 Welcome to the 21 convention Tampa, Florida. This speech is something that we are all about here. Health, having the best physical expression of yourself, learning your body, your diet. And this is actually an interesting story that comes, man, on so many different levels. Years ago, our next speaker was not that healthy. He and his wife, both scientists, his wife, Xiaoqing, and him decided to learn to get healthy in an absolute design, an absolute map, and this produced the perfect health diet. Let's welcome on stage Paul Gemini. Great, man. Thank you, Steve. Well, it's great to be here, and as Steve said, I'm gonna be speaking about how to be healthy. This is really a joint project of my wife and I. We both had long-standing health problems. We'd go to the doctors every year, and every year they couldn't help us, and every year we got worse. Finally, things started to change in 2005 when I discovered the Paleo diet, and that was the first thing we tried that made a difference. It had good effects and bad effects, and so we figured out all we need to fix it, but it was a really crucial clue because it taught us that diet was important, and when we started to think about what had gone wrong on the Paleo diet, we realized that we had some nutritional deficiencies, so we learned nutrition is important, and later on we started learning more and more things. So after nine years of research, after about seven, we published a book, Perfect Health Diet, through Scribner, and we've also recently started a health retreat on the beach in North Carolina, and so what you're getting in the next hour is a really rapid run-through of nine years of research and a lot of experience, all right? So what I want to summarize in the talk are the three most important factors in health, all right? These are the three things that will be constantly affecting your health, and the most important thing to take away from this slide is you have a great deal of control over your health. So diet and nutrition, you're in total control of those. Lifestyle, you have a tremendous amount of control over that. Microbes, you don't have a huge amount of control, but you have more control than anyone else does, all right? And your doctor has relatively little control over these, you know, until doctors start chaining you into their offices and feeding you, your doctor can only do so much to influence the major factors on your health. So the remedies that doctors have are only playing around at the edges of your health. So doctors are tremendous resources for diagnosis, for testing, for advice, but if you really want to be healthy, you need to take charge and you need to manage these aspects of your life, all right? Let's first talk about diet and nutrition. Now, they always teach speakers, you should give people an idea where you're heading, so let me just give you the conclusion. How should you eat? Here's a somewhat abstract summary of our diet, but we chose an apple because it symbolizes health, and we chose the yin-yang symbol because my wife is Chinese. We wanted to represent the concept of balance. So on the left are plant foods, on the right animal foods, and basically the way you want to construct your plate, construct your diet, is with roughly equal parts of meat, fish, or eggs, some starch, typically for us it would be white rice or white potatoes, some kind of sweet plant, like a fruit, berry, carrots, beets, and some kind of vegetable. And then add flavorings, and typically those would include some kind of flavoring fat, like butter, sour cream, coconut milk, maybe nut butters, some kind of acid like vinegar or lemon juice, and some kind of a mommy flavor. A mommy comes from fermented foods, and that would include things like fish sauce, tamari sauce, Worcester sauce, grated cheese, things like that. So the food will end up being about three quarters plant food by weight, about one quarter animal foods. It's a natural whole foods diet, and we exclude a lot of things. The single most important thing to exclude are vegetable seed oils. So any oils high in omega-6 fat, so don't eat anything that has soybean oil in it, corn oil, anything like that. And how does it look on a plate? Beedmenbap is the Korean word for leftovers, basically. And so this is a very typical way you might rapidly make a lunch out of leftovers. It's hard to see, but there's rice in the bottom of that bowl. You just throw in some leftover meat, throw in some leftover vegetables. You can have a piece of fruit on the side. You put in the flavorings. That's a fermented bean sauce for a umami flavor. You throw in some vinegar and a little oil and put it in the microwave. You've got a great balanced nourishing lunch. All right. Now, what are some of the keys? So I want to boil a diet down, give you some of the science and help motivate and tell you what are the crucial pieces of a healthy diet. And the first most crucial piece is you have to eat natural whole foods. That means things that were recently living plants and animals, all right? And now there have been lots of technical advances in industrial food production and they figured out a lot of things, but they haven't yet figured out how to make healthy food, all right, and we know this is true even if you look in babies, all right, and baby formula and compare it to breastfeeding, breast milk, breastfed babies are healthier than formula fed babies. And that's true even though the formula makers, they're trying to match the milk as best they can, all right? So even when we're using all of our resources of technology to try to match the natural food, we still can't make it as healthy. And if you look at the other foods like cakes, cookies, donuts, they're not trying to make it as healthy as regular food. So you can imagine if they're still falling short with formula, they're gonna be falling short with everything else. And people have done lots of experiments comparing industrial foods to natural whole foods. What happens? Here's an experiment from the 1970s where they had two groups of rats, one fed a diet of eggs only, chicken eggs, and the other fed a diet of egg beaters, all right? And artificial made up food and the rats that were fed the natural eggs, the mothers had healthy pups and the pups grew up just fine, but the mothers fed egg beaters, had these little scrawny pups and they died a few weeks after weaning, all right? So these artificial foods are not healthy replacements for natural whole foods and they probably will never be, okay? So you wanna eat natural whole foods. Now how did we go about designing our diet? We called it the perfect health diet, why? Because that's our goal. They say your reek should exceed your grasp. It will inevitably, so you should reach as high as you can. You should reach for perfection and that's what we were aiming for. We had no idea what were the crucial elements of diet and nutrition, so we just decided we try to make, we wouldn't try to figure out what was important, we just try to make everything perfect and that was why it took us seven years to write our diet book, but it also came up with a really good diet and our general strategy was to look at every known nutrient that the human body needs and figure out how to optimize its amount, all right? Now every nutrient, if you keep the context of the rest of the diet fixed, the amount of the nutrient that you get is going to affect your health according to this pattern. So if you're deficient, you're gonna have terrible health. As you add more, your health will get better and better and then you'll get enough so that your body has as much as it needs and your health will plateau and then eventually you'll be taking too much and it will become toxic. And I'll just give you a few quick examples. Here's optimal sodium, all right? What's your chances of dying based on different sodium intakes? And you see here I've, it's basically the same U-curve but flipped upside down because it's easier to measure deaths than health and so what we see is there's an optimal amount. There's a U-shaped curve and it turns out that's about the amount of sodium and two teaspoons of salt per day but all living things have sodium in them and so you get some sodium through food so you should actually be eating maybe half a teaspoon to a teaspoon of salt per day. Here's another one, calcium. And here, plotted vertically is the likelihood of fracturing your hip, all right? And you can see there's again, there's an optimum, all right? So we went through all the known nutrients, tried to find the optimum amount and then worked backwards to food and says, all right, we're gonna eat a natural whole foods diet. What combinations of foods do we need in order to achieve that, all right? And we got that food plate, all right? So what you want, a mix of starch, a mix of sweet plants, vegetables, meat fish eggs and then the various flavorings, all right? Now, there's a lot of evidence that people are malnourished and there's good reasons to think that they should be malnourished the way they're eating, all right, but here's just one example from the Iowa Women's Health Study. They looked at elderly women and see what was the effect of taking supplements and basically for nearly all nutrients, the women who took the supplements had like a 20% lower chance of dying, all right? And the exceptions, they're the ones that increased the risk of dying were iron. So basically, if you're not menstruating or pregnant, it's very difficult to become iron deficient, very easy to get too much. You should pretty much never supplement iron if you're a man or a post-menopausal woman and in fact, you should consider donating blood regularly to get rid of it. Folic acid is another one. It's easy to get an excess of folic acid, especially since they fortify all kinds of foods with folic acid nowadays. And vitamin A, that's really linked to vitamin D deficiency. So vitamin A is fine if your vitamin D is normal, but most people are vitamin D deficient. But most foods show up, most supplements show up as highly beneficial and why, because people are very malnourished. So let's look at, on the right is a natural whole foods diet. All of these fruits, vegetables, plants, seafood, meat, fish eggs, all of those things are very high in micronutrients. They have a lot of micronutrients per calorie, but what are people eating a lot of? It's like things on the left and people try to make them healthier by buying, back to nature, 100% natural triple ginger cookies. But if you look at the ingredient list, what are they eating? They're eating flour, starch, sugar, oil are the top three ingredients and then a bunch of flavorings. And basically what's happened, the food manufacturers have extracted ingredients from plants like starch, like oil, like sugar, but they've thrown away all of the micronutrients that were in the plants and all of the other nutrients and they've just put in flavorings. And so you're getting essentially no micronutrition and lots of micronutrients, all right? And that is something that just started happening a little over a century ago, all right? It's really a recent development in human evolutionary history, all right? Now it turns out when you look at diet, there are certain nutrients that are really crucial and that you can easily miss in a natural whole foods diet, all right? So if you just take your starch, your sweet, your vegetable, your meat and flavor it, then you might easily be missing some key nutrition. And therefore we recommend that people eat what we call supplemental foods. We call it that because we want you to think I need to take these routinely just like I would a supplement. So eat these foods either daily or weekly on a regular schedule and key foods, eggs, all right? So if you think what's in an egg yolk? It's all the nutrition a chicken embryo needs to develop. And if you know in pregnancy, that's when we have our highest nutritional needs. You know, you're building a whole creature, all right? So egg yolks have to have the nutrition to build a whole creature. And similarly, fish eggs, extremely nutritious. So if you want it, you could substitute caviar for your eggs, but it's really important to get some kind of egg every day. Another crucial one, I'll talk about that more, bones, joints, tendons, all right? That gives us extra cellular matrix, the connective tissue that holds all of our cells together. Seafood, good for omega-3 fats. Liver is really crucial. So I'd say liver and egg yolks are the two things you really don't want to miss and then the bones, joints, tendons. A few other things, shellfish will fill in some key nutrients. Starches are really pretty crucial. They're valuable for electrolytes like potassium. They're valuable for fiber. You really need the fiber from starches in order to be of good health. And they're also valuable as a carbohydrate source. Fermented vegetables, really important. They provide beneficial bacteria. I'll talk about that more. Colorful vegetables, but really all vegetables, green leafy vegetables, seaweeds, orange plants like carrots, they're all good for you and you want to get a diversity. Now, in terms of animal foods, what's a very common mistake? People only pick one part of the animal and eat that over and over. So they say, oh, I like ribeye steak. So the only part of a cow I'm ever gonna eat is ribeye steak and I'll have that steak over and over again. People tend to like muscle meats, we're in that habit. But in fact, different nutrients appear in different parts of the animal and if we're gonna be well nourished, we need to provide all the parts of ourselves to our body. And why is that so crucial? Well, I think it's good to think about our ancestral environment and the necessity of fasting. All right, now fasting is something we all do overnight, every night while we sleep, all right? And it's a very natural part of our physiology. But think about the natural environment. Here's a quote from a Jesuit missionary who was among the Indians of Canada in the 1630s and he said, I saw them in their hardships and their labor suffer with cheerfulness. I found myself with them threatened with great suffering. They said to me, we shall be sometimes two days, sometimes three without eating for lack of food. Take courage, Chihine, let thy soul be strong to endure suffering and hardship. Keep thyself from being sad, otherwise thou wilt be sick. See how we do not cease to laugh although we have little to eat. All right, so it's very common among hunter-gatherers you might go three days without food. All right, and it's similarly with animals, all right? Animals don't have food available every day. What happens to our bodies when we fast like that? Well, we can actually see this in cells if you put cells in culture and you starve them for three days, what happens? The cells just shrink in size, all right? So all of these cells, they cannibalize themselves and they shrink in size, but they're still fully functional. So everything the larger cell can do, the smaller cell can do, all right? And that's how we maintain full functionality. Our bodies, after a fast, we're designed to cannibalize ourselves, shrink our bodies, but we retain full functionality so we can still go out and hunt, fight, whatever we need to do. And this is very basic to biology and what's the implication for us? In fact, it's crucial to our health to go through this fasting and feeding cycle because when we're fasting, cannibalizing, that's actually a very smart process. What happens, our bodies look around for everything in our bodies that we don't need like bacteria, viruses, like damaged, mitochondria, damaged things. We don't cannibalize the healthy tissue, we cannibalize the unhealthy tissue. If you never fast, you're never clearing up those infections, those damaged materials, all right? And then what happens when you feed, you reconstruct everything and you grow yourself back, and when you feed, what's the point of feeding? You need to give yourself the nutrition, you need to rebuild all that tissue. And if you're, and the mistakes people make in diet, they never fast, so they're never cleaning things up, and then when they feed, they're eating things like those cookies that don't give them the nutrients they need to rebuild whatever they cannibalize. And so they're gradually breaking down their bodies and damaging their health. And the thing people most overlook is this exercise of matrix material. So here are experiments if you take tissues and you rinse them with detergent that washes away all of the cell membranes and then you rinse them with water so that all of the proteins that were inside the cell and the DNA, it all gets flushed away. What are you left with? Well, it still has the shape of an organ. And in fact, it has so much information, this extracellular scaffolding is so sophisticated that if you put stem cells on it, you can regrow the organ and have a functioning organ. So every stem cell when it hits the extracellular matrix, it knows, all right, this was extracellular matrix for a nerve cell, I'm gonna become a nerve cell. This was extracellular matrix for a blood vessel endothelial cell, I'm gonna become an endothelial cell, all right? So there's a lot of information in that extracellular matrix. It has a lot of complex molecules and it has a very different chemical structure than the rest of your body. And you need to eat that extracellular matrix and the best sources are basically connective tissue. And so things like these bones, joints, tendons, but people don't eat those nowadays because you need to make soups and stews and you need to cook them for a while for those to become edible and people don't take the time. Another key aspect of diet, you need to listen to your brain, listen to its desires, follow them. The brain is very closely programmed to like and get pleasure from things that are good for us. When we eat good food, it's a pleasurable process, all right? And we have, for instance, a specific hunger for salt and animals will go to great length. So here's some elephants who have mined 700 feet into the side of a mountain along a salt lick in order to get salt. And there's very little salt in that park in Africa. And so all of the animals go there even though there are predators waiting to prey on them. But they all brave the predators in order to get the salt because they need it. And similarly, we develop hunger and cravings for whatever our bodies are lacking. My wife used to have an iodine deficiency. Whenever she saw an all-you-can-eat-crab restaurant, she wanted to go in and she would eat like 40 crabs and I would be stuffed after 12 crabs. But she could keep eating because her brain told her, oh, you really need this. And we didn't figure it out that it was an iodine deficiency until later, all right? So what does that mean? It's very important that you put together your food in the most delicious proportions, all right? And so which cuisines do you want to emulate? Well, basically any elite royal cuisine of the past, any fancy cuisine that was created for the richest audience, people for whom money was no object and they just wanted the optimal flavor, like classic French cuisine. And so here are some quotes from Julia Child. The only time to eat diet food is while you're waiting for the steak to cook. Fat gives them flavor. If you're afraid of butter, use cream. And the big life-changing event for her that got her into the diet field was I had my first French meal and I never got over it. It was just marvelous. We had oysters, lovely dry white wine, lovely scalloped potatoes, and with a lovely creamy buttery sauce and roast duck. If you look at her, she wouldn't necessarily look like, she's tremendously healthy, she was overweight, but she lived in 93, she was quite a bit healthier then, and that was probably at least 15 years ahead of average life expectancy then, all right? And it turns out, classic French cooking, just about perfect macronutrient ratios, just about perfect proportions of carbs, fat, and different types of things, all right? So when you're thinking about putting together your food, try to make your food delicious, all right? And now one thing I like to do is look at obituaries from centenarians and super-centenarians. And what's the most common thing you find about diet? It's that they love to cook, all right? The best thing you can do to make yourself live a long time is to learn to cook and learn to enjoy cooking. And why is that? If you're cooking for yourself, you're working with natural whole foods, plants and animals, and when you cook for yourself, you wanna make things delicious, all right? And so you're gonna follow those innate brain preferences toward the right proportions, the right mix of foods. So if you're cooking for yourself and you're good at it, then you're almost automatically gonna generate a very healthy diet, all right? So that's my quick summary of the optimal way to eat. Now, let me go on to the second area, lifestyle. All right, now it turns out, when you look at centenarians, super-centenarians, lifestyle is just as important as diet in extending lifespan. And so if you've read Dan Butner in his Blue Zones books, all right, he goes around the world looking for places where people live a long time, and they don't find a lot of consistency in their diets, all right, so it's hard to find some dietary thing that makes these places stand out. But what does make them stand out? Well, there's a lot of islands, all right? And there's a lot of remote places, all right? A lot of places that got civilization late, they didn't get electricity, they didn't get automobiles. And so what do people do? They're also often in warm places like the Mediterranean, all right, where people don't need air conditioning or heat, get a lot of sunshine, okay? So these people, they're living very natural lives. They're living outdoors, they're walking lots of places. It's expensive to import food, so they're eating locally grown foods and fish, a lot of seafood, they get a lot of exercise, it's dark at night, they get a lot of social interactions with their neighbors, so it's a very non-industrial lifestyle, and what is the optimal lifestyle? Well, it's very similar to that. It's also very similar to the lifestyle of an animal, all right, so how does an animal live? Well, it gets up in the morning, it goes outdoors, but it was already outdoors, so it hasn't gone anywhere, but it does find its friends, it interacts with them. It, at some point, decides it wants to go to the gym and fetch some food, now the gym happens to be its cafeteria, so it has to get some exercise in order to get its food. When it catches its lunch, it eats it. When it's done eating, grooming, exercising, then it relaxes with its family, with loved ones, and then it gets a good night's sleep, all right, so this is the essence of the healthy lifestyle, and we need all of these elements in our lives each day in order to be completely healthy. Now, all six of these things share a common feature. They entrain circadian rhythms, all right, circadian means on a 24-hour cycle like the sun, the day-night cycle, and all of these things are meant to be rhythmic parts of our lives, all right, and all right, so what happens? Our body has lots of clocks. Every cell has a circadian clock, its own internal clock. We have a trillion cells in our body. All of those trillion clocks need to be synchronized, okay, in order for us to have good health, all right, so we have to make sure each of those cellular clocks is working, all right, it's not like the grandfather clock that stopped ticking, and then we have to make sure they're all keeping the same time, right, it's like in the spy movies, all the spies have to get together, synchronize their watches, if they're going to work together successfully, if our cells are gonna work together successfully, they have to synchronize all of their clocks, and if you achieve that, then you'll gain at least six years of life expectancy, all right, so that's a really big gain. What happens if you fail to do it? Well, we have all these different ways of doing it, and it turns out just screwing up any one of them is pretty terrible, all right, so if you look at people that get sleep loss, either because they do night shift work, or they have sleep apnea, which obstructs their breathing and wakes them in the middle of the night, here's the list of diseases they get, and they lose about six years off their lifespan, all right, but totally different way of training circadian rhythms is exercise, all right, that's something we need to do in the daytime, and it establishes good circadian rhythms, and what about people who never exercise, what happens to them? Well, they lose six years off their lifespan, and they get exactly the same list of diseases as the people who do night shift work, all right, or have sleep apnea, all right, why is that? These things are feeding into the same biological pathways, okay, and that's where they deliver their benefits, okay, so circadian rhythms are really crucial. All of these things, most of our lifestyle influences on health work through our circadian rhythms, all right, now why are circadian rhythms so crucial? Well, think of these deaf, dumb, and blind movers trying to move a sofa, all right, they have no ears and mouth, so they can't talk to each other, all right, but they need to lift at the same time, they need to walk in the same direction, or else the sofa is gonna fall down, all right, so they need to coordinate their activities, but if they can't communicate, how do they do it, all right, and our cells are in that situation, our cells need to cooperate with all the other cells, they need to achieve biological things that they can't do alone, they need to do it with a cluster of other cells like an organ, everybody needs to be working together, but they need to all do it at the same time, they need to be all be running the same program, and how do they achieve that, they achieve it through clocks, all right, and they all have to have their clock synchronized, if they don't have their clock synchronized, then they won't do it, so all of our cells, they've got a biological program, at this time of day, I'm gonna do this, all right, and if all of our cells are have the same time, then they'll be able to interact with each other successfully, and all the functions, all of our bodily functions will be executed well, all right, how do we give time to those clocks, all right, how do we get all the clocks ticking, and all of them synchronized, well, there are five main ways, all right, one of them is light exposure, one is exposure to ambient temperature, one is through social interactions, one through exercise, one through meal timing, okay, so let me talk a little bit more about each of those, how does light give us our timing, well, it turns out when light, mostly blue light, but also ultraviolet light and a little bit of green, when it strikes our retina, there are some special receptors that send signals to a part of the brain called the suprachiasmatic nucleus, which is where the so-called central clock is located, so it's a single most important clock in the body, and that portion of the brain sends signals up to the rest of the body, this is what I think the time is, all right, so that's a very important clock, and what drives it, blue light is really crucial, all right, and everything from about here on yellow up can affect it somewhat, but basically red, orange, and yellow with no green has no effect on the central clock, all right, so what does that mean? In the nighttime, you can use red, orange, yellow light with no problem, all right, it won't have any effect on your circadian rhythms, it won't tell your brain that it's daytime, okay, but in the daytime, you really need all this blue light, so whenever you're exposed to blue light, it's telling your body it's daytime, okay, so by day you need to get sunlight, and when you're indoors during the day, you need to expose yourself to bright full spectrum lighting, all right, now what kind of lighting do people actually buy if you look at these lights, you'll see they have a yellowish tinge to them, all right, and that's the worst possible kind of lighting to buy, all right, don't buy anything that says cool white bulb, all right, that's uncool, okay, what you want is something with a color temperature of at least 5,500 Kelvin, and it should be, it should look a little harsh, it should look very bright, very blue, all right, like think of the halogen headlights, and what should things look like at night, they should look like a campfire, all right, campfire, color temperature more like 600 Kelvin, all right, and it's very red, very yellow, and very little blue, okay, so these yellow lights, they have too much blue, they'll disrupt your night, but they don't have enough blue to untrain your day, all right, so now it turns out, since Thomas Edison invented the light bulb, all right, he's a great man in many ways, but he really damaged our health with that one, so we now have these light bulbs all around us at night, and it turns out that having all that light at night is probably disrupting our health, and so for instance, light exposure at night is closely tied to obesity rates, so in this study they split light exposure up into three groups, a low light group, middle light, third, and a high light third, and the darker the light, you know, basically the people with middle amounts of light exposure at night are 10% less obesity than people with highest light, and people with the lowest light exposure are 20% less obesity, and we know that circadian rhythm disruption causes obesity in animals, so this is very consistent with what we know. All right, temperature, really important. We wanna be exposed to warmer temperatures in the day, cooler temperatures at night, now in our natural environment, outdoors, that happens automatically, there's no place in the world you can go where it's hotter at night than in the day, okay, but now that we have artificial control of our environments, what do we do, especially if you're in the South, you put air conditioning on all day, so it's cool, and you go through offices, the mall, everything's very cold, and then you get home and you wanna save money on energy, and so you turn the air conditioning off and now it gets warm, so you've reversed the day-night cycle, all right. Food, extremely important circadian rhythm and trainer, it's very important to do intermittent fasting, have an extended overnight fast. You should never eat any calories at night, and you should have at least a 12-hour night, so once it's nighttime for you, don't eat any more calories, and you should actually extend the fast longer than 12 hours, so I generally do about 16, and I think that's about optimal. You have to make sure all of your food comes in in the daylight, all right, so what happens, these are two groups of mice. In this black line, the mice had their food fed to them equally throughout the 24 hours of the day, all right, and mice, when they get food, they just go eat it if they're hungry, and so these mice were eating all day, no circadian rhythm entrainment. The other mice, they got exactly the same food, all right, but it was just within a restricted window, eight-hour window, and what happens? They live 50% longer, all right, that gets back to what I said about the fasting. Our bodies really need a fasting period to go cannibalize themselves and clean up all the junk, and then they need a feeding period in which they reconstruct themselves, and you're short-circuiting that. If you're always feeding yourself through 24 hours, you're never cannibalizing yourself because disposing of this food that came in is a higher metabolic priority, and it trumps that, so if you're feeding all the time, then you're never cleaning up your body, and it really shortens your lifespan, all right. Now also, meal timing when you eat, so you need to be on that fasting feeding cycle, but then what's the optimal time to feed? It's between about noon and 4 p.m., all right, and but you wanna get all of your food intake in the daytime, okay, and it turns out, it used to be said that skipping breakfast was bad for your health. Turns out that's not true. Skipping breakfast is good for you because it helps concentrate your food intake, but skipping breakfast is terrible if it leads you to eat food at night, all right. So late night eating is really bad for you and leads to obesity and other problems, all right, but if you don't eat at night, skipping breakfast is just fine. All right, one last thing about the meal timing issue, this is another reason why diets tend to fail, all right, when people are trying to lose weight, they wake up in the morning, their brain is fresh, they have a lot of willpower, and so they say, all right, I'm not gonna eat, okay, so they restrict their eating, all right, and then as the day goes on, they get hungrier and hungrier, and by the time it's nighttime, their brain is tired, so their willpower is lower, all right, and then they give in and they start eating, so they're eating at night, and so what have they done? They totally reversed the circadian rhythm, and they're feeding at night and fasting in the day, and that's very disruptive to their bodies, to their health, and it leads to weight gain, all right. Physical activity, all right, the keys, in the daytime, we need to get exercise or activity, we need about 30 minutes of moderate intensity exercise per day, modern intensity is where you're working fairly hard, but it's comfortable and fun, you know, your breath, your heart rate are just about, if you exerted yourself a little bit harder, your breath would get rapid, you know, your pulse would get too high, it would be unpleasant, you'd have to be, you'd feel like you were working hard, so just below that point, that's moderate intensity, if you get 30 minutes per day, then you're getting enough to train circadian rhythms, if you do it every day over time, it builds up a level of fitness. This is from a long running study, started in the 1970s, where they give people a treadmill test to assess their fitness, they also started assessing strength later, and then they track them, and see how long they live, see what health problems come up, and it turns out, if you were in the low level of cardiorespiratory fitness, compared to the high level, people in the high level fitness have 75% lower mortality over the next 10 years, all right, so exercise and fitness does have a huge impact, but just more and more fitness is not better, all right, so what happens when we look at different levels of activity, well, it basically follows a line like that red line that I've gone, as you go up to about half an hour a day of moderately intense activity, you keep improving your health, but once you've reached that point, then further exercise increases your fitness, but it doesn't increase your health, it no longer reduces your risk of dying, all right, why is that? It's not fitness that prevents you from dying, it's circadian rhythm and training, and once you've gotten that 30 minutes of exercise, you've been trained your circadian rhythms as much as you're going to, all right, another important conclusion, when we do a circadian rhythm and training thing, the effect persists for about 36 to 48 hours, all right, so what does that mean? If I exercise today, I get the benefits for 36 hours, but then the benefits have lapsed, I need to exercise again in order to get the benefits, and it's the same with all of the other circadian rhythm and training things, you need to do them every day, if you miss one day, then you have to say, I'm absolutely not gonna miss the next day, never miss two days in a row, then you've totally lost the benefits. Another key element, social interactions, we're social creatures, we need to have social interactions, and if we don't get them, it damages our health significantly, all right, so we need social engagement, but curiously, we don't necessarily need engagement with actual human beings, so in some experiments, it turns out that if you look at human faces, hear human voices, if you watch television, you watch movies, you can train, your brain can be fooled into thinking you're getting social interactions, social engagement, and you can improve your health, it's very important that these social interactions happen during the day, all of your stressful interactions should be in the daytime, in nighttime, you don't need to avoid people at night, but your nighttime interactions, they should be intimate, comfortable, stress-free, so now, often when I give these talks, someone will ask a question, all right, what's the best time to have sex, and then what I say as well, intimate, comfortable, loving sex is great at any time, passionate, stressful sex only in the daytime, all right, so, okay. Now, all of these daytime and training things, you need to concentrate them in the daytime and not do them at night, all right, and that's true of social interactions as well, okay, so, and like I said, television in trains are daytime rhythms, and that can explain a paradox, so every time they do studies of television viewing, they find that it's terrible for your health, one Australian study found that for every hour of television viewing, you lose 22 minutes off your life, plus you have to watch 12 minutes of commercials, so, basically it's a really bad idea to watch TV, but it's funny, you would think if looking at a screen was such a problem, then all these people who get jobs where they're looking at computers all day would have terrible health, but you look at them and no, there's no negative health effect to having an office job where you look at a computer all the time, all right, so what's going on, it's that the TV viewing is happening at night, it's disrupting their circadian rhythms, whatever happens at the office in the day is not disrupting circadian rhythms, all right, so, in the evening, what do you want? You want companionship, all right, you want loving support, and like I said, with a lot of these things, even if you can't get the really authentic, you know, like a loving mate, you can often find substitutes, a good substitute is a dog, so it turns out here's a heart disease study of people who had a heart attack and they looked at the likelihood of having another heart attack and dying, and of the dog owners, there were 87 dog owners, only one died in like the five or six year follow-up, but of the 282 people who didn't have a dog, 19 died, all right, so that's more than a six-fold higher risk for the non-dog owners, so having some kind of companionship, loving support is really crucial. Very important to create a pro-sleep environment, as Shakespeare said, sleep is a nourisher of our health. We need it. Disrupted sleep increases mortality by 90%, and for good sleep, it's really important that you control your environment, create a quiet environment, a dark environment, have a regular bedtime, go to bed early enough so that you can wake to a natural waking, don't wake with alarms, and like I said, all of these circadian rhythm training effects, they, their influence extends for 36 to 48 hours, okay, so everything that you've done in the previous 48 hours will affect your sleep, and the better you've entrained your circadian rhythms in the previous 48 hours, the better your sleep will be that night, okay, so tend to all those other things, like social interactions, like exercise, like meal timing, and particularly if you have sleep problems, you need to fix those, okay, all right, so summary, what's the best strategy? Get bright natural light in the day, arrange your environment so that you get orange red lights at night, and I recommend having two sets of lighting in your home, nighttime lights, daytime lights, all right, so, and define your own 12 hour day, all right, so in our home we use 8 a.m. to 8 p.m., and at 8 a.m., I go around the, our home, open all the drapes, get as much sun as I can, turn on all of our bright, natural, 5,500, 6,000 Kelvin color temperature lighting, all right, make the environment light as bright as I can, at 8 p.m., I go around, close all the drapes, turn off all the white lights, turn on orange lights, all right, and then we have then, we're lit like a campfire, all right, get daily exercise, very important, intermittent fasting, have an extended overnight fast, do your eating only in the daytime, try to get most of your calories between noon and four, all right, so make that your biggest meal, now most people will have to do cooking in the evening, so get used to having leftovers, all right, so do most of you, do all of your cooking in the evening, but don't eat immediately after cooking, save it, eat it the next day, when it's gonna be healthier for you. Make sure you're exposed to warmer temperatures in the day, cooler temperatures at night, make sure you get social interactions in the daytime, have a calm, loving environment, all of your stress, schedule it, all right, if you have to have a fight with your spouse, you know, agreed to have it the next day, you know, in the daytime, all right, don't do it at night, and make sure you have a regular sleep schedule where you can get plenty of sleep, all right, third driver of health, germs, bacteria, other things, now this is really crucial for health, and how do we know this? Well, we can look back at history, and going back to about 1880, life expectancy in 1880 in the US was under 40 years, all right, nowadays it's about 80 years, all right, so we've doubled our life expectancy, and how did we do that? Well, here's the rates of mortality from all these diseases, and we only have data going back to 1900, but that blue line that's falling, that was infectious disease mortality, all right, none of the other lines have gone down, all right, now one of them is heading down now, cardiovascular disease, and why is that? Well, heart attacks are caused by infections, all right, so all of these serious infections, they used to kill mostly infants who have suppressed immunity, and they killed a lot of young people. When people survived childhood infections, they'd still maintain all those infections in their body, and those infections would gradually build up and eventually give them a heart attack 50, 60 years later, and so this is really, this line is really the echo of this line, these are the people who survived these, and once you got to the point where no one was having them, then the heart disease rate is going to go down to zero similar to this, it's projected to reach down to this level about 2020, which is about one human lifetime after the time we got rid of these infectious diseases. Now, what got rid of them, all right, it's really hygiene, all right, there were two big things that did it, one of them was the invention of things like flush toilets, indoor plumbing, sewage treatment, piped water coming to everyone, so we'd all get clean water, and when we had diarrhea, we'd go to the toilet and we'd flush it down and it would all get treated, so the germs would no longer spread from one person to another, all right, and that was a huge improvement, and if you know the timeline, when did Thomas Crapper invent the flush toilet, all right, that was around like 1870, when did we complete the build out of sewage treatment and sewage lines in the United States, it was in the 1930s, 1940s, all right, so that whole process was going on between about 1870, 1940, and that coincided with this drop, and then the other big factor, the invention of the automobile, all right, so Thomas Edison's scourge of humanity, but Henry Ford, great benefactor, all right, so what happened, we used to have all these horses going around all of our towns and cities and the horses would leave horse manure all over the place, all right, and people would have to go collect it and they'd pile it up in New York City, they were generating something like a million tons of horse manure per day, just from, you know, in the year 1900, they'd pile them up on street corners and eventually they'd be ferried out to the country for use as manure, but what do you have when you have all this manure around on the streets, you've got lots of flies, and the flies go sit on the manure and then they go around and they sit on food and everything else, and they're spreading germs all over the place, all right, and so when we replaced all the horses with the automobiles, and by about 1940, everybody has an automobile, all right, so we got rid of a lot of germs, okay, and there were a few other things like the invention of vaccines, antibiotics didn't come around until the 1940s, all right, so penicillin, the first antibiotic, I think it was discovered around 1938, but wasn't available until after World War II, that was really after, you know, the only thing that really helped with was syphilis among the major causes of death, all right, now it's important to realize, although we brought infectious disease mortality low, we haven't eliminated infections, and everybody carries chronic infections, everybody gets them, all right, so here's just one study, they looked at five common infections, they looked at who's got antibodies against these infections, the prevalence was 94% have antibodies to cytomegalovirus, 90% have antibodies to herpes symplexvirus one, that gives you cold sores in the mouth if you don't brush your teeth for a long time, 38% have herpes symplexvirus two, 80% H. Pallori, 42% commutafilinimonia, and here's a plot, well over 70% of people had at least three of the five, okay, so everybody gets these infections, they have significant health effects, it's almost impossible to get diabetes if you're not infected with cytomegalovirus, all right, but unfortunately, almost everybody is, so all right, but all of these things sabotage our health, as we go through life, we acquire more of them, so here's a rate of acquisition, C. pneumoniae, if you're 20 years old, 27% chance you're infected by 40, 34% chance by 50, 53% chance by 75, 65% chance, and similarly with herpes symplexvirus two, 16%, 24%, 46%, 56%, 63%, every year of your life, you have some chance of getting exposed to these things, once they're in your body, they're there to stay, they gradually multiply over the course of your life, the burden becomes greater and greater, and they cause more and more health problems for you as you get older, all right, now it turns out there's a geographic distribution of germs, where you're most likely to be exposed to germs, tends to be in the U.S., the South has the highest infection rates, and if you look at diseases, disease rates, they track the infection rates, all right, so this particular one was Chlamydia, but others are similar, generally speaking, places with high infection risk, they tend to be wet, wooded, warm, they have a lot of ticks and mosquitoes, Alaska has a high rate of infections, that's probably because they don't entrain circadian rhythms well, they don't get a lot of sunlight, they don't make vitamin D, all right, so here's diabetes prevalence, here's stroke prevalence, here's obesity prevalence, where is a good place to live if you don't wanna be exposed to microbes, the Rocky Mountains, really good location, they don't really have mosquitoes, they don't have ticks, when you go to high elevation, you're pretty well protected, all right, some keys to hygiene, cook things in water, all right, and so if you're simmering, you're boiling, you're gonna kill all the germs, food is a major vector for germ transmission, if you think of, what are we putting into our bodies every day or putting in three or four pounds of food, you can easily, some germs can hijack or take, stow away and take trips along with that, and it's really good to kill them before you eat them, how did the recent Ebola epidemic start, it's thought that the reservoir of Ebola in Africa is the bat population, and bat stew is a pretty popular food in Africa, all right, so maybe the way it got started, somebody ate an undercooked bat, all right, they hadn't simmered their bat long enough and they picked up an Ebola infection, all right, so, and there's others, you know, so pork tends to be a good source of infections, a lot of people get hepatitis infections from eating pig liver, you wanna cook things well, it's important to wash your hands, so again, hygiene, like I said, automobiles, plumbing, and hand washing helps, merry well, sexually transmitted disease are a very common source of infections and burden, avoid mosquitoes and ticks, all right, so that's another major vector for infectious disease transmission, all right, now there's another aspect to these microbes, all right, they're not all bad, we all have some beneficial bacteria or we should have them living in our guts, all right, and why are those so crucial, well, microbes fight other microbes, all right, they're all trying to occupy a certain ecological niche, and if you have friendly ones that are beneficial to us, occupying the niche of your gut, when a pathogen comes in, those microbes won't wanna give up their space, and they'll try and kill that pathogen, all right, so this is really the first line of immunity for you, and if you have a low microbial diversity, that means there are unoccupied ecological niches in your gut, and that means pathogens have an opportunity to take up residence there, then they can spread into your body, all right, so if you don't have a good gut flora, you're at risk for getting infections, and also you're at risk that the bacteria that you do have, more and more of them are going to be pathogenic, all right, and in general, and this is true in both humans and animals, in humans we observe it, in animals we do experiments and prove it, more species diversity in the gut leads to better health, lower risk of poor health outcomes, we also know if you give, for instance, livestock, low dose antibiotics, so not big enough to eradicate all the germs, but enough to reduce microbial diversity, make them vulnerable, what happens, they become obese, all right, so that's actually a common tactic used by food producers to help fatten their animals before slaughter, is you give them low dose antibiotics, okay, and humans can do the same thing, if you take antibiotics, you'll reduce the microbial diversity in your gut, and you'll promote poor health, and so what can you do to address that? We'll eat diverse sources of fiber, you need to eat starchy foods, they have a form of fiber called resistant starch, best way to get it, take your starches, cook them at night, several days before you're gonna eat them, refrigerate them, all right, and then take them out at mealtime, and prepare them, you can just warm them up, and then make fermented vegetables, and eat fermented vegetables regularly, so those will have a very healthy bacteria, and over time that will increase the diversity of the flora in your gut, all right, so evidence that it works, I mentioned at the beginning, my wife and I, and a partner, Whitney Ross Gray, who cured her multiple sclerosis on an ancestral diet, and our diet, have started a health retreat in North Carolina on the beach, okay, and we call that the perfect health retreat, it's basically, it's primarily an educational program, so we've got science classes, we've got like four exercise classes a day, looking at different aspects of movement, so in the early morning will be things like, it could be yoga sun salutations, it could be posture or breathing, late morning is an, late morning, late afternoon, we have two, the moderate intensity things that entrained daytime rhythms, and in the evening, meditation, stress relief, preparation for night, relaxation, calm your body, and we create the environment, so you can see in the daytime, bright natural light, at nighttime, orange lights, here's a property, you see a lit for nighttime, we do various exercise classes on the beach, we teach things like healing, massage, fascia, release, other techniques, we have cooking classes, we teach cooking, and the whole week models a healthy lifestyle, all right, so you get to experience everything implemented in the perfect health way, where we've optimized every aspect of nutrition, of lifestyle, environment, and health, and by modeling it, we help to teach people how they can implement these things in their daily life and get the full benefit of them going forward, and now I've started publishing some results from the retreats, so it's sort of like a short clinical trial, we bring people in, they adopt all of our diet and lifestyle advice for a week or two, we've had people up to 30 days, we've had tremendous results, the very first woman who went through it, she was scheduled for two knee replacements and a hip replacement, she walked with a cane, she took like six pain pills every day, and within 30 days she had thrown away her cane and almost cut out the pain medication, 75 days later she was working as a gardener, and it was completely cured, she didn't need any surgery. I just had, we just finished a retreat last weekend, and one of the attendees wrote on Facebook that when she came she had been hobbling up and downstairs, she'd had shooting knee pain that she'd had for many years, and she had to go downstairs very carefully one at a time, and she said she's only been back home four days and the knee pain has gone and she's going quickly down the stairs each step, so you can have very significant changes in a pretty rapid period, and we've had great results for weight loss, also great results for underweight, so everybody's weight normalizes, and we're hoping over time to build up a record of really good health improvements for all kinds of diseases, and to publish, demonstrate things, and I put a few things up on my website, PerfectHealthDiet.com, and eventually PerfectHealthRetreat.com, and I invite you if you really want to learn all these things in the most expeditious way, you get a thorough education on how to be healthy and see it modeled, and hands-on learning, then the retreats are a great thing to come to. So in summary, what should the food look like? That's a tendon stew on the left, seafood, shellfish, great source of zinc, liver, and onions, and you can have ice cream, you can have desserts, we actually recommend having some dessert as your very last food of the day, and the lifestyle, go outdoors, interact, exercise, eat natural whole foods, have a loving, comfortable environment at home, and get a good night's sleep, all right? You can sum that all up, live like an animal, like a successful animal, live our ancestral lifestyle. Okay, thank you very much. All right, let's give it up for Paul Germany. Thanks, Paul, that was fantastic. I missed some of it, but I got most of it, and I'm really glad I came, or was able to be present for it. During the presentation, can you touch briefly on antibiotics? Can you speak a little bit further to that? Specifically, if you have any preferences for them when working with the doctor, to do at least damage to your gut and such? Yeah, well, you know, I've had three courses of antibiotics in my life, twice they damaged my health, and once they really fixed it, and, you know, so you have to view these things, all of the therapies that doctors have have risks, and they can have benefits as well, and so antibiotics can be extremely beneficial in the right circumstances, but they are going to damage your gut flora, and they can also damage other aspects of your health, like your mitochondria or liver kidney function. So it's something you really do need to consult your doctor and try to make an intelligent decision to weigh the pros and cons, the risks and rewards, but I would say, you know, if you think you need them, you always want to implement all of these diet, lifestyle tactics first, because very often you'll find you no longer need the antibiotics, even if you do still need them, they'll work much better, and so the one time they worked for me, I had ended up with apparently some kind of bacterial brain infection, but I fixed all of my diet and lifestyle things first, and that really helped me diagnose what was going on, and then the antibiotics worked really well, and now some of them, the one that helped me most was doxycycline, which enters the brain and is relatively benign toward gut flora, and that's a good broad-spectrum antibiotic, but it's really, you know, consult your doctor and also know some of the negative effects, you know, like a commonly prescribed antibiotic is ciproflexicin, and that can give terrible side effects to people who are deficient in magnesium, so you should really make sure you're replete with magnesium before you take it and supplement magnesium while you're taking it, and you know, doctors won't necessarily tell you everything that you ought to know about these things, so you really wanna manage your own health as much as possible, you know, create the best possible context for treatment through diet, nutrition, lifestyle, and then think along with your doctor about how best to treat your condition. One more question. Paul, I really enjoyed your talk. I'm a medical resident from Canada, and I was wondering, you know, I have a month coming up where I'm gonna be doing 24-hour shifts every few days and I wanna ameliorate the damage to my circadian rhythm, you know, I thought about things like, you know, the next morning, possibly just getting some blue light and cranking it up just to get my body back in the groove, I'm just wondering what tips would you recommend for someone like me who has to go through that? Yeah, that's what I would do. I would invest in some blue-blocking glasses, you can get ones that fit over your regular glasses, and, you know, define your own 12-hour day, 12-hour night, all right, so in your 12-hour day, you know, also have these bright, you know, you can get like a little desk lamp that has, you know, a very bright natural light, you know, carry that around with you, you know, wherever you're working, you know, set it up, you know, so that it's shining near your eyes, and then during your night, put that away and put on the blue-blocking glasses, make sure all of your food intake is during the day, fast during the nighttime while you're working, you can have black coffee, things like that, but don't have any calories. And, and, you know, similarly, you know, in the work environment, you're not in control of your social interactions, but you can try to, you know, tamp back the social interactions at the nighttime, you know, so do lots of talking to colleagues in the daytime, you know, but at night, if you have time to withdraw a little, to rest, you know, do things like reading, that would be a good time to do it. Also, you can do things like slow breathing exercises, and this actually works really well with biofeedback from heart rate variability, so if you have a heart rate monitor, you can check your heart rate variability on your smartphone, and, you know, you can do deep, slow breathing, you know, so breathe in deeply, slowly, for five to seven heartbeats, breathe out, exhale very slowly for seven to nine heartbeats, and that will de-stress you, and it's a very effective means of reducing the level of stress in your body. So in the daytime, no need to do that, stress is not bad for you in the daytime, but at night, you want to, you know, do that kind of breathing exercises, you know, do a little mindfulness meditation, you know, keep yourself as calm as you can. So, you know, all of these tips, there may be things you can control in your work environment, and, you know, try to make the environment as close as possible to, you know, a good circadian rhythm in training environment as you can. All right, thank you so much. Thank you. Thank you. Thank you.