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Dressing french dressing. Exactly. That's good. I'm AJ Jacobs, and my current obsession is puzzles, and that has given birth to my new podcast, The Puzzler.

Something about Mary Poppins.

Exactly.

This is fun.

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For every 10% of time that you spend sitting, you have a 10% increase in all cause mortality.

That's crazy.

Yeah. Sitting for more than an hour at a time is literally what's killing most of us right now.

He's a world renowned surgeon, entrepreneur, and founder of Next Health, dr. Darshan Shah.

Western medicine is so disease focused and so reactive that unless things are really bad, there's nothing they can offer you. The patients I was seeing, they're like, how come no one told me this?

Before we jump into this episode, I'd like to invite you to join this community to hear more interviews that will help you become happier, healthier, and more healed. All I want you to do is click on the subscribe button. I love your support. It's incredible to see all your comments, and we're just getting started. I can't wait to go on this journey with you. Thank you so much for subscribing. It means the world to me. The bestselling author and host the number one health and wellness podcast, on Purpose with Jay Shetty. Hey, everyone. Welcome back to On Purpose, the number one health and wellness podcast in the world. Thanks to each and every one of you that come back every week to listen, learn, and grow. Our mission here is to make the world happier, healthier, and more healed, and we do that through introducing you to experts, stories, scientists, researchers, and doctors who have insights that we can all apply and improve our day to day life or maybe even the way we think and live. Now, today's guest is someone that I've been working with personally for quite a few months now, if not a bit longer than that.

And he's someone that I'm excited to introduce you to because he has so much great insight, and I love the way he approaches some of the challenges that we're all facing in our daily lives with our health and wellness. Today's guest is Dr. Shah. Darshan shah MD. A health and wellness specialist, board certified surgeon, published author, entrepreneur, and founder of Next Health, the world's first and largest health optimization and longevity clinic. With expertise in all body systems, dr. Shah has performed over 15,000 surgical procedures, including trauma surgery, general surgery, and reconstructive procedures. As a health and wellness specialist, Darshan has advised thousands of patients on how to optimize their well being and extend their life's plan. Please welcome to the show, Dr. Shah.

Dr. Shah, thank you so much for having me.

Good to have you.

Yes.

Yeah, I was thinking about it. I think we started working together probably just under a year ago.

It feels like it feels like about a year.

About a yeah, about a year. And I remember we got introduced through my health coach, I believe. Now I'm, like, trying to piece it together.

You have to connect the dots because you're a health coach.

Right. So Mona Sharma, who I've worked with for quite a few years now, she introduced us.

Right.

You have this incredible facility. I know it's definitely in La. Because that's where I go. Where else do you have it?

So, yeah, we have three locations in La. One in New York, and one also in Hawaii right now in Maui, which is sadly, right now what? They're going through a lot. And now we're actually franchising all over the world. So we'll be in Dubai, we will be in Canada, Australia, and all over the United States here pretty soon.

And talk to me about this transition that you made very early on in your journey, or not early on, actually. Sorry, more recently. More recently, you made a shift in your career because you went from practicing as a doctor traditionally to now building Next Health. Talk to me about that transition and asked you about why you did that and what was the reasoning behind it.

Yeah, I think most physicians never anticipate a complete 180 transition in their career, especially after you've dedicated 25 plus years. But I felt a real need to do that, and it was mainly because of my own personal health. So what happened was I started off as a surgeon. I then also went into the entrepreneurial side of surgery. I brought surgery centers, and I started hiring doctors as well. And so I was spending half my life being a surgeon, treating patients in the operating room, the other half my life running the business and the other half of my life trying to maintain my own health and my own sanity. And unfortunately, that last part of my life just kind of fell through the cracks. Right. And so what happened was I found myself 15 plus years into my career as probably the most unhealthy person in the building that I was working in. I was 40 pounds overweight, and weight doesn't really matter for everything, but for me, that really led to a tons of health challenges, such as I had high blood pressure, and that blood pressure was not getting any better despite being on two medications.

I was pre diabetic, on diabetes medications, and I was not able to move very well. Like, all my joints ached because of an autoimmune disease starting. So I was 1516 years into my career, and I was like, I'm getting really sick. And at that point in time as well, I had my first child. And having your first child is often like a time in your life where you sit and reflect. And I was actually doing the math, utilizing studies that say, like, if you have this hemoglobin A, one C, this level of high blood pressure, this level of obesity, how long you're going to live? And as I was doing the math and I came quickly to the realization I was a little bit older when I had my first child, I was 40, that I would not live to see him potentially graduate from college. And to me, that was a major kind of punch in the gut, right? Like, what am I doing to myself? And so that kind of started this thought process and this transition in my life where I said, I need to make some massive changes here, and I need to do a quick because I need to be alive for this kid.

I did what a lot of people do. I said, I need to find the best of the best doctors. So I went to Beverly Hills. I researched all the best concierge medicine doctors. I hired an expensive concierge medicine doctor. I said, Your job is to get me healthy. Went to his office and paid a pretty penny for this too. It wasn't cheap. He did a bunch of tests on me, and he found out that, yeah, I was pre diabetic, and it was getting a little bit worse, and I was hypertensive, and I need to be another blood pressure medication. And probably the reason I was having difficulty moving and performing all the activities in my life that I wanted to perform with vitality was because I was depressed. So then he added an antidepressant medication to my list of meds. So my list of meds grew from eight medications to twelve medications. And that's all he told me. He just prescribed me four or five more things. There wasn't even a mention of, do you go to the gym? How do you sleep? What's your stress level? Like, not even a question about that. And I thought to myself, like, there is something really wrong here.

And this was the world that I grew up in, right? This is the medical training that I grew up in. Medical school. When I did med school back in the 1990s, you spent one day of one class talking about nutrition, maybe half a day of another class talking about sleep. But it was mostly about sleep disorders, right? Like sleep apnea and things like that. I did not have the knowledge, so how could I expect this guy to have the knowledge, right? I mean, Western medicine is so disease focused and so reactive that unless things are really bad and we can't prescribe you a pill or a surgery, there's nothing they can offer you, really, right? And so I saw, like, a massive flaw here, and I decided that moment in time, like, I need to learn for myself how to do this right. So decided to hire someone else to take position in my office that I had and just take some time off and educate myself. And so that led to six months to a year of going to every conference I could find. And this was like, eight, nine years ago. When I have a struggle, my first instinct is to educate myself, learn, learn.

And so I went to every conference I could find. I went to physical therapy conferences. I went to how to become a personal trainer. Registered dietitian courses. I went to all these conferences, and I learned so much. And then I kind of stumbled into the field of functional medicine. Have you heard of functional medicine? And I'm sure you have. You had dr. Hyman. On here as one of the fathers of functional medicine, my favorite people in the whole world, but learned from him and others about the root cause of illness. And it was incredible. Like, within eight months, I was able to completely turn my health around. And as I was doing this, the patients I was seeing, I was helping them do the same thing. And they were like, how come no one told me this? And so that's what kind of started my new career in medicine. I said, medicine is fantastic if you're helping sick people become unsick. You're treating cancer, you're treating diabetes. But it's also, to me, exponentially more fantastic when you're helping the other 90% of people who aren't sick stay healthy and never get to that point in the first place.

And so for me, it was just kind of bringing all that together and really providing a place for people to go when you're not yet sick, like when you not yet need to go to the doctor, the hospital, where do you go? It's not just the gym, right? There's much more you need to do. There's a lot more work to be done. And that's what I then dedicated my new life in medicine to, is creating that place.

What are those key pillars or the core areas of next health based on functional medicine that you're measuring and that you think we all need to be aware of when we're looking at that 360 degree look at our health, right?

So this is where I think I have this conversation with all my patients. We sit down and we say, look, there is an overwhelming amount of health information out there and a lot of it is not based in science. There's a lot of majoring and minor things, right? There's a lot of focus on what's the best superfood or how much caffeine should I have per day? But in reality, what I tell people is, let's break this down for you into the main components and over time, let me educate you on the main components of health. But let's not major in the minor things. Let's focus on the 20% of the information that's going to give you the 80% of the result, right? Like, what are the key two or three things you need to know on each aspect of your health to create a major difference? And that's the Pareto principle, which is where can you expend the least amount of energy to get the most amount of results? And then once you get that right, you can absolutely go down the rabbit hole further if you want to. So we start off, I have this thing called a wellness wheel, I call it.

There are twelve points in the wellness wheel. We start off with the basics nutrition, sleep and exercise. But then we move on to gut health, immune system health, hormone health, heart health, and brain health. And so then we spend a lot of time talking about each one of those individually and in each one of these categories. What I do is I try to frame it as it's a three step process. And the first step is, number one, how do we make sure you're not dying from this? Right? How do we make sure your nutrition is not killing you, like you're becoming a metabolic disaster with diabetes? Or how do we make sure that your immune system is healthy enough to prevent cancer? How to not die? Basically, the second part of it is how do we improve your health span? How do we keep you as healthy as possible for as long as possible? And then the last part is what's the advanced science out there in the longevity world that we can implement into your life? Once we make sure you're not in trouble and then you've mastered how to take care of your health span yourself, how do we then start applying these new techniques, this new science?

So a lot of people come to us, and they want to jump straight to, like, how do I do nadiv? How do I do hyperbaric oxygen therapy? I'm like, no, hold on a second. Let's make sure you're not eating ultra processed food first because that's what's going to make the biggest difference, right? Yeah. So that's kind of how we frame it. And we go down each one of these categories and talk about what's going to make the biggest difference for people.

Fantastic. I wanted to lay that out for people because I wanted people to understand. A, you've been on this personal journey yourself. There's a professional shift here as well because you can see the kind of challenges that come with traditional medicine and how functional medicine is the future, even though it seems like it's rooted in ancient times or an older method that's coming back and then looking at these key areas. And that's what I want to dive into with you today, if that's okay.

Oh, absolutely.

Touch on all these areas because I'd love to give people whoever listens to this episode, whether you're watching at home or whether you're cooking right now, whether you're listening with a partner or whatever it may be, I want this to be the episode that you come back to, to learn about these areas of your health so you can become more proactive, not reactive, and get focused on the areas that need help.

Absolutely.

Yeah. Let's first start with nutrition because I think that it's such a big area of our lives, and I think it's one of those ones that everyone will say, hey, I was put in for surgery, but I was never really told to change my diet or even when I went last year. You didn't perform the surgery, but you helped me through my hernia surgery. And I've spoken that on the podcast a couple of times, and I was never told to change my diet. However, by the doctors, you did tell me, and so did Mona if you had not told me that, it would have been a lot harder to even recover. So even though it wasn't integral to the surgery, it did affect the recovery. And so let's talk about nutrition. It's such a big part of our life. Let's start with what has gone wrong with our food. What has changed about our food that it's almost like a surprise to us today that what we eat is affecting how we feel?

Yeah, it's really multifactorial. But it's all happened in the last 50 or 60 years. You look at like, obesity rates, heart attack rates, diabetes rates in the last 50 years just exponentially increasing. And I think it's a few things that happened. One was there was a little bit of a panic back in the 50s that we weren't going to have enough food to feed everybody, right? So the government start putting into place subsidies and laws and bringing corporations together to start mass producing food. And that mass production of food led to over farming of soil, packaging foods to make them last longer. But then also you have these packaged foods. They're not that inspiring. So how do you make them taste better? You make them hyper palatable. And then whenever you involve corporate America in anything, right. What's the goal of corporations to make a profit. How do you do that? By making things cheaper and making more of them. Right. So now you have these giant food conglomerates, like making tons and tons of food as cheaply as possible. And that means using chemicals, it means using dyes, it means hiring scientists to make it hyper palatable.

So even though normally you would eat this thing and your body would be like, what is this? This is horrible. And your body will sense how bad it is for you. Now you can't, because the scientists have made it taste good. Right? And so you have this massive kind of explosion of ultra processed food. An entire supermarket. You look at the square footage of a supermarket, only the outside of it is dedicated to fresh food. The entire middle is frozen, processed, boxed, canned food. Right? And we have so much of it in our society right now that that's really what's caused a lot of the problems. In addition to that, we have food coming from all over the world to us. So it's being shipped to us. It's being stored, it's being preserved. It's being grown in soil that's over farmed. And so we've kind of come to this disaster point where most of the food that we see that is being supplied to our population has become full of toxins and basically not healthy for you. So really, we have to really, really look at and take a step back. How do we eat 50 years ago?

And how can we go back to that type of eating pattern.

Mental health is now talked about more than ever, which is awesome. I mean, I don't have to tell you that it's a primary focus of on purpose, but on a day to day basis, many people don't know where to turn or which tools can help. Over the past couple of years, I've been working with Calm to make mental wellness accessible and enjoyable, or as I like to say, fun and easy. Calm has all sorts of content to help you reduce anxiety and stress, build mindful habits, improve sleep, and generally feel better in your daily life. So many bitesize. Options from the most knowledgeable experts in the world, along with renowned meditation teachers. You can also check out my seven minute daily series to help you live more mindfully each and every day. Right now, listeners of OnPurpose get 40% off a subscription to Calm premium@calm.com J. That's Calm. J-A-Y for 40% off. Calm your mind, change your life. I think that's the hard part, right? Like you just said that when you go into a grocery store, you're seeing that the majority of it is taken up by processed foods. People are thinking, well, what do I eat?

Because it's almost like we've got so used to eating out of tins cans, boxes, packets, it almost even takes a second to think of what food isn't in one of those, or isn't refrigerated or isn't frozen or whatever it may be. What would you say, taking your 80 20 principle, as you were mentioning, referring to before, what is that thing that we can do 20%? Because I think when we think about food, it just feels so big and overwhelming. And then the stress of cooking with our busy lives and working and coming home late from work and trying to eat something quickly, what's the quick win or what's the small win that we can make?

Yes, absolutely. So the 20% here is working really hard to eliminate that ultra processed food. Okay, so really focusing on how do you get fresh, organic food into your body as much as possible, I could tell you if you only make this one change, that's all you need to worry about. You don't need to worry about your protein content and your micronutrients. All of that will come with just switching from ultra processed food to organic fresh, whole foods. And then if that's only one thing that you do, you've had a massive win that's going to give you the 80% of the result because it will force you to learn how to make good food quickly. Because we're all busy, right? So how do we make a quick protein shake or how do we make a quick salad and still get the nutrients in that we need to and not feel hungry? Once you start doing that, you find that your hunger goes down just exponentially. You don't need to eat as often and you kind of eliminate snacking is such a huge thing now. It's almost like we're taught that if you're not snacking, you're not going to have enough energy for the day.

And that's only because we're snacking on processed food in between eating processed food. Right. So really, once you start eating whole food again, a lot of people just stop even eating one meal a day. They go straight into lunch and dinner. I eat protein every morning for my meals. I need to have protein in the morning. Most people do. And we could talk about fasting later too, and kind of the change in thought around that. But making that one change is going to give you 80% of the results, in my opinion and my experience talking to hundreds of people about this over the last year or two. And then there's two or three things you can do after that once you got that down. But that would be number one for sure.

What are two and three?

Okay, so number two is managing your glucose response curve. Yeah, exactly. So the science has come extremely far in this. And what we know for a fact is, first of all, we know for a fact that metabolic syndrome, diabetes is rampant, and it's just getting into more and more communities throughout America all the time. And that's because of things like we talked about snacking, ultra, processed food, et cetera. But it's also just people have forgotten how to eat in a way that keeps your glucose curve under control. Now, when I say glucose curve, that means that I'm talking about like, actually measuring your glucose all the time and seeing when it goes up and when it goes down. And so there's a device now that you can buy. It's called a continuous glucose monitor. Have you worn one of these yet?

I haven't, but I've seen them. Yeah, I think my wife had one.

Fantastic. It is a game changer as far as I'm concerned. I mean, I don't recommend a lot of technology and things until it's really proven and vetted, but I really feel this is something we've used for diabetics for years now, but finally people are starting to use it in their regular day life. And you don't have to wear it forever. I just wear mine for like six weeks. And I found incredible amounts of information about how to eat. So, for example, one thing is we all sit down and we start with chips or bread. Right. It's the absolute worst thing you can do. You want to start with your vegetables first. That puts fiber into your body and slows your digestive tract. And then you do your protein and fats. And last is the carbs. Okay. Because that'll slow the release of glucose from the carbs. That's one of the things you learn from wearing a continuous glucose monitor. You also learn from wearing a continuous glucose monitor what foods shoot your glucose through the roof versus radius or anybody else's, right? And it's different. Like, if you eat a banana, it could shoot your glucose through the roof and your friend, no problem at all.

And that's because your microbiome, your metabolism is different than every single other person. So you can personalize the foods that you eat to keep your glucose level steady. And if you keep your glucose level as steady as possible, day after day after day. And you can cheat. It's not like people don't cheat. We all like to eat a dessert every once in a while, or a cookie. But it really makes you cognizant of what's happening internally. And we live our life not being cognizant of what's happening internally until we feel really bad. This really teaches you how your body is reacting to the food that you eat. So I recommend all my patients, six weeks of a continuous glucose monitor, really learn how your glucose curve reacts to certain foods. There's a really good book out there. It's called the Glucose revolution. It's very well written. You can read it in like three 4 hours about how to manage your glucose curve. I love that book. I give it to all my patients as well and I think you learn a lot. So number two is managing your glucose curve.

Well, that's fantastic. You know what? I love talking to you because you make it sound so simple and accessible. Like whenever I talk to you, I find it so easy to understand what I need to do, why I need to do it, why it makes sense. And I don't need to be as well versed in what you're talking about as you are.

Right.

And it's not overly technical in a way that I can't wrap my head around it. So I love how practical you just made that, especially how we eat what's on our plate. Because I think so many of us spend so long trying to figure out, like, oh, maybe I shouldn't eat that and I shouldn't have that. And it's actually the order can make all the difference. And now everyone who's listening or watching make sure that you don't go and start with the bread or the chips.

Get the crude instead.

Exactly. That's why they serve it first. Well, now I guess they serve chips and guac first too. But what was the number? Three?

So number three and number three and number four, it can be switched around based on your particular dietary pattern. But I would say number three is making sure you have adequate protein intake. And a lot of people, they diet and they not just cut back on the carbs they eat, the fats they eat, but they also cut back on the amount of protein they eat. And you lose weight on the scale, but you're losing more muscle mass and you're losing fat. And that's a travesty because you need your muscle mass to support, not just support your bones. And give you strength. But it's also one of the biggest organs in your body that's preventing you from going into diabetes, cancer, and dementia. So preserving muscle mass is key. So I have all of my patients buy this really cool scale that I like. It's called the in body. H two N Scale. H 20 N scale. And it's a scale that you step on, but you also grab under these handlebars and it tells you your skeletal muscle mass. Okay? So you can not just track your body fat percentage, but also your skeletal muscle mass.

And obviously you want to maintain your skeletal muscle mass, especially the older you get. So the closer you get to 40 and 50, you need to have a big store of skeletal muscle mass because it's going to decline. We all start declining after the age of 50, and it takes a lot of protein and a lot of strength training to make up for that decline. And you want to maintain that skeletal muscle mass. Number one thing to do is have 1 gram per pound of body weight of protein per day broken up into three to four divided dosages. Okay, so you do that, you step on this scale. I like weighing myself every day. It gives you that accountability factor, and you can track the data and make sure you're maintaining skeletal muscle mass and if you need to, decreasing fat mass. Now, 1 gram per pound of body weight, people don't really know what is that really. So look it up. Most people weigh somewhere around 150 pounds. Look up 150 grams of protein. Look that up on Google and you'll see all sorts of infographics and it's a lot of protein. It's not a small amount of protein.

And if you're vegetarian or vegan, you can still do this, but you're going to probably need a little bit more because only about 80% of that is bioavailable protein. So you want to maybe even increase a little bit more. And once you see that infographic, once you see or just even buy a little scale and measure out 150 grams of protein, see what it is, you're like, oh, wow, I am really not getting enough protein there today.

I've been thinking about that a lot lately myself. I've been looking at that and Radhi and I were talking about it. I was like, yeah, I'm not sure I'm getting as much protein as I need to be getting. And I'm obviously plant based. So that was something that we were diving into. What are the best plant based sources of protein that you're seeing and that actually add up to that amount? I know what the sources are, but it's almost like, how do you get that much of it?

Yeah, you know what the sources are, like beans and grains, but also I myself and all my vegetarian and vegan friends, I recommend Pea protein powder. It's really good. It goes down easily. You can even add it to your oatmeal and other things that you're eating, and you'll start building up. And look, the idea is not to get from like, 10 grams of protein a day all the way to 150 grams. You build up slowly over time, and you see what kind of works for you. All of this needs to be individualized. And that's why I like having that data point, which is the bioimpidence scale, that in body scale, because you can see, like, oh, wow, my skeletal muscle mass is going up. I'm doing good. Now here's where I need to be, right. So you can really personalize it for yourself.

Okay, fantastic. This is already helping me. I'm listening to everything you're saying. It's so relatable and so actionable immediately, which is fantastic. And I please keep sharing the tools or the gadgets that we can have, or websites or books, because I want all of our community to feel really supported and go, okay, that's what I haven't read yet.

Absolutely. And I have no financial hookup with any of these companies. I'll tell you if I do, but this is the stuff that I love, and I've seen my patients really take to as well, so I'm going to blurt them out. Do your research.

Let's talk a bit about supplements and vitamins, because I think that there's a lot of mixed messaging out there about what's needed, how much of it's needed. Some people are like, well, none of it really gets absorbed, and does it make a difference? And there's always a debate about it. How do you go about figuring out what someone needs as an individual as opposed to just taking what everyone's taking? Because you keep hearing about it everywhere.

Yeah, that's such a great question. And we can't even talk about that, Jay, without talking about number four on the list, which was vegetables. All right. And I'll tell you why. So the fourth thing, which is as important as protein, is getting enough vegetables in your diet on a daily basis. So do you know how much that is, by chance?

I don't. I mean, I have a lot of vegetables, right. But I have no idea. So you're going to have to tell me.

Right, and so not a lot of people really know, like, what's the right amount? And really the amount of vegetables you eat has a lot to do with the amount of fiber intake you need, which 90% of America doesn't get enough fiber, and fiber is a critical ingredient of our diet. Secondly, that's where most of our micronutrients and phytonutrients are, is in those vegetables. Thirdly, they just keep you full and satiated all the time as well. So getting enough vegetables in your diet is extremely important. The number that I've seen and a lot of fitness and nutrition gurus talk about is it's a big number. It's like 800 grams of vegetables, which is about a quart of vegetables, right? So, once again, get your scale and measure this out and see what it is. It's not a small amount. It's like two full salads a day. But that's kind of what we need to work up to. So if you're doing that, the need for supplementation is minimal to none. Actually, I'm not a big supplement pusher. I'd much rather people get it in your diet. The reality of the situation is, however, it's really hard to get that much protein and that much vegetable product into your diet, right?

And of course, we can't talk about vegetables without talking about making sure you're buying organic. You're buying as local as possible. And if you can't, go to Ewg.org Environmental Working Group's website. They'll give you a list of what are the most toxic vegetables and the least toxic out there right now. So look at that website and I'll give you the list. So if you're not getting enough vegetable intake into your diet, the next step is to add some supplementation to that. The most common supplements I recommend for people are vitamin D. We don't get enough sunlight to produce it. We're not getting enough in our diet. So most people do need some vitamin D. It needs to be dialed in based on a blood test. So you do a blood test. I like the vitamin D level to be around 50 to 80. And the vitamin D form that I like people to take is vitamin D three K two. The K two is also another vitamin added in. It prevents overabsorption of calcium with the vitamin D and deposition of calcium in your blood vessels. So vitamin D, three, K two, then fish oil supplement as well.

For the vegetarians and vegans out there, there's some great non fish sources of fish oil as well. So I would do that as well. Magnesium is something that we're all very deficient in, so I would do magnesium as well. And then creatine. Believe it or not, it's amino acid. That has a lot of research behind it. Do you do creatine? Yes. Fantastic. Five to eight milligrams every morning. Just put a scoop in your coffee. It mixes in with anything. I think that's another really interesting good one. And then I kind of then kind of do it based on what I ate the day before. Right. So if I got a couple of good salads in, fine, I don't need to do anything else. If I didn't, I'll take a packet of AG one, which is like a phytonutrient powder, which I really like, and or a multivitamin sometimes as well. I'll do that too. And then protein powders are pretty much always a staple for me as well. That's the other supplement that I use.

You're just putting that onto other stuff?

Yeah, putting that onto other stuff. Putting that into a shake. Shakes are very convenient. There's a really good protein powder I like called Supergut. It's actually a resistant starch and a protein powder and fiber all in one bag. And so Supergut is a fantastic rescue product. I have like, if I've been on a plane for 8 hours or something and I just come home and just take that and I get my nutrition in and that's pretty much it. There's other things you can do, like if you're having trouble sleeping, there's ashwagandha, there's glycine. If you're having trouble with stress, ashwagandha is another good one for that. But then I'm really selective about which ones to use. Yeah, great.

Those are fantastic. That's a really good breakdown for anyone. I mean, I remember when I first started measuring that with Mona, it's like my vitamin D, which you would never have known if you met me or saw me, was ten. And it was just like I was living my life. Like, I was on planes, I was giving keynotes, I was healthy, I was energetic, whatever. And she was just like, I don't even know how you function. I was at a ten and I was unaware.

How old were you when you did this?

This was like a year and a half ago, two years. It was just interesting to me because the only thing I could feel is like, I was feeling a bit of fatigue and that was the only thing. And that's why I think that the reason why I'm raising that for my audience and community here today is don't take it for granted and don't assume that you might be like, oh, I don't need any of these vitamin supplements. It's like it could be the tiniest thing that you're experiencing as a symptom. It's important to take it seriously because you don't want to be at a ten.

You bring up an extremely good point. A couple of points I want to make here. One is you have to become the CEO of your own health. And what I mean by that is a CEO manages a business by looking at numbers on a daily basis, right? Most people manage their health based on a feeling that they have, symptoms that they have. They're not looking at numbers. So becoming the CEO of your own health means knowing what are the key KPIs of your health. There's only about ten of them. Skeletal muscle mass being one of them, body fat percentage being another, vitamin D level being another. You got to keep that dialed in, right? Because the other point I want to make with you is that when your vitamin D level is low, like at this age, and you don't take care of it for 20 to 30 years, that's when the lack of vitamin D leads to the higher risk of Alzheimer's leads to the higher risk of heart attack. Leads to the higher risk of hormone problems. It all started 20 to 30 years before when you barely felt it. You see what I mean?

So looking at those numbers 20 to 30 years ahead of becoming sick is the key to becoming CEO of your own health and then making all those diseases a non issue, making all the things that people die of a non issue. Fantastic.

Yeah, no, I couldn't agree more. And I'm so glad you made that connection because I think when you find it out long term, it then feels like a surprise.

Right?

But actually, it isn't if you're looking at the numbers. And I think we just haven't been trained to look at our health in terms of numbers. Like you'd measure your height growing up, or you'd measure your weight growing up, but those are such poor indicators of health in and of themselves. Without looking at all of these other metrics that we're talking about here today, whether it's your glucose levels, whether it's your vitamin D levels, magnesium, et cetera, you mentioned so many other vitamins and supplements. I just don't think we're trained to know where to look and what to look at, and therefore we're basing it on. I feel tired today, and I think this is something I want to mention as well, that the mind and the body are so connected. But I think so often our physical challenges we think are a mental challenge. So we think we're tired because we're not focused enough or we're not excited enough, or we're not motivated enough. We make the physical issue a mental issue, but it isn't. It's purely a physical. And I know that because I feel so purposeful and love what I do and I'm so joyful about it and I'm so excited about it.

So if my body's not working to the degree I want it to, I'm very clear that you can have all the mental stuff down, but if you're not taking care of your body, it doesn't just you can push it a bit further, but that's not going to get you up the hill.

You're absolutely right. When your brain starts feeling it, usually your body is in big trouble. That's when you start feeling it. So I think your point about the numbers, it resonates with me because that's what happened to me when I became sick. I outsourced my numbers to my primary care doctor and my concierge medicine doctor, and they got my numbers back. They looked at them. And if you've ever seen your blood work sheet, like, if something is out of range, it turns red, otherwise it's all black. It's all like a bunch of numbers. Right? And so because things were, like, barely in the red and not moving, they decided not to even talk to me about them. Right. But in reality, things were changing for a long time and going in the wrong direction. And that's because Western medicine can't really do anything about that number until they can prescribe you a pill for it. And that pill only comes when it's disease time. That's the problem. And I also think people get overwhelmed with the numbers because most people don't know what these numbers mean. So what I really try to do with my patients is give them, like, ten numbers.

These are the ten numbers you need to watch and why, and I think that makes it a lot easier for them. So I give them a spreadsheet. I let them watch their own numbers. And I think it's important for them to watch their own numbers rather than outsource their health to their physician, because they need to know where the optimal range is, not just a disease range. Right. So let me just give you one more real quick on the glucose point. Yeah, it's a really important one. It's a hemoglobin A, one C. And you probably heard of this before, too. It's a measure of your last three months average of glucose, and you're pre diabetic when this number is 5.7, and you're diabetic when it's 6.5 or above. My number was 5.7, and he just put me on a medication. But five years ago, I had measured this with my doctor, and it had gone from 4.7 to 5.0 to 5.2 to 5.3 to 5.4, and no one said anything to me. And I could have done something about it back then before I had to. Now it's an emergency. Right. So I think that's another number people should watch nutrition wise is that hemoglobin a one C number?

And I guarantee you, if people call their doctors and ask for their latest blood work result, it's on there. Or it should be. If it's not on there, you have a bigger problem, but it should be on there, and you'll see kind of where you're at.

This is fantastic. Dr Shah. Thank you so much. All right, I want to dive into let's do exercise next. Wow, you brought that up. I want to dive into it. And if there's ever a time when you want to go back or share something, feel free. This is all about giving the most value to everyone who's listening, watching. When we talk about exercise, I think everyone's kind of always known they need to exercise. One of the things I love, before we start talking about the technicality of it, you talk a lot about the need for social exercising, which I love that, because recently I've been playing so much pickleball with friends. I don't know if you've been playing as well.

I got to play pickleball with you. I love pickleball. Yeah.

And it is like I have played at this point today. I'm not playing today. I played the last five days in a row every day. I probably played for an average of 2 hours a day, on average. Some days were three, some days was one. And it is such an easy workout because you're just running around, you're sweating, you're having good time with friends, you're outdoors. And I've made it a priority in my life that all of my friendships. This year, we're going to do something active together. So instead of getting together and sitting down and eating dinner, even though I love doing that, we're actually going to go on a hike instead, or we're going to go on a walk. And if I don't feel like going on a hike or a walk, then at least we're just going to do something active, whether it be an escape room so that we're moving around, or if it is that I have enough energy to play pickleball, we're doing that. The idea is, how can every friendship be based on fitness that is also fun, rather than friendship, which is based on us sitting on a couch watching a movie together, which, by the way, I still do as well, but that can't be the primary way to hang out.

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Such an incredibly good point. And I just spent the last weekend in Ohio with some of my friends and literally, we would not sit down until we all steps for the day. And pickleball was part of it, hiking was part of it. And the old adage is so true, you become the average of the eight people you surround yourself with. Right? And so if the eight people you're friends with, like my community of friends, we work out together. That is our social activity. And it's so much fun. We find different things to do. We're lucky we live in the hills and we can hike together, we can go to these really fun gyms together. But it makes exercise not exercise. I think what happens and why people don't get enough exercise is because exercise is literally like going to the gym by yourself and it's not inspiring. A lot of times when you go to the gym, especially if you don't have a trainer. And social exercise for me, was the cure to not getting enough movement in my day. Absolutely.

Yeah, it's huge. Tell us about let's talk about what type of movement is needed because I think, again, we have so many preconceived notions. Exercise in someone's head could be like weightlifting. That's what it looks like. Exercise could be doing a high intensity workout at a gym. Exercise could mean a sport. What movement do we actually need to genuinely be healthy in a real way? Because you could be doing any or none of these things and you could or could not be healthy. So what is that? What do we actually need? What do our bodies need?

I love this question because it's counterintuitive, okay? So people are always like, what do I need to do? I go to the gym, how many sets and reps and minutes on the treadmill do I need? And I tell them wait. Once again, pretto principle, all you have to do is move all day long. So sedentary behavior, which means sitting for more than an hour at a time for 8 hours a day, is literally what's killing most of us right now. And so what happens is most people have an eight hour job right out of that eight hour job, they'll sit for 2 hours, maybe get up to go to the bathroom, sit down for two or 3 hours again, have lunch where they're sitting. So just sitting for long periods of time increases your rate of mortality exponentially. So for every 10% additional time you spend sitting, you have an increase of 10% in your all cause mortality. And it's like linear wait, say that again? Yeah, for every 10% of time that you spend sitting over a baseline, you have a 10% increase in all cause mortality.

Crazy.

Yeah, it's crazy how much sitting just moving changes the entire equation. So once you go from being sedentary to not sedentary, your rate of death from heart attacks, from Alzheimer's and dementia, from stroke, from anything goes down exponentially. So what I tell people is, no matter what, every 45 minutes, you can take an exercise snack. And this has been proven in research as well. Every 45 minutes, spend ten minutes getting up and walking around a little bit. If you do that, you've broken the cycle of sedentary behavior completely. So what I do is I have my patients buy like a little egg timer, like a little metal, it looks like an egg. And we just set it to 45, put it down, and when it rings, you get up, walk around, and guess what? That's the same amount of time needed to break the strain on your eyes to break the stress cycle as well. So it's a really good idea to take these exercise snacks when you're at home. I'm sorry, when you're at work, but then also when you're at home, people sit down and watch TV for 2 hours. So it happens again.

So that's step one is don't be sedentary. Even athletes, there's so many athletes that are sedentary during the day or during the evening that they're affected by this as well. So focus on that first. Don't be sedentary. Then step two on exercise is now what kind of activity can we put in to really start moving the needle with how exercise can improve your longevity and health span? So do you want me to talk about that a little bit too?

Yeah, before you dive into that, there's something that I'm really glad to hear that because one thing I've been recommending to a lot of my corporate clients is. I don't know who invented 30 minutes and 60 minutes meetings. I just don't know where that came from. We just invent these things where they have to be that long. And I've started saying to so many of my clients who are living like, I don't live a meeting to meeting life anymore. So I get a lot of movement. I'll stand up, I'll walk over there, I'll walk back, I'll walk next door, I'll jump in a car, we'll walk to the meeting. So I thankfully have a lot of movement in my day. But when I used to work in the corporate world, I used to always tell everyone, have a 55 minutes meeting or have a 25 minutes meeting. That then gives you an extra five minutes to stand up, to walk, to get hydrated, to look out of a window or maybe get some fresh air, and then to look out into the distance so that you're not constantly short sighted. I feel today we're constantly looking at our phone, at our laptop, at an iPad, and we're becoming more and more short sighted.

And that's why it kind of feels like our mind can feel a bit crowded and clouded. And to me, just going outside and looking out into the distance, maybe spotting a bird, a cloud, a distant building, it just opens up the mind a little bit. And I feel like just shifting it from having five minutes off every hour, which isn't going to negatively impact a meeting. You're not going to achieve anything more in that extra five minutes. And same with if you took 15 minutes off a meeting, maybe if meeting shifted to being 45, not an hour, I think you'd achieve so much more in the meeting, too, because now you have less time. And so I just think there's so much there and I just want to give people more value on that, that it's so easy and practical to implement some of this, and a lot of it's just breaking these old rules that have just lasted for far too long.

Yeah, so true. And you must have talked to Google about this, because on Google Calendar, you can program 25 minutes meetings. Do you know that?

I didn't know that.

Yeah, or 55 minutes meetings. So every meeting is automatically, like, cut short by five or ten minutes.

Oh, I didn't know that.

Yeah, and then what I tell people do too, is switch from a regular zoom account to the free zoom account because it kicks you off in 40 minutes.

That's right.

Sorry, guys, I got to go. I'm running out of time here.

Yeah, you might look cheap, but it will save your health.

Yeah, but on that one more double click on that point too, is that if you do have a life where you have to spend a lot of time at your desk, on the computer, on meetings, really consider getting a treadmill desk or a. Walking desk. That's been a game changer for me, too. I'll get 25, 30,000 steps in after 3 hours of meetings. It's pretty incredible amount of steps.

Wow, that's amazing. All right, so go to number two on the exercise.

Okay, so number two. I always think the most important thing that you can first start doing in an exercise routine is strength training, especially after the age of 40. Muscle breakdown is a root of all physical problems and frailty as we age. And so really, getting into a good strength training routine is key. And then secondly, you want to work on your cardio, right? And cardio really need to think about it. In two prongs, there's anaerobic and aerobic. And anaerobic is basically working really hard. And then you have the aerobic where you're not working as hard and you're utilizing oxygen to make energy. So the way you do your anaerobic I like using hit exercises. There's anaerobic training protocols.

Sports.

I get sports. Right, exactly. Where you're working really hard, you don't have to do a lot of that every week, but you do need to get some of that in every week. And then I really like what Peter Tia says about zone two aerobic exercise. Like getting 30 to 45 minutes a day into start every other day or so. I think that's important. But look, it's so hard for people to fit all this into their life, right? So you got to make it as easy as possible. So there's like these seven minute hit routine apps that you can do, which are fantastic. Getting a set of barbells and putting them in your closet or your bedroom so that every time you go there, you do 1520, like Arnold Presses or something. Even that, as long as it's consistent and done on a daily basis for busy people, is going to be extremely helpful. I think a lot of people think, like, it's either go to the gym for an hour, three to four days a week, or just give up completely.

Yeah.

And nothing could be farther than the truth, right? Yeah.

And you're saying literally, having something at your office desk, having something in your bedroom, just that little bit of addition to your already busy life is going to make a difference. And we need to stop having this glorified view of going to the gym and having the perfect workout routine.

Right.

How have you found people get rid of that perfectionist mentality when it comes to health? Because I feel like we also have it with food. We talked about nutrition. We have it with exercise, where it's like, I'm going to eat really healthy or I'm going to eat really bad. Like, if I had a pizza too many days in a row, I might as well just carry on eating pizza because, oh, it's not going to matter that I had vegetables for one day. Although you would argue it does matter. And that one day of breaking the cycle is probably useful. How have you worked with clients on that mental aspect of it? Because that's obviously what I focus on in my work so much. I'd love to hear about it from yours.

Yeah, there's a lot of science around habit building and routine building. Atomic Habits is a great book that I read. There's a couple of others that I really like, and it's this kind of like this reward and cycle that you reward yourself over. You have to consistently reward yourself on a daily basis for doing the right things and then not punish yourself for doing the wrong things. And so I think there's a lot of psychology around that. Honestly, it's really hard. We find it hard for ourselves, too. Right. But I really believe in having a positive attitude about it. I think if you come at it with positivity and say, you know what, it's fine, I messed up, but I'm going to do it, and you're just positive about it, that in itself is a psychological barrier broken into starting today as the first day of your life to start building new habits again. Absolutely right.

Absolutely. Yeah. I think I can't remember who said it, but I've heard the Rock say it plenty of times. He's like, It's either one day or day one.

Right?

And he'll always quote that, right. Mindset like, it's either, one day we'll get to it one day I'll do it one day, or it's like, no, today's day one. This is the day that I'm going to solve it and start it. And I think that's that positive mindset you're speaking.

Yeah, exactly.

Was there a .3 on exercise that you wanted to make? I'm sure there's a .7, but was there another one you wanted to kind.

Of we should probably stop there. On exercise, there's absolutely more you can do. As you get older, your audience spans all ages and everyone, but as you get older, you really want to look at stability and balance. So I try to do stability and balance exercises on a daily basis as well. Things like standing on 1ft, believe it or not. Yeah, just things like that. As we get older, we lose that. And if you're not training it, especially after the age of 50, you're going to keep losing it. And then the number one killer of older people is becoming frail, falling because they lose their balance and breaking a hip or a bone. That's what usually takes out most older people. And so you can avoid that by incorporating some stability balance routines in your life.

I really appreciate you also looking at it from the perspective of, like, let's stop there, because I think so often people listen to podcasts or read books, and there's just so much information, and then that makes us go, all right, I don't know where to start. And so I love the fact that you're like, well, wait a minute. This is step one. This is stage two. I love that very curriculum, systematic based approach to mastering our health rather than starting on point number seven and then figuring it out.

And what I do with my patients is we're having this conversation about everything, but I'll only give them one thing to do, right? And we'll change two or three things and then you come back and we'll do the next thing and then the next thing. So let's not worry about how much protein you have in your diet until you clean out your pantry and get rid of all the crap in your pantry, right? Let's do that first and then let's talk again next week. And so we take it at a stepwise approach. But if whoever's listening to this, if you're taking notes, don't try to implement all of it at the same time. You're overwhelmed and quit.

Yes, absolutely.

Right.

Absolutely. All right, let's talk about sleep. So I've generally been a good sleeper my whole life and very grateful for that.

How do you know?

By measuring. As in I was going to say, yeah, by measuring. Not by how I feel. By measuring. I wanted to talk about an experience that I had that was bad, which was surprising for me. So I was wearing the aura ring for a long time, measuring my sleep, and I was scoring really well. And then during the pandemic, we moved home and we were renting a place that was really disruptive. At night, we'd get real animals in the floorboards, in the walls. There was lots of noises outside. I often because of where we were, and there were certain things about it that I was worried that, what if someone broke in? And there were these other anxieties that I had around it. And it was the first time in my life that I think I consecutively had one and a half years of bad sleep during the pandemic. And it was really interesting because I was doing my supplements, I was eating right, I've always meditated, I was doing everything. And just this one undercurrent meant I was fatigued, I was exhausted, I was irritable. It was so intense because I just wasn't sleeping deeply.

And I'd often wake up multiple times per night, and that wasn't normal for me. And I also was wearing the aura ring at that time, and my sleep score was just not great. And that was actually what forced me to move to this place and get this home, because I was just like I was telling Radhi, I was like, I need to like, it was that bad. And so I know what it feels like to have good sleep and bad sleep. And I think that sleep is one of those areas of our health that we underestimate in terms of how great it can be. But I think so many of us struggle with sleep, whether it be anxiety, whether it be insomnia, whether it be stress. And so I want to start off by talking about tracking your sleep and improving the environment that we sleep in, at least as a starting point. But I do want to get to two and three with you today on your list because I do think there are people who are trying to do all that stuff, but there's still something not clicking. And I'm sure you've experienced this a million times with clients.

So let's start at step one and then see where we go from there, right?

So I agree with you. Like, tracking is a game changer, but I can also tell you that I've had a lot of patients that get super anxious tracking, and they live and die by those numbers, right? So if you're one of those people that the over tracking of sleep kind of changes your day and changes your perspective on your day. Only use tracking for a very specified amount of time. Use it for when you are very mindfully changing your sleep habits and your routines, and then stop worrying it once you got your sleep score up to a score that you like. Right. I personally, I like tracking my sleep all the time. I'm just a real data guy, so I like to see it. But when I go on vacation now, I don't wear my aura ring because I know that the sleep is not going to be as good sometimes. Right. I use it for when I'm being mindful about trying to get better sleep or if something's changed. Like, I notice I had COVID, and right after COVID, I had long COVID and my heart rate was racing for months. I'm sorry to hear that.

Yeah, it was horrible, and it really affected my sleep. But my aura ring told me that this is what's happening. This is why you're not sleeping while your heart rate is racing. So I think the benefit of sleep tracking is really understanding it's not just the number of hours you're sleeping, it's really the sleep pattern. And educating yourself on that sleep pattern. Aura does a good job. Whoop does a good job? The eight sleep mattress has a phenomenal tracker.

Eight sleep is great.

It's great. I love it. Yeah. And understanding how much deep sleep you need, where that deep sleep needs to be in your sleep night, and understanding things like heart rate variability and an average heart rate at night is a game changer right. While you're modifying your sleep environment and your routine. So once we get that in place, then the second thing we do is we absolutely make sure the person doesn't have sleep apnea. All right? So for those of you who don't know what sleep apnea is, that's when you stop breathing at night, your body physically stops taking in oxygen. You don't have oxygen in your body for a few seconds at a time, but all night long that affects your brain, your heart, virtually every organ in your body. So many people have sleep apnea and don't recognize it, and it's really sad because it's causing basically, I tell them it's causing a slow death. Believe it or not, if you have sleep apnea, you have to get it treated right away. There's lots of different ways of treating it. There's dental appliances. There's that CPAP mask you can wear. There's surgery, but you got to figure it out because no matter what you.

What are some of the symptoms that people could notice?

Right. So the symptoms of sleep apnea are, number one, you wake up gasping for air in the middle of the night, or your significant other you're sleeping with tells you that. Secondly, you wake up really tired every morning and you have daytime sombulance, or you're just kind of falling asleep a few hours after you've woken up. Even snoring very loudly can indicate sleep apnea as well. So your spouse, whoever tells you're snoring really a lot. And then there's a questionnaire you can take online. It's a very simple questionnaire called a stop bang questionnaire. S-T-O-P-B-A-N-J. Just Google that and you take the questionnaire. It'll give you a score, and it'll tell you if you need to be evaluated for sleep apnea. So being evaluated for sleep apnea now is much easier. People used to dread going to a sleep lab and getting all the wires put on them. Now you just wear, like, a little device on your finger overnight at home, and we can get a good idea if you have sleep apnea or not. Wow. And the sleep doctors are very good at treating this now as well.

Wow. And you're saying there's different types of therapy or there's different types of treatments for treatment. Sorry.

Treatments for it? Yeah, there's stuff you can get from your dentist, like a little dental appliance that pulls your jaw forward. There's a CPAP mask. There's also surgeries that you can do as well, losing weight, special pillows propping your butt. There's lots of things you can do. Wow.

Okay. Yeah. I can't believe that. It's so fascinating. Right. Again, because these things haven't been measured since we were young, and because we don't know what to look out for. You could be sitting there for months or years going, why do I wake up feeling like this? Maybe I'm anxious, maybe I'm stressed. And that could be a part of it. But there's something else going on as well.

Yeah. I can tell you how many people that I simply asked the few questions I just asked you, and they're like, yeah, I have that. Yeah, I have that. It's like a revelation. And they're 55 years old, and they have sleep apnea. They've had it for 25 years. So it's really sad how under diagnosed it is and how incredibly treatable it is. And that could change the trajectory of your life because once you treat sleep apnea, your metabolism actually gets under control and you start losing weight, you start having less glucose spikes, you start eating better, you feel less brain fog, and then you also prevent sleep apnea is one of the main risk factors for Alzheimer's disease. So you prevent Alzheimer's too. So once again, it's knowing early and treating things early.

What if someone's they're okay just about getting to sleep, but that they wake up multiple times when they're sleeping? What have you found to be useful for someone in that scenario? Have you treated, worked with anyone who has that? I've just met so many more people these days that not telling me they can't sleep. They're saying, I can sleep, but then I'm waking up and then waking up. And these aren't people with kids or anything, so this is like it's just how they're feeling.

Three main reasons for it I normally see. One is nocturia where they have to get up in the middle of the night to go to the bathroom. And so there's medications and exercises you can do to treat that. The second reason is going to bed with anxiety and stresses on your mind. So what I tell people to do is, number one, no electronics and maybe even no TV before going to bed because that can keep you thinking. But keep a notebook by the side of your bed. If you're one of these busy people that just have so many things going through your head, write them all down and then you'll at least download that onto a piece of paper and hopefully get it out of your head. But the third thing that I find that really does this, too is eating or drinking a little bit too close to your sleep. You have this kind of glucose surge that happens after you get to bed and it just wakes you up. So really making sure there's three to 4 hours between your last meal and going to bed is key. Yeah.

And I'm so glad you brought up the devices and conversation because I was talking to a lot of people when people have been saying to me, Jay, I'm experiencing anxiety. One question that I often ask people is, what did you watch last night? And there are some people in the world who can watch the craziest, scariest, eeriest things and not feel anything. And there are people who watch those things and it puts these cliffhanger chemicals, as I like to call them, into your body, which constantly puts you on that cliffhanger, which keeps you up, that makes you wake up with this state of fright. I was just at we went to watch Oppenheimer a couple of weeks ago and we're watching the trailers and the Exorcist trailer came up. There's another Exorcist movie and Radhi just sat there like this. If you're watching sorry. If you're listening, then I'm closing my eyes and my ears and radhi literally sat there like that, and she was like, just tell me when it's done, because she doesn't want to watch it. And that trailer was far too long for a trailer. I felt like it told me the whole movie.

So for Radhi, she knows that. She's aware of that, and so she won't watch and consume content like that. I can watch it and laugh it off and be fine, and it won't affect me unless I'm watching it every day. And I think it's so important that we check ourselves that way because you're just making it harder for yourself in a way you don't need to.

Right? Absolutely. I'm one of those people, I can't watch horror movies anymore. It just affects me way too much. It just sticks in my head. I actually become a scaredy cat at night, and I can't sleep. So I just don't even entertain the thought of watching, like, even a trailer. I'd probably close my eyes from that trailer.

That trailer was haunted. That was like, do not watch the new Exorcist trailer if you want to sleep at night. It stayed with me for a while. No, that's great. Anything else on sleep that you feel as that one, two, three, as we're going in?

Yeah. So number one is sleep apnea. Make sure you don't have it as you're tracking your sleep. Two and three are fix your sleep environment and fix your sleep routine. So your sleep environment needs to be, like how our ancestors slept when they were cavemen. A cold, dark cave. Right. So turn the temperature down in your room. What's even better than turning it down in your room is buying, like, an eight sleep or something that keeps your bed cool itself, but it should be somewhere around 65 degrees. Dark, like totally dark. Like, even the little red lights and alarm clock cover them with black electrical tape and put them in a different room. And then quiet. And most people can't get it fully quiet, or some people, like, the quiet even becomes like it becomes noise to them. So a sound machine, like a white noise machine, is very, very effective in improving your sleep. And what's really cool about doing these things is you can do, like, one thing and see how it affects your sleep score. And then a week later, buy a white noise machine and see what happens to your sleep score.

You might not feel it physically the next day, but your tracker will tell you you went up from 85 to 95 just by buying a white noise machine. And I've seen it happen over and over again. And so your sleep routine, what I like to tell people is your sleep routine actually starts the moment you wake up. And there's probably, like, only 3% of people that the moment they wake up, they actually go outside to expose themselves to sun. Right. Most people just they go from being inside to going in their garage, getting in their car, going to work, parking in the garage. No one goes outside anymore in the morning. I make it a point to take me and my kids outside first thing in the morning. Expose yourself to sunlight that sets your circadian rhythm. Your melatonin is going to start secreting like it's 14 hours afterwards. That's key sleep routine starts first thing in the morning. And then you know how the iPhone now has like a sleep alarm, right? So it's not an alarm clock to wake you up, it's when you need to start preparing for sleep. So when that alarm goes off 2 hours before sleep, all the lights turn off as much as possible.

Switch on some soft orange colored bulbs instead and just start winding down your brain. A big part of that is avoiding electronic devices.

Absolutely. Yeah. Great advice. No, great advice. And all things that I've been practicing. I used to worry about sleeping at 65 degrees because I'd think it would feel cold. And what I always remind people is, you still have your duvet, you still have your blanket over you. You don't have to be cold. You can still wear pajamas. Right. It's just cooler in the room. And that's been done wonders for my sleep, even for sleeping in longer and being more comfortable. The cave like darkness has always been a big win for me and huge. And I think that we've always tried to have very early dinners, and that's been such a huge thing of like we try and eat dinner at like six, six thirty p. M. Just so that when you're in bed at 930 that it's easier to go to sleep. But all things we've had to work on over time and adjust and figure out. And it's not always perfect.

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And part of, like, the eating dinner earlier thing, too, is our caveman ancestors didn't eat after it became dark. Right? And so it's really food is another item that sets your circadian clock almost as much as light does as well. So that's a key factor, eating earlier. But yeah, it's all little things and one at a time. And you're not going to change everything overnight. It might take a year, but it benefits you for the next 50.

Yeah, right, absolutely. I want to dive into so there's a few areas left, and I want to take bits and pieces of all of them. I don't want to do all of them, but I want to dive into gut health just because it's so I didn't realize for years I was having gut issues because I just didn't know what they even meant. I didn't know how to know. I think today, now, people are much more informed. I'm talking about like 10, 13, 15 years ago when I didn't feel it was in the Zeitgeist or the conversation as much. How can someone be conscious and aware if they're not already, that they may have leaky gut, that they may have gut issues that they're not fully conscious or aware of, or they're being negligent? I was one of those people who, even if there was some discomfort, I would just write it off because you're young and you're fit and you're healthy and you don't care about it too much, what should people be looking out for?

Yeah, no, that's a really good point. And once again, by the time you become symptomatic from some of this stuff, a lot of damage has already been done for a long period of time. Right. And so what I look at here is another one of those biomarkers, one of those CEO of your own health type of things, which is a biomarker called hsCRP, highly sensitive C reactive protein. This is a marker of inflammation. It's a very simple test that every doctor lab can do. We've been doing it for like 50, 60 years in medicine, but it's a marker of inflammation. You want this number as close to zero as possible, but a lot of times it'll go up to one, two, three, or four. And usually that comes from some sort of situation going on in your gut. So your gut is the biggest organ in your body, protecting you from the outside environment. Most people think it's your skin, but your gut actually has four or five times the surface area of your skin does. And so when that barrier to the outside environment is disrupted, toxins from the outside environment filter into your bloodstream causing inflammation.

Inflammation is when your immune system is overactive and you not only destroy the toxins, but you start destroying your normal brain, heart muscle, bone cells, all of it. So you need to know when you have inflammation going on in your body. The first way to tell is by this blood test. And then probably after that blood test has been elevated for months and years, is you finally start feeling it in your gut. So if you get this measured and you have this a little bit too high, then you start need to looking at your gut as a primary source. Secondary source would be your oral health, believe it or not.

Yeah, talk to about that. Go for it.

Yeah. There's a huge association between poor oral health, dementia, and heart attacks as well. And that's because a lot of inflammation takes place in your mouth. If you have cavities, if you have gingivitis, et cetera. So if your inflammation levels are high, you need to go see the dentist, make sure your oral health is okay. But then you need to start treating your gut. Here's where a functional medicine doctor can be extremely helpful because they can really sort through, like, what is going on with your gut? Do you have leaky gut? Why do you have leaky gut? 10% of the population has gluten sensitivities. 7% is dairy sensitive or probably even more. These are just estimates. And once you start eliminating those inflammatory foods, the toxins in your food from your diet, your gut starts to heal. And we can put you on a gut healing protocol, reduces inflammation. And inflammation is the root cause of all the major diseases. Once you treat inflammation, your chance of getting all the other diseases are much less right. So you got to focus on your gut. And so this is where I tell my patients, like, look, it's not just about sleep, exercise, and diet.

Now we need to start talking about gut health. That's another thing we need to talk about. And so hsCRP is the biomarker for that, measure that. And then of course, if you're having symptoms, bloating, diarrhea, constipation, definitely need to go get that checked out.

Yeah, it can be so easy to just kind of feel embarrassed about it or be negligent of it or to just kind of brush it off to the side.

But I can't tell you the number of men and women that I see that are like, don't want to talk about it because they're just like, doctor, I have a lot of gaff. They're so embarrassed about it. But it's like, let's double click on that. We need to figure that out. Right? Yeah.

And it's almost like it's weird what we've been taught to be ashamed of in society when these are like really normal, natural things that we all need to be massively aware of. It's interesting how the most important things in society become the most taboo to talk about. We're talking about health right now. Money is another one in a different way, or even relationship challenges or things that are vulnerable have become this thing of, like, don't talk about it. It's weird.

Sad, right?

Yeah, it's really sad. Yeah, it's really sad.

Well, hopefully, I mean, stuff like this podcast, you bring it to light, people start talking about it, and bringing it more into mainstream conversation is so important.

Yeah, I think that's what's needed. I mean, I know for a long time I didn't know who to talk to about things because you just don't hear it.

Right.

And I think when people are talking to their doctors, also having physicians who we feel understand this language, and that's why I think with you saying that we need to become the CEO of our own health, I think we've always wanted to outsource it to a doctor or to a healthcare professional, whatever it may be. And the truth is, no one's going to care about it as much as you.

Absolutely.

And so it has to start there. So I want to focus on this one because it's so interesting. So you obviously talk about heart health as one part of your wellness wheel. And it fascinates me because even when I've seen it on your wellness wheel a million times when I've been in and when we know how important the heart is, we rarely talk about heart health. And if we do, we kind of do it in a soft way. We don't really talk about it from a scientific point of view. And you talk about how important it is to know our levels at 25 years old. Is it apob?

Yeah, apob, right? Yeah.

So walk us through that and understanding what that is, what it means, and how do we know, right, exactly.

So I think everyone's heard about watching your cholesterol levels, right? Okay. So right now, what happens is you get your cholesterol levels measured sometimes in your 30s if you're lucky. Usually doctor wait till you're 40. And unless it's like over a really high number, no one's really going to do anything about it. And then people will start talking to you about your diet and managing your exercise. Exercise more, eat better, eat less fat, eat less cholesterol. Then you just kind of let it go until all of a sudden it's an emergency for you to get on a statin. And I think it's kind of 1015 20 years too late at that point in time. Right. The damage has already been done. If you do cardiac testing, you'll see that there's already blockages in blood vessels at that point in time, and most of the time, these are not diagnosed until people have their first heart attack. No one even looks at the blood vessels until you've had a heart attack. And it's really sad the way this whole thing goes. And it's especially sad because heart attacks and strokes can become like an orphan disease, like a disease that never affects us if we just do it right.

And this is where I think medicine has made, like, a tremendous, incredible amount of knowledge that's been gained. And this is where I try to really encourage my patients to really partner with their medical doctors and really get this treated. So when I say, know your apob level, I love apob. It's a new type of cholesterol measurement, kind of lumps together all the bad forms of cholesterol, which I even hate saying bad cholesterol, but it lumps that together, the dangerous forms. And knowing what your apob level is, when you're 2025, that's kind of the baseline where you want it to be, right? So as this starts creeping up, you want to start doing things about it with your exercise, diet, sleep, gut, health, all of that matters. But then when it gets to a certain level that's a little bit too high, that's when you want to start doing cardiac testing and diagnosis. So there's really great tests that can be done now, cat scans of your heart that can tell you 2030 years ahead of time before you have a heart attack if you have a blockage. And we have great therapeutics now to turn back the time on these blockages, to get rid of these blockages, to prevent you from having a heart attack.

I can't tell you the number of patients that we've had in our clinics that we've done this scan on preventatively, and how many of them actually had to go straight to the emergency room to get a blood vessel opened up. Double clicking on this just because I think it's really important for your audience to know apob. And there's another one everyone needs to get measured when they're young is LP Little A, or even young or old, if you've never had it done, got to measure LP Little A. LP little A is a genetic form of cholesterol that can't be treated with diet, nutrition and exercise, or cholesterol lowering medication, traditional ones. And if you're one of the few percentage of people that have it, you'll still get massive blockages in your arteries at a very young age. So most people don't check that until it's too late as well, and we can treat that now as well. So LP, Little A and apob, two tests everyone need to ask their doctor about.

That's fantastic. I'm so glad you're, like, giving us a vocabulary of knowing what to check, because I think otherwise, I know I just go up to my doctor and be like, well, how healthy is my heart? And they're going to be like, you're fine. And I think that's the challenge. We don't really have a vocabulary or we don't know the exact tests and checks that need to happen. And again, I think you've given us so many across the board, and I just hope everyone who's listening or watching, please, please go and check these things out, because I just want you to live a healthier, longer, happier life. And so much of this could either make it easier or harder, right?

Absolutely. And I think there's different types of people. Some people like you, you want to know, and you want to know as soon as possible because you want to make sure you get it treated or take care of it before it becomes a big problem. And so those are the type of people I think will take this information and really run with it. Then there's another type of people that will take this information, bring their notes to their doctor. Some of their doctors will say, okay, let's check it. Some will be like, no, you don't need to do that. And they'll be like, okay, I'll just leave it. Which it's fine, but I really encourage people to become the CEO of their own health, become more aggressive and proactive in learning and tracking these things and pushing your doctor on some of this stuff. And then you have a group of people that just like, they want their head in their sand, like, I don't want to know until it's a problem. Tell me then. Which there's not much you can do about that except take care of them.

Yeah, absolutely. We've talked about brain health before on the show, but I wanted to talk about cancer.

Yeah.

And the reason why I want to touch on that, obviously, is because I think the rates are just going up and up and up. I've lost two people in the last four years, three people in my entire life, people that I'm very close to. This does not include your auntie, your mom's friend, not even just looking around the whole space, but people that I'm directly close to, and all from different causes, all from different reasons. It's something that I think that we all have a fear around, because you just hear it so often and everyone's going through something. Like, you talk about cancer's biggest enemy is being diagnosed at stage one. But whenever I've had friends or people I love, we always find out at stage three or four. So how do we get that? What do you need to do?

So cancer diagnostics literally, in the last five years has become incredibly revolutionized. And there's two tests that have done this. One is a test called the full body MRI. Like the pernuvo's scan, which is what.

We did when I think right, exactly.

Yes, you did the full body MRI. And that happened because we've always had MRI scanners. But now MRIs are becoming more ubiquitous and cheaper. These are no radiation scans of your entire body, and they're getting quicker, too. So we can do the whole body in, like, under an hour. I always say if Steve Jobs had one of these, he'd still be alive today. So it's a scan that scans your whole body for not just tumors, but also other anatomical abnormalities that can kill you, like aneurysms in your brain or your aorta. So I think that's a very useful test. It's controversial because you do find a lot of what's called incidentalomas. These are incidentals that you end up chasing down a rabbit hole as far as what is that thing over there? But if you can tolerate a little bit of having diagnostics done and a little bit of stress while you figure out what those things are, you'll know a lot more about your body in enough time to take care of an issue. So that's one technology. The second technology, which is truly revolutionary, is the liquid biopsy. This is the Gallery Grail test, and this is a blood test that you can do, and you just send in a vial of blood.

They check it for little fragments of DNA from active tumors in your body. Okay. And so it can diagnose 50 of the most hard to diagnose tumors at very early stages. And right now, unfortunately, this test is expensive and not covered by insurance. My feeling is, as the technology evolves, it'll become cheaper and cheaper, of course. And it'll become the new standard in medicine, is to check everyone for this once a year. Because the reason cancer is so hard to treat is because of being diagnosed at stage three or four, when it's sometimes metastatic. Right. And then you have to go chemo, radiation, surgery. It's so hard. But once you diagnose it as stage one, it's like it's not even had a chance to get there. Right. So this blood test, if you can afford it right now, once a year, I would start doing it. If you can't, it's going to get cheaper. Keep your eye out on it. I think it'll get cheaper really quickly. As a lot of technology is becoming right now. It's going to revolutionize the way we diagnose cancer. And then everyone, in addition to those, you can't just do those.

Each of those detects its own things. Right. You got to get your colonoscopy, do it early, especially if you have a family history of colon. Exactly, yeah. Very important.

I was scared for, like, a week.

Yeah, it is scary. But the nice thing about colonoscopy is not just diagnosing cancer. Like, if you go in there and you see a precancer, you can remove it immediately. So it's like treatment as well. Right. And then for men, get the PSA test, which is a blood test for your prostate. For women, make sure you get your mammograms and make sure you get your OBGYN exams. That's kind of like the array of preventative diagnostics you want to do now in the 21st century to basically diagnose cancer before it kills you as soon as possible.

And how do we cancer proof our body?

Cancer proofing is done by doing all of the other things that we talked about today. Getting seven, 8 hours of sleep, making sure that your nutrition comes mostly from whole foods, not processed foods, and exercising and not being sedentary. The other thing is eliminating toxins from your day to day life. And so we can talk about that a little bit, if you like, how to eliminate toxins. So the pareto principle on that is realize where do you spend the most time? Right? You spend the most time probably at work and sleep in your bed at night. That environment, the air in that environment, you want that to be as clean as possible. So you want to detoxify your air, your water, your food and chemicals on your skin. So air, buy an air purifier for each one of those environments. If the air is not perfectly clean. For your water, I recommend getting undersink reverse osmosis system in your kitchen, where you get most of your drinking water, drink it out of glass bottles for the most part and for your food organic. Or go to that website called Ewg.org. And finally, for the cosmetics that you use and the stuff you put on your body, there's a great app called Think Dirty.

And you can put any product in there or scan the barcode. It'll tell you the level of toxin and recommend to you the most nontoxic products. You do that, you've covered 80% of the landscape. Like you're living in a mostly nontoxic environment. I'm sure there's people that have other things that they do, but that, to me, are the keys.

Yeah. My wife is my think dirty app. Like, she can figure out she's checked every product. She got us to switch to glass bottled water. She put the reverse osmosis osmosis system in. She's just so on top of all this stuff. And I'm like, if I didn't have her in my life, I don't know what I'd be doing right now. And it's incredible how these and also when someone recommends these things, when my wife first came up with this reverse osmosis water thing, I was like, come on, do we really need it? And it's interesting how we have such random resistance to a lot of these things. We kind of overthink it, or we underthink it, where we just go, oh, well, that can't be. That such a big deal. I think the whole bottled water thing is now blown up. When my wife was talking to me about it, like four or five years ago, and at the time it was like, I could have been a bit like, oh no, it doesn't matter, it's just a plastic water bottle. And now you see the research, right? And so I think it's so interesting how if you have someone in your life, your friends, your family who are recommending things to you, be open minded about it, because you have no idea when it's finally going to be proven.

And I'm hoping that anyone who's listened to this, please, please share this episode with friends and family members, because I think what Dr. Shah's done beautifully today is he's laid out step one, step two, and step three. And so whether you're someone who's just getting started in your journey or whether you're someone who's trying to refine it and improve it and enhance it in a deep know, you've kind of given.

The pathway for all of and, you know, you're right. It's so easy to be skeptical, right? It's hard to be not skeptical and open minded and do your research and really dive in. But you do such a good job of trying to get people to break through that barrier of skepticism and opening their mind. To new possibilities that I think if people were to just kind of even they pick up one thing and switch it on their own, you're going to make a positive change. Right? I agree.

Dr. Shah, you've been incredible today. I mean, you've given us such a wealth of insight. And like I said at the beginning, I want this to be the episode that you come back to to go, if I'm looking at my gut health, what do I need to focus on? If I'm looking at my nutrients, what do I need to focus? Please, please take a screenshot of this episode right now. I want you to make sure that you tag Dr. Shy and I on social media so that he can see what resonated with you. So that I can see what's that one thing you're trying what's that thing that is now your day one, not your one day? What is the thing that you're putting into practice that is going to shift how you feel that is going to shift how you live your life? What is the thing that you've been avoiding measuring, that you're going to measure from now on to make sure that you can start taking the proactive steps in avoiding some of these challenges that you can? Dr. Shah, I want to ask you the final five, of course, which we do with every guest, but I want to make sure that I ask, where should people find you?

Where should people follow you? Where can people connect with your work to continue to be educated?

Yeah, so I've been doing this course for my patients now for many years, and a lot of them want their family and friends to do this, but they might be living in different countries. So I recently started putting the entire course on my Instagram page. So at Darshan Shaw, MD, if you go there, it's all kind of in order. We're going to start with nutrition, then move on to sleep and move on to exercise, et cetera. And over the course of the year, we'll have all the content on there, but in a sequential fashion.

That's fantastic. So Darshan Shah, MD on Instagram is the place to go and follow. We're hoping you're going to upload it to TikTok as we need to. We need Darshan Shah MD on TikTok too. I love it. Both of them would be amazing. Dr. Shah, these are your final five. We ask these to every guest, sometimes a different mocktail of all of them, but we need one word to one sentence maximum for each question. So, question number one. What is the best health advice you've ever received?

Get up and start moving.

Nice. All right, question number two. What is the worst health advice you've ever received?

Let your doctor watch your blood markers.

Right? Wow. All right, question number three. What is something you used to be skeptical about in terms of health and wellness techniques, but now you swear by?

Yeah. This whole field of eliminating toxins from your day to day environment. I used to think it didn't matter, but it matters so much again. Yeah.

You think our air purifier, what are.

They trying to sell me? But it does make a huge difference.

Right. Question number four. What is something that you used to swear by for your health and now you actually think, no, I don't need to focus on that anymore.

Intermittent fasting. I know a lot of people will get upset at that answer, but I think there's a lot of science to the contrary now.

Yeah, let's dive into that. Let's segue into that for a second.

Yeah. So intermittent fasting is great for people that need to start eating less calories on a day to day basis. It's a good way to manage your caloric intake. But like I said earlier, a lot of people end up taking less protein, and so they lose skeletal muscle mass. And that's what happened to me. I was intermittent fasting. I started and my skeletal muscle mass on my scale started, like, plummeting, and I was like, what is happening? And it's all because of intermittent fasting, so I stopped it. So it's really more about what molecules you're putting into your body, I think, rather than the timing of it. And I think you really want to be careful if you are intermittent fasting, that you're still getting your protein intake. And you are also not in the category of people that are either pregnant or breastfeeding or an athlete. I think I've seen a lot of athletes actually cause a lot of damage to their metabolism by intermittent fasting.

I'm not an athlete, but I found that when I was experimenting with it. So I stop eating dinner by, like, 06:30 p.m., and I don't eat until the next morning, until 09:00 a.m.. So that's the closest I get to it. But I'm someone who needs to eat three meals a day and I don't snack a lot. And so for me, it's like those three meals are my main meals and I'm very happy with them. So breakfast, lunch and dinner. So I eat breakfast at nine, lunch at twelve to one, and then dinner at six. And it's like, for me, that keeps my energy steady. I'm not overeating or undereating at any point. It works for me. And so I've always been interested in that as well because I've always found myself feel healthier, happier and stronger when I'm doing that.

And that's the key. You have to go by how you feel. And I think you said another key where you don't have to snack during the day. Like, you're obviously eating whole foods and you're eating an adequate quantity where you're not having a snack. So that's another key as well.

Yeah, absolutely. All right, fifth and final question, dr. Shah, which is, if you could create one law that everyone in the world had to follow, what would it be?

Get yourself a group of friends that you are so happy and proud to be around, that you share common interests in where you want your life to go, not just where it's at right now.

It's a great answer. Everyone, that's Dr. Shah on On Purpose, thank you so much for listening and watching again. I hope that you take away and practice, as Dr. Shah kept saying, just one thing from this episode and watch how your life changes. Again, a big thank you. Follow Dr. Shah on instagram at Darshan Shah MD, on instagram and on TikTok soon to come. Make sure you do that, and I hope that you stay happy, stay healthy, and stay well. Thank you again.

Thank you so much.

Thank you, Jay.

Thank you.

If you love this episode, you'll enjoy my interview with Dr. Daniel Amon on how to change your life by changing your brain. If we want a healthy mind, it actually starts with a healthy brain.

I've had the blessing or the curse to scan over a thousand convicted felons and over a hundred murderers, and their.

Brains are very damaged. I'm Jay Shetty, and on my podcast, On Purpose, I've had the honor to sit down with some of the most incredible hearts and minds on the planet. Oprah, Kobe Bryant, Kevin Hart, Lewis Hamilton and many, many more. On this podcast, you get to hear the raw, real life stories behind their journeys and the tools they used, the books they read, and the people that made a difference in their lives so that they can make a difference in ours. Listen to on purpose with Jay. Shetty on the iHeartRadio App Apple podcasts or wherever you get your podcasts. Join the journey soon. Hey, I'm Wilma Valdarama, executive producer of the new podcast. Dave My Abolita first. Each week, the incredible Vico Ortiz and fabulous Abuelita Liliana Montenegro will play matchmaker for a group of hopeful romantics. Right, Vico?

You know it listen to Dave Mai Abuelita first Thursdays on the iHeartRadio App and Apple podcast, or wherever you get your podcast.

And remember, don't do anything I wouldn't do.

Just do it.

Better besitos.