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Health Framework

Throughout the last few years and after graduating college, I’ve thought a lot about my health. More specifically, about health span, or how well I live.

These days, many are focused on longevity or extending how long we live. I’m less concerned with life extension due to my genetic history.

I do, however think there are a lot of simple interventions we can adopt that have an outsized impact on how well we live. Consequently, these changes will also positively affect how long we live.

The way I'm currently thinking about health is through 5 pillars: nutrition, exercise, sleep, emotional health, and exogenous molecules. This framework is attributed to Dr. Peter Attia and the work he does with his patients.

  1. Nutrition

Peter has a nutritional framework that specifies three levers we can pull with nutrition:

  • Dietary restriction: restricting what you eat (avoiding carbs, sugar, etc.)
  • Time restriction: restricting when you eat
  • Caloric restriction: restricting how much you eat

"Always pull one, sometimes pull two, occasionally pull three – never pull none." — Peter Attia

Another space I’m excited about is metabolic fitness. A company that is doing great work here is Levels. Levels enables you to monitor your blood glucose in real time using a continuous glucose monitor (CGM).

The goal of using a CGM is to give you a direct view into how your food and lifestyle affect your blood sugar. This enables you to personalize your diet and optimize your metabolic health.

Specific practices I've found effective are:

  • Eating unprocessed, whole foods.
    • This includes whole food forms of beans, tofu, chickpeas, green leafy vegetables (spinach, lettuce, collards, kale, chard), eggs, blueberries, blackberries, garlic, onions, mushrooms, zucchini, asparagus, broccoli, cabbage, cauliflower, celery, cucumber, peppers, avocados, fish, lean red meat, chicken, oils, olives, chia seeds, and apple cider vinegar.
  • Avoiding bad ones including vegetable oils and added sugars.
  • Logging meals
    • This simple practice draws awareness to your eating. It helps me realize when I'm eating out of boredom rather than hunger.
  1. Exercise

Exercise is one of the most important tools we have at our disposal. Exercise has 4 pillars: stability, strength, aerobic efficiency, and anaerobic performance.

Stability

Stability is the most important element. If you don’t do stability work, none of the other stuff matters.

Stability is the ability to safely transmit force from the body to the outside world across the muscles which are designed to carry the load. It is overlooked, but is the foundation upon which everything should be done with respect to exercise. My stability work centers around flexibility, mobility, and movement correction for injury prevention.

After having injuries in my ankle, elbow, and shoulder I realized it's time to spend more time on the quality of movement and stability.

I'm a big fan of dynamic neuromuscular stabilization (DNS) and Functional Range Conditioning (FRC) to train proper stabilization and movements.

DNS is based on a re-engineering of the development of movement patterns that occurs between three months of age and walking. The idea behind it is that we are born with the innate ability to move efficiently, but we lose our natural movement patterns by sitting all day. It was originally developed to help kids with cerebral palsy, but is now used to help anyone with movement deficiencies.

FRC is focused on getting to end range of motion and reinforcing that range by challenging it. This is done through controlled articular rotations (CARs) along with progressive and regressive angular isometric loading (PAILs and RAILs, respectively). CARs are a component of FRC that involves moving a ring through the biggest circle possible without any extraneous or compensatory movement. PAILs and RAILs are the application of isometric load to an end range of motion. Despite the focus on movement and mobility, FRC is more of a performance than a rehab modality.

I also train stability using Peloton's pilates, barre, core, and yoga offerings to help me create a more holistic stability routine.

Strength

Strength is utilizing the muscle to generate force. I think strength training is the most daunting at first, but the benefits cannot be overstated. It is the most powerful tool you have to change your body composition, and I would argue your overall health as well. Age-related muscle loss, called sarcopenia, is a natural part of aging. After age 30, you begin to lose as much as 3% to 5% per decade.

It's important to start small and focus on finding a routine that you enjoy. Consistency matters more than how much you're lifting.

Specific movements to focus on are:

  • Push
  • Pull
  • Squat
  • Deadlift
  • Press
  • Row
  • Hip Hinge
  • Lunge

I try to follow a holistic strength training regimen with a mixture of dumbbells, kettlebells, trap bars, bands, and functional bodyweight movements.

Peloton has a 6-week beginner strength program dedicated to teaching the foundations of strength training with proper form.

Aerobic Efficiency

I train aerobic efficiency using zone 2 training. Zone 2 is the highest level of exertion that is effectively pure mitochondrial oxidative phosphorylation before you start to net accumulate lactate. Done properly, Zone 2 exercise should improve mitochondrial function, fat utilization, and lactate clearance.

I do zone 2 training using a Peloton bike at 56-75% of my functional threshold power (FTP). Peloton provides programming to calculate and improve your FTP. My zone 2 training is done in sessions of at least 45 minutes.

Anaerobic Performance

I train anaerobic performance by training in Zone 5. I think people spend too much time in zone 5 and not enough time in zone 2. You don't need to be spending much time in zone 5, but it should not be neglected completely.

I like to train in zone 5 in a few different ways:

  • Peloton bike
    • I'll do four minutes at 125% of FTP
    • Recover for four minutes
    • A one to one work/rest alternating between zone 5 and zone 2 for 20 minutes
  • Air bike
    • I'll do four minute Tabata protocols using the air bike
      • i) 20:10 (20 sec sprint with 10 sec recovery)
      • ii) 10:20 (10 sec sprint with 20 sec recovery)
  • Rower
    • I'll do HIIT workouts using the rower machine
      • 30 sec all-out followed by 60 sec recovery for as long as I can go

Weekly exercise routine:

  • Daily stability work, having one day dedicated to stability
  • 3-4 hours of zone 2 cardio (45 minutes minimum per session)
  • 3-5 bouts of strength training
  • 1-2 sessions of zone 5 cardio
  • Low-level physical activity and movement throughout the day
  1. Sleep

Sleep is a perennial topic. Sleep scientist Dr. Matthew Walker wrote an excellent book titled Why We Sleep that gives a detailed overview of sleep, why it's important, and what not getting enough of it can do to us.

"The physical and mental impairments caused by one night of bad sleep dwarf those caused by an equivalent absence of food or exercise. Routinely sleeping less than six hours a night weakens your immune system, substantially increasing your risk of certain forms of cancer. Insufficient sleep appears to be a key lifestyle factor linked to your risk of developing Alzheimer's disease. Inadequate sleep — even moderate reductions for just one week — disrupts blood sugar levels so profoundly that you would be classified as pre-diabetic." — Matthew Walker

I track my sleep with an Oura ring. After doing so for over two years, specific practices I implement to optimize my sleep are:

  • Consistently getting enough time in bed
    • The goal should be to spend enough time in bed to give your body opportunity to sleep 8 hours or more
  • Go to bed and wake up as close to the same time each day
    • Keep that wake up time as consistent as possible even on the weekends so you aren't "jet-lagging" yourself
  • Sunlight exposure in the day time to regulate circadian rhythm
  • Being conscious of caffeine and alcohol consumption
  1. Emotional health

This pillar is a catch-all for mindfulness, distress tolerance, relationships, and digital wellbeing.

Specific practices I have success with are:

  • Sauna usage
    • Sauna use could offer a great way for the body to mimic exercise in people who are disabled, depressed, or otherwise not willing or able to exercise
  • Cold therapy
  • Meditation with Waking Up and Oak
  • Breath work with Peloton
  • Digital wellness and minding my content diet with Opal
  • Personalized soundscapes to focus, relax, and sleep with Endel
  • Journaling and doing a brain dump of everything on my mind
  1. Exogenous molecules

While the first four pillars are fundamental, supplements can fill in gaps in our diet or genes. Dr. Rhonda Patrick has a genome analysis tool that allows you to export your 23andMe data and get a comprehensive report tailored to your genes. This report gives you the most impactful genes and what research suggests may be the most impactful nutritional and lifestyle insights specific to those genotypes.

Supplements I currently take: