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Shadowing practice: Best Exercises for Overall Health and Longevity - Dr Peter Attia and Dr Andrew Huberman

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  1. I've heard you talk before about some of the prime movers for longevity and all risk mortality.0:03
  2. And I'd love for you to review a little bit of that for us.0:11
  3. I think we all know that we shouldn't smoke because it's very likely that we'll die earlier if we smoke nicotine.0:15
  4. I'm neither a marijuana nor a nicotine smoker, so I feel on stable ground there.0:21
  5. But anytime we see smoking nowadays, people really want to distinguish between cannabis and nicotine.0:26
  6. So I am curious about any differences there in terms of impact on longevity.0:31
  7. But in that context, what are the things that anyone and everyone can do, should do to live longer basically?0:37
  8. How long you got?0:46
  9. Well, you tell me.0:48
  10. You tell me.0:51
  11. I'd like my final decade to be between 90 and 100.0:52
  12. No, I meant how long do you...0:56
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  1. I'm just kidding.0:58
  2. And will we spend from now until you're 90 talking about this?0:58
  3. Well, there's a risk of that.1:01
  4. So let's start with a couple of the things that you've already highlighted.1:02
  5. So smoking, how much does smoking increase your risk of all -cause mortality?1:05
  6. And the reason we like to talk about what's called ACM or all -cause mortality is it's really agnostic to how you die.1:09
  7. And that doesn't always make sense.1:16
  8. I mean, if you're talking about a very specific intervention like an anti -cancer therapeutic, you really care about cancer -specific mortality or heart -specific mortality.1:18
  9. But when we talk about these sort of broad things, we like to talk about ACM.1:27
  10. So using smoking, smoking is approximately a 40 % increase in the risk of ACM.1:30
  11. What does that translate to?1:36
  12. That means I'm shortening my life by 40 %?1:39
  13. No, it means at any point in time there's a 40 % greater risk that you're going to die relative to a non -smoker and an eversmoker.1:43
  14. So it's important to distinguish.1:50
  15. It doesn't mean your lifespan is going to be 40 % less.1:51
  16. It means at any point in time standing there, your risk of death is 40 % higher.1:53
  17. And by the way, that'll catch up with you, right?1:58
  18. At some point that catches up.2:00
  19. High blood pressure, it's about a 20 to 25 % increase in all -cause mortality.2:02
  20. You take something really extreme like end -stage kidney disease.2:08
  21. So these are patients that are on dialysis, waiting for an organ.2:12
  22. And again, there's a confounder there because there's what's the underlying condition that leads you to that.2:15
  23. It's profound hypertension, significant type 2 diabetes that's been uncontrolled.2:20
  24. That's enormous.2:25
  25. That's about 175 % increase in ACM.2:26
  26. So the hazard ratio is like 2 .75.2:30
  27. Type 2 diabetes is probably about a 1 .25 as well.2:34
  28. So 25 % increase.2:38
  29. So now the question is like, how do you improve?2:40
  30. So what are the things that improve those?2:41
  31. So now here we do this by comparing low to high achievers and other metrics.2:43
  32. So if you look at low muscle mass versus high muscle mass, what is the improvement?2:48
  33. And it's pretty significant.2:55
  34. It's about 3x.2:56
  35. So if you compare low muscle mass people to high muscle mass people as they age, the low muscle mass people have about a 3x hazard ratio, where 200 %2:58
  36. increase in all -cause mortality.3:06
  37. Now, if you look at the data more carefully, you realize that it's probably less the muscle mass fully doing that.3:08
  38. And it's more the high association with strength.3:17
  39. And when you start to tease out strength, you can realize that strength could be probably 3 .5x as a hazard ratio, meaning about 250 % greater risk if you3:19
  40. have low strength to high strength.3:32
  41. And high strength is the ability to move loads at 80 to 90%.3:34
  42. It's all defined by given studies.3:38
  43. So the most common things that are used are actually, they're used for the purposes of experiments that make it easy to do.3:40
  44. I don't even think they're the best metrics.3:48
  45. So they're usually using grip strength, leg extensions, and wall sits, squats, things like that.3:49
  46. So how long can you sit in a squatted position at 90 degrees without support?3:58
  47. It would be a great demonstration of quad strength, a leg extension.4:02
  48. You know, how much weight can you hold for how long relative to body weight, things like that?4:06
  49. You know, we have a whole strength program that we do with our patients.4:10
  50. We have something called the SMA.4:13
  51. So it's the Strength Metrics Assessment.4:15
  52. And we put them through 11 tests that are really difficult.4:16
  53. You know, like a dead hang is one of them.4:21
  54. Like how long can you dead hang your body weight, stuff like that?4:22
  55. So we're trying to be more granular in that insight, but tie it back to these principles.4:25
  56. If you look at cardio respiratory fitness, it's even more profound.4:30
  57. So if you look at people who are in the bottom 25 % for their age and sex in terms of VO2 max, and you compare them to the people4:34
  58. that are just at the 50th to 75th percentile, you're talking about a 2X difference roughly in the risk of ACM.4:43
  59. If you compare the bottom 25 % to the top 2 .5%.4:53
  60. So you're talking about, you know, bottom quarter to the elite for a given age.4:57
  61. You're talking about 5X, 400 % difference in all cause mortality.5:02
  62. That's probably the single strongest association I've seen for any modifiable behavior.5:09
  63. Incredible.5:13
  64. So when you say elite, these are people that are running marathons at a pretty rapid clip.5:14
  65. Not necessarily.5:19
  66. It's just like what the VO2 max is for that.5:19
  67. Like my VO2 max would be in the elite for my age group.5:21
  68. My VO2 max, you know, but again, I'm training very deliberately to make sure that it's in that.5:25
  69. So I wouldn't consider myself elite at anything anymore, but I still maintain a VO2 max that is elite for my age.5:29
  70. I consider you an elite physician and guy all around.5:35
  71. But true.5:41
  72. But in terms of.5:44
  73. OK, so the point is like you don't have to be a world class athlete to be a leader.5:45
  74. Yeah, got it.5:49
  75. So maybe we could talk a little bit about the specifics around the training to get into that, you know, top two tiers there, because it seems that those are5:51
  76. enormous positive effects of cardiovascular exercise far greater than the sorts of numbers that I see around, let's just say supplement A or supplement B.5:58
  77. And that's, you know, like this is my whole pet peeve in life, right?6:08
  78. It's like I just can't get enough of the machinating and arguing about this supplement versus that supplement.6:11
  79. And I feel like you shouldn't be having those arguments until you have your exercise house in order.6:19
  80. You know, you shouldn't be arguing about your this nuance of your carnivore diet versus this nuance of your paleo diet versus this nuance of your vegan diet.6:26
  81. Like until you can deadlift your body weight for 10 reps, like then then you can come and talk about those things or something like that.6:35
  82. Let's just go up with some metrics like until your VO2 max is at least to the 75th percentile and you're able to dead hang for at least a minute6:41
  83. and you're able to wall sit for at least two.6:49
  84. Like we could rattle off a bunch of relatively low hanging fruit.6:51
  85. I wish there was a rule that said like you couldn't talk about anything else health related.6:56
  86. Like we just we can make that rule.6:59
  87. No one will listen to it.7:01
  88. I don't know about that.7:02
  89. We can make whatever rules we want.7:03
  90. We can call it a Tia's rule.7:04
  91. And one thing I've done before in this podcast on social media is just borrowing from the tradition in science, which is it's inappropriate to name something after yourself unless7:06
  92. you were a scientist before 1950.7:13
  93. But it's totally appropriate to name things after other people's.7:16
  94. I'm going to call it a Tia's rule until you can do the following things.7:18
  95. Don't talk about.7:22
  96. Please refrain from talking about supplements and nutrition.7:23
  97. There it is.7:26
  98. Hereafter, thought of referred to and referenced as a Tia's rule.7:26
  99. I coined the phrase not him.7:31
  100. So there's no ego involved, but it is now a Tia's rule.7:32
  101. Watch out.7:35
  102. Hashtag a Tia's rule.7:36
  103. Oh, God.7:37
  104. Wikipedia entry, a Tia's rule in all seriousness.7:39
  105. And I am serious about that.7:42
  106. Dead hang for about a minute.7:43
  107. Seems like a really good goal for a lot of people, at least.7:45
  108. That's our goal.7:48
  109. I think we have a minute and a half is the goal for a 40 year old woman.7:49
  110. Two minutes is the goal for a 40 year old man.7:52
  111. So we adjust them up and down based on age and gender.7:54
  112. Great.7:59
  113. And then the wall sit.7:59
  114. What are some numbers?8:00
  115. We don't use a wall sit.8:01
  116. We do as just a straight squat, air squat at 90 degrees.8:02
  117. And I believe two minutes is the standard for both men and women at 40.8:06
  118. Great.8:10
  119. And then because for some people thinking in terms of EO2 max is a little more complicated, they might not have access to the equipment or to measure it, etc.8:11
  120. What can we talk about, think about in terms of cardiovascular?8:19
  121. So run a mile at seven minutes or less, eight minutes or less?8:22
  122. That's a good question.8:25
  123. So there are a really good EO2 max estimators online and you can plug in your activity du jour.8:26
  124. So be it a bike, run or rowing machine.8:34
  125. And it can give you a sense of that.8:37
  126. And I used to know all of those.8:39
  127. But now that I just actually do the testing, I don't recall them.8:42
  128. But it's exactly that line of thinking.8:45
  129. Can you run a mile in this time if your EO2 max is approximately this?8:47
  130. Great.8:51
  131. And I think somewhere in my podcast realm, I've got all those charts posted of this is by age, by sex, this is what the EO2 max is in each8:52
  132. of those buckets.9:05
  133. Trivate.9:06
  134. We'll provide links to those.9:07
  135. We'll have our people find those links.9:08
  136. And then you mentioned deadlifting body weight 10 times.9:10
  137. I just made that one up.9:13
  138. That's not one that we include.9:14
  139. But something like that.9:15
  140. We use farmer carries.9:18
  141. So we'll say for a male, you should be able to farmer carry your body weight for, I think we have two minutes.9:20
  142. So that's half your body weight in each hand.9:26
  143. You should be able to walk with that for two minutes.9:29
  144. For women, I think we're doing 75 % of body weight or something like that.9:32
  145. Yeah.9:35
  146. Great.9:36
  147. I love it as indirect measures of how healthy we are and how long we're going to live.9:36
  148. It's basically grip strength, it's mobility.9:42
  149. Again, walking with that much weight for some people initially is really hard.9:44
  150. We use different things like vertical jump, ground contact time, if you're jumping off a box, things like that.9:49
  151. So it's really trying to capture, and it's an evolution.9:54
  152. I think the test is going to get only more and more involved as we get involved.9:57
  153. Because it took us about a year.10:02
  154. Beth Lewis did the majority of the work to develop this.10:04
  155. Beth runs our strength and stability program in the practice.10:07
  156. And basically I just tasked her with, hey, go out to the literature and come up with all of the best movements that we think are proxies for what you10:10
  157. need to be the most kick -ass, what we call sentinary into Catholic, which is the person living in their marginal decade at the best.10:17

American accent training with a Huberman Lab conversation on longevity

This clip is a conversation between two hosts on the Huberman Lab podcast, working through blunt questions about smoking, blood pressure and risk. It runs at 208 words per minute, faster than 67% of the catalogue, so you have to keep pace rather than pause after every phrase. Rated B2, it is a real test of american accent training: two native speakers talking over each other, correcting themselves and reaching for precise numbers, not reading from a script.

The tone shifts fast. It opens on a personal aside, "I'd like my final decade to be between 90 and 100." then turns into a data heavy exchange about all cause mortality. That mix of banter and clinical detail is why this clip works for english speaking practice for daily use: you get natural interruptions like "No, I meant how long do you..." sitting right next to dense phrasing like all cause mortality.

Shadow this line: hedges, interruptions and a blunt percentage

Three moments here are worth pulling out and shadowing on their own before you try the whole exchange.

  • "How long you got?" is four words carrying a full question, said flat and fast, the kind of compressed native speech that trips up learners who expect full sentences.
  • "Well, you tell me." is the deflecting reply, repeated a second time in the transcript, so listen for how the stress moves on the second pass.
  • "So using smoking, smoking is approximately a 40 % increase in the risk of ACM." is a long, information dense sentence you have to say without losing the number in the middle.
  • "No, it means at any point in time there's a 40 % greater risk that you're going to die relative to a non -smoker and an eversmoker." is a correction, and the speaker leans harder on the number the second time it appears, since he is clarifying, not repeating.

A B2 order for shadowing english speaking practice b2 through the smoking exchange

Work through this clip in a fixed order rather than jumping around, since the exchange builds one idea on top of the last.

  • Start with "I'd like my final decade to be between 90 and 100." It is short, personal, and sets the emotional register before the data starts.
  • Move to "How long you got?" and its reply "Well, you tell me." to hear how a genuine question gets deflected in conversation.
  • Take "So using smoking, smoking is approximately a 40 % increase in the risk of ACM." and repeat it until the number lands in the same place every time.
  • Finish with "No, it means at any point in time there's a 40 % greater risk that you're going to die relative to a non -smoker and an eversmoker." since it reuses the same number under pressure, which is the real test of whether you can pronounce it under pace, not just read it once.
  • Loop those four lines together as one short block before moving on to the rest of the clip. This is where daily english conversation practice pays off, since the register keeps switching between personal and clinical without warning.
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