Transcript

Longevity Simplified · HER

0:07
Pam Peeke, MD: Hi, I'm Dr.
0:08
Pam Peeke, and this is episode 569 of The Bold and the Brave Her Podcast.
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Now, today I'm joined by a newbie, someone I want to
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introduce to the entire community.
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His name is Dr.
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Howard Lux.
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He's a board-certified orthopedic surgeon with over 30 years of clinical
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experience and a long time focus on helping people remain active,
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strong, and capable as they age.
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He's an athlete, a fellow athlete, yay and he's author of a really cool book
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that I really think that you will love.
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It's easy to read, and it's fairly straightforward, sort
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of the way, you know Howard is.
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And it's called Longevity Simplified.
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He also wrote Built to Move, Born to Heal.
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I could be wrong, but isn't that the name of your Substack?
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Howard J. Luks, MD:
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That is
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Pam Peeke, MD: There you go.
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He's got an awesome Substack.
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I always look forward to every one of his, you know, daily Substack updates
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because he writes so well, and he really makes you think, you know, as you're
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looking at this whole issue of longevity.
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Howard, welcome to the Her Podcast
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Howard J. Luks, MD:
1:30
Thank you.
1:30
it's a pleasure to be here
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Pam Peeke, MD: All right.
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Why'd you write the book?
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Howard J. Luks, MD:
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Yeah.
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so a long answer.
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Um, I used to write about orthopedic surgery a lot.
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At one time, I had the busiest solo doctor's ortho site on the internet.
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And then I started to see things in myself, in patients, and realized that it
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had nothing to do with orthopedic surgery.
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It had to do with metabolic health.
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And as I dove down each topic, when I want to learn something, I write about it.
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So I started to write articles about insulin resistance,
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hypercholesterolemia, fitness, et cetera.
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And a lot of people had told me along the years to write a
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book, to put that into book form.
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And then came the pandemic, and I took that opportunity to, to collate
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it all and write it as a book
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Pam Peeke, MD: That's fantastic.
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I mean, it came out in 2022, and honestly, you were prescient.
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You know, you, you really, had looked at this whole issue of, as
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it were, longevity long before it became like the word of the day.
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You know, it's getting to a point where, you know, I, I wonder what
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it means anymore because it's, it's being kicked around, diluted.
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You know what it reminds me of, Howard?
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Remember the old days when the word wellness first cropped up
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and everyone was like, "Oh, let's get on the wellness, train"?
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And next thing you knew it was diluted.
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And yeah, suddenly it just sort of meant anything you wanted it to mean.
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And, you know, I'm, I'm hoping longevity doesn't go that, that route in a big way
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Howard J. Luks, MD:
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it's sticky online.
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So it's already gone that way because if you can't sell it, then, then a lot
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of people aren't going to talk about it.
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So that's why I wrote the book, because the things that pull the, the, the
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levers that you have to pull to live a longer, a- and healthier and better
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life are simple, easy, and affordable.
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it doesn't require a monthly subscription to anything.
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Um, And influencers can't sell that
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Pam Peeke, MD: Yes.
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How interesting is that?
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So one of the, you know, in this book, Longevity Simplified, you
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obviously look at this whole issue of longevity long before it was cool.
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And goals and, you know, basically why it is that we're, we should
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even be interested in this.
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I think for the longest period of time, it was always about lifespan,
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how long are you gonna live?
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Yeah, that's really special if you're, you know, really miserable in the last third
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of your life, so that's not gonna help.
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Healthspan clearly, you know, leans into the quality of life
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during that period of time.
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And ideally, you'd like healthspan and lifespan to be kind of the same and
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that's kind of one of our goals here.
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But, you also speak about metabolic health, not metabolic disease, which is
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what I think a lot of people, you know, see so much written about, but you're
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actually talking about metabolic health.
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What do you mean by that?
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Howard J. Luks, MD:
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Yeah.
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Well, I want to give people the goal to strive for instead of just telling
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them that th- that they're sick.
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I think that's defeatist.
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So metabolic health.
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If you boil down a lot of the major causes of death and disability, it
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comes down to our metabolic health.
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And if you drill down on that, it comes down to the health of our mitochondria.
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So everyone has heard that term by now, right?
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They're the powerhouse of our cells.
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But if you're not fit and active, you don't have enough of them, they're
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not working efficiently, they can't oxidize fat in, in deference to glucose.
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They can't handle lactate to use as fuel.
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So someone who's metabolically healthy is capable of doing all those things,
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something we've referred to as metabolic flexibility, where the mitochondria
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prefer to burn fat for fuel as opposed to glucose, can burn lactate
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when it's available with exertion.
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And those who are, are metabolically flexible and have a lot of,
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efficient mitochondria to produce energy are metabolically fit
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Pam Peeke, MD: So, you know, it's the mighty mitochondria
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is what it gets down to.
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You know, I'm kind of laughing 'cause I remember, you know, when I was a
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med student or even an undergrad at Berkeley, you know, every time they
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mentioned mitochondria, it was like, okay, you know, now we're starting to
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get hairy and do the hairy science thing.
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And I kept saying to myself, "I wonder if we could ever explain this to consumers."
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You know, 'cause it, it, it does get ugly, you know, very quickly actually.
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but now, we even have products that start with mito, as you're well aware.
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And um, now people are, are recognizing this little powerhouse, as you say,
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but you know, kind of the engine of the cell, and all the rest of it.
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You don't have to worry about what happens with ATP and the rest of it.
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All you have to remember is there's a little powerhouse in there.
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How do you take care of your mitochondria best?
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Howard J. Luks, MD:
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Exercise.
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That's it.
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You need, you need various forms of exercise.
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And I link my discussions on Substack to the biology of aging too,
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because I f- I firmly think that our workouts need to change as we age.
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But exercise is the only way to build the efficiency, effectiveness, and
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metabolic flexibility of your mitochondria
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Pam Peeke, MD: Okay.
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What kind of exercise?
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Howard J. Luks, MD:
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Yeah.
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So specifically aerobic exercise.
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There are benefits to mitochondria with, with weight training but to, to focus on
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metabolic health, it's aerobic exercise.
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And as a lot of people ar- argue online, most of it sh- should
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be in the low heart rate domain.
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What a lot of influencers will say is zone two, but a lot of people
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don't understand what zone two is.
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Zone two is not an exact heart rate.
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It is a metabolic state.
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It is where you're using fat efficiently, and you can't do it with any formula.
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You can't figure it out, because you can breathe through your nose.
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You have to be put on a machine to figure out what your a-
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aerobic zones actually are
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Pam Peeke, MD: Okay.
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You know, it's interesting.
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There's now a big controversy about the zones, as you're well aware.
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So some people are saying, you know, "Enough already with the zone thing."
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and, "We don't need that," and back and forth.
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What do you think?
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Howard J. Luks, MD:
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Yeah.
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No, I'm, I'm firmly in the camp that the only way to build metabolic
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flexibility, is through low heart rate aerobic exercise, and
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that's for a number of reasons.
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High heart rate domain work will build mitochondrial efficiency, effectiveness,
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and ability to burn lactate a- as fuel.
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It will not improve your metabolic flexibility.
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So we can take a lot of fit athletes, elite athletes, and throw them
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on a CPAP machine, and they're not gonna have great numbers.
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So just because you're fast and capable, it does not mean that, that
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your mitochondria are functioning well.
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Also if you are working and if you want to build, your-- build your mitochondrial
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fitness, you need to do a lot of volume.
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so you can't do a lot of high-intensity volume because you're gonna break.
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You're gonna be in my office because your Achilles tendon's gonna hurt,
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your hamstring's gonna pull, et cetera.
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So if you're working and your schedule is tight and you just don't
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have the time to do a lot of low h-hea-heart rate volume, then high
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heart rate exercise is fine, right?
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You can do a Tabata workout, you can do some hill sprints, and you're
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gonna derive a lot of benefit.
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But don't kid yourself into thinking that you're gonna derive
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the fittest mitochondria around.
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They will be fit, but you can get a lot fitter if you can throw a lot of
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high volume, low heart rate work at it.
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This is one reason why a lot of runners, predominantly I'm a runner, but I'll
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hop on a bike twice a week to do a lot of my exercise there, because I don't
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want to, to accumulate the physical pounding on my bones and tendons that,
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to match the volume that I desire
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Pam Peeke, MD: That's actually, you know, I think what you just said,
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it's extremely welcoming to everyone.
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I think people really think that you have to go out there
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and kill yourself in a big way.
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I also think that high-intensity interval training has been taken to
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weird levels that it shouldn't in terms of frequency as well as duration.
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Marty Jabala is a wonderful friend, and he's obviously the king of
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the whole thing, and he just rolls his eyes and goes, "You know,
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they misinterpreted what I said."
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So, you know, I think what, what I love about what you're saying is the fact
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that you can do this, lower heart rate.
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You don't have to be hitting some crazy, you know, heart rate
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and maxing out your VO2 max.
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Instead just basically enjoying more frequency of the lower
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heart rate um, aerobic exercise.
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I think then what you can do is add in here and there, some
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high-intensity interval training.
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And quite frankly, y- you know, if you know how to do it well Marty Jabala wrote
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a fantastic book about how to do that.
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I mean, you could do it in five minutes, 10 minutes, 20 minutes.
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and so when you wanna do a little, as it were, exercise snack just throw
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it in there, because I think the scientific literature really supports
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the fact that you get-- you derive good metabolic benefit from that let
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alone what's going on with training.
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it's just that you don't have to kill yourself.
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when I started my running, you know, years ago, Jeff Galloway and I met, and,
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he is the famous sort of walk run guy.
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And, you know, I looked at him and I said, "Look, here's the deal.
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I'm built like a sprinter.
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I'm a resistance trained athlete.
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I'm built like a sprinter, you know.
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I have no right doing marathon . I just, like, don't, like, don't go.
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But I really like the community, the crazy people out there, the medal at the end
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of the thing, and all the rest of it."
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So I said, "Oh, okay.
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So I'll go through it."
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He goes, "Just do it, you know, my way.
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I'll show you, you know, how to play with it."
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So I did a lot of what Jeff, you know, basically, showed me and demonstrated,
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and, it worked like a charm.
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I did Boston, New York.
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I've done, you know, all the big guys.
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and I enjoy it sort of all right until I hit mile twenty, and then
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it was sort of like, you know, this is losing its joy right now.
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But, you know, you just get through that last 10K.
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But, you know, it's interesting I never ever leaned into killing yourself.
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And I would watch a lot of my colleagues, both in, marathon and triathlon do that.
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And I, I said, "Why?"
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"Well, the harder you train…"
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And I'm like, "Yeah, the harder you train, the more you see people like Dr.
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Lux, because you're gonna injure yourself."
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Howard J. Luks, MD:
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That's exactly it.
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No, you're exactly right, and I emphasize that all the time.
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I never want today's workout to ruin tomorrow's because those of us
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who can remain consistent are, are going to win this training battle.
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And I'm training for life, I'm not training for a podium.
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I don't need to win anything.
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I just want to be able to continue running.
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And, you know, I love our group runs.
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We go as slow as the slowest runner each weekend, depending on who joins
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us, and we can talk and chat and laugh, and before you know it, you
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know, eight or 10 miles is gone.
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Or I can sit on a bike and watch a movie, you know, or
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talk to a friend on the phone.
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These are easy miles, and they're incredibly meaningful.
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You don't have to sweat and be dying for it to matter.
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as long as your heart rate is up your heart doesn't care
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whether you're riding or running.
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And most people, let's face it, most people cannot run and remain
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under their aerobic threshold.
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So you have no choice.
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You're either walking or you're riding a bike, ' cause that's the only way that
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you can do low heart rate training well
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Pam Peeke, MD: Yeah.
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So the-- as you're well aware, and I certainly am, the mass
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majority of people are not runners,
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Howard J. Luks, MD:
14:17
Great
14:17
Pam Peeke, MD: right?
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I mean, I really am a sprinter.
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I, I really should never have been running.
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But again, it was so much fun, I just sort of got caught up with it.
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But, you know, ugh, the mass majority of people don't run.
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So what do we tell them?
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So they're saying, "No, I have no interest in running," and blah, blah,
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and, "Yet I want to be able to derive longevity benefits of my aerobic workouts.
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So what do I do?"
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Howard J. Luks, MD:
14:46
Yeah.
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So get a heart rate strap or some way to, to reliably judge your
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heart rate because wristwatch is just not good in many people.
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And get outside and walk.
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And if you have to increase your pace, great.
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If you need to find some hills, great.
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But you wanna get your heart rate up.
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If you're very fit, your, your heart rate is not going to leave
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the 90s when you're walking, and you wanna increase the effort a little.
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So I think walking with weight in that situation is great.
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rucking is another ter- term for it.
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I enjoy rucking, on weekends.
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people look at me strange in the neighborhood or on the
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trails, but I don't really care.
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But walking absolutely works, and it can fit the bill, w- whether
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it's with a dog or your friends.
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Just if your heart rate is getting up, then, then, then you're doing real work
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Pam Peeke, MD: Women are wearing those weighted vests.
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Your thoughts?
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Howard J. Luks, MD:
15:45
Yeah.
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So, um, it depends why they're wearing it.
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If you're wearing it because you think you're building bone density when
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you're walking, no, it's not working.
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But if you're, if you're wearing it to add some strain and some weight,
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so get your heart rate up, great.
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Go for it
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Pam Peeke, MD: Okay.
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All right.
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Very good.
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I also, you know, think women especially over the age of, 60 or so may have
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a little curvature of the spine, and it may not be the world's greatest
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thing to, you know, have that weighted vest on 'cause, you know, of the
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imbalance and, and the rest of it.
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I don't know.
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What do you think?
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Howard J. Luks, MD:
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You know, they're not gonna-- I don't think they're going to be carrying
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enough weight for it to matter.
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Pam Peeke, MD: Okay
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Howard J. Luks, MD:
16:31
Yeah.
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You know, I mean, if you're rucking around with thirty, forty
16:34
pounds, then you need-- Right.
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Then you need a stable platform, a good straight, well, a well-aligned
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spine 'cause that can get spicy.
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But if you're walking around with ten, fifteen pounds around your
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waist or, you know, chest, I don't think that's gonna be a problem
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Pam Peeke, MD: A lot of members of our community have been asking, you know,
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"What measurement should I start out with?
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Right now, I wanna know where I am now in terms of my longevity journey."
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The measurements being physical measurements.
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So for instance, I suggest hand grip.
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What else can they do?
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So with hand grip, that's a no-brainer.
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I mean, just, you know, for 30 bucks you can go buy a dynamometer yourself.
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I use the Camry one.
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I'm not sure how you do it.
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and I've been measuring mine for a very long time, and, it, really gives
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you fantastic feedback on overall body strength, which is, has really
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nothing to do so much with the hand as it were obviously if you don't
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have massive arthritis and pain there.
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But it's a marvelous way to be able to measure yourself, say, on a
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monthly basis and kind of see where you are, as you pick up strength.
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So that's one way.
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Do, do you like that as well?
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Howard J. Luks, MD:
17:55
I do.
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it is a good proxy cause in general, people who have good grip
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strengths are going to be doing other activities that'll build mu-
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that will build muscle elsewhere.
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Pam Peeke, MD: Right
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Howard J. Luks, MD:
18:07
I like sit-to-stands, um
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Pam Peeke, MD: Okay, so be specific about sit to stand.
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What, what is it that people have to do?
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Over what period of time they're timing themselves?
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What should they be able to accomplish?
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Howard J. Luks, MD:
18:21
So it's 30 seconds and I'd love to see 15 or more
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Pam Peeke, MD: 15 sit-to-stands, and that basically means completely unassisted.
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And, basically, your little behind has to touch that chair, okay?
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That doesn't mean you lean into the chair and sit there for a while.
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You just touch the chair and up you go again, so that you're
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constantly got tension on yourself.
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I kinda, you know, level up on it a little bit, and I hold onto a,
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20-pound kettlebell or something like that and see if I can nail 15 and 30.
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So far so good.
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Knock on wood.
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Praise God.
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what else you
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Howard J. Luks, MD:
19:00
What about calf raises?
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I like calf raises
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Pam Peeke, MD: Okay, now tell me about calf raises.
19:05
What about
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Howard J. Luks, MD:
19:06
So it really depends on people's age, but I'd love to see, I'd love
19:10
to see a minimum of 30 calf raises
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Pam Peeke, MD: Over
19:15
Howard J. Luks, MD:
19:15
30
19:15
Pam Peeke, MD: per- period of time
19:17
Howard J. Luks, MD:
19:17
yeah, before he gets tired.
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I don't give him a time
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Pam Peeke, MD: other words, you do it to fatigue.
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Howard J. Luks, MD:
19:22
Correct
19:23
Pam Peeke, MD: Ah, okay.
19:26
I-- okay, I'm gonna laugh about this because I think a lot of my, you
19:29
know, audience already knows this, but I was born with, Jurassic calves.
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You know, and I never knew calves were a thing until one day, when I
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was doing the, the full stack on the calf raise and some guy came over
19:45
to me, tapped me on the shoulder and said, "I wish I had your calves."
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And I just stood there and I said, "Why?"
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And he said, "Well, look at them."
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And then I looked at his and I realized that, you know, I had large calves.
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And, it was just a, a wonderful gift from my father's side of the
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family, which was more athletic.
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And, so I have like seventeen-inch calves, and those suckers can go on forever.
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And I'm-- you know, so you know what this reminds me of is when we're looking at
20:18
longevity and we're talking about our bodies and body composition, et cetera,
20:24
you know, take a moment and do a little inventory, and what are you really
20:28
proud of and, and what did God give you?
20:32
You know, like a little gift.
20:33
Everyone's got something different.
20:35
You know?
20:36
It could be like an amazing back or abs, you know, that just cry out for, "Hey,
20:42
six-pack," or whatever the issue may be.
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You know, your body fat distribution, anything.
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I think it's time to be much more aware and proud of what you already have.
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when you mention the calves, I just smile.
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My little calves, um, and there they are.
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My quads are called Thelma and Louise, because they love to kill hills on a,
21:06
bike, and I discovered this in triathlon training.
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Everyone else is like, "Oh, another hill."
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And I'm like, "Yeah, you know, let's do this."
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Howard J. Luks, MD:
21:14
Runners love h- runners love hills.
21:16
I just love hills.
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I, I'm a trail runner
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by nature, so I just, I look at hills and smile
21:28
Pam Peeke, MD: Yeah.
21:29
I really like to hike.
21:31
I like to-- I like to be in nature and, you know, the
21:35
rougher the hike, the better.
21:36
You know, if you've got scree, if you're dancing around on stones, it, it's good
21:42
with me because it helps me balance.
21:45
I practice balance and get a chance to show flexibility.
21:49
Do I fall on my ass?
21:50
Oh, absolutely.
21:52
Epic fails right and left.
21:54
You know, I've got more torn up clothes than you can shake a finger at.
21:58
But you know something?
21:59
It's fun.
22:00
I'm playing.
22:01
I'm having a damn good time, and I continuously challenge myself.
22:06
So that's something that I would wish everyone else would do.
22:10
Now, there's also some other tests that you can do.
22:13
Let's just say you're someone who's been, fairly sedentary, okay?
22:18
And now you're just-- you don't even know where you are.
22:22
So we got the hand grip thing, we've got the sit to ska- stand we've got the, calf.
22:28
What, what about just somewhat like Cooper does with his walking tests how
22:34
fast does it take for you to actually walk a mile, that type of thing?
22:39
I mean, does that help, too?
22:41
Howard J. Luks, MD:
22:41
It does.
22:42
I don't really use those tests, but I, you know, I'm, and everyone
22:48
should know, I'm not a researcher.
22:50
I'm just an orthopedist who's been sitting in the office with patients for 30 years.
22:55
And I come up with a lot of activities that I'll ask people about.
22:59
You know, can you get two bags of groceries inside?
23:02
Can you get up and down the stairs without getting short of breath?
23:05
Can you do a pull-up?
23:06
Can you do a pushup?
23:07
How many?
23:08
Can you do a wall sit?
23:09
How long?
23:09
Yeah.
23:10
On and on.
23:11
So I'll use these, these assessments as opposed to a lot of the more formal tests
23:18
Pam Peeke, MD: see.
23:18
Okay.
23:19
I like the plank test
23:21
Howard J. Luks, MD:
23:21
How so?
23:23
Pam Peeke, MD: You know, it's just wonderful.
23:24
How long can you hold a plank With appropriate form.
23:29
Howard J. Luks, MD:
23:29
Yep
23:30
Pam Peeke, MD: One of my patients once, well, she's just fabulous.
23:34
She was quite obese.
23:36
And, she tried a plank just once when she had begun her journey, and, she was
23:42
laughing so hard, she could barely contain herself 'cause she said, "Well, Dr.
23:47
Peake, you said there were four points.
23:48
You know, I got my, you know, here I am with my elbows on the ground.
23:53
I've got my toes over there and I'm holding the plank.
23:56
But the trouble, I don't have four points, I have five because
24:00
my belly touches the floor."
24:02
And then I said, "Okay, maybe we should just hold off on the
24:06
planks for the time being."
24:08
And then one of her proudest moments was when she showed me, she had someone in
24:13
the gym show, you know, take a picture.
24:16
And that picture was fabulous.
24:19
It just showed her on four points.
24:21
She no longer had a belly that hung down and that actually touched the ground.
24:26
So to me, that was an absolute point of, celebration.
24:32
Howard J. Luks, MD:
24:32
That's awesome
24:33
Pam Peeke, MD: I just love that.
24:35
And you know, when you say, "I'm just an orthopedic surgeon," hell,
24:38
you've got 30 years of listening to people on a daily basis.
24:43
This is why I love talking to people from the front trenches who
24:48
are really seeing the practical reality on a day-by-day basis.
24:54
And I could hear that in your book.
24:57
You know, your book really spoke to that with the examples that
25:01
you gave and, and back and forth.
25:03
So when we come back, I'm gonna pick it up with your book and
25:07
looking at tracking your progress
26:09
And we're back.
26:10
All right, so the book is fabulous, and again, the book is Longevity Simplified.
26:17
And what I love about this is it's just insanely practical.
26:22
It's based upon, you know, Dr.
26:24
Lux, 30 years plus of listening to people on a daily basis and taking care
26:30
of them and understanding what are the biggest challenges people face oftentimes
26:38
at multiple levels, whether they're an elite athlete or whether they are someone
26:44
who is just beginning their journey.
26:47
They've had an awakening, and they said, "Okay, you know,
26:50
I'm a little bit of a mess."
26:51
All right?
26:53
What are the easiest things for people to do to be able to stay focused on
26:59
longevity and not on just the short term, how I look, you know, how I feel
27:06
this very moment but really keeping longevity as the ultimate goal?
27:13
Howard J. Luks, MD:
27:13
Yeah.
27:14
You have to establish a few good habits.
27:16
You know, you need to cook your own food.
27:19
You need to eat real food.
27:21
So I don't like ultraprocessed foods.
27:23
You have to set your bedtime ritual, right?
27:26
So my last meal is three, three hours prior to bed, and I'm generally in
27:31
bed around the same time every night.
27:33
I try to get up around the same time because your circadian
27:36
rhythm, that's your body's internal clock, is really important.
27:40
And if you ke-keep to those habits, it, it works.
27:44
You need your aerobic exercise.
27:46
You need to set a goal for that.
27:48
I don't care if you start with 20 minutes a day.
27:50
I don't care if you start with 10 minutes twice a day or an hour a day.
27:54
Just set a goal and hit it.
27:56
But set an achievable goal, because if the goalpost is too far upfield, you're
28:03
not gonna reach it, and then you failed, and now you're gonna f-feel miserable.
28:07
Some sort of resistance exercise.
28:09
I don't care if it's chair squats, calf raises, attempted push-ups
28:14
on a kitchen counter, lifting your dog, some groceries, some gardening.
28:19
It doesn't matter.
28:20
You need some resistance exercise.
28:22
You have to keep your muscle, especially as you age.
28:26
Friends.
28:28
We all need friends.
28:30
We need to see them in person b-because loneliness kills.
28:34
It's equivalent to smoking half a pack of cigarettes a day in
28:39
terms of its effect on our life.
28:41
And for me, a big one is, having a sense of purpose.
28:45
Why am I doing this?
28:45
What's getting me out of bed every morning?
28:48
What's driving me?
28:49
What's behind this?
28:50
Because, you know, it's pushing me to, to do activities.
28:55
It's pulling me out of bed in the morning.
28:57
It's not, "Oh, crap, I gotta get up."
28:59
It's, "Okay, let's go."
29:01
You know, "I have to do this because of this."
29:03
Boom.
29:04
and setting those simple habits, and in 30 days, when those habits
29:10
are set, it becomes a lot easier.
29:12
It's hard work.
29:14
I said long-- I, you know, I tell people these are simple
29:18
strategies because they're effective strategies, but they're not easy.
29:22
It's very hard.
29:23
And we can't pick and choose, our levers.
29:27
We can't say, "Oh, well, I'll sleep better, and we'll see what happens."
29:30
No.
29:31
We need to sleep better.
29:32
We need to eat better.
29:33
We need to move more.
29:34
We need to lift some heavy things.
29:36
We need to see our friends, and we need to derive a s- a sense of
29:40
purpose or find our sense of purpose.
29:42
Pam Peeke, MD: What I'm hearing from you is routine and practice.
29:47
Howard J. Luks, MD:
29:47
Yes.
29:48
Our
29:48
body
29:48
loves routines
29:50
Pam Peeke, MD: Yeah, routine is…
29:51
You know, you know one of the reasons why I love it?
29:53
You stop thinking.
29:55
Howard J. Luks, MD:
29:55
Yep.
29:56
Pam Peeke, MD: What's to think about?
29:56
I, I mean, hello everyone, don't you brush your teeth in the morning?
30:00
What do you do?
30:00
Like, hold a committee meeting and discuss it?
30:03
No.
30:04
You just march in there and you do the damn thing because it's a routine, right?
30:09
And
30:09
so what I'm hearing from you is establishing routines, and
30:15
that does not happen overnight.
30:18
Howard J. Luks, MD:
30:18
No,
30:19
Pam Peeke, MD: What
30:19
happens instead is that habits take a while for the brain to
30:26
wrap its head around, literally.
30:28
What you're doing is you're establishing new neural pathways, and those neural
30:34
pathways do not occur overnight.
30:36
You have to keep hammering, hammering, and hammering un- until finally
30:41
the moment you didn't have to think about it, it became a habit.
30:46
It became your routine.
30:48
If you have to go, "Should I?
30:50
Should I not?"
30:51
Or if you're, you know, convening another committee and
30:55
finding ways to get arou- No.
30:57
It has not become a habit.
30:58
It is not a routine yet.
31:00
All right?
31:00
So slap yourself in the head and, and get back to it again and
31:04
keep practicing again and again.
31:07
Don't we do this for everything in life, or did I miss that part?
31:11
I mean,
31:11
this is so terribly important.
31:13
There's nothing in life that's worth it where we haven't done this, right?
31:18
Howard J. Luks, MD:
31:18
That's right.
31:18
And you got to get some, some rain boots, you got to get a raincoat, you got to get
31:23
some warm gloves because we don't just do it when it's 70 and sunny in the morning.
31:27
You know, I tell everyone, all my kids run and work out.
31:31
I've told none of my children to run or work out.
31:35
But they've seen me leave the house at the same time, whether
31:39
it's sunny, cold, rainy, blah, blah, wind, it doesn't matter.
31:44
You know, I was outside.
31:46
And so that's the habit that I built, and I really, and I protect it.
31:53
I protect my bedtime, I protect my run times, and it's gonna
31:59
take a lot for me to change that
32:01
Pam Peeke, MD: And, you know, I think that that's extremely important.
32:05
Don't just be you know, fair weather.
32:08
So if it's nice out and it's a gorgeous fall day and now, now we're gonna run.
32:13
Yeah, but what happens when it gets a little bit colder?
32:16
What happens, you know, when it's raining or there's some inclement weather
32:20
going on, or whatever the issue is?
32:22
Suddenly, you know, you kinda lost the drive.
32:24
What's that about, I always think of about that word that
32:27
we use in science, hormesis.
32:30
Howard J. Luks, MD:
32:30
Right.
32:30
Pam Peeke, MD: kill you makes you stronger,
32:32
Howard J. Luks, MD:
32:32
It's true.
32:34
And a lot of people think that we love every run or love every
32:38
workout.
32:39
W- we don't.
32:41
There are times I'm dying as I'm tying my sneakers.
32:46
But when you're done, I've never regretted a run or a workout.
32:51
So the feeling when you're done, that's the reward
32:55
Pam Peeke, MD: When I was training for a marathon, you know, I came up
32:59
with my own little rule, and it turns out after talking to a number of my
33:03
friends, you know, they felt the same way, although, you know, it was a
33:07
little different on the actual metric.
33:10
So the first mile is just, you know, kill me now, right?
33:14
It's just, "No, this is not fun.
33:16
Why am I doing this?"
33:17
And I, I always turned it into a sitcom.
33:20
You're paying to do this, okay?
33:22
You will get a nice medal if everything goes well, and you
33:26
get a really nasty-looking T-shirt, and, and you're really…
33:29
You're paying money to do this to yourself,
33:32
okay?
33:33
And I just keep laughing and laughing.
33:34
Okay, fine.
33:35
So the first mile's done.
33:37
You know, when I start feeling the best is at mile three.
33:41
Howard J. Luks, MD:
33:41
Absolutely
33:41
Pam Peeke, MD: takes me three miles before it finally kicks in, and it's like, "Okay,
33:47
Howard J. Luks, MD:
33:47
Yep.
33:48
Pam Peeke, MD: We're doing it."
33:49
Howard J. Luks, MD:
33:49
agree completely.
33:50
I never judge a run in the first mile.
33:53
Uh, especially, look, I'm 63 years old, so something always hurts, you know,
33:59
whether it's an ankle or a hip or a knee.
34:01
And so I n- I need to wait at least a mile to see if it's all
34:05
gonna go away and settle itself out
34:08
Pam Peeke, MD: Exactly.
34:09
I- it's, it's what I call the organ recital.
34:11
You know, in the morning it's like, you know, what part of
34:14
me is, is not cooperating?
34:16
Okay.
34:17
You know, how's that going?
34:18
We start with the brain and work our way down.
34:21
And there it is.
34:22
But yeah, I, I completely hear you.
34:25
There's something else you did in your Substack that I just found to
34:28
be exquisitely attractive, and that is what I don't do for longevity.
34:36
Okay, I thought that was the coolest list ever.
34:40
Go for it
34:41
Howard J. Luks, MD:
34:41
Yeah.
34:42
So, I don't remember exact list and exact order, but right,
34:47
I'm, I'm gonna get there.
34:48
So, achieving longevity and a better life is about being active,
34:55
being able to be active and remain independent as we get older.
34:59
And so if you're not kicking ass in your 50s and 60s, you're not gonna
35:03
be kicking ass in your 70s and 80s.
35:05
It's just not gonna happen.
35:07
And so in our pursuit of longevity, we're reaching for, for…
35:12
We're reaching for supplements, or we're getting into a sauna, or we
35:15
bought a cold bath, or we bought an infrared panel, or we're stepping on
35:21
a machine that shakes our legs, and we're thinking that we're building
35:25
bone density, or a fanny pack that, you know, u- you know, that vibrates.
35:30
This is not money well spent.
35:33
All you have to do is put your headphones on, call, call,
35:37
call a friend, and go outside.
35:40
you can really achieve what you need to do, with just, a
35:45
minimum of effort and some time.
35:48
As I tell a lot of patients I list these seven levers, quote-unquote, in my book.
35:53
And if you're pulling all those and you wanna strive for the extra 0.1%
35:59
or 1%, great.
36:01
Go jump in a sauna, do a cold plunge every now and then if your brain wants it.
36:06
Do it for no other reason 'cause it's not a longevity benefit.
36:10
A- and take a few supplements maybe, although there's so few that survive
36:15
the science um, other than creatine.
36:19
Other than that, save your money and buy some good walking shoes
36:23
Pam Peeke, MD: One of the things that I really, um, love with this whole
36:26
issue about, you know, what not to do was you kept it so damn simple.
36:35
Howard J. Luks, MD:
36:35
Right
36:35
Pam Peeke, MD: It was just simple.
36:37
It was like, no, you don't have to do what Bryan Johnson did.
36:40
Isn't it interesting that after all the millions he spent on, you know,
36:45
the lab testing and the equipment and, you know, tricking out his entire
36:50
life, it, it-- then he ends up with,
36:53
you know, some autoimmune
36:55
gastrointestinal issue.
36:57
It's like you can't buy your way out of life.
37:02
It, it just doesn't work that way.
37:03
I, I sincerely hope he does well, and I'm sure with all of his resources, he's
37:08
gonna have the, the best healthcare, you know, to deal with this issue.
37:12
it's just one of those things.
37:14
You can't do that.
37:16
You know, most of the people I know who-- You know, a years ago, I met some people
37:23
that, I now hang out with all the time.
37:27
I was the, chief medical correspondent for Discovery Health
37:31
Television, and they'd asked me to go to the National Senior Games.
37:35
And they were in, Carnegie Mellon.
37:39
so, you know, they kind of go around to the various universities 'cause
37:43
of the need for the, you know, track and field and all the rest of it.
37:47
So there I was at Carnegie Mellon, and I, I'd never in my life, right?
37:53
I didn't even know this Senior Olympics thing existed, but
37:57
it sounded so damn cool.
37:59
And what's really amazing is I've made extraordinary friends with
38:04
these athletes, and in November, I'm actually joining their board.
38:09
I am a, a Senior Olympic triathlete competitor, and
38:14
it was a lot of fun, right?
38:16
And so these people that I've met, I mean, you'd think, you know, are they
38:22
drinking, like, really wild, expensive, you know, beverages in the morning that
38:29
will cost you a monthly $125 or what?
38:34
No.
38:35
No.
38:36
You know, they'll say, "Yeah, I have my Cheerios, I throw
38:39
some strawberries on it.
38:40
yeah, I have a banana and, and whatever before I go out and some
38:43
peanut butter and, you know, and then I train, and I do my thing.
38:48
And, oh, and then I have a little fish and some veg stuff."
38:51
I mean, I'm like, "What?"
38:53
This is so clean and so simple, yet these are world record holders in everything
39:00
from the, you know, from swim meets to track and field, and on and on.
39:06
They just kept it in-- They actually look at you cross-eyed
39:10
if you try to make it more complex
39:12
Howard J. Luks, MD:
39:12
Correct.
39:13
'Cause it's just the consistency.
39:14
They trained.
39:15
They showed up for their training every day
39:19
Pam Peeke, MD: Yeah.
39:20
And, and they're very humble about it.
39:22
They're just, you know … So I had on my podcast, back in the fall Natalie, Grabow.
39:30
Now, Natalie Grabow became very famous because she is 80, and she
39:36
went on to, be the first 80-year-old woman to ever successfully complete
39:42
the Ironman Kona Triathlon.
39:46
and, and the best part was her face plant right as she was getting up to
39:53
the arch, you know, the finish arch.
39:55
And I talked to her about that.
39:57
I said, you know, we'd become good friends, and I said, "Natalie,
40:01
you had that look on your face."
40:03
You know, 'cause what it was was someone had kicked up the, computer carpet,
40:08
and, she didn't see it 'cause my God, it was 16 hours and 44 minutes, and she
40:13
was a little dark out there, and she was just trying to get under the damn
40:18
arch so that she can clock her time.
40:21
She never saw the little wrinkle, and so she face-planted.
40:24
And when she r- when she came up, when you look at her face, it,
40:28
it had that look that says, "I'm gonna kill the SOB who did this."
40:32
You know, it wasn't like, "Oh my gosh, I fell and I'm a delicate…"
40:36
No.
40:36
"I'm gonna sock the guy who did this," you know, because there have been so
40:40
many people before her who had, you know, finished, in under 17 hours.
40:46
So when I was talking to her, I said, you know, here she is.
40:51
She didn't even know how to swim until she was 59 years old.
40:57
What, what's the message there, ladies and gentlemen?
41:00
You know, you just never know when the adventure's gonna
41:04
show up in your lifetime.
41:06
Howard J. Luks, MD:
41:06
You can do it
41:07
Pam Peeke, MD: not me, I've never done that."
41:09
Stop that.
41:11
Howard J. Luks, MD:
41:11
Right.
41:11
We-- You're right.
41:13
We tend to lose the abilities we don't train.
41:16
And we can train to do a lot of things no matter how old we are
41:20
Pam Peeke, MD: It's just amazing.
41:22
Howard J. Luks, MD:
41:22
Yep.
41:23
I start- I started rock climbing in my late 50s.
41:28
now, now I'm a decent climber.
41:31
Pam Peeke, MD: Yeah
41:31
Howard J. Luks, MD:
41:31
sport.
41:32
So, you just, you just have to try
41:36
Pam Peeke, MD: I know.
41:36
I did the same thing with triathlon.
41:39
I was like, you know, after a while the marathon was like,
41:41
"Okay, I'm kind of done with this."
41:43
and I ended it with Boston.
41:46
and that was, my goodness the year before, the bomb.
41:53
And so, you know, I, it, it was kind of like very interesting that way.
41:57
And I, maybe I have ADD or something because I just got
42:02
tired of doing one thing.
42:03
So they said, "Why don't you do three things?
42:06
How about we do swim, bike, run?"
42:08
And I said, "Okay, let's do that."
42:10
And I just had a blast.
42:12
I didn't even know how to clip onto a bike, you know?
42:16
I mean, I'm, got very strong legs, but I just never got around to doing anything.
42:21
And then suddenly, you know, I clipped on, I'm like, "I'm flying.
42:25
Kind of liking this.
42:26
this.
42:26
is kind of cool."
42:28
And Thelma and Louise, my quads, were kind of loving it.
42:31
Calves were loving it.
42:33
You know, and there you go.
42:34
So what are, what are you gonna do?
42:37
Oh my goodness gracious.
42:39
So how can people find out more about you and how to follow you?
42:46
Howard J. Luks, MD:
42:46
Yeah.
42:46
So the only places where I'm active is on X, and you find me
42:52
H-J-L-U-K-S, and on Substack, howardluks, L-U-K-S, md@substack.com
43:01
Pam Peeke, MD: And that's, Built to Move, Born to Heal.
43:05
And, and the last name is Lux, and that's L-U-K-S, just so you make sure you know.
43:12
And you know something?
43:13
Keep writing the way you do.
43:15
You do so beautifully.
43:18
You know, I love in your book how you ended it.
43:21
You know, in closing, my best longevity simplified advice to
43:26
you is, here it comes: create a calorie deficit, then stay lean.
43:33
And that, when we say calorie deficit, that doesn't mean, like,
43:36
you know, you lop it down to nothing.
43:38
What it means is just a gradual decrease over time, allowing your
43:43
body to metabolically adjust and, and something that's quite reasonable.
43:48
You know what you can eliminate every day.
43:50
Don't give me that look.
43:52
All
43:52
right.
43:53
The next one is get sleep, and high-quality sleep.
43:59
It's not just, you know, clocking eight hours.
44:02
It's, it's very much like that lifespan, healthspan thing.
44:06
It's not just the quantity, it's the quality of your sleep.
44:10
Pay attention to your sleep hygiene.
44:13
Eat real food, as you had said before.
44:16
Please, this ultraprocessed stuff, enough already.
44:21
Move often throughout the day.
44:24
Boy, is that a bitch.
44:26
So for all of us who are working away, doing our thing here, and standing, you
44:33
know, in our studios and our, you know, Versa Desks and, up and down we go.
44:39
And what I do, what I keep near me is I keep a kettlebell.
44:45
I could just, you know, kinda nail that little sucker.
44:47
And I keep a nice light one, so I could just do a number of things with it
44:52
real quick that kind of opens me up.
44:55
I keep a band near me so I can open myself up, and then I do hip
45:00
opening exercises if I have to sit, because my body cannot stand to sit.
45:07
Ugh.
45:08
Howard J. Luks, MD:
45:08
Great
45:09
Pam Peeke, MD: Can't stand it.
45:10
Ugh.
45:11
All right.
45:11
Push and pull heavy things.
45:14
I think that that's totally cool.
45:17
You know?
45:17
People forget that.
45:19
Push and pull heavy things.
45:20
If you wanna know what that looks like, go to an airport.
45:24
Howard J. Luks, MD:
45:24
Sure.
45:25
Pam Peeke, MD: and pull
45:26
Howard J. Luks, MD:
45:26
But also, you know, so many people when they're working out, they
45:29
do leg extensions, they do bench press, they do shoulder press,
45:32
so their back is getting nothing.
45:34
And their whole posterior chain, which supports the spine, just
45:39
atrophies and looks awful on an MRI.
45:42
And then they start to hunch forward, and then their back
45:44
starts hurting, and then they rest.
45:46
So it's just gonna get worse.
45:48
So you have to do a lot of posterior chain work, and that's
45:51
where the pulling comes in
45:53
Pam Peeke, MD: This is why I love my go-to, which is the kettlebell deadlift.
46:01
You can really nail your posterior chain by doing that.
46:05
I mean, it is, oh, I feel so good.
46:07
Just so long as you get perfect form.
46:12
You have to have a straight back.
46:13
You have to hip hinge.
46:15
And you know why I love it so much?
46:17
When you lift as a woman in life, I know what you're doing.
46:21
You're humping over.
46:22
Ah.
46:23
The worst thing you could do.
46:25
Hip hinge.
46:27
Sit almost like you're on an invisible chair.
46:31
And oh my gosh, your back is gonna love it.
46:34
It's such a great feeling.
46:35
All right.
46:36
Push and pull heavy things.
46:37
Socialize.
46:38
You just said that.
46:40
And here's the thing I love.
46:42
Have a sense of purpose.
46:44
And, you know, I like to add the word meaning.
46:47
Have meaning
46:48
and purpose in your life, because otherwise, why the hell
46:51
get out of bed in the morning?
46:53
Howard J. Luks, MD:
46:53
Exactly.
46:54
Pam Peeke, MD: Seriously.
46:55
Howard J. Luks, MD:
46:55
correct.
46:55
Correct
46:56
Pam Peeke, MD: That's exactly where it is.
46:58
Howard, I cannot thank you enough for being on the podcast.
47:02
Everyone out there, Longevity Simplified by Howard Lux, L-U-K-S.
47:11
And run on over to his Substack, which is Built to Move, Born to Heal.
47:16
Built to Move, Born to Heal.
47:18
I so thoroughly enjoy it every single day, so I know that you will too.
47:24
If you like me, then you're gonna like Dr.
47:27
Lux.
47:27
Come on now, you know?
47:29
And there it is.
47:30
All right, 30 years of experience says he knows what he's doing.
47:34
All right.
47:34
Now, I also want to take a moment to thank my sponsor, and my sponsor is SkinSafe.
47:44
SkinSafe is an app developed by the Mayo Clinic, and it takes the guesswork out of
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shopping for skincare and personal care products based on decades of clinical
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research to analyze ingredients and match products to your unique skin profile.
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You know me, I'm evidence-based.
48:03
Mayo Clinic, hello.
48:04
All right.
48:05
So you always know exactly what's safe for you, whether you've got
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sensitive skin, allergies, or just wanna get the hell away from all the
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48:17
So download the app that you saw in the ad, and use the link in the description to
48:23
get 20% off a SkinSafe premium membership.
48:26
Now, take a moment and leave us a review because we love to hear from you.
48:32
It's been a production of Podcast Health, and I have something to share with you.
48:37
You know how I love little quotes.
48:39
Well, this is kind of based upon what Dr.
48:42
Lux and I were talking about, routine, and it came from Aristotle.
48:48
"We are what we repeatedly do.
48:51
Excellence, then, is not an act, but a habit."
48:57
Do remember that, everyone.
48:59
Now, get on out there and carpe diem, seize the day, and thanks for listening.