The personal blog of Peter Attia, M.D.

How you move defines how you live

How you move defines how you live
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My clinical interest is longevity, which is a function of lifespan and healthspan; In math parlance, longevity = (lifespan, healthspan). Lifespan is pretty easy to define. It’s the number of years you live. Healthspan is intuitively obvious, but a bit harder to define. For simplicity, let’s agree that healthspan is a measure of how well, not necessarily long, you live. Further, let’s agree that one without the other—long lifespan with poor healthspan or short lifespan with rich healthspan—isn’t what most people want. This has the makings of a complex, nonlinear, multivariate optimization problem.

The figure below is from my office whiteboard last week. I was explaining the relationship between lifespan (x-axis) and healthspan (y-axis) to one of my patients. My goal is to move the black line to the blue one.  Live longer (more x-axis) and live better (altered shape of decline curve).

I’m in the (very slow and time consuming) process of writing a book on this topic, which is really two books in one—the science of longevity and the “art” of it, the latter being a nuanced discussion about how one applies said science (most of it in animals) to the species of interest—people. If you don’t spend much time in the longevity literature, this distinction may not seem warranted. If you do spend time in said literature, it will be obvious why such a distinction is necessary.

Lifespan, at the first order, is driven by how long one can delay the onset of atherosclerotic disease (CHD, CVA), cancer, and neurodegenerative disease. Delay the onset of these, and you live longer. It’s a probabilistic truism. Obviously, I will explain this in great detail at the appropriate time, but I don’t want to focus on this topic today.

Healthspan, in its most distilled form, is about preserving three elements of life as long as possible:

  1. Brain—namely, how long can you preserve cognition (i.e., executive function, processing speed, short-term memory)
  2. Body—specifically, how long can you maintain muscle mass, functional movement and strength, flexibility, and freedom from pain
  3. “Spirit”—how robust is your social support network and your sense of purpose

In this post, I’d like to focus on one subset of healthspan: item #2—movement. But before I do, a brief digression will be helpful.

The hack—Darwin meets MacGyver

Evolutionary biology can, at times, provide a helpful framework for longevity. Our need for sleep and our resilience to short-term food deprivation are just two examples of traits that served our interests tens of thousands of years ago and continue to do so today.  Some of the interventions that can make you live longer and live better will find their foundation in understanding evolutionary biology. But many won’t. That is, many things I (and others) argue are necessary for longevity don’t really have an obvious foundation in evolutionary biology. Why?

Enter “the hack.”

A hack is something we do that gets around a problem, even if it’s not especially elegant. A patch might be an easier way for some to understand what I mean (cf. software patch). The hack can be elegant, the hack can be cumbersome, but its purpose is the same—something is getting in the way of a desired outcome and we need a workaround.

When I talk with my patients I try to differentiate interventions I propose as “evolutionary sound” or as “hacks.” Inasmuch as this framework is helpful, let me expand.

Our evolutionary ancestors were primarily concerned with survival. There was no survival more important than reproductive survival—ensuring you lived long enough to reproduce. Natural selection would prioritize short-term survival over long-term survival or quality of life. [As a very interesting, but too-nuanced-for-now aside, the evolution of APOE genes from the E4 to E3 to E2 variants may be great examples of this…yes, this will be discussed in the book, space permitted.]

Take stress response as an example. The stress response was an essential part of evolution. Without it, fending off an animal trying to attack you, or hunting for food in a state of starvation would not have been possible. Nothing about our evolutionary development selected for, or rewarded, equanimity. Our ancestors probably did not have the luxury of inner peace. It’s also not clear if it would have been necessary, or even helpful. But I argue that our current environment places sufficient non-evolutionary stress on us, and, as such, a hack that separates us from this stress is, indeed, helpful.  Furthermore, we now have the luxury of aspiring to things our ancestors could never dream of. They were preoccupied with reproducing and not dying; we aspire to play with our great grandchildren, we machinate on our legacies, we argue about if the Oscars are really inclusive enough.

Years ago, when I read Jared Diamond’s magnum opus, “Guns, Germs, and Steel,” I remember thinking to myself how horrible it must have been to have lived even as recently as just a few hundred years ago, let alone a few thousand years ago. It really had a profound impact on me, though it was not the central thesis of his book at all. I realized that on my “worst” day—lost my cell phone, got a speeding ticket or had a fender bender, missed my flight, got food poisoning from some bad sushi—it didn’t really matter. Technology and civilization took a bunch of really acute problems—lethal infections, starvation, trauma, war, for example—and traded them for more chronic ones—lower back pain, heart attacks, type 2 diabetes, and Alzheimer’s disease. I’m not minimizing the latter. These problems matter, but evolution didn’t confront them and therefore we can’t readily turn to evolutionary insights for solutions. Parenthetically, it might not have been as miserable as I imagine, namely because our ancestors didn’t know any better. It’s not like they would have “missed” Tweeting on their smartphones or racing around on their carbon fiber bikes, lamented the loss of their favorite sports team, or missed the pleasure of sipping neat Don Julio 1942.

Think about what Peter Parker’s uncle said to him shortly before he was killed, “Remember, with great power comes great responsibility.” I think of our modern lives as a great power, or a great privilege, to be more accurate, I suppose. I would never want to go back and live as my ancestors did tens of thousands of years ago (or even a hundred years ago, though it might make for a nice vacation) and so I should pause for a moment and acknowledge the complete privilege of living today in this incredibly narrow sliver of time.  I love the internet. I love that agriculture and crop domestication have allowed me to live in civil society with dense populations and no fear of starvation. I love that a simple antibiotic can save my life from a formerly lethal infection. I love being able to sit down in a car or airplane, and I love the freedom those machines have brought me.

So if these examples of things I love are some of my great privileges, what are my great responsibilities? This is where hacks come in. We need hacks to prevent these great privileges from killing us—slowly—which they will do if we’re not deliberate. What are my hacks? A bunch of things that make virtually zero evolutionary sense but, if bolted onto my modern life, can give me—if I can thread the needle correctly—the best of both words.

Meditation, intermittent fasting, heavy compound joint and hip-hinge training, intense interval training, body work, supplements, drugs, introspection, sleep hygiene. These are my hacks. Let’s focus on one hack, in particular—movement preparation.

The savant of movement

I met Jesse Schwartzman through a mutual friend. After our first workout together I was blown away, but it wasn’t the workout that impressed me, it was the preparation routine Jesse put me through, prior to making me puke, that impressed me. I’d never felt more ready to move. Jesse’s formal bio is at the bottom of this page, but I just call him the savant of movement. One day Jesse and I were having coffee and he commented at how annoyed he was by the endless stream of “heroic” tweets and IGs of super-humans doing one-armed acrobatics or whatever the stunt of the day is. He commented, astutely, I noted, that the world needs another super-human trying to convince the rest of us we should be like him/her like it needs another dictator.

What we actually need are examples of how real people can be empowered to preserve muscle mass, move functionally, maintain freedom from pain, and be the best athletes of their lives. An “athlete-of-life” can hip-hinge, squat, carry, shift, push, pull, rotate, and anti-rotate with confidence and fluidity. On a deeper level, one should also re-connect to their childhood movement patterns, before the toll of life and technology wreaked havoc. We need to re-learn how to roll, crawl, and hang, which are patterns that can release the “brakes” from our everyday movement that sabotage strength and lead to pain and injury.

Watch a 2-year-old squat and you’ll know what I mean. They look like perfect little power lifters. By the time they are in grade school, and they’ve been sitting for hours a day, the first thing I see is tight hips. [Picture below courtesy my friend Pat Jak, also obsessed with correct movement.]

To that end, we decided to make a video of the exact warm-up sequence Jesse put me through so I could share it with my patients. If they (and you) find this video helpful, we’d like to produce more of these covering more specific topics, such as how to protect/ build/ rehab knees/ shoulders/ lower back, etc.

Before diving into the videos, I know at least one person is reading this and thinking, “What the hell is Attia talking about? He’s the king of doing stupid stuff like flipping 450-pound tires, swimming 12 hours, doing Tabata deadlifts…” And you’d be right. I do/did a lot of stupid stuff. But I always differentiate the stupid (“super-human”) stuff I do from the longevity drivers. My pet peeve, and that of Jesse, is that good people are misled by the heroics of big-personality super-humans who lead them to believe they need to do these things to live better. In reality, it’s almost always the opposite. You don’t have to do super-human feats to have great healthspan and, by extension, longevity. But you do have to do some very deliberate things to overcome our civilized environment. So while I call Jesse the savant of movement, he prefers to call himself the anti-super-human teacher.

Below are four videos, a brief introduction, and one video for each of the three stages of the warm-up:

  1. Tissue preparation
  2. Muscle activation
  3. Dynamic preparation

In addition, we’ve put together a “tear sheet” for each of the three stages in case you want take them with you to the gym until you commit to memory.

I should point something out, since I know it will come up. With the recent publication of Tim’s book, Tools of Titans, I’ve been getting a lot of requests to make a video of my so-called “Jane Fonda” routine. In Part II of the videos, below, I do a glute med activation exercise, but it is not the full sequence I describe in Tools. That’s ok…the form that Jesse and I demonstrate, coupled with the description in the book, should be sufficient to get you through the full routine of seven movements. For the purpose of movement preparation, one only needs a bit of activation (hence the vertical plane, only). What I describe in Tools is a therapeutic routine I perform once or twice each week.

Lastly, and most importantly, I want to thank Elliot Stern and Kelly Choi for shooting, producing and editing these videos from start to finish. If you could only see the outtakes…

Introduction


Here is direct link: https://youtu.be/ZVUQb2G_Mvw

Here is link to tear sheet, summarizing all three parts

Part I: Soft tissue preparation


Here is direct link: https://youtu.be/zdRgJpxifqA

Part II: Muscle activation


Here is direct link: https://youtu.be/JElEpnVH35Q

Part III: Dynamic preparation


Here is direct link: https://youtu.be/BGrw5z1SjtA

 

Jesse Schwartzman, MS, RD, ACSM CPT, holds a Master’s Degree in Nutrition and Applied Exercise Physiology from Columbia University, and is a Registered Dietician. Jesse, along with his wife Patty, currently owns and operates Fit4ward in NYC and the greater Fairfield County, CT, where he manages and engages in deeply personalized work with his clientele in all aspects of health.

Early on in his career, the importance of adopting lifestyle behaviors to support exercise and nutrition goals became a fundamental focus of his work. Joint mobility and tissue health, proper fascia and nervous system regeneration, fueling techniques, sleep and recovery, identifying asymmetries, and proper neuromuscular motor patterns are incorporated with every individual.

Jesse now has over 10 years of experience in the health and wellness industry in one on one personal training, nutritional counseling, health coaching, group workshops, and the corporate setting. Jesse previously trained clients at the highest certification level at Equinox Fitness Clubs, and managed Equinox’s most elite trainers and exclusive clientele in the Tier 4 Program at the “E” club.

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About the Author:

Peter Attia, M.D., is a physician in private practice in NYC and CA. His practice focuses on longevity and healthspan. His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things.

Discussion

  1. jason volstad  January 22, 2017

    thank you very much for this.

    (reply)
  2. Tom Kirkendall  January 22, 2017

    Peter, I’m glad to see you are finding time to blog again. This is a fascinating topic. Art DeVany is also writing a book on aging, and he previews some of his thoughts in this recent lecture: https://youtu.be/G92kHgieiKk

    (reply)
    • Peter Attia  January 22, 2017

      Yes, I’ve seen this.

  3. Brian Caron  January 22, 2017

    Peter,

    I’m a 44 year old male that has a fake hip.(surgery was in 2006) Right now, my workout consists of lifting(not much cardio). I use machines and go somewhat light on legs. Are there movements I should avoid? I keep hearing squats are important…can I do them?

    (reply)
    • Peter Attia  January 22, 2017

      Brian, I can’t comment, obviously.

    • Jesse Schwartzman  January 23, 2017

      Brian, squats are an important movement. In a normal hip replacement surgery there are no contraindications to squatting after the operation has fully healed, and most would encourage the exercise. You may want to limit your range of motion, and not squat below thighs parallel to the ground. Also do not overload the move with weight resistancebur focus on balance and instability challenges like wobble boards or bosu balls instead.

    • Jay  April 16, 2017

      Hello Peter. I discovered you from Tim’s podcast and have been researching diets for a long time and think the concepts you cover are the right path. I have a couple of questions as I havent found these on the blog yet and I know it is hard to comment. I am a recovering addict with anxiety and ADHD (yes, I have been diagnosed and had treament)

      1) Do you have any research, info, or imput about how a ketogenic diet impacts mental health such as the ailments I deal with?

      2) Do you think intermittant fasting is useful and would it be good provided you receive a clean bill of health from your doctor and his support that a few day fast would be useful before switching to a more keto diet?

  4. Chris  January 22, 2017

    Peter,

    Often your comments here (and those of your readers) offer as much value to your posts as the posts themselves. This comment will not fall into the “value add” category, I’m afraid.

    I just want to say thank you for producing such high quality, high value information. I am a fellow member of the blogging world, specific to my business (nut nutrition or lifestyle. Actually closely related to the work you hated…fundraising and revenue generation), and I know first hand how intense and time consuming it can be (blogging…not fundraising, though that too). So as someone in the blogging space, I am always amazed by your posts and admire the effort and detail you put into every post.

    I have been implementing many of your ideas as I experienced much of what you experienced. Training for a marathon, I got fat. Really fat. Blood pressure was hypertensive, 44″ stomach…well on my way to metabolic syndrome (if not suffering from it outright) while running hours and hours and hours every week.

    Since going ketogenic, my weight has dropped, my strength is up (hitting PRs in deadlifts, squats, chin ups, cleans all the time). Blood pressure is down. No cravings, no hunger and my prescription reflux medicine is collecting dust after years of needing it daily.

    What is most amazing is this, my wife said to me last week:

    “Even if you weren’t losing weight at all, your mood is so positive and energy is so off the charts that I would never want you to change your diet.”

    My clients, staff and colleagues have asked me what Im doing based purely on my energy levels and positive moods.

    Focusing on physical health is important but those other measures, like the happiness of those we love and how we interact with the world is an essential marker in quality of living.

    Look at that…maybe I did tie my comment into your post after all.

    Your stuff is hugely valuable on so many levels, for the lay person and for the person who wants to really geek out on this stuff. When I visit my GP I often bring questions based on what you’ve written and feel like a participant in my health care vs a passive consumer.

    Thanks again Peter,

    Chris

    (reply)
    • Peter Attia  January 22, 2017

      Longevity = f(lifespan, healthspan). A lot people underestimate the 2nd variable…

    • Chris C  January 30, 2017

      Excellent post.

  5. Sheila  January 22, 2017

    Thanks for this Peter!

    I’m looking for the “tear sheet”?

    Sheila

    (reply)
    • Peter Attia  January 22, 2017

      It’s a hyperlink near the bottom. In the “intro” video section.

  6. Sheila  January 22, 2017

    I’m curious what you think of rebounding – on a high quality rebounder, with respect to lymphatic activation.

    I like to do 15 minutes or so of a “health bounce” before my kettlebell swings (I’m doing the Simple & Sinsister Pavlov program. I also jump back on during swing sets to keep my HR slightly elevated.

    I’m going to incorporate your exact 3 step program above and wonder if I should do my 15 min bounce before or after or at all? I will say I’m a big fan of this little tramp!

    Thanks!

    Sheila

    (reply)
    • Peter Attia  January 22, 2017

      I don’t have experience with it. Maybe others can chime in.

    • Jesse Schwartzman  January 23, 2017

      Hi Sheila. I would suggest bouncing after you do the full 3 part sequence to make sure you are mobile and have the right muscle firing sequence for such a dynamic and reactive exercise. But if nothing else, do the soft tissue sequence beforehand, as the lower body soft tissue foam rolling will help your tissue be more elastic on the bounce. I have not used the rebounder personally but I would probably not do it every day as the repetitive motion without enough recovery may cause stress to the soleus, achilles, and knees. But in general it sounds like a fun incorporation into exercise.

  7. Tom Kirkendall  January 22, 2017

    Peter, I just got through watching the videos. They are very well done.

    I have a few questions.

    I’m curious as to how you incorporate the movement sequence that you go through in the video into your workout regimen.

    Do you do this entire sequence before you engage in your weightlifting routine? Or do you do the movement sequence independent of your weightlifting workout?

    Likewise, do you do the movement sequence before you engage in an aerobic workout, such as sprinting or biking?

    Generally, how many times a week do you do the movement sequence?

    It occurred to me after watching the videos that every golfer on the PGA Tour ought to watch this.

    (reply)
    • Peter Attia  January 22, 2017

      I will Jesse chime in, but I do the entire sequence (which I can do in 10-12 min) before my workouts. I also occasionally do the shin box drill in between dead lift sets.

    • Jesse Schwartzman  January 23, 2017

      Good questions Tom. This warmup is designed as a catch all for almost any type of sport or activity you want to accomplish. Counteracting sitting and technology was also a focus. I do this routine before lifting and running, but also on “off” days to keep my body limber and to make tight muscles more elastic.

      Down the line, we may create some more sport specific content that would have more plyometrics, or extra dynamic stretching depending on the skill. So you can consider this a possible every day activity, it’s like brushing your teeth for your body.

  8. Adam Shortt  January 22, 2017

    Thank you very much Peter and Jesse for sharing!

    (reply)
  9. Sheila  January 22, 2017

    HaHa – Pavel! Must have beh mod on my mind…

    (reply)
  10. Jeffrey Bickford  January 22, 2017

    Thank you Peter, Jesse, Elliot, and Kelly! This is just what I needed!

    (reply)
  11. sk  January 22, 2017

    Dr T:
    Below is really common sense, but a brilliant insight and in this media age is so overlooked and misunderstood in every facet of modern life. Thanks for your caring.

    My pet peeve, and that of Jesse, is that good people are misled by the heroics of big-personality super-humans who lead them to believe they need to do these things to live better. In reality, it’s almost always the opposite. You don’t have to do super-human feats to have great healthspan and, by extension, longevity

    (reply)
    • Susan Moskaly  January 23, 2017

      You have us given a true gift, Peter and Jesse. Thank you so much for your generosity. This will help many folks, including me. I can’t wait to start putting these routines into practice.

  12. sk  January 22, 2017

    Jesse, along with his wife Patty, currently owns and operates Fit4ward in NYC

    Is there contact info for them?

    (reply)
  13. Louis Malinow  January 22, 2017

    Dr. A—

    I’m a 49 year old concierge internist, lipidologist, hypertension specialist and share your passion for personalized biohacking (love Bulletproof, Ferris, Paleo literature, and of course Tom Dayspring who obviously got you excited as well) ……….most of my day is spent as a motivational speaker talking food, biochemistry, movement, etc with my patients. My question:

    I, my wife, and even my 20 year old daughter take metformin. Almost everything I’ve read looks good……almost everything…….the question is your belief in importance of mitochondrial uncoupling as an anti-aging tool……some of the literature strongly favors, but there is some dissonance on the topic. In addition to high healthy fat, LC, movement, metformin (or berberine with its PCSK9 properties)………any other quick biohacks to enhance mitochondrial uncoupling?
    Your stuff is terrific. Thanks so much!

    (reply)
    • Peter Attia  January 22, 2017

      Thanks, Louis. I don’t really think of it as much through the lens of uncoupling; more through the lens of nutrient sensing.

  14. Johan Aardal  January 22, 2017

    Is it possible to do a generalized 80/20 version (do the 20% that gives 80% of the return) of the full routine for those who can’t or won’t committ to the full ~30 min? And if, which movements would you pick?

    (reply)
    • Peter Attia  January 22, 2017

      Of course, but which movements will depend on the person. My 80/20 is diff from yours.

    • Johan Aardal  January 22, 2017

      Indeed; how would you recommend finding your personal 80/20?
      Going through the 26 movements and feeling it out/using common sense or would you need to see a professional?

      Surely individualizing is best, but I assumed people on average get more benefit from certain movements (e.g. rolling hamstrings vs calves?), hence why I asked for a generalized 80/20.

      Thanks for putting yourself on the mat and sharing such in depth programming pro-bono.

    • Jesse Schwartzman  January 23, 2017

      Agreed with Peter. It’s all personal. But any one of these three routines stands on its own as a sequence worth doing. Start with soft tissue and then start sprinkling in exercises from the second and third routines. Also, know the more often you do it, the faster it gets. If the full 3 phase routine takes longer than 10-15 minutes, you still need to practice.

    • Johan Aardal  January 24, 2017

      Thanks Jesse, sounds good. One thing I would advise if you want to make your guide more awesome; turn it into a mobile friendly webpage with animated gifts of each movement accompanying the text. Actually just saw a reddit post hit the front page with a similar guide (guy looks a bit like Peter..) https://www.reddit.com/r/Fitness/comments/5pwxki/foam_rollers_and_lacrosse_balls_are_awesome/

      Got the roller you recommended, feels like a step up from your basic solid core roller.

      Cheers!

    • Brad  January 29, 2017

      I personally think that for most trainees, particularly older or low experience ones would benefit more from a HIT (slow rep cadence) type of resistance (weight lifting) routine, of short duration, than a yoga-ish body weight type routine like this. For building or retaining muscle mass and strength and the resultant positive myokinome/hormonal effects. The reason is the intensity of muscle stimulation is higher and/or across more muscle fiber types. Once sufficient strength is obtained perhaps graduate to a routine with more ballistic, higher rep speed, movements.

  15. Beau  January 22, 2017

    Love this, spot on content and format. By the way, your writing has tightened up considerably since I started reading your blog. It was always enjoyable, but this is on a new level. Looking forward to the book.

    (reply)
    • Peter Attia  January 23, 2017

      Better get tighter if I’m ever going to finish this book!

  16. Norm  January 22, 2017

    Thanks Peter and Jesse for this impressive stuff!

    Are there any talks/writings by Jesse on nutrition/weight loss? If any, where can we find them?

    Thanks

    (reply)
  17. Marcella  January 23, 2017

    Hello Peter,
    It is great to see that you’re blogging again. I miss reading your information on health and nutrition.
    Thanks old friend.

    (reply)
  18. Camilo  January 23, 2017

    Thanks Peter & Jesse for the workout and sharing.

    Born in the 1940’s I managed to get here (2017) with no medication (well one fungal infection about 12 years ago), no issues so far with lipids, BP, A1c, etc, and we will try to be in the blue curve as long as I can. Well I hope to read the book one day.

    (reply)
  19. Angela L.  January 23, 2017

    I just recently have been learning about this line of thought through Katy Bowman and her writings. She’s especially helpful for women dealing with pelvic floor issues. It’s liberating to be able to think of movement and exercise in different terms than just “exercising” once a day, but instead whole body movement and daily activity in a functional and healthy pattern. Thank you for sharing!

    (reply)
    • Jesse Schwartzman  January 23, 2017

      You really “get it” Angela. It’s not about breaking workouts into sections and body parts, but mobilizing and stabilizing fundamental human movement patterns on a day to day basis. Then you can use your body freedom in any activity you choose. You will get much more out of this sequence doing it on a day to day basis than for 2 hours on Sunday.

  20. Larlkyn Lee  January 23, 2017

    Hi Peter,

    In terms of hacks, do you have any experience incorporating EMS devices such as a Compex to improve or facilitate better recruitment of all muscle fibers during warms ups and during training? My interest is on the recruitment of deep muscle fibers which are hard to get to. Perhaps going heavy may not be the best for joint mechanics but maybe a combination of both EMS, and say a movement like a deadlift at slightly lower weight might be a better strategy. Love to hear your thoughts on this.

    (reply)
    • Peter Attia  January 23, 2017

      I don’t have any experience with it outside of rehab.

  21. Marie  January 23, 2017

    I am curious about what you think of the Blue Zones? Seems to be a very proven way of eating and living well into your 100s for some! There is so much confusing information out there about food and to your point about your wife (an older post) being able to eat sweets and not affect her, I wonder if some folks can eat larger amounts of meat and not be affected (although be atypical much like a sweet eater who never gains weight). I’ve heard of certain tribes in Africa who can eat mostly meat and be healthy but have they genetically adapted to thrive on the local food sources?

    (reply)
  22. Ioan  January 23, 2017

    Hi Peter and Jesse and thanks for the great article !

    I found your ”Jane Fonda” protocol 2 weeks ago in ”Tools of Titans” and started to try it.
    Since half an year i have ITB issues which made me stop running in the last 2 months.
    I understood that the above protocol helped you a lot with your knees. Would you recommend ”Jane Fonda” protocol as rehab for ITB syndrome and if so, how often would you suggest to perform it ?
    Or do you have some other recommendations for ITB ?

    Thanks a lot and looking forward to read your book !

    (reply)
  23. jayne  January 23, 2017

    That was wonderful! Thank you both

    (reply)
  24. Tony  January 24, 2017

    I think one thing missing from this article is the fact that this will require a little bit of deliberate practice before you can do it in 10 minutes on autopilot before the workout.

    (reply)
  25. David Porter  January 24, 2017

    Another outstanding contribution to this seemingly never-ending quest for longevity. Thank you, sir.

    (reply)
  26. Eric Best  January 24, 2017

    I have a relatively mild form of Ehlers Danlos Syndrome, would you guess that these techniques would be less beneficial, more beneficial, or the same? My joint hypermobility is lessening with age (I’m 31), so I no longer dislocate joints; but I assume my myofascia are already loose given my hyperelastic skin and muscles pretty much hang off of my bones when relaxed. Thoughts?

    (reply)
    • Jesse Schwartzman  January 25, 2017

      More beneficial I would argue. This sequence is about getting your prime movers to do the work (rotating and stabilizing) instead of mobilizing helper muscles that often cause us pain (like hip flexors, lower back, TFL) Pay close attention to keeping a neutral spine and not rotating from your lower back.

  27. Todd Skelton  January 25, 2017

    This is great. I just purchased a Trigger Point foam roller and did this sequence today. It took me around an hour to complete, so I will need to work on the speed in order to actually have time to workout. I just went ahead and skipped the workout today, but still feel great from just doing the stretches.

    (reply)
    • Jesse Schwartzman  January 25, 2017

      Excellent. Remember, the foam roller is not a massage therapist. You should spend no more than :45 on each muscle group. But I know there is a learning curve. Nice job taking your time to master each move.

    • Jesse Schwartzman  January 25, 2017

      The foam roller facilitates soft tissue elasticity. But nobody ever became a better mover from foam rolling 🙂

  28. Simon Hunter  January 25, 2017

    This is pure gold, thanks so much for sharing.

    (reply)
  29. Brandon Fox  January 25, 2017

    Refreshing take on things (usually check here for my nutritional itch). With the arms overhead sequence I don’t know if it might be preferential to keep some form of cervical retraction (and subsequently upper thoracic extension) when lifting the arms overhead. Totally nitpicking, but it seems like there may be some lower cervical or cervicothoracic hyperextension when looking up at ceiling during said overhead motion. Similar concept to locking the L/S into neutral with pelvic tilt (ensuring all motion comes from hip and not L/S)- all motion would come from upper T/S and shoulder girdle motion versus some (albeit slight) lower/mid cervical motion. Overall love the post and video format.

    (reply)
    • Jesse Schwartzman  January 25, 2017

      I don’t mind a little cervical extension in the move to counteract the cervical flexion we experience most of the day with smart phones and laptops. However if we are fine tuning, I would recommend a chin pack on a glider followed by cervical extension, mimicking the McKenzie method for spine and neck pain.

  30. Palak  January 25, 2017

    Hi Dr. Attia,
    As a former engineer and current Stanford med student, the content and style of your posts have always resonated. This one is especially timely as I’m on the tail end of a travel intensive and sedentary residency interview trail (rad onc), but I hope to get back into competitive martial arts during my rotation-free last year of med school. How do you counteract the erosion of your hip hinge mobility when travelling extensively?

    (reply)
    • Peter Attia  January 25, 2017

      A lot of deliberate effort.

  31. Norm  January 25, 2017

    Hi Jesse,

    Thanks for the link to your Facebook page, it already has great content and many gems ! To pick two out of many:

    1) 5 grams of carbs to 1 gram of fibre ratio In a food is generally a good start
    2) Sweeteners can really mess with your taste buds and biological signals

    Keep up the great work!

    (reply)
  32. Pat MacNeill  January 25, 2017

    I can’t thank you guys enough for putting together this content! I have had terrible hip mobility for many years and have had limited progress using various yoga and stretching routines. The level of detail provided has given me the understanding that has alluded me for many years.

    (reply)
  33. Bret Scher  January 26, 2017

    Hey Peter. Excellent job, as always. You will likely see me doing these at the PAC this week.

    I know you are a very busy guy, but I have a favor to ask for a fellow physician, former endurance athlete, San Diegan who works out at the same gym as you.

    I have a book launching in the next few weeks, and I would love to send you an advanced copy and get your input.

    My focus is the foundational principles of a healthy lifestyle, made very simple. It’s for all those overwhelmed patients who give up before they start or don’t even know where to start.

    The idea is to give them a way to go forward that takes the pressure off. I hope to present a balanced, scientifically accurate evaluation of lifestyle medicine, and help them build a sense of self-efficacy and “can do.”

    It’s not on the same level as most of your topics, but it is a good intro to get people to a place where they can start to consider the level of care you provide.

    So what do you say? And please don’t say “Negative Ghost Rider the pattern is full.” Shoot me an email at bret@myboundlesshealth.com. Thanks!

    (reply)
    • Peter Attia  January 26, 2017

      Bret, I am sadly no longer a member of the PAC…

  34. Lydee Scudder  January 26, 2017

    The videos are fantastic. Worked through the dynamic warmup 3 times so
    far. Would love to see you and Jesse do more of these.

    (reply)
  35. Seth  January 26, 2017

    Hi Peter,

    First of all, thanks to you and Jessie for these videos, they are great! I’ve heard from some trainers and others in the fitness community that “stretching” is something that should be done away from your lifting sessions. My question is whether it is ok to do the muscle activation exercises as part of a warm-up right before a lifting workout. including squats, bench presses, deadlifts etc. What are your thoughts?

    thanks!
    -Seth

    (reply)
    • Jesse Schwartzman  January 26, 2017

      Good question. Static stretching for long periods of time decreases fascial tension, creates plastic deformity in ligaments, and increases injury risk. Dynamic stretching: bouncing in and out of stretches increases plasticity and elasticity of tissue. None of the muscle preparation stretches in sequence 2 are meant to be done for more than :40, and in the dynamic warmup you are meant to bounce in and out of the stretch, creating tension and then releasing it. The way to increase flexibility is not to “stretch” but to load max ranges of motion gradually.

  36. Benas  January 27, 2017

    Found this:
    https://www.ncbi.nlm.nih.gov/pubmed/2874369 – Effect of activated charcoal on hypercholesterolaemia; Seven patients with hypercholesterolaemia were treated for 4 weeks with activated charcoal at a dose of 8 g three times a day. Plasma total cholesterol and LDL-cholesterol decreased by 25% and 41%, respectively, whereas HDL-cholesterol increased by 8%.

    Peter, what is the best way one can reduce LPS (bacterial endotoxin) concentrations in blood?
    Lots of research coming out that it’s causing/big factor in insulin resistance, Alzheimers, CVD etc. Maybe aging too

    (reply)
  37. Benas  January 27, 2017

    Another interesting study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442161/ – 4 months of Quigong increased telomerase activity by 75%.

    (reply)
  38. Peter Steele  January 27, 2017

    Firstly, big thanx to Peter & Jesse for doing these vids !
    Secondly, Peter, in an older blog post, you mentioned very briefly that in 2015 you did a 6-mo. fasting “experiment” where you fasted 23 hrs daily (eating all daily calories in 1 hour)…I’ve looked for a more extensive write-up of your experience but couldn’t find one…any way you could provide a Cliffs Notes version of your thoughts/results of that experiment ?

    (reply)
    • Peter Attia  January 28, 2017

      I think I discussed in detail on a podcast, but don’t recall which one. Maybe first one with Tim Ferriss?

  39. Jenny Carr  January 27, 2017

    Hi Peter,
    This is totally unrelated to this post. You made a comment a long while back that hypothyroidism should not be treated with t4 without t3. Where could I find more info on this. When I asked my primary care doctor about this she referred me to an endocrinologist (3 month wait so I haven’t seen him, yet).
    Thanks
    Jenny

    (reply)
    • Mike  January 28, 2017

      Hi Jenny

      I’ve been living without my Thyroid since 2006 so I have experience
      with this topic. The best book I found that could possibly answer
      your question is titled “Tired Thyroid” by Barbara Lougheed. If nothing else
      read before your Endo appt.

      Mike

  40. Mike  January 27, 2017

    Peter, thank you so much for your recent post about muscle activation. Also thank you for all your past info posting about cholesterol and how the body processes work in regards to this topic.  I have used your site for reference for many, many years. As an example of my own forward progress , in this area, my recent CIMT went down from .897(95 percentile 7 years ago when I had it done) to .821 (71 percentile retesting several months ago). Going in the right direction with more work to do!

    Question about muscle:

    I really like what you and Jesse put together. I have experience trying to figure something like this out. So I understand what you two provided is significant. My right leg is a bit shorted than my left. In 2013 I had an xray done by a Chiro and it showed 17 mm shorter on my right leg. About half structural and half functional. My issue is my right pelvic area(short side) wants to stay in anterior tilt mode. I work with a massage therapist – he uses Deep Muscle Stimulator device(s) – and can make the anterior tilt on that side go away. However, it comes back. (Note: the Deep Muscle Stimulator device allows him to cover multiple body areas in 1 hour).

    What you and Jesse provided really helps with this as I now have something I can do once or twice a day to activate my body/muscles delay the anterior tilt.

    My question is what muscles need to be strengthened to help my body be able to support my situation. I currently focus on Rectus Abdominal(planks), Eternal Oblique’s( Wood Chop), Glute ( squats and ham glute machine) and calfs. It has taken me years to get where I am so figuring this stuff out is not trivial.

    I have noticed my left quad and maybe the left psoas(long side) wants to remain tight and my right calf(short side) wants to stay tight. Do I need to strengthen the left quad and right calf more? Correcting muscle imbalances is difficult!

    I would be happy to work with Jesse if he does remote consulting.

    Thanks again,

    Mike
    57 years old

    (reply)
    • Jesse Schwartzman  January 30, 2017

      Hi Mike. This sounds like a classic spirall line issue causes my the leg length discrepancy. Look at the work of Thomas Myers and you will see what I mean. Look up an exercise called “90/90’s” and experiment with other spiral line stretches. I think the exercises you are doing are great but you need to unwind your fascia before you load and strengthen.

  41. Peter  January 27, 2017

    My chiro told me he was not familiar with the term “locked long” and that he wanted to understand the physiology behind rolling the hamstrings side to side. Any insight?

    (reply)
    • Jesse Schwartzman  January 30, 2017

      Some fascial lines are chronically pulled long while others are pulled short. Hamstrings are pulled chronically long as they are overstretched from gait, quads are locked short. Extensors are generally locked long while flexors are locked short.

  42. Sheila  January 27, 2017

    Thanks for your reply Jesse!

    I am doing it after the warm up. It is not really “exercise” as I only do what is called a “health bounce,” which means my feet do not leave the mat. I push up from my heals that remain on the mat. There is some good research on this – you might want to check it out, specifically with NASA for returning astronauts. This bounce is for stimulating the lymphatic system. I have read that they are introducing this in nursing homes for older people – more beneficial than treadmill for example. And, they can start slowly with 2 minutes or so.

    I do 15 minutes then my kettle bell series with a light bounce again between sets. I wonder if I would be getting the impact that you describe based on the fact that I am not leaving the mat. Also key is that I have a high quality mat that does not have a big give in it – there are many brands that do harm, so I’ve read. I use the Cellerciser. There are bungee cord mats that have too much give and do not the g-force that one wants – again based on the research.

    If you ever do look into it, I’d love to hear your thoughts.

    Thank you again for doing the vids – I cannot tell you how many friends and clients I have already sent it to. And, after one session only I slept better (doing it in the evening) than I have in months! I can somewhat isolate this as the cause, I believe.

    You and Peter are the best!!!

    Sheila

    (reply)
  43. Sheila  January 27, 2017

    The NASA research on rebounding. This is from Wikipeidia so, not sure if they are capturing it correctly…

    NASA study and scientific support generally[edit]
    The single most important and most frequently quoted scientific research study on rebounding was conducted in 1980 through NASA by A. Bhattacharya, E.P. McCutcheon, E.Shvartz, and J.E. Greenleaf; Biomechanical Research Division, NASA-Ames Research Center, Moffett Field, California, in cooperation with the Wenner-Gren Research laboratory, University of Kentucky, Lexington, Kentucky.[9] The key findings for this study include the following:
    “.. . for similar levels of heart rate and oxygen consumption, the magnitude of the bio mechanical stimuli is greater with jumping on a trampoline than with running, a finding that might help identify acceleration parameters needed for the design of remedial procedures to avert deconditioning in persons exposed to weightlessness.”
    “The external work output at equivalent levels of oxygen uptake were significantly greater while trampolining than running. The greatest difference was about 68%.”

    “While trampolining, as long as the G-force remained below 4-G’s, the ratio of oxygen consumption compared to biomechanical conditioning was sometimes more than twice as efficient as treadmill running.”

    “The G-force measured at the ankle was always more than twice the G-force measured at the back and forehead while running on a treadmill.…While jumping on a trampoline, the G-force was almost the same at all three points, (ankle, back, forehead) and well below the rupture threshold of a normal healthy individual.”

    ” …averting the deconditioning that occurs during the immobilization of bed rest or space flight, due to a lack of gravireceptor stimulation (in addition to other factors), requires an acceleration profile that can be delivered at a relatively low metabolic cost….for equivalent metabolic cost, and acceleration profile from jumping [on a trampoline] will provide greater stimuli to gravireceptors.”

    (reply)
  44. Aviv  January 27, 2017

    Hi dr. Attia,
    First of all I would like to thank you for the great service you are doing for me and all of your other readers in this blog and this specific post.
    In your “hacks” list you mentioned Supplements!
    I wonder if you mind sharing what supplements are you taking?
    I know that it might be very different from one person to the other and I promise you I won’t take your words as medical advice… 🙂
    Thanks a lot!
    Aviv from Israel (Big fan of your work!)

    (reply)
    • Andy  March 26, 2017

      Episode 65 of The Tim Ferriss Show

  45. John Nelson  January 31, 2017

    I know you’re in San Diego and New York and those are too far for we midwesterners to reach. So how does one go about finding a doctor in, say, Minneapolis who does what you do (medical practice wise) and isn’t going to just regurgitate the “low fat, whole grains, lots of fruits for energy” mantra that’s shortening our lives?

    (reply)
  46. Omar  January 31, 2017

    It is based only on my personal experience and a few others.
    -When done regularly, a foam roller is not enough and will feel too soft. More precise and hard tools will be needed such as anything solid and one with a plane base for stabilization.
    I use personally a small glass jam for tensor fasciae latae and a golf ball for the finish for precision. Only with such tools you will really understand how much tension you still have in those muscles.
    – Up to now, I was able to elicit LTR(Local twitch response) only with “hard” and small tools most of the times.
    An indication of the location a Mtrp (myofascial trigger point) can be seen when a muscle exhibits a local twitch response.
    A LTR is an involuntary twitch of the muscle that is thought to reduce spontaneous electrical noise at the motor endplate leading to greater tissue extensibility.(Chen 2001, Hsieh 2011, Chou 2011)with also short-term positive therapeutic benefit. (Hong 1994, Rha 2011)
    And you will feel that release of tension and pleasure immediately after the LTR. It is really something to try !
    But do not get overboard or you may end up with bruises or pinched nerves in some location(I experienced both)

    Omar

    (reply)
  47. Nancy  February 1, 2017

    Thank you so much for these videos. I had an lightbulb moment a few years ago – my Mom (in her 70s) and I were in my garage and she was unable to step up onto a box about two feet up. I was shocked. When does this happen I thought and how can I not let it happen to me? I’m in my mid 50s with insulin resistance challenges and not much of an athlete, but I can still climb and go into a full squat (like a child). I plan to hang onto this mobility and not let it slip away in the next decades.

    (reply)
  48. Carl Aiau  February 2, 2017

    Amazing stuff! Production quality is great, but I was hoping for some Borat impersonations, maybe next time?

    (reply)
    • Peter Attia  February 2, 2017

      I almost did this whole video in my Borat lime green mankini…

  49. KelleyB  February 2, 2017

    “Healthspan”: good term. I also like the concept Andrew Weil promotes in his book Healthy Aging: compression of morbidity.

    (Disclaimer: I’m not a fan of everything promoted by Dr. Weil, but I do like that term.)

    Cheers!

    (reply)
  50. centinel  February 2, 2017

    Hi, Peter. I haven’t read your point of view about K. Hall-NuSI published keto study. Did you write anything on the subject? I would like very much to know your opinion about results and author’s conclusions. Thank you.

    (reply)
    • Peter Attia  February 3, 2017

      Nope.

    • Michael  February 3, 2017

      I am also looking for thoughtful and sober responses to Hall’s study Dr Hall presents a very well conceived experiment
      His data and his conclusions are not easily dismissed

    • Peter Attia  February 3, 2017

      I believe others have offered what you are looking for.

  51. Henry J. Burke  February 3, 2017

    Peter thank you for all you do.

    (reply)
    • Peter Attia  February 3, 2017

      Thank you, Henry. Glad you enjoy it.

  52. Adam  February 3, 2017

    I’m also interested in your opinion about Hall-NuSI study, Peter. Please, do not bother, we admire your work and value your conclusiones in a special way.

    (reply)
    • Peter Attia  February 4, 2017

      I wasn’t planning to bother… 🙂

  53. Dave  February 3, 2017

    The videos are excellent. Thank you for producing and sharing them. I’m even using the warmup routines alone on my off days just to feel refreshed.

    – Dave

    (reply)
  54. KelleyB  February 4, 2017

    Hi again Peter: Just listened yesterday to your January podcast with Jocko Willink. I loved it! I especially pricked up my ears at the following statement you made (I’m paraphrasing): “I don’t like to talk much anymore about nutrition, because nutrition is a pseudoscience masquerading as a religion or dogma.” (Or maybe you said it’s a “religion masquerading as a pseudoscience.”) You also said your thoughts on the topic have changed in the last couple of years and then went on to share your present thinking.

    THANK you for saying this. As someone who has studied and thought about nutrition for 35+ years and has observed (unscientifically) people’s eating habits over that same time period, that has long been my impression. (I have a BS in the topic but never became an RD.) There’s no one precisely right way to eat for every body (I’m using two words there deliberately). There are a handful of general guidelines that seem to hold true for promoting health no matter who you are, but that’s about it. Yet many people become so dogmatic about their food-related beliefs.

    I’m really hoping you’ll develop this idea in a future blog post. Or maybe it’s a topic you’ll explore in your book. (I sent you an email about your book, btw.)

    Thanks, as always, for all you do! Cheers.

    (reply)
    • KelleyB  February 4, 2017

      Edit to clarify:

      I hold a BS in the *subject* of nutrition and food science.

    • Peter Attia  February 5, 2017

      Easy to confuse plain old BS in nutrition, huh? 🙂

    • Peter Attia  February 5, 2017

      Glad you appreciate it, Kelley.

  55. Chris  February 5, 2017

    Hi Peter,
    a little off-topic but is it worthwhile to do a medium fat, medium carbohydrate diet? So I was thinking to lower daily carbs from 240/250 grams to 120-130 grams and add more fat to my diet instead.(I’d like to keep some carbs for various reasons) Or is lots of fat only healthy if you are mostly in ketosis? (I have T1D btw)

    (reply)
  56. Sitting Mike  February 6, 2017

    Dear Doctor Attia and Mr. Schwartzman,
    Thank you so much for these videos. As as 65
    year old, I find them wonderfully useful.

    (reply)
    • Jesse Schwartzman  February 8, 2017

      Happy to hear, Mike.

  57. Brent Klapthor  February 7, 2017

    Great stuff. Thanks!

    Any thoughts on what a proper cool down should look like after a workout?

    (reply)
    • Jesse Schwartzman  February 13, 2017

      A proper cool down Is more about getting the nervous system back to parasympathetic mode. I would lay on the floor and put your hands on your belly to focus breathing in that area. 5 count inhalation, 5 count hold, 10 count exhalation. Do for 5 minutes. I also like a stretch called Bretzel 2.0. But don’t just crank and stretch muscles. You won’t improve flexibility, and could damage the ligaments long term. An effective cool down is about getting the heart rate down gradually, and getting proper circulation back to your tissue..

  58. Mark E.  February 13, 2017

    Hey Peter,

    I sent an email through the contact form, but figured I would post a comment as you respond to those more frequently. We share a similar story–I was an engineering undergrad, then had a change of heart and went into medicine. I did a neurosurgery residency at UT Southwestern but was unable to finish due to a seizure disorder caused by multiple concussions from martial arts. I completed an anesthesia residency at Hopkins not long after you were there. I took time off between neurosurgery and anesthesia to treat a hydrocodone addiction. I finished anesthesia residency extremely overweight and found nutrition and fitness after residency and now am an active crossfitter, endurance athlete and nutrition fanatic. Like you, I enjoy the practice of medicine, specifically anesthesiology, but am most passionate about the type of medicine you practice. I wanted to reach out to you to possibly seek some mentorship in getting involved in the type of medicine you practice. Hope to get to talk to you. I know you are extremely busy, but was hoping you had some time for a fellow Hopkins grad. -Mark

    (reply)
  59. Norm  February 14, 2017

    Back to CGM.

    Apologies if it has been highlighted before. As the CGM does not directly measure glucose levels in the blood, it measures glucose levels from the fluid under the skin (interstitial fluid), not sure if I have got the technical name for the fluid right. So, there is a time delay for the blood glucose levels to appear in the fluid which the CGM is sensing. Apparently this time delay is between 20-30 minutes and the CGM would be showing the glucose levels that were 20-30 minutes ago in the blood. Also, CGM needs to be calibrated with the blood glucose monitor otherwise it will keep moving further and further away from actual blood glucose levels.

    (reply)
  60. Colin Gavignet  February 20, 2017

    Hi Peter, I’ve been reading your blog for over a year and having a great time with it.
    1) I imagine you’ve read born to run?
    2) can I really eat all the bacon, sausage, fat I want? It makes me feel great but I am worried about going against accepted knowledge.
    Thanks for your blog. It’s always a great read.
    Colin

    (reply)
  61. Philip  February 20, 2017

    Hi Peter,
    What are your stats on the big 3 powerlifts (squat, bench, deadlift)?
    Phillip

    (reply)
    • Peter Attia  February 20, 2017

      In high school at BW of 158, I was 495, 275, 505. I don’t bench today and I don’t go below 5 reps on squat and D/L today, so no idea, but less than high school for sure.

    • Philip  February 22, 2017

      Nice.

      You can always use the formula from Wendler’s 5/3/1 book to convert rep maxes to estimated 1 rep maxes. He suggests mass + (mass * reps)/30.

      I don’t know where it comes from nor why it works at all. But it does seem to give a reasonable result when I compare my 1RMs to other rep maxes.

      Did you take one of Rippetoe’s courses yet?

    • Peter Attia  February 22, 2017

      Yes, I have. I would peg my max D/L today in the high 400’s, but prob not 500. Nowhere near my old numbers in squat.

  62. Chris B.  February 24, 2017

    Hi Peter. I just wanted to take a moment to let you know how much you inspire me and many others. I have no doubt you are a busy person. So the fact that you take time out of your day to share such valuable information, at no cost to us readers, is a testament to your character.

    Yesterday I stumbled upon your 2013 Tedx talk regarding insulin resistance as a possible precursor to diabetes. While you may regret not showing compassion for your diabetic patient whose foot needed amputation, your love for others is made abundantly clear every time selflessly blog, participate in podcasts, or otherwise share what you’ve learned with the general public.

    Thanks again.

    (reply)
    • Chris B.  February 24, 2017

      That was supposed to say “precursor to obesity”. Ah well.

    • Peter Attia  February 24, 2017

      Chris, thank you so much for your kind words. Really means a lot and I’m glad you find this helpful.

  63. Paula O  February 24, 2017

    Peter:

    I echo Chris’ sentiments above; I couldn’t improve upon his praise, but it bears repeating.

    As a non-competitive, not-anything-like-an-athlete kind of person, your digestion and regurgitation of the biochemistry, etc. is very useful for me. It wasn’t until I had numbers (aka, data) that I could really wrap my brain around NK, but also to explain it to my nurse practitioner (and I’m an RN, by the way!) I cannot use the information in a true “performance” situation, but I do perform everyday: in my job, my everyday life – and that counts! Yes, losing weight, not continuing onto the metabolic syndrome death sentence, etc. has been my primary motivation, but do I feel better? HELL YES – and for someone that has been on diets from hell that means a lot to me. It means I haven’t quit, and I don’t want to. It explains why I no longer feel compelled to eat when I only ate an hour ago, why I can fast for 18-24 hours without a whole lot of effort. I’m no longer hangry, ever.

    Please don’t stop writing anytime soon. It makes a world of difference, if only to people like me. I refer to you and several of your colleagues whenever someone expresses interest because I work with the profession of slow-changers: healthcare professionals. If I can pique the interest of a single one, I consider it a minor victory.

    With gratitude

    (reply)
    • Peter Attia  February 25, 2017

      Thank you, Paula. No end in site to the writing, either. Just signed to put my book together, so that will keep me busy for a while and hopefully make up for the sporadic blog posting.

    • Naren  March 2, 2017

      “Just signed to put my book together”

      Wawa Weewa!

      Hope this means a book tour at some point, and you hit the podcast circuit including Joe Rogan’s.

    • Peter Attia  March 2, 2017

      Indeed.

  64. Greg  February 25, 2017

    Hi Peter and Jesse,

    Firstly Peter thanks for everything that Eating Academy is and for everything you share.

    My questions are probably more directed at Jesse. Can you direct me to research on Fascia that supports the activation/warm-up procedures in the videos? Particularly around the use of rollers and massage and the how and why this works. Also if you were able to suggest one or two books – of a textbook type (around this sort of muscle/sports physiology) that you would recommend I’d also much appreciate that. I’d like to use it to learn more about my Yoga practice as well as my sports and physical adventures.

    Thumbs up to both of you for the videos and looking forward to some specific shoulder stuff…. Soon?

    Thanks guys and keep up he good work.

    (reply)
    • Jesse Schwartzman  February 27, 2017

      Hi Greg. I am glad you found the videos helpful. There is a wealth of research on self myofascial release, which you can access easily, and you will find in consensus: foam rolling increases acute ROM right after therapy (10-20 minutes) long term ROM if done consistently over time, and that there is no statistically significant ROM difference between :30 and :60 or longer of soft tissue work (although longer foam rolling work may help alleviate DOMS) The important thing to remember is that foam rolling in not a panacea, no matter how crazy the soft tissues gadgets are becoming (spikes, cold, hot, vibration) no one foam rolled their way to better movement significantly. The soft tissue work is more of a tool to increase acute elasticity, and the lymphatic system. Then you need to do the real work to stretch and load the movement pattern.

  65. Andre  February 28, 2017

    Peter, you look awesome, skin and everything. Radiating. Surely biomarkers for ageing must have improved! You should got those measured!

    My wife and me were wondering on what diet regimen you settled with now? VLCHF? Keto? Bullet? IF?

    (reply)
    • Peter Attia  March 2, 2017

      No particular regimen. I’m surviving and getting by as best I can with the limitations I’ve imposed on myself.

  66. Carolina  February 28, 2017

    Great post. I am taking the ideas to the gym today. I realise I have been focusing too much on the HIIT portion and not at all or very little on the rest.
    I am looking forward to your book.

    (reply)
  67. Dominic  March 7, 2017

    A fascinating series, just wondering one thing. In the comments there’s talk about doing this in 10-12 minutes. Is that because the foam rolling gets very short? I’m just wondering because 40 seconds per place, 9 places that’s 6 minutes itself and 12 minutes assuming it’s 40 seconds per side.

    (reply)
    • Peter Attia  March 7, 2017

      More because you end up customizing the routine to your needs and certain movements can be shortened or even eliminated.

  68. Dan S  March 18, 2017

    Comment #2453

    Thoughts on cold exposure for healthspan?
    And how is it kids tolerate cold water so well?

    Appreciate the knowledge – Thanks

    (reply)
  69. Ariana  April 4, 2017

    Hi Peter,
    I’ve been following your posts and podcasts for a while and have learned a lot from them (thank you!). Where movement is concerned, have you ever looked at the Tracy Anderson Method? She was originally known as trainer to the stars, etc. but if you try her stuff, the woman has developed a huge database of movements that really enhance proprioception and are just great for the brain’s body map in general. I used to be a marathon runner and total gym junkie but I don’t think I have ever been as coordinated and balanced in my life. I do her workout almost every single day (for the past 6 years) and really feel like my body is aging gracefully. With all her novel positions and movements, I am sure she activates the brain a lot more than a lot of other fitness methods (all due respect to all sports though, moving is a good thing in general so I would never bash any other sport!). Anyway, I’d love to get your insight on her method.

    (reply)
  70. Ariana  April 4, 2017

    Also, look into Z-health – these guys are all about movement and look at it from a neurological perspective rather than a purely muscular one. They do a lot of cool stuff, it’s worth checking out. And the guy who heads up, Eric Cobb, does a ton of blog posts and interesting videos on a regular basis.

    (reply)

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