#329 ‒ Special AMA: Peter on exercise, important labs, building good habits, promising longevity research, and more

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We discuss:

• Overview of episode topics (and Peter’s car stereo saga) [1:45];
• The importance of grip strength and the best methods for training it effectively [3:45];
• Exercise while traveling: strategies for staying active and maintaining an exercise routine [14:45];
• Why women should prioritize strength training [18:00];
• The limited role of exercise in weight loss and its greater importance in improving health, body composition, and insulin sensitivity [19:45];
• The “top five most important biomarkers” for assessing health [22:45];
• Promising developments in longevity research [28:15];
• The development of Klotho as a neuroprotective drug: challenges, timelines of trials, and more [34:00];
• Peter’s updated view on the potential of epigenome manipulation to restore aged cells to their youthful state [39:45];
• How reversing age-related epigenetic changes in immune cells could revolutionize our approach to aging and disease [43:30];
• The “objective, strategy, tactics” framework, and the importance prioritizing impactful lifestyle habits over less significant health trends [49:30];
• Strategies for building and maintaining good habits [56:45];
• How to think about drugs and supplements as part of a longevity toolkit [1:02:00];
• Peter’s recent reading list [1:05:15]; and
• More.

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Overview of episode topics (and Peter’s car stereo saga) [1:45]

Car stereo saga

• Peter shares a funny story about a mechanic who has been trying to fix his car stereo for weeks
• Finally, one morning he got a video from his mechanic of AC/DC’s “Back in Black” playing at full volume in his car — “an awesome text message” to wake up to 
• Nick asks Peter if he ever installed big subwoofers in his car; Peter reveals he didn’t own a car until med school, relying on biking and public transport before that.

AMA Format Overview:

• Today’s episode is a more conversational style of the AMA, mixing specific and broad questions.
• Topics to be covered include exercise, labs, cancer, action prioritization, longevity, books, and other miscellaneous subjects.

The importance of grip strength and the best methods for training it effectively [3:45]

• Grip strength is important probably for a little bit of the reasons that we understand “the drunk under the streetlight problem”
  • Which means the old adage of the drunk guy standing under the streetlight and someone asks him what he’s doing and he says he’s looking for his keys and they ask him if this is where he dropped him and he says, “No, but this is where the light is.”

⇒ So sometimes where it’s brightest is where you end up looking 

• Not to minimize grip strength, but to point out that in the literature, when you are interested in studying the relationship between strength and outcomes, you need an objective measurement of strength to test
  • Outcomes being everything from onset of dementia, all-cause mortality, cardiovascular disease, etc.

If your hypothesis is strength is positively associated with, correlates with or even causal towards these things, you have to be able to test it 

The question becomes, how do you test strength 

• Should we have people deadlift things? 
• If you go through that exercise, you pretty quickly realize that’s probably not a good idea because most people don’t deadlift and technique is pretty important in deadlifting
  • It’s pretty easy for somebody to hurt themselves
• What scientists have done instead over the years is they’ve tended to study things that anybody can do, even if they don’t do the particular exercise that’s being tested
  • You shouldn’t be testing squat strength or deadlift strength if a person doesn’t deadlift or squat

The things that have typically emerged as strength tests are grip strength, wall sits, bench press, leg extension, and sometimes leg press 

• Wall sits are a test of at least isometric quad strength
• If you don’t bench press, that’s a bit of a stretch

Peter adds a caveat, “I don’t think there’s something super, super magical about grip strength. We just have such an abundance of data on it because it’s such an easy thing to test.”

The next question: is there something magical about having a strong grip? 

• Partly yes
• A strong grip in isolation doesn’t really exist
  • There’s really no example where a person has a very strong grip in their hand, but their forearm, deltoids, scapula, triceps, all of these other things are weak

A strong grip is a way to test very strong, very stable control through the upper extremity all the way down to the outside world, and that’s a very practical thing 

• Just talk to any person who’s reached an age where they can’t open a new jar of pickles or they struggle to unlock a door or they struggle to carry a heavy plate 
• When your grip strength goes, your quality of life absolutely goes

⇒ Again, grip strength is just a proxy for people who are strong 

How should you train it? 

• What’s undeniable is the strength of the association
• Peter is not even going to go into that because the data on the association between grip strength and any and everything, positive warrants, no further discussion

⇒ The more important question: is it causal?  

• If grip strength is just a proxy for health and increasing grip strength does nothing to increase health, then we really shouldn’t be talking about this ‒ Peter doesn’t believe that that’s the case
• Peter makes an argument for that in Outlive, going through the Bradford Hill criteria and explaining why he thinks there is causality in the association
  • In other words, why is it that increasing metrics of strength and endurance also improves lifespan and healthspan? 
  • Not that they are just markers of healthy people who go on to have a better lifespan and healthspan

What you really want to do is all of the other things that rely on strong grip 

• Squeezing a little grip squeezer bought on Amazon is not the optimal way to train grip strength

Examples of what you want to do are exercises that involve carrying and pulling and hanging 

• Doing a seated cable pull, if you’re doing a pull down
• Doing a pull-up
• Doing a farmer’s carry
• Doing a deadlift

Peter doesn’t do very many things that are “deliberate grip strength exercises”, but when he does farmer’s carries, he’s almost exclusively doing that to push the limits of his grip 

⇒ 2 of these things that are the easiest for people to test on themselves at the gym with the least amount of equipment are the farmer’s carry and dead hang 

• Peter mentioned earlier, that if you haven’t deadlift before, you probably shouldn’t just start deadlift without understanding the form

Goals depend on how extreme you want to go 

• There’s a standard out there that basically says the definition of exceptional strength is being able to walk with twice your body weight for 30 seconds
  • So if you weigh 175 pounds, you should be able to do a trap bar deadlift with 350 pounds and then carry it, walk with it for 30 seconds
  • Obviously that’s a very high standard
• A more reasonable standard for maybe sub-elite athletes, for a male in his 40s: to be able to carry his body weight for 1 minute is good and for 2 minutes is very good
  • So again, if you weighed 175 pounds, you’d put 175 pounds on a trap bar, you’d pick it up and march with that for one to two minutes
  • For a woman, carrying 75% of her body weight would be an excellent achievement
  • You might discount that by 10% per decade [after age 40]

Peter adds, “I don’t think a person should be discouraged if the first time they try to do that they can’t do it. In fact, if you haven’t been doing that thing and if you’re not used to deadlifting and doing a lot of pull-ups and hangs, I would not expect anybody to be able to do that.”

You want to work up to that goal without going to maximal effort (build resilience slowly) 

For example, if a 175 lb. person tried that test 

• They want to carry 175 pounds on a hex bar for at least a minute and 30 seconds 
• Peter wants you to drop the weight on that bar to 150 pounds (25 pounds below that 175) and do 30 seconds sets
  • Do 10 sets at 30 seconds
  • Then, advance weight and or time accordingly,
  • But you to be able to get through those 10 sets such that at the end of the 10 you’re really completely gassed
    • That’s the way Peter likes to see people build strength

The dead hang …

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