tests and my inflammatory markers, c r p, fibrinogen, et cetera, were off the charts.

My liver enzymes were up. Um, I never checked my cardiac enzymes. Um, so it was clear that I had to let this resolve, um, before I started to head back out. Um, as my resting heart rate started to recover, my H R V started to tick back up. Uh, to normal. Um, I started walking because walking works. Um, and I was having a more exaggerated heart rate response to walking than I should have.

I shouldn't have had much of a response at all. Um, and I wouldn't have six, six weeks ago, but I was, so I decided to wait until that started to improve. So when I saw less of a cardiac burden with, with walking better recovery, heart rates, um, again, lower H R V in the morning, lower resting heart in the morning, uh, I started to walk further.

I started to walk hills. I started to take the dogs for a walk for a solid hour and a half or so. Um, and that came with a recovery burden at first. Uh, so, you know, I recognized, you know, what my H R V was and resting heart rate the day after a longer bout of walking. And as that started to improve, you know, the other day I started running.

Um, you know, I'm running slower than usual. I had, you know, the heart rate is a little higher, but I'm going to continue to do the same thing. Uh, I recovered from a stress fracture a number of years ago, and it's not too dissimilar. You know, I was out for eight weeks and it just took me a long time to get back.

But, uh, you know, I, I wanna avoid re-injuring myself. Uh, I want to, you know, co covid just does some nasty things to all of our tissues. Um, and, uh, the effects on the cardiac system, uh, our conduction system and our mitochondria, uh, are just profound. Um, so I'm just gonna let it. Run its course and do its thing, and I'm adding on my, my activity wisely.

Um, but again, I would watch your resting heart rate, watch your respiratory rate. Uh, if you do wear a watch, um, uh, or have an aura, uh, check your H R V, uh, see what your response is to the exercise. See what you're, what you're in the morning and guide. Use that as a guide to getting back out there. But it's gonna take you longer than you think, uh, in most instances, uh, to, to return, especially if you've been out for a few weeks.

Yeah, you, 

[01:15:16] Jerry Teixeira: I found the same thing. Um, now a heart rate variability, H R v, um, I, I is a way to measure the health or the functioning, um, of your autonomous nervous system. So, Um, can you maybe touch on, because I know you, I think you're the only person that I've seen make this connection, uh, between the musculoskeletal system and the autonomous nervous system and how when H R V is going down, uh, indicating, you know, high, high stress load on the autonomous nervous system, you see injury rates going up.

Uh, H R V can be measured. Apple watches, I think Samsung watches Garmin there, there's a lot of them that can do it now. And I understand there's chest straps and ora rings, so we don't have to get into what the best piece of equipment is or any of that. But for, for people that do have a piece of equipment or a considering it, um, what, like, what's the utility of them paying attention to their H R V and, you know, at, at a real high level, using H R V to help guide their decisions when it comes to, you know, when to train, how hard to train?

[01:16:24] Howard Luks: Sure. Uh, so a H I V, uh, It comes about because our heart does not beat regularly. If your heart, if your pulse is 60, you don't have a heartbeat every one second, you'll have it 0.99 seconds, 1.1 seconds, 0.96, sector, et cetera. And the differences or variability between those beats will determine your heart rate variability more complex.

But suffice it to say,

your sympathetic and parasympathetic nervous systems both comprise the autonomic nervous system and your sympathetic nervous system, or the flight and fright response, um, drives your H R V down and makes your heart rate more regular. The parasympathetic nervous system is your chill, nervous system. It's getting you to be able to relax, to concentrate, et cetera.

That will increase your H R V for the most part. So once you have a baseline established and you know what your H R V is, you can then observe trends that are going to occur, like illness or over training. Uh, too little training, too much training. These are all going to impact upon your, your H R V. You could imagine if you're training more, maybe a little too much, your sympathetic nervous system, the flight and fright response, um, is gonna be overactive.

So your H R V is going to drop. Um, and if you're well rested and you've recovered, um, exercise will will boost your your H R V. So if you were inactive, you had an H r V of 25, and now you're starting to become active, you're walking more, you're moving more, you may notice that it's, you know, 35, 36. Um, you may notice after exercise, it goes down to 24 the next day.

Okay? It's telling you, you know, not necessary to stop, but chill out, not a hard day. Uh, so h i v is useful for me on a long-term signal and a short-term signal. It, it, it anticipated that I was going to get sick the day before I got sick, uh, and sometimes more than a day. And when I felt better, clearly the data was showing me that I wasn't, um, as a runner, My H r V has foretold almost all of my injuries because I tend to ramp up, you know, towards the end of the winter.

Um, I have a bunch of races that I like to run in the spring. Um, but in general I put the load on a bit too fast. So, and if, if I look back almost, you know, the second week of May every year, I, I have to drop off in terms of my running. Uh, and my H R V warn me that because you'll start to see it level off or drop, and you'll have some lower days in a row.

Um, and it's just telling you you're training too much. Um, so you have to, if you monitor your loads and you monitor your H R V, um, you'll see the correlations there and you'll find it a very useful signal. Um, I personally, I love the H R V for training app, right by Marco Tini. Um, it's a single app. You don't need to buy whoop subscription or $400 Aura ring, uh, $12 app.

Um, it measures your H I v using your, uh, phone camera. Uh, it's been validated, uh, many times. It's very accurate and the data behind it is very useful 

[01:20:46] Jerry Teixeira: without a doubt. Now, when it comes to H R V and how to, um, apply the data you gather there toward, you know, toward tailoring your exercise load when it comes to, uh, musculoskeletal injury and, and considerations for how to seek care for those things, uh, when it comes to how to know how much zone two versus, you know, if you're doing too much.

Zone three to five, all, all this stuff we've talked about, you actually have a pretty, uh, a pretty robust, uh, you know, offering of articles on your website. So I wanna make sure that I, I plug that, um, because I've actually sent to, to my own clients, I, I've had more than one client where they are, uh, from an old injury that maybe wasn't resolving and they're, they're considering going under the knife and I'm like, oh, make sure you read this and this, you know, not, not telling them, don't listen to your doctor.

Just telling them, Hey, here, here's an, you know, here's an ortho that can give you some, you know, kind of an alternative opinion. Um, or, or something for you to discuss, you know, with your doctor. So, right. I definitely wanted to make sure before we conclude that if people want additional information about any of this stuff that we've kind of gone over here.

Number one, your book is great. Uh, and, and I can't stress enough with a book. It's the perfect book to gift to people that you want to get healthier and you want it to be accessible. You know, to them it's not David Sinclair's book. It's not this technical, you know, if, if you're wanting to geek out on the science, it's not, that's not this book.

You know, this book is gonna be the book to try to help bring other people into the fold and improve their health, uh, in, in a, in a easy, easy to grasp way. Um, but again, your website's a wealth of information. I encourage people to go there. And then you're, you're very active on Twitter. I encourage people to go check you out on Twitter.

Uh, which is just your, your name, right? 

[01:22:38] Howard Luks: Hj. 

[01:22:39] Jerry Teixeira: L h J L E K S. Okay. So you can check him out on Twitter. Like I said, he's active there. Check out his website, uh, email list, all that good stuff. Um, it, it was a pleasure interviewing you, Howard. I had a good time. Hopefully people found this beneficial and, uh, one of these days I plan to make it out and, and you can take me on a run.

Fantastic. Jerry, thank you 

[01:22:58] Howard Luks: for being here. Thank you my friend. Have a great evening.