A few years ago, I was on a business trip to Palo Alto and I was seated next to a middle aged man who had boarded early in a wheel chair. I was curious as to his condition and he was open to talking. He had a form of Muscular Dystrophy where the average life expectancy when he was born was somewhere in his 20’s, but treatments had extended those averages and he was in his early 40’s. I asked what was his secret to his health as he looked vibrant and solid. He said when he was young, his neighbor was the wrestling coach and a history teacher. The coach started taking him to school in 7th grade. They left early to be there at 6:30am and the boy initially would wait in the gym until the 7:55 bell rang. At some encouragement from the coach, he started to work out. Not only did he not get worse, some of his symptoms improved and he became much stronger and more mobile. When he moved on to high school, the wrestling coach stuck with him and worked out with him nearly everyday in the gym and on the mat. The experience stuck with him into adulthood and he told me he trained nearly every morning for 1.5-2 hours. When I think of him and a handful of others that had early life challenges and turned to physical training as part of their treatment, they are the best inspiration. Their mortality and lifestyle were at risk earlier in life. For most of us, we largely ignore training and how we eat and quietly bake in poor health early in life that blooms later in various metabolic or other chronic conditions.
While not perfect, my physical work has provided a good foundation for my health. I too had good mentors and and workout partners that exposed me to a variety of practices. Even so, the last few years has served more as my Harajuku moment, that has made my commitment to wellbeing more durable. As you hit your 40’s, taking care of yourself becomes a must, in your 50s and 60’s it becomes nearly impossible. Taking care of yourself in a way as a profession becomes a necessity to have health span, but even more importantly for those of us who enjoy working hard, your professional lifespan. Your resiliency becomes more about consistency and quality of the physical work you do. Even with that knowledge the vast majority choose decline or the easy path of taking a pill for this or that.
My goal this year has been to reboot my health after recovering from surgery and getting lazy and gaining excess weight since I turned 50. My goal is to participate not to win; well, to win too at times!
To that end I’ve simplified how I approach health. I’ll be testing both blood markers in December and a fitness test a friend of mine and I created for ourselves close to 20 years ago as a rough measure of where we are. Well over 70% of men in their 60’s per the CDC take some drug for a metabolic issue, such as high blood pressure or cholesterol. Attia would have us all on statins which may not be bad and I may do that eventually but here is how I look at wellbeing and fitness at least for now.
The basic blood markers and measures count and I believe it important to get them in line before you try to go down any detailed other markers beyond the basics because you will positively impact many other markers by getting the big 5 solid. According to “Good Energy” by Casey Means M.D. less than 6.8 percent of all adults are within the normal range of the 5 basic biomarkers. So you should start there. Normal isn’t really what you should be shooting for but is a good place to start.
Also, there seems to be a particular compulsion at the moment to go real time with these markers. CGM , other wearables etc. Well being is far simpler than all that but go for it for a while if you want to wire yourself but in honestly, I think the overfocus they can create on short term action can become distracting and move you away from long term routine and lifestyle that is sustainable. Return at any moment to these five and you will have a good baseline of your internal well being. The tests I think are gender universal, your targets are your own but progress is really all you want. The sweet spots on these are my own.
- Triglycerides: “Normal” <150 mg/dL Sweet Spot <80 mg/dL
- HDL Cholesterol: “Normal” >40 mg/dL Sweet Spot 50-90 mg/dL
- Fasting glucose. Sweet spot under 85
- Blood Pressure 120/80
- Waist to height ratio- the king of all markers: Suite Spot .48
Beyond the above, for me it is all about mobility, strength, and resilience. I think folks like Huberman, and Attia are overly narrow and broad at the same time but they are a place to start and serve a large audience. What is critical is you develop your own simple plan and then see how you are doing periodically. For me the following principles apply well:
- Be consistent
- Alter your workouts
- Focus on mobility and flexibility as much as strength
- 3:1 ratio slow vs. max effort days for cardio
- Peak once or twice a year
- Most of the time, workout at 60%
- Warm up
- Have a partner if you can
- Set aside the time like it is a ritual
- Suffer now and then
- Most of all, simply move
The following is the fitness test I put together years ago and have used most years. There is plenty limited with it but there is a lot of benefit to it in that you can modify the exercises according to your level and age and it gives you a way of marking your fitness over time. I do it once or twice a year just to check in with how I am doing. We developed this long before some of the new online personalities have become popular but it matches my bias that doctors and scientists are often the last to know or popularize what works for fitness and health. Look to the practitioners in the field and what works for you.
The Test:(you must be observed by someone that won’t let you cheat)
- Pushups max- tennis ball or lacrosse ball or fist under chest. No long pauses
- Squat hold for time or wall sit for time
- Sit ups max in 60 seconds
- Plank for time
- Hang for time
- Optional ring pull ups-knees below waist, no “kip”
- Row or ski erg- 2 minutes for distance
- Row or ski erg, 8 minutes for distance
- Optional two handed kettlebell swings 100 reps for time
- Optional Cooper 1.5 mile run-
Nearly all of the above can be progressed to more or less difficulty. For example, pushups can be wall push ups or modified to knee push ups. Please understand these are just my impressions from my own path to be used as inputs. Do your own work.
