Latest / CareTalk: Healthcare. Unfiltered. / Why Exercise Beats Longevity Hacks w/ Dr. Jordan Metzl, Author, The Athlete's Book of Home Remedies

Transcript

Why Exercise Beats Longevity Hacks w/ Dr. Jordan Metzl, Author, The Athlete's Book of Home Remedies · CareTalk: Healthcare. Unfiltered.

• 0:07
  John: Welcome to Care Talk America's home for incisive debate on healthcare, business, and politics.
• 0:12
  John: I'm John Driscoll, the chairman of the Yukon Health System, and today I am delighted to be hosting with one of my favorite fitness nerds, Dr. Jordan Metzel, who in addition to being a brilliant orthopod, is one of the leaders in fitness.
• 0:29
  John: And Mo Mo, the motivational impact of fitness to change people, the arc of people's life and aging.
• 0:37
  John: At a time when we are in a longevity moment, people are investing in longevity businesses.
• 0:43
  John: We're talking about all kinds of odd cocktails to improve and increase people's lifespan.
• 0:50
  John: Dr. Jordan Metzel has just published a great book, push Unlock Them.
• 0:54
  John: Science of fitness, motivation to embrace health and longevity, and perhaps Dr.
• 1:00
  John: Jordan will change the conversation about lung longevity back to where it should be.
• 1:05
  John: Motivation and fitness.
• 1:06
  John: Welcome to the show.
• 1:07
  Dr. Jordan Metzl: Thank you so much.
• 1:08
  Dr. Jordan Metzl: Great to be with you.
• 1:10
  John: So, uh, Dr. Metzel, maybe talk about your own, uh, the arc of your own relationship with fitness, uh, perhaps starting with your dad and, and, and, and, and, and you could tell us whether you are actually a better athlete than your two brothers as well.
• 1:27
  Dr. Jordan Metzl: That's the most important part first.
• 1:29
  Dr. Jordan Metzl: But, uh, yeah, I guess just starting with the backstory, it's a, it's a pleasure to be here and to talk to you and your audience about this interface of medicine and fitness and preventive health.
• 1:38
  Dr. Jordan Metzl: So I'm a sports medicine physician at Hospital for Special Surgery, and I've been here for 25, 26 years.
• 1:45
  Dr. Jordan Metzl: And, uh, I basically had two separate circles of my life growing up.
• 1:49
  Dr. Jordan Metzl: Uh, and I went through, you know, I came through a family where both parents were doctors, um.
• 1:54
  Dr. Jordan Metzl: All my brothers are Dr. Metzel.
• 1:56
  Dr. Jordan Metzl: Three of the four of us are medical doctors.
• 1:58
  Dr. Jordan Metzl: Um, and in the medical training and medical part of my life, the circle was, you know, something is broken, let's fix that broken thing.
• 2:06
  Dr. Jordan Metzl: And then simultaneously, I had a parallel track of being active.
• 2:10
  Dr. Jordan Metzl: I played, uh, soccer in high school and college and ended up starting to do marathons and residency.
• 2:16
  Dr. Jordan Metzl: And started doing triathlons and, um, very much started to have this kind of separate circle of being actively involved in, in fitness.
• 2:23
  Dr. Jordan Metzl: So I had the circle of medicine and the circle of fitness, and they were two separate circles.
• 2:28
  Dr. Jordan Metzl: Now after practicing sports medicine for a while, I realized that getting people up and moving was a great thing to do and that my vantage point as a sports medicine physician was pretty unique and that I could hopefully inspire them to start doing that.
• 2:41
  Dr. Jordan Metzl: So I started talking to my patients about exercise and essentially went in one ear and came out the other for, for some people.
• 2:47
  Dr. Jordan Metzl: So then I had the idea of, listen, why don't I start.
• 2:50
  Dr. Jordan Metzl: A fitness community.
• 2:51
  Dr. Jordan Metzl: I started really small in the basement of a gym and started teaching fitness classes to kind of 10, 15 people.
• 2:58
  Dr. Jordan Metzl: And the idea was that if I could work on strengthening their muscles, they would have less pain and do better.
• 3:03
  Dr. Jordan Metzl: And the benefit for me was, uh, you know, relative to the end part of your question.
• 3:07
  Dr. Jordan Metzl: If I made my muscles stronger, I could beat my brother.
• 3:10
  Dr. Jordan Metzl: Um, we were doing the same events, marathons and triathlons, and I could beat him in triathlons if I made myself stronger.
• 3:16
  Dr. Jordan Metzl: So there was both a benefit for my patients and a side benefit for me.
• 3:20
  Dr. Jordan Metzl: Um, what I realized going forward from that, and that was about 15 years ago, was that from my vantage point as a doctor, I could basically.
• 3:27
  Dr. Jordan Metzl: Help push this conversation.
• 3:29
  Dr. Jordan Metzl: So I started kind of reaching out to different, uh, venues and started growing this program called Iron Strength.
• 3:35
  Dr. Jordan Metzl: And the idea was to teach people and to prescribe the medicine of exercise for people on mass.
• 3:41
  Dr. Jordan Metzl: And so we started getting bigger, you know, jump fast forward to today, we now have over 50,000 people in this kind of community, and we run about.
• 3:49
  Dr. Jordan Metzl: 27, 28 programs a year all free, and we get people out.
• 3:53
  Dr. Jordan Metzl: We have three of our signature programs have over a thousand people, um, doing workouts on mass on the flight deck of the Intrepid, which is an aircraft carrier parked in the Hudson River.
• 4:02
  Dr. Jordan Metzl: And, and it's really wonderful.
• 4:03
  Dr. Jordan Metzl: I started with people that were basically a lot like me, kind of people that were runners and triathletes, but over time, you know, people brought their parents and grandparents and kids and we have this kind of multi-generational program now, and it's really great.
• 4:15
  John: That's the intimidating thing I think about fitness for a lot of people, but let's maybe get back to that in a second.
• 4:21
  John: There's an enormous amount of interest in kind of longevity.
• 4:26
  John: The, the doctor Brian, Brian Johnson on Netflix kind of ingesting all kinds of things, including, you know, the trans transfusions from his family members.
• 4:36
  John: And there's a lot of, there's this wave of supplement after supplement and health advice after.
• 4:42
  John: What does, what are the longevity hackers of the moment get wrong about health?
• 4:48
  John: Health and health span?
• 4:50
  Dr. Jordan Metzl: Well, so I think there are a couple terms here.
• 4:52
  Dr. Jordan Metzl: So first of all, you know, wanting to live a longer, healthier life is a great thing, and it's certainly nothing new like the ancient Egyptians, you know, were buried with their slaves and, and pets because they thought they would have them in the afterlife constantly.
• 5:05
  Dr. Jordan Metzl: Leon, in 1513, went out and searched of the Fountain of Youth and, uh, didn't, wasn't successful, but has a great statue, um, after himself in St. Augustine, Florida.
• 5:13
  Dr. Jordan Metzl: And, um.
• 5:14
  Dr. Jordan Metzl: You know, the idea that we want people to live longer, healthier lives is a, is a great thing.
• 5:19
  Dr. Jordan Metzl: The problem is that much of the advance we've had with longevity is related to, you know, scientific advances in the past 150 years.
• 5:27
  Dr. Jordan Metzl: So, you know, sanitation, uh, vaccines.
• 5:31
  Dr. Jordan Metzl: Clean water, antibiotics, those things more than doubled life expectancy from, you know, the mid 18 hundreds was about 42, 43 years old to now it's close to 80.
• 5:41
  Dr. Jordan Metzl: Um, what we're talking about now are people obsessing about kind of the margins, um, when it comes to kind of doing supplements and all these different kinds of things.
• 5:50
  Dr. Jordan Metzl: And listen, I have no problem if somebody wants to do something and they're not affecting anybody else and they wanna spend their hard and money on.
• 5:57
  Dr. Jordan Metzl: On some of these different ideas, I have no problem with it.
• 6:00
  Dr. Jordan Metzl: Um, but I think we need to really focus on what we know the most about.
• 6:04
  Dr. Jordan Metzl: And by far we have the best evidence on the Medicine of movement.
• 6:09
  Dr. Jordan Metzl: Exercise is the most studied drug we have for longevity, and more importantly, healthy longevity, maintaining your health, um, throughout your lifespan.
• 6:18
  John: I mean, just, just to be clear, your message in push is the most important prescription for a healthy life.
• 6:26
  John: Is exercise and movement.
• 6:28
  Dr. Jordan Metzl: I have the front quote of the book.
• 6:30
  Dr. Jordan Metzl: I'm gonna, I actually have it right here, Gandhi.
• 6:33
  Dr. Jordan Metzl: Uh, you must visualize the change you wanna see and me commit to getting off your ass.
• 6:38
  Dr. Jordan Metzl: That's the message every single day, every single way commit to getting off your ass.
• 6:42
  Dr. Jordan Metzl: And that's what the message is of this.
• 6:43
  Dr. Jordan Metzl: I want you to push yourself, both physically and physiologically, is
• 6:47
  John: disappointed that that wasn't the headline, that it was pushed, but, but let's dig into one of the, I think the, the, one of the more interesting things you.
• 6:55
  John: Sort of layout in the book 'cause it's not just a prescription for fitness.
• 6:58
  John: You get under, get into the psychology and the motivation of fitness and movement and non-movement and non fitness.
• 7:07
  John: You refer to motivation as a science.
• 7:09
  John: Is it really a science or are people, are certain people just born to be athletes and others are born to be sedentary?
• 7:16
  John: I mean, that's sort of the way our society is, is, is today.
• 7:19
  John: I mean, what is can, if Mo is, is motivation a science?
• 7:24
  Dr. Jordan Metzl: Yeah, great questions.
• 7:25
  Dr. Jordan Metzl: And so listen, what I like to think about is what makes people have habits and what are those habits over their course of their life.
• 7:32
  Dr. Jordan Metzl: I mean, my previous books have been a lot about this kind of medicine, fitness interface, you know, books on running and taking care of your achy knees, but this is the first time I've kind of really.
• 7:41
  Dr. Jordan Metzl: Uh, weighted into this water of motivation, and I will tell you it's a lot easier to read somebody's MRI and see if they have a torn meniscus or a torn ACL than it is to understand motivation.
• 7:50
  Dr. Jordan Metzl: It's a very murky subject and there's not a one size fits all.
• 7:55
  Dr. Jordan Metzl: But what I did for this book is I interviewed a whole number of my patients, some of whom were exercising into their nineties, and really wanted to get an idea of what is motivating them.
• 8:03
  Dr. Jordan Metzl: And I came away with the idea.
• 8:05
  Dr. Jordan Metzl: That, you know, motivation is either for some people built into their DNA, what they do.
• 8:10
  Dr. Jordan Metzl: And I think I'm really lucky that, you know, my amazing family and parents, particularly my dad was a big driver in pushing me to, uh, you know, move every single day.
• 8:20
  Dr. Jordan Metzl: But that's, if that's not part of what you do, and unfortunately, the vast majority of people in our country and in our world are not exercising regularly.
• 8:27
  Dr. Jordan Metzl: Um, despite the health benefits.
• 8:29
  Dr. Jordan Metzl: What can we do to start thinking about their equation and how can we change that?
• 8:33
  Dr. Jordan Metzl: And, and so one of the analogies I give is like a tractor tire, and that it takes the most energy to get that tire off the ground.
• 8:40
  Dr. Jordan Metzl: Uh, and once it starts rolling, it, it adapts the momentum of its own.
• 8:43
  Dr. Jordan Metzl: And so how do you adapt that momentum?
• 8:45
  Dr. Jordan Metzl: And it takes several months of consistency.
• 8:47
  Dr. Jordan Metzl: But if you can really think about.
• 8:49
  Dr. Jordan Metzl: Consistent behaviors.
• 8:50
  Dr. Jordan Metzl: Um, and, and I try and get into some of that.
• 8:53
  Dr. Jordan Metzl: Um, it really helps change your motivational profile and that in a habit starts to form over time.
• 8:59
  John: And, and maybe talk a little bit about the knowledge, emotion and belief components of motivation, because I think a lot of people know they should be exercising more, but.
• 9:10
  Dr. Jordan Metzl: That's right.
• 9:11
  Dr. Jordan Metzl: So what I try and do is to break down, you know, you know, you should be doing this.
• 9:14
  Dr. Jordan Metzl: You're emotional about what you're doing.
• 9:16
  Dr. Jordan Metzl: I believe I should be doing it.
• 9:18
  Dr. Jordan Metzl: The theme I keep coming back to, which I think is the easiest for people to kind of understand for me as well, was the idea of lowering your cost to act.
• 9:25
  Dr. Jordan Metzl: What does that mean exactly?
• 9:26
  Dr. Jordan Metzl: So I wanna lower my cost to act well.
• 9:29
  Dr. Jordan Metzl: Lowering my cost to act means I wanna take whatever it is that's kind of blocking me from doing this.
• 9:33
  Dr. Jordan Metzl: And I wanna remove as many barriers as I can.
• 9:36
  Dr. Jordan Metzl: I have a great patient story for this and that.
• 9:38
  Dr. Jordan Metzl: I had a patient of mine who, like many knew it was important to start exercising, exercising regularly at a busy finance job here in New York and, uh, couple kids and just didn't have time to do it.
• 9:48
  Dr. Jordan Metzl: And so overall, he was starting to put a little bit of weight and feeling lousy and less energy, and he kept saying, I know I need to do this.
• 9:54
  Dr. Jordan Metzl: I've kind of paid subscriptions, I did all these different things.
• 9:57
  Dr. Jordan Metzl: And so we thought about how can we lower your cost to act?
• 10:00
  Dr. Jordan Metzl: This guy loved his shoes and his running shoes, and so what he did is he would go to his local gym right over here on 62nd, 63rd Street, and they have day lockers, and he would put his exercise clothes and his running shoes in his day locker and lock it in the morning, six 15 in the morning.
• 10:17
  Dr. Jordan Metzl: And in these day lockers, if you don't.
• 10:19
  Dr. Jordan Metzl: Show up by the end of the day, they cut off your lock and put your stuff in the lost and found.
• 10:22
  Dr. Jordan Metzl: And so he essentially forced himself to stop off on the way home by locking his clothes in, his running shoes, in his day locker.
• 10:28
  Dr. Jordan Metzl: And when he was there, you know, the cost to act was lowered and that made a difference for him.
• 10:32
  Dr. Jordan Metzl: And he was there.
• 10:33
  Dr. Jordan Metzl: It's like, all right, I might as well start.
• 10:34
  Dr. Jordan Metzl: And he started an exercise habit that he was able to keep going and still is going to this day.
• 10:37
  Dr. Jordan Metzl: So people have different ways to lower their cost to act.
• 10:40
  Dr. Jordan Metzl: Some people prepay a trainer or join a group or have a club or whatever, but you know.
• 10:45
  Dr. Jordan Metzl: Figuring out lowering your cost to act is the best way to start thinking about into changing that discussion around, around motivation.
• 10:52
  John: I mean, the, the thing that I, that's striking about the lack of movement is, is basically you lay out a case that says the, that low movement and little exercise is as dangerous as smoking or diabetes, which is just a shocker.
• 11:06
  John: I mean, this, it could, is it possible that lack of movement can be as dangerous as a, a chronic disease like diabetes or, or, or putting your lungs to risk with smoking?
• 11:16
  Dr. Jordan Metzl: Not only do we have great evidence on that, but we have great evidence on the preventative nature of exercise, independent of some of the issues like, you know, lifestyle or dietary changes or weight.
• 11:26
  Dr. Jordan Metzl: It's much healthier to be moderately overweight, mild to moderately overweight and active than it is to be very thin and inactive.
• 11:34
  Dr. Jordan Metzl: So in our days of GLP one, everybody wanting to get as skinny as possible.
• 11:38
  Dr. Jordan Metzl: That doesn't really necess necessarily equate to many, many health benefits.
• 11:43
  Dr. Jordan Metzl: Activity is the best drug movement is by far the safest, free, and most effective drug across the entire spectrum of, of the human condition.
• 11:53
  Dr. Jordan Metzl: That's why I'm so passionate about prescribing it, not only saying people should do it, but actually prescribing it to patients and to my community on a regular basis.
• 12:01
  John: What's it going to take to get other doctors to prescribe movement?
• 12:05
  John: Because you, you're not, you're not actually laying out the, the old presidential fitness test.
• 12:11
  John: You're not saying everybody needs to mar be a marathoner.
• 12:14
  John: You're your, your, your exercise prescription is actually with, within most people's ambition and ability.
• 12:21
  John: What's it gonna take to get doctors to start to prescribe exercise?
• 12:25
  Dr. Jordan Metzl: Well, it's interesting.
• 12:26
  Dr. Jordan Metzl: We started now about 10 years ago when I started recognizing I had this kind of community and that it was impactful.
• 12:32
  Dr. Jordan Metzl: Um, about 10 years ago now, we started a seminar next door for the second year med students at Cornell called prescribing the Medicine of Exercise.
• 12:39
  Dr. Jordan Metzl: And we started looking around for curriculum of, to look at the effective exercise on chronic disease and mental health and prevention.
• 12:47
  Dr. Jordan Metzl: The exercise prescription and there was literally no curriculum for medical students.
• 12:51
  Dr. Jordan Metzl: Like you learn about how to do all kinds of exotic things and you learn nothing about the thing that probably makes a bigger difference than many of the things you spend, you know, days and weeks studying.
• 13:03
  John: Pause on that, that if exercise is one of the most important elements of fitness, there has to be some, something you learn in medical school about exercise and the science of.
• 13:15
  Dr. Jordan Metzl: Not a thing.
• 13:16
  Dr. Jordan Metzl: Not a thing.
• 13:16
  Dr. Jordan Metzl: There was zero curriculum and so we started kind of looking through this curriculum.
• 13:20
  Dr. Jordan Metzl: That was 10 years ago.
• 13:21
  Dr. Jordan Metzl: There's a little more movement now, but still not as much as I would like to see.
• 13:25
  Dr. Jordan Metzl: But there are certainly, as you see some of the advertising around different healthcare systems, I know here at HSS we're looking at starting a center around movement and longevity.
• 13:34
  Dr. Jordan Metzl: There are many others doing the same.
• 13:36
  Dr. Jordan Metzl: There has been with this kind of longevity craze, which you know.
• 13:40
  Dr. Jordan Metzl: I'm not a big believer.
• 13:41
  Dr. Jordan Metzl: We can dramatically extend life expectancy, but we definitely can extend.
• 13:45
  Dr. Jordan Metzl: We're not, oh,
• 13:45
  John: come on,
• 13:46
  Dr. Jordan Metzl: healthy longevity.
• 13:47
  Dr. Jordan Metzl: We're
• 13:47
  John: not all gonna, we're not all gonna live to 150.
• 13:49
  John: Come on
• 13:50
  Dr. Jordan Metzl: Dr. I don't want, but we can definitely extend healthy longevity.
• 13:53
  Dr. Jordan Metzl: We can reduce the risk of disease.
• 13:55
  Dr. Jordan Metzl: Um, certainly.
• 13:56
  Dr. Jordan Metzl: And so by thinking about those things with movement, you know, we wanna think about how do we ensure our patients and our community can be as active as possible?
• 14:05
  Dr. Jordan Metzl: And, and I think healthcare systems in general are starting to.
• 14:09
  Dr. Jordan Metzl: Lean into that, but it still is community dependent, geographically dependent.
• 14:13
  Dr. Jordan Metzl: Um, so there's, there are a number of factors, which I think we still have to kind of sort out, but I think we're heading in the right direction.
• 14:19
  John: A lot of people who might be less motivated to exercise than the the triathlon family that you belong to.
• 14:27
  John: Think of exercise as a luxury good.
• 14:30
  John: And you, and you kind of make a, a, a, a passionate case of the opposite by, by laying out your plans.
• 14:36
  John: And maybe talk a little bit about that, that exercise isn't the luxury.
• 14:40
  John: It's, it's sort of an, an essential element of fitness.
• 14:44
  Dr. Jordan Metzl: That's right.
• 14:44
  Dr. Jordan Metzl: So, you know, what I try and break down for people is how they can think about structuring their exercise, programming, some combination of, you know, cardiopulmonary fitness, but also strength.
• 14:53
  Dr. Jordan Metzl: I make a strong impassioned case for the importance of building and maintaining muscle across your lifespan for healthy longevity.
• 15:01
  Dr. Jordan Metzl: And we think about muscle in two categories.
• 15:02
  Dr. Jordan Metzl: Number one is just for locomotion.
• 15:04
  Dr. Jordan Metzl: If somebody comes in to see me with an achy knee or an achy shoulder, you know, by strengthening the muscles around that achy body.
• 15:11
  Dr. Jordan Metzl: Part, we can reduce some of the symptoms and maintain joint mobility, but secondarily, muscle is extremely important, both for its endocrine and exo exocrine property.
• 15:21
  Dr. Jordan Metzl: So when you build and maintain skeletal muscle, when you start exercising, you're able to store glucose in the, in the form of glycogen, which is important for fuel going forward.
• 15:31
  Dr. Jordan Metzl: It also reduces some of the load on your pancreas, so you're better able to regulate blood, blood sugar.
• 15:36
  Dr. Jordan Metzl: Just by keeping your muscle mass.
• 15:38
  Dr. Jordan Metzl: And then also when you exercise muscle secretes, anti-inflammatory properties called interleukins, and these act throughout the body, uh, to reduce general inflammation.
• 15:47
  Dr. Jordan Metzl: There's a concept called inflammaging, the inflammatory basis of chronic disease, so things like heart disease and cancer and diabetes, uh, et cetera.
• 15:56
  Dr. Jordan Metzl: Almost every chronic disease is related to this chronic inflammatory state and building and maintaining muscle.
• 16:02
  John: Yeah, they just, I think, I think it's really important to underscore that.
• 16:06
  John: Dr. Metzel.
• 16:06
  John: 'cause I do think that is a a a uni a well held held, now well documented part of, of of, of what's happening with chronic disease, that inflammation affects all of the bad stuff that is, is, is, is accelerating the worst types of aging in chronic disease.
• 16:24
  John: And you're saying, I thinks that simple exercise and, and lifting weights or, and end movement actually can materially change the arc of that.
• 16:35
  Dr. Jordan Metzl: Absolutely.
• 16:36
  Dr. Jordan Metzl: You know, the big three, neurodegenerative disease, cancer, metabolic syndrome, such as, uh, diabetes, metabolic diseases, uh, very much related to chronic inflammation.
• 16:45
  Dr. Jordan Metzl: These are the most expensive diseases, uh, in our world and certainly in American and western healthcare systems.
• 16:52
  Dr. Jordan Metzl: And getting off your.
• 16:55
  Dr. Jordan Metzl: You know what tush, every single day tush can help reduce the disease burden, um, across the board in these things.
• 17:02
  Dr. Jordan Metzl: So absolutely, we should be not only thinking about treating disease, we should be thinking about preventing disease with the medicine of movement and muscle.
• 17:10
  John: And you, you, you actually have a pretty straightforward plan.
• 17:13
  John: Do you wanna talk through the, your four week push plan to get folks started?
• 17:18
  Dr. Jordan Metzl: Yeah.
• 17:18
  Dr. Jordan Metzl: Listen, we were trying to look at is there a, a way to evaluate motivation and the, I, you know, again, as I mentioned before, looking at an MRI, like your meniscus is torn.
• 17:29
  Dr. Jordan Metzl: It's not you have a broken wrist on your x-ray, you don't.
• 17:32
  Dr. Jordan Metzl: You assess your motivation was a much more challenging concept, and so there wasn't a great kind of motivational tool to assess somebody's motivation.
• 17:41
  Dr. Jordan Metzl: There's a lot of different factors, but what I tried to do was trying to give some of the basic paradigms of motivational assessment.
• 17:48
  Dr. Jordan Metzl: How motivated am I?
• 17:49
  Dr. Jordan Metzl: What am I doing?
• 17:50
  Dr. Jordan Metzl: What am I daily activities?
• 17:51
  Dr. Jordan Metzl: How often am I thinking about doing these types of things?
• 17:54
  Dr. Jordan Metzl: Give a basic score that you would add up at the end of, uh, those different categories and then, you know, over a period of four weeks, try and change your score a little bit at a time.
• 18:03
  Dr. Jordan Metzl: One thing we just recently learned from a big study published, um, outta Germany, looking at basically small behavior changes affecting people's health.
• 18:11
  Dr. Jordan Metzl: Just sleeping a little bit more, exercising a little bit more, changing your dietary patterns.
• 18:15
  Dr. Jordan Metzl: Even these small changes can have a much more significant effect than we thought previously on healthy longevity.
• 18:22
  Dr. Jordan Metzl: So what I'm after.
• 18:23
  John: What, what would be a small change
• 18:25
  Dr. Jordan Metzl: if you just maybe so, you know, trying to walk five minutes more, trying to do something that makes you huff and puff a little more.
• 18:30
  Dr. Jordan Metzl: Trying to do air squats during the day when you're just sitting around or standing around trying to just make small behavior changes that can add up over time and they seem to make a significant difference in your health profile.
• 18:42
  Dr. Jordan Metzl: So I'm not after the Grand Slam home run, I'm after just, you know, small singles a little bit at a time.
• 18:47
  John: Mm-hmm.
• 18:49
  John: And, and what, you've got 80 exercises.
• 18:52
  John: In the book, what would be the, your top five to get people started?
• 18:58
  Dr. Jordan Metzl: Well, listen, I want things, what I put in the back of this, where things people do anytime, anywhere with body weight.
• 19:04
  Dr. Jordan Metzl: Um, you don't have to join a fancy gym.
• 19:06
  Dr. Jordan Metzl: Um, you can literally do these things anywhere.
• 19:08
  Dr. Jordan Metzl: So things like squats and lunges and planks and pushups, and I give all different kinds of variations of these things based on your age.
• 19:17
  Dr. Jordan Metzl: Your strength and your mobility.
• 19:18
  Dr. Jordan Metzl: So listen, there's different ways to do a plank based on what you're able to do.
• 19:22
  Dr. Jordan Metzl: Are your knees off the ground?
• 19:24
  Dr. Jordan Metzl: Are your knees on the ground?
• 19:25
  Dr. Jordan Metzl: Anything is better than nothing.
• 19:27
  Dr. Jordan Metzl: And I have people,
• 19:27
  John: and what I love about your book though is you, you just need to buy the book.
• 19:32
  John: And then the exercise program is free.
• 19:34
  John: I mean, I just, I wanna make this really straightforward.
• 19:37
  John: It's a really well thought through set of routines where people can get started sort of out of the gate.
• 19:43
  John: It's actually incredibly practical.
• 19:46
  Dr. Jordan Metzl: Thank you.
• 19:47
  Dr. Jordan Metzl: No, I mean, it's a combination of my medical world, uh, you know, treating disease and my fitness world preventing disease, and so I try to marry them together to give people an assessment tool and, and to try and figure out how they can assess their motivation and then build functional strength throughout their life.
• 20:02
  John: We're at the beginning of the year, and a lot of people have committed to, uh, to, to great greater fitness, more activity, and a lot of those commitments just fall by the wayside.
• 20:12
  John: Historically, 80 to 90% of people's, um, new Year's resolutions fail.
• 20:17
  John: What's the, maybe we could, uh, wrap with what, what would be the one piece of advice you'd give the, the, the, the person who's motivated but not active yet to keep, to make a resolution about, about how to push themselves.
• 20:31
  John: And how to keep it.
• 20:33
  Dr. Jordan Metzl: That's exactly a great question.
• 20:35
  Dr. Jordan Metzl: That's exactly what, what I want people to do.
• 20:37
  Dr. Jordan Metzl: So maybe think about how I can lower my cost to act.
• 20:40
  Dr. Jordan Metzl: I mentioned before how I can make that behavior change that I wanna be practical in my life.
• 20:45
  Dr. Jordan Metzl: And to me the the biggest help in lowering the cost to act.
• 20:49
  Dr. Jordan Metzl: Is fun and community.
• 20:50
  Dr. Jordan Metzl: Those seem to be the two most influential things.
• 20:53
  Dr. Jordan Metzl: So number one, am I smiling when I'm, do I like walking outside?
• 20:57
  Dr. Jordan Metzl: I like walking up a hill.
• 20:58
  Dr. Jordan Metzl: I like, you know, doing tango class.
• 21:00
  Dr. Jordan Metzl: I like yoga.
• 21:01
  Dr. Jordan Metzl: Something that makes you smile.
• 21:02
  Dr. Jordan Metzl: You're much more likely to be consistent with.
• 21:04
  Dr. Jordan Metzl: And number two is the power of community.
• 21:06
  Dr. Jordan Metzl: Um, you know, the exercise classes that I run.
• 21:09
  Dr. Jordan Metzl: Great, but I'm sure they're as great as any other exercise people could do.
• 21:13
  Dr. Jordan Metzl: The benefit of what I've been doing is building community, so I'm actually prescribing exercise by prescribing community.
• 21:19
  Dr. Jordan Metzl: Just people don't fully recognize it.
• 21:21
  Dr. Jordan Metzl: That's why they're having such a great time, and they'll do it.
• 21:23
  Dr. Jordan Metzl: And so find a community and make it something that makes you smile and you're much more likely to succeed.
• 21:29
  John: Well, thank you Dr. Jordan Metzel, the new, uh, the, the longtime fitness guru and the most recently the author of Push.
• 21:40
  John: Um, if you liked what you heard or you didn't, we'd love you to prescribe sub, uh, subscribe on your favorite service to care talk.
• 21:48
  John: Dr. Jordan, thanks so much.
• 21:49
  Dr. Jordan Metzl: It was a pleasure to visit with you.