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  • Marc Andreessen and Joe Lonsdale on Tariffs and Trade

    AI transcript
    0:00:02 AI is happening, and AI is only happening in two places.
    0:00:05 Like, it’s only U.S. versus China, and there’s a whole competition thing there.
    0:00:07 But, like, the U.S. is, like, very powerful.
    0:00:11 If you disaggregate sectors of the economy over the last 25 years,
    0:00:15 what you find is basically everything that technology touches basically collapses in price.
    0:00:19 If the country is growing faster, it’s going to be a fundamentally happier place
    0:00:22 because people, whichever side of the political spectrum you’re on,
    0:00:23 there’s going to be a sense of optimism.
    0:00:25 There’s going to be a sense of opportunity.
    0:00:27 There’s going to be the sense that your kids are going to live better lives than you do.
    0:00:34 Today on the A16Z podcast, we’re sharing an episode from Joe Lonsdale’s American Optimist,
    0:00:37 recorded live at the first Ronald Reagan Economic Forum.
    0:00:42 Joe sits down with A16Z co-founder Mark Andreessen to explore one of the biggest questions of our time.
    0:00:45 Can the rise of AI spark a new American industrial revival,
    0:00:50 and what would it take to make sure the entire country, including rural America, shares in the growth?
    0:00:55 They cover the history of U.S. manufacturing, the debate over tariffs and trade,
    0:00:59 and how AI and robotics might create the jobs and economic momentum of the future.
    0:01:03 They also dig into immigration, regulatory bottlenecks,
    0:01:06 and what smart policy should look like in an AI-driven world.
    0:01:07 Let’s get into it.
    0:01:13 This information is for educational purposes only and is not a recommendation to buy,
    0:01:16 hold, or sell any investment or financial product.
    0:01:20 This podcast has been produced by a third party and may include paid promotional advertisements,
    0:01:24 other company references, and individuals unaffiliated with A16Z.
    0:01:29 Such advertisements, companies, and individuals are not endorsed by AH Capital Management LLC,
    0:01:31 A16Z, or any of its affiliates.
    0:01:34 Information is from sources deemed reliable on the date of publication,
    0:01:37 but A16Z does not guarantee its accuracy.
    0:01:43 Mark, everyone, welcome to our first annual Reagan Economic Forum.
    0:01:44 It’s an honor to have you guys here.
    0:01:48 We talk a lot here, of course, about Reagan’s economic pillars and policies,
    0:01:52 which include deregulation and lower taxes and lower spending,
    0:01:53 all of which are very relevant today.
    0:01:57 But Mark, I want to start off asking you about someone I know you’ve been reading about
    0:01:59 and President Trump’s been reading about from 100 years before,
    0:02:00 which is William McKinley.
    0:02:04 And William McKinley, of course, was a staunch protectionist at first.
    0:02:07 Is this historical example of how to revitalize American industry relevant today?
    0:02:10 Is it relevant to everything we’re doing in AI and energy?
    0:02:11 Like, how do you think about this?
    0:02:14 Yeah, so I’ve been doing my best to kind of spin up in the history of this.
    0:02:16 And so there was something in the 19th century,
    0:02:18 actually originally created by Alexander Hamilton,
    0:02:20 when he was Treasury Secretary, called the American system.
    0:02:23 And, you know, this was like 80 years before McKinley, 90 years before McKinley.
    0:02:26 What they were dealing with was the British Empire, right?
    0:02:28 The UK was the preeminent industrial power.
    0:02:31 They were the first, like, giant industrial power on planet Earth
    0:02:35 and had built this very commanding economic, technological military position.
    0:02:38 And, of course, America at the time of the Revolution was mostly farmland.
    0:02:40 And then there was this raging debate between Hamilton and Jefferson
    0:02:44 as to whether you’d want America to be an industrial, kind of urban, financialized power,
    0:02:45 which is what Hamilton wanted,
    0:02:48 or of kind of a rural farming aristocratic power,
    0:02:49 which is what Jefferson wanted.
    0:02:50 And Hamilton won that debate.
    0:02:52 And so that led to what was called the American system.
    0:02:57 The American system led to the creation of the United States as an industrial power.
    0:02:58 That developed over the course of the 19th century.
    0:03:01 But it really took off at the tail end of the 19th century
    0:03:04 in what was called the Second Industrial Revolution.
    0:03:08 And so between, call it, 1870, 1880, and, like, 1930,
    0:03:12 basically everything we view today as the modern world was basically invented then.
    0:03:15 And you could almost look around the room here today,
    0:03:18 and you could say basically every piece of physical infrastructure,
    0:03:20 everything around us, literally everything.
    0:03:25 The airplane manufacturing techniques to be able to make modern glassware at scale,
    0:03:29 air conditioning, television, radio, the automobiles we drove to get here.
    0:03:31 It all was the result of the Second Industrial Revolution.
    0:03:34 And then the McKinley presidency was right in the middle of that period.
    0:03:36 It’s really when the whole thing catalyzed.
    0:03:39 And so it was really the point at which America became the world’s industrial superpower.
    0:03:42 And then, of course, that led to America being able to become a huge player
    0:03:44 in both World War I and World War II,
    0:03:47 ultimately winning World War II and becoming the arsenal of democracy.
    0:03:49 It all kind of floated out of that period.
    0:03:52 And so the American system is something that people really don’t like to talk about these days
    0:03:54 because it was heavily protectionist.
    0:03:58 And the whole theory of it was you don’t industrialize just with a single technology
    0:03:59 or a single company.
    0:04:02 You industrialize by having an entire ecosystem, right?
    0:04:04 You industrialize by having not just three car companies,
    0:04:08 but by having all the thousands of part suppliers that make all the parts for the cars.
    0:04:10 And so the Brits had done this.
    0:04:12 They had run a very heavily protectionist program
    0:04:15 to be able to boot up the first industrial revolution in the UK.
    0:04:17 They then advocated for free trade
    0:04:18 when exports became more important.
    0:04:21 McKinley was the inheritor of the American system,
    0:04:24 and so he was heavily protectionist to build up the second industrial revolution.
    0:04:27 And then he actually switched to become more of an advocate for free trade
    0:04:30 because as American exporters were becoming more successful,
    0:04:31 they needed exports, they needed foreign markets.
    0:04:34 And then, by the way, in the 20th century,
    0:04:36 basically every industrial revolution in every other country
    0:04:38 that has worked in the last hundred years
    0:04:39 basically follows that model as well.
    0:04:41 So it’s the same thing Germany did.
    0:04:42 It’s the same thing Japan did.
    0:04:43 It’s the same thing Korea did.
    0:04:45 It’s the same thing China is doing right now.
    0:04:48 China’s basically been running the American system playbook in China.
    0:04:51 And so, and then this goes to tariff policy.
    0:04:53 And I’m not here to make an argument like it’s like in favor of tariffs,
    0:04:55 but more of a historical observation
    0:04:57 that there has been this phenomenon over time
    0:05:00 that if you want to have the kind of clustering effect
    0:05:02 that leads to industrial preeminence,
    0:05:05 it is not unusual to have a combination of tools
    0:05:07 and kind of tools and methods used to do that.
    0:05:09 It has been historically characteristic
    0:05:10 that tariffs would be a part of that.
    0:05:12 But it’s also historically characteristic
    0:05:13 that there becomes this point
    0:05:15 when you also therefore want to go for exports
    0:05:16 and you want to go for free trade.
    0:05:17 And McKinley specifically,
    0:05:20 he ran for office very much on the idea
    0:05:21 of having a high and permanent tariff.
    0:05:22 Once he was in office,
    0:05:26 he switched more to a model of what he called reciprocity, right?
    0:05:27 And basically it was,
    0:05:28 we start out by tariffing,
    0:05:30 but the goal actually is to get everybody to lower their tariffs.
    0:05:33 The goal is to get a world of much more free trade
    0:05:34 and then therefore these American exporters
    0:05:36 were able to succeed globally.
    0:05:38 And of course, he was able to use American tariffs
    0:05:40 as a lever to get other countries to drop their tariffs.
    0:05:41 And so in that sense,
    0:05:43 what we’re going through right now in the U.S.
    0:05:45 is sort of very characteristic of that.
    0:05:47 And what makes maybe the whole thing kind of more poignant
    0:05:50 is there is this kind of fundamental underlying question,
    0:05:51 which is do we want the U.S.
    0:05:53 to be an industrial superpower or not, right?
    0:05:54 And in the 19th century,
    0:05:56 they were like completely clear that they wanted that.
    0:05:56 And in our time,
    0:05:58 I think we’re still ambiguous about it.
    0:06:00 So it’s interesting though,
    0:06:02 because, and you’ve said this yourself in other contexts,
    0:06:04 we had this manufacturing wave.
    0:06:05 And then in starting the 1960s,
    0:06:08 services really drove a lot of our growth the last 60 years,
    0:06:09 which obviously was not as tied to that.
    0:06:10 So the elite,
    0:06:11 maybe we’re not thinking about these issues as much.
    0:06:13 And I guess the question is today,
    0:06:15 are we shifting into something else?
    0:06:17 Is it an AI-driven economy?
    0:06:17 What is it?
    0:06:19 And it seems like Trump’s camp’s a little bit split.
    0:06:21 You have really two visions.
    0:06:21 One vision,
    0:06:24 you’d say maybe more like the Bannon side
    0:06:26 is more focused on reviving traditional manufacturing
    0:06:27 through tariffs,
    0:06:29 through industrial incentives.
    0:06:30 Then you have the other side
    0:06:31 that’s more about tech acceleration
    0:06:32 via AI,
    0:06:33 via chips,
    0:06:33 via energy.
    0:06:35 So how do these things play into,
    0:06:35 I mean,
    0:06:37 are we going to be able to copy the past
    0:06:38 or is it a new policy here?
    0:06:38 Yes.
    0:06:39 I mean,
    0:06:40 this is sort of the central question,
    0:06:40 I think.
    0:06:42 So my read of the trajectory basically
    0:06:44 is call it between 1870 and 1920.
    0:06:46 The U.S. economy was heavily based on industrialization,
    0:06:48 all the stuff I just talked about.
    0:06:48 By the way,
    0:06:51 very high immigration environment at the time,
    0:06:52 very rapid rate of immigration
    0:06:53 and then actually very high tariffs.
    0:06:54 And by the way,
    0:06:56 an annual growth rate of something like 3x,
    0:06:58 the current growth rate of the U.S.,
    0:06:59 with a much smaller population
    0:07:00 and with fewer tools to work with.
    0:07:03 Then there was sort of the 1920 to 1970 period
    0:07:05 where the growth rate was maybe something like 2x,
    0:07:06 the rate that we have now.
    0:07:08 And that was the space race
    0:07:09 and rockets and electronics
    0:07:10 and the beginning of the computer industry
    0:07:12 and it went quite well
    0:07:13 from an economic growth standpoint.
    0:07:14 And then around the time I was born,
    0:07:15 around 1971,
    0:07:17 basically the U.S. economy
    0:07:19 permanently downshifted its growth rate
    0:07:21 and both in terms of productivity growth,
    0:07:22 which of course measures
    0:07:24 technological transformation in the economy
    0:07:25 as well as economic growth.
    0:07:27 And so we went from like super high growth
    0:07:28 to like high growth to low growth.
    0:07:31 That low growth coincided with this shift, right?
    0:07:33 With all the shifts that happened in the 1970s,
    0:07:35 many of which Reagan was a reaction to,
    0:07:36 but many of those shifts happened
    0:07:37 and many of those shifts have continued.
    0:07:38 As you said,
    0:07:39 less industrial enthusiasm,
    0:07:41 more what they call services.
    0:07:42 And by the way,
    0:07:43 the good news of that transition
    0:07:44 is the transition to knowledge work
    0:07:45 has worked really well.
    0:07:47 And we live and work in places
    0:07:48 like Silicon Valley and Austin
    0:07:50 and others that have done phenomenally well
    0:07:51 because you’ve got all these tech companies
    0:07:53 that are global exporters to technology
    0:07:54 and the AI revolution is happening in the U.S.
    0:07:56 You know, and it’s absolutely tremendous.
    0:07:57 But, you know,
    0:07:58 we transformed the American economy
    0:07:59 to basically have knowledge work
    0:08:00 on the high end
    0:08:01 and then financialization,
    0:08:03 banking and currency
    0:08:04 and being the safe bond asset
    0:08:05 on the other hand.
    0:08:06 And then we basically chose
    0:08:08 to de-industrialize, right?
    0:08:09 And we chose to de-industrialize
    0:08:11 through a set of explicit policy choices,
    0:08:12 not least of which is
    0:08:13 we made a lot of industrial activity
    0:08:14 illegal over time.
    0:08:15 And I would argue that formula,
    0:08:16 first of all,
    0:08:17 it just hasn’t worked that well
    0:08:18 in terms of growth, right?
    0:08:19 If it doesn’t pay off
    0:08:20 in terms of productivity growth
    0:08:20 and economic growth,
    0:08:22 like how is it actually going?
    0:08:22 And of course,
    0:08:23 the problem,
    0:08:24 the irony of this is
    0:08:25 if you don’t like populism,
    0:08:27 the way that you get populism
    0:08:28 is slow growth, right?
    0:08:29 Because slow growth
    0:08:30 puts everybody in the mind
    0:08:31 of zero-sum, right?
    0:08:32 Everything becomes a zero-sum
    0:08:33 kind of fight for resources
    0:08:34 because people don’t think
    0:08:35 that there’s a lot of opportunity
    0:08:35 in the future.
    0:08:37 And so the formula
    0:08:39 that kind of all the smart people did
    0:08:40 actually created the preconditions
    0:08:41 for the sort of research
    0:08:43 of populism on both left and the right.
    0:08:44 And then the other kind of
    0:08:45 really critical thing
    0:08:46 happening right now
    0:08:47 that you see just happening
    0:08:47 kind of everywhere
    0:08:48 in our politics and society
    0:08:50 is this just giant divide
    0:08:50 between the cities
    0:08:51 and the countryside.
    0:08:53 And I’m sort of a weird
    0:08:54 example of this myself.
    0:08:55 I grew up in rural Wisconsin
    0:08:56 in what was sort of
    0:08:57 originally farming
    0:08:58 and then sort of light industry
    0:08:59 kind of world.
    0:09:00 And then when I graduated college,
    0:09:01 I moved to California.
    0:09:02 I did a jump to
    0:09:03 kind of the polar opposite
    0:09:04 kind of culture
    0:09:05 and kind of world.
    0:09:05 And of course,
    0:09:06 when I was in Wisconsin,
    0:09:07 I was like,
    0:09:07 wow, those smart people
    0:09:08 on the coast
    0:09:08 must be so much better
    0:09:10 and smarter than we are.
    0:09:10 And then I got to the coast
    0:09:11 and I was like,
    0:09:12 wow, these people on the coast
    0:09:12 really hate everybody
    0:09:13 where I grew up.
    0:09:15 This is interesting.
    0:09:16 I knew they didn’t like us.
    0:09:17 I didn’t realize they despised us
    0:09:19 quite to this degree.
    0:09:20 And so now we have this
    0:09:22 just like raging cultural,
    0:09:23 social, economic disconnect
    0:09:24 between the cities
    0:09:24 and the countryside,
    0:09:26 which I think is quite dangerous.
    0:09:27 Let’s be controversial
    0:09:28 and dig into this
    0:09:29 a little bit more in cities.
    0:09:30 So I think a lot of us
    0:09:31 have noticed
    0:09:32 that our cities
    0:09:33 are deeply dysfunctional.
    0:09:34 they’re broken
    0:09:35 in our society, right?
    0:09:36 I think we have a candidate
    0:09:37 who’s like a socialist Islamist
    0:09:38 who’s in danger
    0:09:39 of taking over New York
    0:09:40 very soon right now.
    0:09:41 And we have all sorts of problems.
    0:09:42 People can’t afford
    0:09:43 to have kids in cities
    0:09:44 the way they’re set up.
    0:09:45 I think there’s this
    0:09:46 cost disease for everything.
    0:09:47 What went wrong?
    0:09:48 What’s going on
    0:09:48 with these cities?
    0:09:49 And what’s an optimistic
    0:09:50 take on it, Mark?
    0:09:51 How can we fix this?
    0:09:52 Yeah, so the guy in New York
    0:09:53 is interesting
    0:09:54 and he’s kind of running
    0:09:54 slightly behind Cuomo
    0:09:55 for New York mayor,
    0:09:56 but he’s literally running
    0:09:56 a platform,
    0:09:57 among other things,
    0:09:58 of having city-owned
    0:10:00 grocery stores, right?
    0:10:01 And so the joke is
    0:10:02 he’s reinventing bread lines
    0:10:03 for the 21st century.
    0:10:04 That’s impressive.
    0:10:05 Really tremendous platform.
    0:10:07 Seattle is another case study
    0:10:07 of this.
    0:10:08 Seattle, to give you a sense
    0:10:09 how crazy things are,
    0:10:10 the district in Seattle,
    0:10:11 the city council district
    0:10:12 where the most Microsoft
    0:10:13 and Amazon executives live,
    0:10:15 I elected a city council woman
    0:10:16 who ran a platform
    0:10:16 of nationalizing
    0:10:17 Microsoft and Amazon.
    0:10:19 Right, and then, you know,
    0:10:20 in the Bay Area,
    0:10:21 I live in ground zero
    0:10:22 of dysfunction and collapse
    0:10:23 and I’ve got thousands
    0:10:24 of stories from the Bay Area.
    0:10:25 Yeah, so I think there’s
    0:10:26 like a very fundamental
    0:10:27 political economy thing
    0:10:29 happening which falls out
    0:10:29 of this sort of
    0:10:30 economic transformation
    0:10:31 that’s happened
    0:10:31 and this policy transformation
    0:10:32 that’s happened
    0:10:33 and so there’s actually
    0:10:34 a French writer,
    0:10:35 a geographer,
    0:10:35 who has, I think,
    0:10:37 the best analysis on this
    0:10:38 and has written a great book
    0:10:38 on it called
    0:10:39 Twilight of the Elites
    0:10:39 and what he basically
    0:10:40 observes is if you look
    0:10:41 at all the Western countries
    0:10:42 through this process
    0:10:44 of sort of deindustrialization
    0:10:45 and financialization
    0:10:46 and sort of technology
    0:10:46 and knowledge work
    0:10:47 becoming preeminent
    0:10:48 at the high end
    0:10:48 of the economy,
    0:10:49 you sort of have
    0:10:50 this pattern where
    0:10:51 basically like
    0:10:53 in an agricultural economy
    0:10:54 or in a manufacturing economy,
    0:10:55 you kind of have to spread
    0:10:55 everything out
    0:10:56 throughout the country
    0:10:57 because like natural resources
    0:10:58 really matter
    0:10:59 and energy really matters
    0:11:00 and physical infrastructure
    0:11:01 matters and access
    0:11:03 to trains and all these things,
    0:11:03 you know, really
    0:11:04 in rivers and water
    0:11:05 and so forth really matters
    0:11:06 but if you’re going
    0:11:07 to replant the sort of
    0:11:08 commanding heights
    0:11:08 of your economy
    0:11:09 on knowledge work,
    0:11:09 then what you’re going to do
    0:11:10 is you’re going to slam
    0:11:11 basically all economic growth
    0:11:12 into the cities, right,
    0:11:13 which is what Silicon Valley
    0:11:14 has done, right?
    0:11:14 So you’re going to
    0:11:15 all the software developers
    0:11:16 in one place.
    0:11:17 The good news is
    0:11:17 they’re going to eat
    0:11:18 at high-end restaurants
    0:11:19 and they’re going to
    0:11:19 employ a lot of nannies
    0:11:20 but fundamentally
    0:11:21 they’re going to be
    0:11:21 sitting in conference rooms
    0:11:23 designing software together
    0:11:24 and you want that
    0:11:24 to happen in a single
    0:11:25 concentrated place
    0:11:26 and so what happens
    0:11:27 is basically
    0:11:27 the cities become
    0:11:28 a magnet for basically
    0:11:29 two kinds of people.
    0:11:30 One is sort of
    0:11:31 the upper class
    0:11:32 which is to say
    0:11:33 kind of the highly educated
    0:11:34 elite in the knowledge
    0:11:34 of professions
    0:11:35 who make enough money
    0:11:36 where they can afford
    0:11:37 to buy, you know,
    0:11:38 three million dollar houses
    0:11:39 so you’ve got basically
    0:11:40 like super expensive homes
    0:11:41 and then you’ve got
    0:11:42 so-called public housing, right?
    0:11:43 Council estates in the UK
    0:11:44 or section 8, 8H
    0:11:45 or whatever it is
    0:11:45 housing here
    0:11:46 where you’ve got
    0:11:47 basically public housing
    0:11:48 and then the public housing
    0:11:49 is basically
    0:11:50 it’s people who are
    0:11:50 very low-paid
    0:11:51 kind of on the low end
    0:11:52 of the service economy
    0:11:53 and then that’s the city
    0:11:54 and then who’s squeezed
    0:11:55 out of the city
    0:11:55 is basically right
    0:11:56 the entire middle class
    0:11:57 is squeezed out
    0:11:58 and just to give you
    0:11:58 an example of this
    0:11:59 in the Bay Area
    0:12:00 if you’re a cop
    0:12:00 or a firefighter
    0:12:01 in the Bay Area
    0:12:02 and you work in Palo Alto
    0:12:03 you commute three hours
    0:12:04 both ways
    0:12:05 just to be able to like
    0:12:06 have a house
    0:12:07 and afford a family, right?
    0:12:08 And then of course
    0:12:08 you look what’s happening
    0:12:09 in the cities
    0:12:09 and like there’s like
    0:12:10 lots of dogs
    0:12:11 there’s very few kids, right?
    0:12:11 And it’s like
    0:12:12 what on earth is that about?
    0:12:14 Well, you can’t buy a house
    0:12:15 you can’t have a family
    0:12:16 you may not even own a car
    0:12:17 like how are you
    0:12:17 going to get kids anywhere?
    0:12:19 But what happens is
    0:12:20 from a political standpoint
    0:12:20 is the cities
    0:12:21 that are run
    0:12:22 in their local democracies
    0:12:24 it’s these super high-end
    0:12:25 kind of very progressive elites
    0:12:26 and then it’s sort of
    0:12:27 the clientele underclass
    0:12:28 right of, you know,
    0:12:28 in the US
    0:12:29 it’s Hispanic immigrants
    0:12:30 or African Americans
    0:12:31 in Europe
    0:12:32 it’s their other kind
    0:12:32 of clientele underclass
    0:12:33 that they’ve developed
    0:12:34 in places like Paris
    0:12:35 and so you’ve got
    0:12:36 this high plus
    0:12:37 you’ve got this kind of
    0:12:37 old political
    0:12:38 kind of structure
    0:12:39 of sort of top plus bottom
    0:12:40 kind of configuration
    0:12:41 which you’ve done
    0:12:42 is you’ve squeezed the middle
    0:12:43 and you’ve ejected the middle
    0:12:43 out of the cities
    0:12:44 into the countryside
    0:12:46 but you’ve de-industrialized
    0:12:47 and so there’s no
    0:12:48 new economic activity
    0:12:49 happening in the countryside
    0:12:50 for all the middle class
    0:12:50 people to do.
    0:12:51 This so far
    0:12:52 is not an optimistic panel, Mark.
    0:12:53 Sorry.
    0:12:54 Sorry.
    0:12:56 Let me try to make it optimistic.
    0:12:56 Sorry.
    0:12:57 Let me try to make it optimistic.
    0:12:58 Okay.
    0:12:59 Let me try to make it optimistic.
    0:13:00 These are choices.
    0:13:01 These are choices.
    0:13:02 These are policy choices.
    0:13:03 Sometimes the way
    0:13:04 this stuff gets painted
    0:13:05 is that these are just
    0:13:06 like impersonal economic forces
    0:13:07 or technology forces
    0:13:07 and of course
    0:13:08 you know I get this a lot
    0:13:09 it’s like you idiot
    0:13:10 don’t you understand
    0:13:10 that like you know
    0:13:11 manufacturing is old fashioned
    0:13:13 we have all this new stuff
    0:13:13 we shouldn’t need you know.
    0:13:14 No these are choices
    0:13:16 like there were specific choices made.
    0:13:17 So the classic choice
    0:13:18 the classic choice
    0:13:18 that was made
    0:13:19 since I wrote the Reagan Library
    0:13:20 I’ll beat up on Nixon.
    0:13:21 So Richard Nixon
    0:13:22 the year I was born
    0:13:22 1971
    0:13:23 he proposed something
    0:13:24 called Project Independence.
    0:13:25 He actually
    0:13:26 visionary visionary president
    0:13:28 he saw the energy crisis coming
    0:13:28 and he said
    0:13:29 it’s a national imperative
    0:13:30 to build a thousand
    0:13:31 new nuclear power plants
    0:13:32 civilian nuclear power plants
    0:13:33 in the U.S.
    0:13:33 by the year 2000
    0:13:34 cut the entire U.S.
    0:13:35 electric grid over to nuclear.
    0:13:36 by the way
    0:13:37 would have gotten us
    0:13:38 to electric cars
    0:13:39 probably 30-40 years faster
    0:13:40 and would have completely
    0:13:41 separated us
    0:13:42 from strategic involvement
    0:13:42 in the Middle East
    0:13:43 for energy.
    0:13:44 So that was the good news.
    0:13:45 The bad news is
    0:13:46 he created the EPA
    0:13:47 and the Nuclear Regulatory Commission
    0:13:48 which then prevented
    0:13:48 Project Independence
    0:13:49 from happening
    0:13:50 and of course
    0:13:51 no new nuclear power plants
    0:13:51 got built.
    0:13:53 But that was a policy choice
    0:13:54 right
    0:13:54 and I’m sure
    0:13:55 that was not the result
    0:13:55 that he intended
    0:13:57 but that was a policy choice.
    0:13:58 And by the way
    0:13:58 a lot of this is happening
    0:13:59 right now in Washington
    0:14:00 like there is an opportunity
    0:14:01 to look at everything
    0:14:02 from nuclear power
    0:14:03 minerals
    0:14:03 natural resources
    0:14:04 I was on a call
    0:14:04 this morning
    0:14:05 on natural resources
    0:14:06 with very promising
    0:14:07 progress being made
    0:14:08 you know rare earth metals
    0:14:09 there’s construction
    0:14:10 we have a project
    0:14:11 to build a new city
    0:14:11 in California
    0:14:12 we’ve bought
    0:14:13 four times the acreage
    0:14:14 of Manhattan
    0:14:15 in Solano County
    0:14:16 we’ve had the opportunity
    0:14:16 to build like
    0:14:17 entirely new cities
    0:14:18 in this country
    0:14:19 there’s any number
    0:14:20 of these policy decisions
    0:14:21 that we could make
    0:14:21 that would cause
    0:14:22 revitalization
    0:14:22 so we’re going to fix
    0:14:23 better policies
    0:14:24 there’s something else
    0:14:24 going on though
    0:14:25 which I think you and I
    0:14:26 are both very bullish on
    0:14:27 which is this AI wave
    0:14:28 and AI services
    0:14:28 right
    0:14:29 and so I think
    0:14:30 one thing that’s very
    0:14:31 interesting right now
    0:14:32 is obviously we all know
    0:14:33 there’s major cost disease
    0:14:33 in our society
    0:14:34 healthcare is becoming
    0:14:35 more and more unaffordable
    0:14:36 I think people are talking
    0:14:37 about our 36 trillion dollar debt
    0:14:39 it’s actually 150 trillion more
    0:14:40 if you include our healthcare
    0:14:40 promises
    0:14:41 much bigger problem
    0:14:42 obviously education
    0:14:43 housing
    0:14:43 all these things
    0:14:45 are becoming less affordable
    0:14:46 but you and I have both seen
    0:14:47 that a lot of these new technologies
    0:14:48 are going to turn
    0:14:48 some of these services
    0:14:50 into much more affordable products
    0:14:50 and I think we’re making
    0:14:51 big bets on that
    0:14:52 tell us about this
    0:14:53 yeah so first of all
    0:14:54 just a moment on AI
    0:14:55 so you asked a question earlier
    0:14:56 which is there’s a traditionalist view
    0:14:57 of like we need to go get the jobs
    0:14:58 that used to exist
    0:14:59 we need to somehow bring them back
    0:15:00 and here you get into this argument
    0:15:02 of well you’ve got Chinese laborers
    0:15:03 working for a dollar an hour
    0:15:03 or whatever
    0:15:05 it was just not cost effective
    0:15:05 to bring those jobs back
    0:15:07 what we have though
    0:15:08 is we’re at this very specific
    0:15:09 and important and fundamental
    0:15:10 and I think profound
    0:15:11 turning point in technology
    0:15:12 which is the rise of AI
    0:15:13 and I would say the good news
    0:15:14 let’s make the panel optimistic
    0:15:15 the good news is the US
    0:15:17 is like by far the leader on AI
    0:15:18 now by the way
    0:15:19 we need to decide
    0:15:20 whether we want to be the leader in AI
    0:15:21 because there’s like a lot of forces
    0:15:22 in the US
    0:15:23 and in the US government
    0:15:24 that are trying to prevent that
    0:15:24 from happening
    0:15:25 but
    0:15:26 there’s over a thousand laws
    0:15:26 at state level
    0:15:28 we’ve been trying to fight and stop
    0:15:29 that would screw this up
    0:15:29 right so there’s a lot of people
    0:15:30 who are against this
    0:15:31 California state government
    0:15:32 almost passed a law
    0:15:33 outlaw AI in California
    0:15:34 six months ago
    0:15:35 which is an indication
    0:15:36 how crazy California is
    0:15:36 but yes
    0:15:38 it’s like everything else
    0:15:39 we can have it if we want it
    0:15:40 AI is happening
    0:15:41 and AI is only happening
    0:15:42 in two places
    0:15:43 like it’s only US versus China
    0:15:45 and there’s a whole competition thing there
    0:15:45 but like the US
    0:15:46 is like very powerful
    0:15:47 on this
    0:15:47 and then by the way
    0:15:48 the US is benefiting a lot
    0:15:49 because Europe
    0:15:50 has basically made AI illegal
    0:15:51 like they’re regulating themselves
    0:15:52 to death
    0:15:53 and so the smart AI people
    0:15:54 in Europe
    0:15:55 are moving to the US
    0:15:55 and so like
    0:15:56 the US really is ground zero
    0:15:57 for AI
    0:15:58 today
    0:15:59 AI is software
    0:16:00 right
    0:16:01 and so when you use AI
    0:16:02 you use chat GPT
    0:16:03 it’s an app on your phone
    0:16:03 right
    0:16:04 there’s no manufacturing
    0:16:05 kind of component
    0:16:06 people are building
    0:16:06 giant data centers
    0:16:08 but it’s not a huge generator
    0:16:09 of like middle class jobs
    0:16:10 but there’s another turn
    0:16:11 on AI that’s coming
    0:16:12 which is the turn
    0:16:13 to embodied physical AI
    0:16:14 which is robotics
    0:16:14 right
    0:16:15 and this is a transition
    0:16:16 that has already happened
    0:16:17 it’s already actually happened
    0:16:18 in drones
    0:16:19 where drones went from
    0:16:20 being human piloted
    0:16:20 to actually being
    0:16:21 autonomously piloted
    0:16:22 they now fly themselves
    0:16:23 it’s a transition
    0:16:24 that’s happening
    0:16:25 in cars right now
    0:16:25 right
    0:16:26 where cars went from
    0:16:27 basically purely
    0:16:27 physical products
    0:16:28 to now basically
    0:16:29 being rolling computers
    0:16:30 that drive themselves
    0:16:31 and if you haven’t
    0:16:31 tried this yet
    0:16:32 if you ever
    0:16:33 have the misfortune
    0:16:33 of finding yourself
    0:16:34 in San Francisco
    0:16:35 take a Waymo
    0:16:36 it’s amazing to live
    0:16:37 in a cyberpunk
    0:16:38 future reality
    0:16:38 where you’re in
    0:16:39 literally a state-of-the-art
    0:16:40 self-driving car
    0:16:41 that’s literally out
    0:16:42 of the Jetsons
    0:16:42 driving past people
    0:16:43 who are dying
    0:16:43 of fentanyl overdoses
    0:16:44 on the sidewalk
    0:16:45 I recommend
    0:16:46 having the experience
    0:16:46 at least once
    0:16:48 but the self-driving car
    0:16:48 really does work
    0:16:49 like it’s really happening
    0:16:50 and then what’s going
    0:16:51 to happen
    0:16:52 you’ve all probably seen
    0:16:52 you know Elon
    0:16:53 has this Optimus robot
    0:16:54 that he’s building
    0:16:54 these humanoid robots
    0:16:56 like the general purpose
    0:16:56 robotics
    0:16:58 thing is going to happen
    0:16:59 and it’s going to happen
    0:16:59 in the next decade
    0:17:00 and it’s going to happen
    0:17:01 at giant scale
    0:17:01 and I think there’s
    0:17:02 a plausible argument
    0:17:03 which Elon also believes
    0:17:04 that robotics
    0:17:04 is going to be
    0:17:05 the biggest industry
    0:17:05 in the history
    0:17:06 of the planet
    0:17:07 it’s going to be gigantic
    0:17:08 there’s going to be
    0:17:08 billions
    0:17:08 tens of billions
    0:17:09 hundreds of billions
    0:17:09 of robots
    0:17:10 of all shapes
    0:17:10 sizes
    0:17:11 descriptions
    0:17:11 running around
    0:17:12 doing all kinds
    0:17:12 of things
    0:17:13 those robots
    0:17:14 need to get designed
    0:17:14 and built
    0:17:15 right
    0:17:16 and so my view is
    0:17:17 we don’t try to get
    0:17:18 the old manufacturing jobs
    0:17:18 back
    0:17:18 what we should do
    0:17:19 is lean hard
    0:17:20 into the manufacturing jobs
    0:17:21 of the future
    0:17:22 which is designing
    0:17:23 and building
    0:17:24 all of these new things
    0:17:24 right
    0:17:25 by the way
    0:17:27 right
    0:17:27 and robots
    0:17:29 and we shouldn’t be
    0:17:30 building manufacturing lines
    0:17:30 that have people
    0:17:31 sitting on a rubber mat
    0:17:32 for 10 hours
    0:17:33 screwing screws in by hand
    0:17:34 but we should be building
    0:17:34 what Elon calls
    0:17:36 alien dreadnought factories
    0:17:36 right
    0:17:36 which is like
    0:17:37 these super sophisticated
    0:17:37 factories
    0:17:38 with like tons of robotics
    0:17:40 but you can imagine
    0:17:41 thousands and thousands
    0:17:42 of different categories
    0:17:42 of industrial production
    0:17:43 that have to happen
    0:17:44 all across the U.S.
    0:17:45 in order to make this happen
    0:17:46 and would cause
    0:17:47 just like enormous
    0:17:47 economic growth
    0:17:48 throughout the country
    0:17:49 we get a huge payoff
    0:17:50 from all the tech investment
    0:17:51 that the coasts are making
    0:17:52 but we generate
    0:17:53 many tens or hundreds
    0:17:54 of millions of jobs
    0:17:55 in the countryside
    0:17:56 and then the U.S.
    0:17:57 would lead
    0:17:58 it would be the third industrial
    0:17:59 or fourth industrial revolution
    0:17:59 we would lead
    0:18:00 in the development
    0:18:01 of all these new things
    0:18:02 and then you get
    0:18:02 to the national security
    0:18:03 side of this
    0:18:04 which is
    0:18:05 if you don’t do this
    0:18:06 you’re living in a world
    0:18:07 of Chinese robots everywhere
    0:18:08 and that has
    0:18:09 very profound consequences
    0:18:10 for let’s just say
    0:18:11 yeah profound consequences
    0:18:11 and it’s an important
    0:18:12 policy point
    0:18:13 and I want to dig
    0:18:14 into this a little bit more
    0:18:14 a lot of
    0:18:15 I was just in an interview
    0:18:16 up there
    0:18:16 like aren’t we going to
    0:18:17 destroy tens of millions
    0:18:18 of jobs
    0:18:18 isn’t AI scary
    0:18:19 a lot of people
    0:18:20 are very scared right now
    0:18:20 with the disruption
    0:18:21 I’m very excited
    0:18:22 about the higher productivity
    0:18:23 because I see it
    0:18:24 being disinflationary
    0:18:25 I see it creating more jobs
    0:18:26 assuming we’re aligned
    0:18:27 how do we explain this
    0:18:27 to people
    0:18:28 how do we explain
    0:18:28 this is actually
    0:18:29 a really good thing
    0:18:29 for the country
    0:18:30 because a lot of Luddites
    0:18:31 are going to attack this
    0:18:32 they are going to try
    0:18:32 to stop it
    0:18:33 yeah so the Luddites
    0:18:34 are wrong
    0:18:34 they’re wrong
    0:18:35 in the sense of like
    0:18:35 for the reason
    0:18:36 they’ve always been wrong
    0:18:37 which is the reality
    0:18:38 is we have not
    0:18:39 in the last 50 years
    0:18:39 been in an era
    0:18:41 of fast productivity growth
    0:18:41 technological change
    0:18:42 we’ve been in an area
    0:18:43 of slow productivity change
    0:18:44 slow economic growth
    0:18:46 AI if it works the way
    0:18:47 that actually people
    0:18:48 either hope or fear
    0:18:48 that it’s going to work
    0:18:49 it’s going to cause
    0:18:50 productivity growth
    0:18:50 to shoot up
    0:18:51 that will naturally
    0:18:52 accelerate economic growth
    0:18:53 but look if it just
    0:18:54 stays as software
    0:18:55 then the result of that
    0:18:56 is it’s going to make
    0:18:57 the cities much better off
    0:18:57 right it’s going to make
    0:18:58 San Francisco and LA
    0:18:59 and New York much better off
    0:19:00 and Austin much better off
    0:19:01 but it’s still not
    0:19:02 going to answer this question
    0:19:03 of what happens
    0:19:03 in the countryside
    0:19:04 to answer the question
    0:19:05 of what happens
    0:19:05 in the countryside
    0:19:06 you need to get
    0:19:07 to the next thing
    0:19:07 you need to make
    0:19:09 AI hardware as well
    0:19:09 as software
    0:19:10 and you’re right back
    0:19:11 to that same prescription
    0:19:12 of basically re-industrializing
    0:19:12 the country
    0:19:13 and again
    0:19:14 not re-industrializing
    0:19:14 the country
    0:19:15 on the stuff
    0:19:16 that has already left
    0:19:17 re-industrializing
    0:19:17 the country
    0:19:18 based on all the things
    0:19:18 that have to be
    0:19:19 invented and built
    0:19:20 and it’s just like
    0:19:21 we know
    0:19:21 I’d be just like
    0:19:22 incredibly highly confident
    0:19:23 that there’s going to be
    0:19:24 these giant industries
    0:19:26 of computerized everything
    0:19:26 AI powered
    0:19:27 all kinds of hardware
    0:19:28 of all kinds of
    0:19:29 shape sizes to descriptions
    0:19:29 you know
    0:19:30 you’re funding a lot
    0:19:30 of that kind of thing
    0:19:31 I’m funding a lot
    0:19:31 of that kind of thing
    0:19:32 I mean look
    0:19:33 the entire defense base
    0:19:34 has to get rebuilt
    0:19:35 around this day
    0:19:35 we’re going to redo
    0:19:36 the manufacturing
    0:19:36 we’re going to build
    0:19:37 roads and tunnels
    0:19:38 and everything cheaper
    0:19:39 it’s going to be exciting
    0:19:39 yeah
    0:19:40 and so this is the thing
    0:19:41 to do
    0:19:41 like to me
    0:19:42 the path on this
    0:19:42 is very clear
    0:19:43 because we have to do this
    0:19:44 because it’s necessary
    0:19:44 from a national security
    0:19:45 standpoint
    0:19:46 we have to do it
    0:19:46 because we need
    0:19:47 the economic growth
    0:19:47 we have to do it
    0:19:48 because we need
    0:19:48 an answer
    0:19:49 for the entire population
    0:19:50 of the country
    0:19:50 not just the cities
    0:19:51 yeah
    0:19:52 and we have to do it
    0:19:52 because if we don’t do it
    0:19:53 China’s going to do it
    0:19:54 and we don’t want to live
    0:19:54 in that world
    0:19:55 so I want to circle back
    0:19:57 to another controversial topic
    0:19:58 which over the last
    0:19:58 several decades
    0:19:59 you mentioned this
    0:20:00 we’ve kind of pursued
    0:20:01 deindustrialization
    0:20:02 financialization
    0:20:03 we’ve also pursued
    0:20:04 mass immigration
    0:20:05 and the view
    0:20:06 from the tech world
    0:20:07 has almost always been
    0:20:08 we need more
    0:20:08 of the smartest people
    0:20:09 to come here
    0:20:09 and build with us
    0:20:11 a lot of my smartest friends
    0:20:11 are immigrants
    0:20:12 and they’ve built great things
    0:20:14 but at the same time
    0:20:15 some of this mass immigration
    0:20:15 has really affected
    0:20:16 the working class
    0:20:17 in certain ways
    0:20:18 that’s maybe not great
    0:20:18 I know your views
    0:20:19 have evolved on this topic
    0:20:21 like what is the right
    0:20:21 immigration policy
    0:20:22 and how does it tie into
    0:20:23 what you’re seeing
    0:20:24 for the next few decades
    0:20:25 yeah so separate it
    0:20:26 you know the classic split
    0:20:26 between so-called
    0:20:27 high-skilled and low-skilled
    0:20:28 immigration
    0:20:29 so on the low-skilled
    0:20:29 immigration side
    0:20:30 it’s actually
    0:20:31 a lot of the AI doomers
    0:20:32 kind of have this split
    0:20:33 personality
    0:20:33 where they’re like
    0:20:34 AI’s going to eliminate
    0:20:34 all the jobs
    0:20:35 and we need to import
    0:20:36 another 100 million people
    0:20:37 from the third world
    0:20:38 as fast as possible
    0:20:39 or we won’t have any
    0:20:40 you know so there’s a bit
    0:20:41 of a weird kind of
    0:20:42 disconnect I think
    0:20:43 in the logic on that
    0:20:44 look the country
    0:20:44 went through this before
    0:20:45 as I said earlier
    0:20:46 there was very high
    0:20:47 immigration between
    0:20:48 like 1870 and 1920
    0:20:49 they closed the gates
    0:20:50 in 1925
    0:20:52 and 1925 to 1970
    0:20:52 you could argue
    0:20:53 it would have grown faster
    0:20:54 with higher immigration
    0:20:55 but they grew a lot
    0:20:55 faster than we’ve grown
    0:20:57 right and so
    0:20:57 like I do think
    0:20:58 if you have AI
    0:20:59 if you have advanced
    0:21:00 high productivity growth
    0:21:01 if you have lots of
    0:21:01 robots running around
    0:21:02 I do think there is
    0:21:03 a question of exactly
    0:21:04 how much low-skilled
    0:21:05 labor you need in the country
    0:21:06 which bears on a lot
    0:21:07 of the immigration debates
    0:21:08 the high-skilled
    0:21:08 immigration debate
    0:21:09 is the one that’s coming
    0:21:10 and it’s not really
    0:21:11 top of mind right now
    0:21:11 but it’s the one
    0:21:12 that’s coming
    0:21:13 and the reason it’s coming
    0:21:14 is because I mean
    0:21:15 look we need talent
    0:21:16 of course to build
    0:21:16 all the AI
    0:21:17 build all the robots
    0:21:17 to do all these things
    0:21:18 and you see this
    0:21:19 in the debates
    0:21:20 around the universities
    0:21:20 with the move
    0:21:21 that the administration
    0:21:22 is doing on foreign
    0:21:23 students and so forth
    0:21:24 and there’s this kind
    0:21:25 of very one-sided
    0:21:25 argument that’s happening
    0:21:26 on that right now
    0:21:27 which is you kind of
    0:21:27 need a limited
    0:21:28 high-skilled immigration
    0:21:29 from the rest of the world
    0:21:29 or you’re not going to
    0:21:30 have the smart people
    0:21:31 building stuff here
    0:21:32 and I would say
    0:21:32 you know look
    0:21:33 like Joe
    0:21:34 our portfolio
    0:21:34 at our firm
    0:21:35 is like the United Nations
    0:21:36 it’s founders
    0:21:37 from 100 countries
    0:21:38 I benefited enormously
    0:21:39 by working in a place
    0:21:40 characterized by very
    0:21:40 high-skilled immigration
    0:21:41 the thing that’s really
    0:21:42 coming to roost though
    0:21:43 is this fundamental issue
    0:21:44 which kind of nobody
    0:21:45 wants to talk about
    0:21:46 but I’ve started to talk about
    0:21:47 which is it’s the intersection
    0:21:49 of DEI and immigration
    0:21:51 that has really I think
    0:21:52 warped I think our perceptions
    0:21:53 on high-skilled immigration
    0:21:54 over the last 50 years
    0:21:55 and you see this by the way
    0:21:56 in like you look at like
    0:21:57 the foreign enrollment rates
    0:21:58 of the top universities
    0:21:59 which went from like
    0:22:00 2 or 3 or 4 percent
    0:22:01 50 years ago
    0:22:02 to whatever 27 or 30 or 50
    0:22:03 and Columbia is over half
    0:22:04 right
    0:22:05 70 percent or whatever it is
    0:22:05 and so there’s been
    0:22:06 this massive transformation
    0:22:07 in who gets educated
    0:22:08 and then there’s been
    0:22:09 this massive transformation
    0:22:09 of who gets admitted
    0:22:11 through affirmative action
    0:22:12 and then as we now know
    0:22:12 at DEI
    0:22:14 and again this goes straight
    0:22:15 to the political divide
    0:22:15 in the country
    0:22:16 which is if you’re a family
    0:22:17 if you’re parents of a kid
    0:22:18 where I grew up
    0:22:20 and you’ve got a smart kid
    0:22:21 and you think you’re going
    0:22:21 to get them into
    0:22:22 you know a top university
    0:22:22 in this country
    0:22:24 like you are fooling yourself
    0:22:25 like there is no chance
    0:22:26 right
    0:22:27 because they’ve got their
    0:22:28 well like
    0:22:29 the top universities basically
    0:22:30 the top universities
    0:22:31 have basically an admissions program
    0:22:32 that looks like this
    0:22:33 it’s like DEI for white people
    0:22:34 which is the donors
    0:22:35 and all the fake sports
    0:22:36 right
    0:22:36 and so
    0:22:37 a lot of fake sports
    0:22:38 like I have a friend
    0:22:38 who got into Yale
    0:22:39 to play varsity croquet
    0:22:40 which let me just say
    0:22:41 is not a sport
    0:22:42 that we played a lot
    0:22:42 in rural Wisconsin
    0:22:44 and then you’ve got
    0:22:44 DEI generally
    0:22:45 for the other groups
    0:22:46 and then you’ve got
    0:22:47 this immigration influx
    0:22:48 and as a consequence of that
    0:22:50 it is nearly impossible
    0:22:51 for somebody coming
    0:22:52 from like a midwestern
    0:22:52 or rural background
    0:22:53 or southern background
    0:22:54 to get into the US
    0:22:55 by the way
    0:22:56 this doesn’t just affect
    0:22:56 white people
    0:22:57 this also obviously
    0:22:58 we now see how
    0:22:59 it’s affecting Jewish people
    0:22:59 but it actually also
    0:23:00 affects African Americans
    0:23:02 in a very interesting way
    0:23:02 which is actually
    0:23:03 both the universities
    0:23:05 and the corporate employers
    0:23:05 are literally
    0:23:06 this is true
    0:23:07 they literally import Africans
    0:23:08 so that they don’t have
    0:23:09 to hire African Americans
    0:23:10 because it still
    0:23:10 counted as black
    0:23:11 there was a great story
    0:23:12 the thing that woke me up
    0:23:12 to this
    0:23:13 there was a story
    0:23:13 in the New York Times
    0:23:14 20 years ago
    0:23:14 about Harvard
    0:23:15 is this is
    0:23:16 Harvard admits
    0:23:16 black students
    0:23:17 but which ones
    0:23:18 back when the New York Times
    0:23:18 could talk about
    0:23:19 these things honestly
    0:23:20 and it quoted actually
    0:23:21 Henry Louis Gates
    0:23:21 and Lonnie Guineer
    0:23:22 at the time
    0:23:23 at Harvard Law School
    0:23:24 basically observing
    0:23:25 that African Americans
    0:23:25 were not benefiting
    0:23:26 from an affirmative action
    0:23:27 because Harvard
    0:23:27 had figured out
    0:23:28 that they could
    0:23:28 import Nigerians
    0:23:29 right
    0:23:30 and again
    0:23:30 it’s just like
    0:23:30 great
    0:23:31 the Nigerians are great
    0:23:31 they’re very smart
    0:23:32 they’re very productive
    0:23:33 it’s fantastic
    0:23:34 all other things being equal
    0:23:34 you’d like to have
    0:23:35 as many of them
    0:23:35 in your country
    0:23:36 but is that really
    0:23:37 why we’re doing
    0:23:38 the set-aside programs
    0:23:39 and so there is
    0:23:40 this really fundamental question
    0:23:41 which is like
    0:23:42 what level of untapped talent
    0:23:43 exists in this country
    0:23:44 that a combination
    0:23:45 of DEI
    0:23:45 and immigration
    0:23:46 have basically cut
    0:23:47 out of the loop
    0:23:48 for the last 50 years
    0:23:49 and how long
    0:23:51 can we have this story
    0:23:51 to everybody
    0:23:52 in the Midwest
    0:23:52 and the South
    0:23:53 that says
    0:23:53 sorry
    0:23:54 because of historical oppression
    0:23:55 your kids are SOL
    0:23:57 this is the angry populism
    0:23:58 people are worried about
    0:23:59 that’s affecting our politics
    0:24:00 yeah like what do you do
    0:24:00 like this is what
    0:24:01 I’ve really come to appreciate
    0:24:02 from growing up
    0:24:03 in the one place
    0:24:03 and now being in the other place
    0:24:04 which is
    0:24:05 if you’re in the center
    0:24:05 of the country
    0:24:06 you’re just like
    0:24:06 wow these people
    0:24:07 really hate me
    0:24:08 they really hate my kids
    0:24:09 they’re really out to get me
    0:24:10 and like that’s just
    0:24:11 such a toxic dynamic
    0:24:12 like that’s a very
    0:24:12 very bad thing
    0:24:13 for that to continue
    0:24:14 so I guess to finish
    0:24:15 on a more positive note
    0:24:16 we have all these challenges
    0:24:16 you’ve outlined
    0:24:17 no sorry
    0:24:17 it’s fair
    0:24:19 I think in order to be optimistic
    0:24:20 you first have to say
    0:24:21 what are the challenges
    0:24:21 and diagnose it
    0:24:22 and then say
    0:24:22 what are the ways
    0:24:24 here’s an optimistic thing
    0:24:25 which is we have talent
    0:24:25 in this country
    0:24:26 we have so many smart people
    0:24:27 in this country
    0:24:27 who are not being
    0:24:28 properly trained
    0:24:29 properly educated
    0:24:30 and properly employed
    0:24:31 we really genuinely do
    0:24:32 we have tons of smart kids
    0:24:32 running around
    0:24:33 who have all kinds of potential
    0:24:34 who have been completely
    0:24:35 cut out of opportunity
    0:24:36 for the last 50 years
    0:24:37 so we’re going to have
    0:24:39 this wave of productivity growth
    0:24:39 it’s going to be
    0:24:39 in the real world
    0:24:40 with robotics
    0:24:41 we’re going to start to build
    0:24:42 hopefully to get the policies right
    0:24:43 and it’s going to lift
    0:24:44 all these people up
    0:24:45 what are the bottlenecks
    0:24:46 or things in the way
    0:24:46 of doing that
    0:24:47 we have the amazing
    0:24:48 secretary of energy here
    0:24:49 energy is obviously
    0:24:50 a really key thing
    0:24:50 to get right
    0:24:52 there’s obviously the chips
    0:24:53 there’s the critical minerals
    0:24:53 you mentioned
    0:24:54 regulatory stuff
    0:24:55 is insane in this country
    0:24:56 it needs to be fixed
    0:24:57 like what are the biggest ones
    0:24:58 you’re focused on
    0:24:59 and how are we going to get
    0:25:00 those to a place we need
    0:25:00 that it ends up
    0:25:01 with the optimistic outcome
    0:25:02 so I say yes
    0:25:03 those
    0:25:05 so I mean
    0:25:05 the good news on this
    0:25:06 is a lot of it’s obvious
    0:25:06 right
    0:25:07 the minute you look at it
    0:25:07 you’re just like
    0:25:08 well obviously
    0:25:09 we have to do these things
    0:25:10 if you talk to anybody
    0:25:10 running businesses
    0:25:11 in any of these sectors
    0:25:11 they’ll tell you
    0:25:12 right off the bat
    0:25:13 the things that need to happen
    0:25:14 and the current administration
    0:25:15 I think is pretty devoted
    0:25:16 to a lot of this
    0:25:17 the other positive thing
    0:25:17 that’s happening
    0:25:18 there’s this new book
    0:25:19 out called Abundance
    0:25:20 from Ezra Klein
    0:25:20 who I would say
    0:25:21 I disagree with
    0:25:22 on approximately zero
    0:25:22 of everything
    0:25:23 but I think this book
    0:25:24 is really good
    0:25:25 and I think he and his co-author
    0:25:25 you know
    0:25:26 they don’t necessarily
    0:25:27 have the policy prescriptions
    0:25:28 I would outline
    0:25:29 but they make this point
    0:25:30 of liberals used to believe
    0:25:31 in building things
    0:25:32 right
    0:25:32 well I mean
    0:25:33 if you go all the way back
    0:25:34 like communists
    0:25:34 really believed
    0:25:35 in building things
    0:25:35 right
    0:25:37 all like Soviet iconography
    0:25:37 100 years ago
    0:25:38 was all like rockets
    0:25:39 and skyscrapers
    0:25:39 and cars
    0:25:40 and motion
    0:25:40 and energy
    0:25:41 and it was all amazing
    0:25:42 and they built
    0:25:42 all these huge things
    0:25:44 and then liberals
    0:25:45 up until basically
    0:25:45 the 1970s
    0:25:46 they really believed
    0:25:47 in building things
    0:25:47 they really believed
    0:25:48 in building the future
    0:25:49 and so Ezra
    0:25:49 and Derek Thompson
    0:25:50 are trying to recapture that
    0:25:51 by the way
    0:25:52 there’s a bunch of leaders
    0:25:52 of that party
    0:25:53 in Washington
    0:25:53 that are now
    0:25:54 pushing that quite hard
    0:25:56 although it seems hard
    0:25:57 to believe these days
    0:25:57 but you know
    0:25:58 there may be an opportunity
    0:25:59 for some actual bipartisanship here
    0:26:00 and again
    0:26:01 it just makes sense
    0:26:01 if the country
    0:26:02 is growing faster
    0:26:03 it’s going to be
    0:26:04 a fundamentally happier place
    0:26:05 because people
    0:26:06 whichever side
    0:26:06 of the political spectrum
    0:26:07 you’re on
    0:26:07 Reagan
    0:26:10 there’s going to be
    0:26:10 a sense of mourning
    0:26:10 in America
    0:26:11 there’s going to be
    0:26:12 a sense of opportunity
    0:26:12 there’s going to be
    0:26:13 the sense
    0:26:13 that your kids
    0:26:13 are going to live
    0:26:14 better lives
    0:26:14 than you do
    0:26:15 and I don’t think
    0:26:16 that’s a particularly
    0:26:16 partisan view
    0:26:17 at the end of the day
    0:26:18 and I think
    0:26:18 there may be
    0:26:18 an opportunity
    0:26:19 to maybe bridge
    0:26:20 the divide a bit
    0:26:20 and I want to dig
    0:26:21 a little tiny bit deeper
    0:26:22 as we end
    0:26:23 into what that means
    0:26:24 because for me
    0:26:24 for example
    0:26:25 I think both of us
    0:26:25 see how healthcare
    0:26:27 doesn’t need to take up
    0:26:27 20% of our GDP
    0:26:28 right
    0:26:29 it’s very obvious
    0:26:29 that AI
    0:26:30 can make these things
    0:26:31 half a third the cost
    0:26:32 for better outcomes
    0:26:33 and yet
    0:26:34 every one of our states
    0:26:35 in this country
    0:26:36 has very powerful
    0:26:38 provider and payer lobbies
    0:26:38 and has very powerful
    0:26:39 cartels
    0:26:40 that block competition
    0:26:41 and so if we want
    0:26:41 to go build something
    0:26:42 with AI
    0:26:42 we’re not allowed to
    0:26:43 right now
    0:26:44 do you see
    0:26:45 the left and the right
    0:26:46 tech working together
    0:26:47 to fight these special interests
    0:26:48 to actually fix
    0:26:48 the regulatory state
    0:26:49 because it’s not like
    0:26:49 the administration
    0:26:50 could just do it
    0:26:50 right
    0:26:51 it’s going to take
    0:26:51 a lot of effort
    0:26:52 like what does
    0:26:53 that coalition look like
    0:26:54 of the good guys
    0:26:55 against this kind of
    0:26:56 broken regulatory cartel
    0:26:57 in all these industries
    0:26:58 is that something
    0:26:58 we’re going to all
    0:26:59 have to fight
    0:27:00 yeah so the way
    0:27:00 I think about this
    0:27:01 is there’s basically
    0:27:02 three components
    0:27:02 to the American dream
    0:27:03 right there’s
    0:27:04 a house for your kids
    0:27:05 and kind of a definition
    0:27:06 this goes back
    0:27:07 to the geographic lens
    0:27:08 the house needs to be
    0:27:09 like near a place
    0:27:09 where there’s like
    0:27:10 great job opportunities
    0:27:11 right so it can’t be
    0:27:12 the house in the middle
    0:27:12 of nowhere
    0:27:12 it has to be a house
    0:27:13 where there’s going
    0:27:14 to be great jobs
    0:27:14 and you know
    0:27:15 a safe environment
    0:27:15 and so forth
    0:27:16 number one
    0:27:17 number two
    0:27:17 is health care
    0:27:18 you need great health care
    0:27:19 for you and your family
    0:27:19 and then three
    0:27:20 is education
    0:27:20 you want to send
    0:27:21 your kids to good schools
    0:27:23 if you disaggregate
    0:27:24 sectors of the economy
    0:27:25 over the last 25 years
    0:27:26 what you find is
    0:27:27 basically everything
    0:27:28 that technology touches
    0:27:29 basically collapses
    0:27:29 in price
    0:27:31 and so television sets
    0:27:32 and computer games
    0:27:33 and anything with
    0:27:34 electronics in it
    0:27:34 basically
    0:27:35 productivity growth
    0:27:35 in those sectors
    0:27:36 has advanced very fast
    0:27:37 product prices have collapsed
    0:27:38 everything is much cheaper
    0:27:40 but if you chart
    0:27:41 housing education
    0:27:41 and health care
    0:27:43 the prices of those things
    0:27:43 are skyrocketing
    0:27:44 right and we all see this
    0:27:45 it’s just the price
    0:27:46 of housing is exploding
    0:27:47 the price of education
    0:27:47 is exploding
    0:27:48 the price of health care
    0:27:49 I mean health care
    0:27:50 is 20% of the economy
    0:27:51 on its way to 50%
    0:27:52 and so the prices
    0:27:53 are exploding
    0:27:53 and so it’s like
    0:27:54 okay what makes
    0:27:55 those three components
    0:27:55 of the American dream
    0:27:57 have these exploding prices
    0:27:58 basically it’s two things
    0:27:59 number one is
    0:28:00 and these are interrelated
    0:28:01 but number one is
    0:28:02 technology is not really
    0:28:03 touching them very much
    0:28:03 and you could say
    0:28:04 the tech industry
    0:28:05 has done a bad job
    0:28:06 at addressing housing
    0:28:07 and health care
    0:28:07 and education
    0:28:08 or you could say
    0:28:09 that those industries
    0:28:10 have been resistant to it
    0:28:11 but technology hasn’t
    0:28:11 really touched them
    0:28:12 that much
    0:28:12 which means that
    0:28:13 the productivity growth
    0:28:14 hasn’t happened in them
    0:28:15 and then the other thing
    0:28:16 is they’re heavily regulated
    0:28:17 they’re heavily dominated
    0:28:18 by the government
    0:28:18 they’re heavily regulated
    0:28:19 and then in all three
    0:28:20 of those sectors
    0:28:21 the government
    0:28:22 both restricts supply
    0:28:23 right and so
    0:28:24 zoning laws
    0:28:25 university certifications
    0:28:26 and so forth
    0:28:27 right mean that
    0:28:28 it’s very hard
    0:28:28 to actually build
    0:28:30 new of those three things
    0:28:31 and then the government
    0:28:32 responds to the political
    0:28:33 pressure caused
    0:28:33 by the rising prices
    0:28:35 by subsidizing demand
    0:28:36 and of course
    0:28:37 if you subsidize demand
    0:28:37 and it affects supply
    0:28:39 you get skyrocketing prices
    0:28:40 right and so every time
    0:28:41 there’s a housing crisis
    0:28:41 you know it’s a
    0:28:42 perpetual housing crisis
    0:28:42 in California
    0:28:43 the answer always is
    0:28:44 subsidies for home buyers
    0:28:46 which always has the effect
    0:28:47 of driving prices up further
    0:28:48 and making the problem worse
    0:28:49 right and so
    0:28:50 those are the microeconomics
    0:28:51 of what’s happening
    0:28:52 I don’t think there’s
    0:28:53 easy answers on this
    0:28:54 but I think the acknowledgement
    0:28:55 that this is in fact
    0:28:56 what’s happening
    0:28:56 and then I think
    0:28:58 the people have to decide
    0:28:58 that they do not want
    0:28:59 to live this way
    0:29:00 I think the marginal
    0:29:01 American voter
    0:29:02 needs to decide
    0:29:02 look it’s just not
    0:29:03 acceptable that if I can’t
    0:29:04 spend three million dollars
    0:29:05 I can’t have a house
    0:29:06 that’s in a good neighborhood
    0:29:06 with a good job
    0:29:07 attached to it
    0:29:08 and it’s just not
    0:29:09 acceptable that a
    0:29:10 four-year college degree
    0:29:11 is going to cost a million dollars
    0:29:11 which is what it’s
    0:29:12 on its way to doing
    0:29:13 and it’s just not
    0:29:14 acceptable that like
    0:29:15 this healthcare you know
    0:29:15 monster is running
    0:29:16 out of control
    0:29:16 and so you know
    0:29:17 in many ways
    0:29:18 this is like the
    0:29:18 fundamental policy
    0:29:19 political question
    0:29:20 of our time
    0:29:20 that kind of needs
    0:29:21 to be dealt with
    0:29:22 again these issues
    0:29:23 become much easier
    0:29:23 to deal with
    0:29:24 in a high growth
    0:29:24 environment
    0:29:25 right
    0:29:25 in an environment
    0:29:26 with very rapid
    0:29:27 technological development
    0:29:28 let me give you
    0:29:29 the good news story
    0:29:29 on healthcare
    0:29:30 everybody talks about
    0:29:30 healthcare
    0:29:31 you can’t break
    0:29:31 these curves
    0:29:32 there’s one area
    0:29:33 of healthcare
    0:29:33 that is incredibly
    0:29:34 sophisticated
    0:29:35 technologically advanced
    0:29:36 and the price curve
    0:29:37 looks like Moore’s Law
    0:29:38 the price curve
    0:29:38 looks like video games
    0:29:39 the price curve
    0:29:40 is just a straight line
    0:29:40 down
    0:29:41 and the quality
    0:29:41 of the service
    0:29:42 has gone way up
    0:29:43 and that’s LASIK eye surgery
    0:29:44 right
    0:29:45 and the reason
    0:29:45 that’s the case
    0:29:46 is because it’s
    0:29:47 outside the system
    0:29:47 it’s a discretionary
    0:29:48 purchase paid for
    0:29:48 by the consumer
    0:29:49 LASIK eye studios
    0:29:51 are in like strip malls
    0:29:51 and they’ve got
    0:29:52 three people
    0:29:53 and like a super advanced
    0:29:54 incredibly advanced
    0:29:55 like laser eye machine
    0:29:56 and you go in there
    0:29:56 and you get zapped
    0:29:57 and you have perfect eyesight
    0:29:58 and every year
    0:29:59 it gets better and cheaper
    0:30:00 and so that’s like
    0:30:01 an example of what happens
    0:30:03 if you’re able to touch
    0:30:04 these sectors with technology
    0:30:04 and if you’re able
    0:30:05 to get them out
    0:30:05 from under
    0:30:06 all the regulatory
    0:30:07 and government overhang
    0:30:08 and so that potentially exists
    0:30:09 I think throughout the system
    0:30:10 but fundamentally
    0:30:11 we have to decide
    0:30:11 we want it
    0:30:12 and fundamentally
    0:30:13 the population
    0:30:13 in the country
    0:30:13 has to decide
    0:30:14 that it wants it
    0:30:15 well I’m optimistic
    0:30:16 more of the leaders
    0:30:16 in the tech
    0:30:17 and government sector
    0:30:18 are going to be on our side
    0:30:18 and push through
    0:30:19 and fix these regulations
    0:30:20 and the technology
    0:30:21 is going to get us there
    0:30:22 so thank you Mark
    0:30:22 for being here
    0:30:23 appreciate it
    0:30:23 good
    0:30:28 thanks for listening
    0:30:30 to the A16Z podcast
    0:30:31 if you enjoyed the episode
    0:30:32 let us know
    0:30:32 by leaving a review
    0:30:34 at ratethispodcast.com
    0:30:35 slash A16Z
    0:30:36 we’ve got more
    0:30:37 great conversations
    0:30:38 coming your way
    0:30:39 see you next time

    Today we’re sharing an episode from American Optimist featuring Marc Andreessen in conversation with Joe Lonsdale, recorded live at the inaugural Ronald Reagan Economic Forum.

    They explore one of the most urgent and complex questions of our time: Can AI and robotics catalyze a new era of American industrial strength—and how do we ensure the entire country, including rural communities, shares in the upside?

    Marc walks through the history of U.S. industrialization, the lessons of tariffs and trade from leaders like McKinley, and how America’s shift to a services-based economy helped fuel our current urban-rural divide. The conversation spans immigration policy, housing, education, energy, and the path to a true AI-powered manufacturing revival—touching on what needs to change and how.

    This episode is a must-listen for anyone thinking about the future of American productivity, growth, and leadership in the age of AI.

     

    Resources:  

    Find Marc on X: https://x.com/pmarca

    Follow Joe on X: https://x.com/jtlonsdale

    You can find his writings here: https://blog.joelonsdale.com/

     

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  • 641. What Does It Cost to Lead a Creative Life?

    AI transcript
    0:00:08 it wasn’t necessarily a fait accompli that i would have this kind of hit or anything like that
    0:00:13 i was taken to task by the critics and i was considered really polarizing and difficult
    0:00:16 um let’s back up for a second please say your name and what you do
    0:00:20 david ajmi is my name and playwright is my game
    0:00:26 ajmi has been a playwright for a few decades now his work was typically staged
    0:00:33 in regional or repertory or experimental theaters but never under the much brighter lights of
    0:00:39 broadway or the west end that changed last year with a play he wrote called stereophonic
    0:00:44 stereophonic is a play about a dysfunctional family and art making and about the struggle
    0:00:51 to become an artist that’s another way of saying that stereophonic is a play about the mind of david
    0:00:56 ajmi i always work off of tropes in the culture but then it’s always really a way for me to talk
    0:01:04 about me the plot of stereophonic is so slender that it barely sounds like a plot a five-piece band
    0:01:10 is struggling to record their second album the band very much resembles fleetwood mac at least
    0:01:16 superficially there are two sound engineers also and the entire play takes place in california
    0:01:23 recording studios in the late 1970s that’s it but that slender plot supports an entire universe of
    0:01:29 emotion some of the most psychologically astute writing you’ll ever hear on a stage and then
    0:01:34 there’s the music stereophonic is not a musical not even close but the music says a lot of things
    0:01:41 the characters aren’t able to and the music was written by will butler a longtime member of the band
    0:01:47 arcade fire last year as we were trying to make a series about the strange economics of the live
    0:01:53 theater industry stereophonic had just moved to broadway from a well-received off-broadway run
    0:02:01 at playwrights horizons i saw the play a few times i loved it we wound up making a pair of episodes
    0:02:08 about it we interviewed producers cast members and david ajmi stereophonic went on to be nominated for
    0:02:15 more tonys than any play in history and at one five including best play and so when i was recently
    0:02:20 in london for some other tapings and i saw that stereophonic was in rehearsals for its debut in the
    0:02:26 west end i asked ajmi if he would meet up in a recording studio and tell us everything he’s been up
    0:02:33 to as you’ll hear he is a fun person to have a conversation with he is super smart but also earnest
    0:02:41 he’s remarkably candid he’s rarely mean-spirited except toward himself sometimes and he’s consistently
    0:02:48 interesting at least to me i hope you will agree today on freakonomics radio after a stereophonic
    0:02:52 size success what can david ajmi possibly do now
    0:03:12 this is freakonomics radio the podcast that explores the hidden side of everything with your host
    0:03:31 david ajmi grew up in brooklyn in a turbulent syrian jewish family he describes the turbulence well in a
    0:03:37 memoir called lot six we also learned that ajmi started reading the new york times when he was two
    0:03:43 he saw his first broadway musical at five he went to college at sarah lawrence and the grad school for
    0:03:49 playwriting at both juilliard and the university of iowa and then came the hard work
    0:03:58 the last time we spoke which was just as stereophonic was starting to explode you said there have been times
    0:04:04 when you thought about just quitting playwriting but you didn’t and now you’ve been writing plays for
    0:04:12 roughly 30 years and when you look around you realize that almost nobody really does that anymore yeah
    0:04:18 i think it’s true i sort of made some decisions and choices that compromised me in terms of the kind of
    0:04:24 life i would have i was willing to do that because i knew that my purpose here is really to do a certain
    0:04:31 kind of writing and to be very very truthful and exploratory in the kind of work i do and if i can’t
    0:04:37 have that freedom to explore and sort of mull over what i believe the truth is for me in this kind of
    0:04:43 dramatic dialectical context of a play i don’t want to do it and i don’t know if i want to do anything
    0:04:49 you know what i mean that kind of feels like that is my reason for being so i made a lot of sacrifices
    0:04:55 to get to write these plays what do you mean by sacrifices i would live in people’s homes i’d live in
    0:05:02 attics i’d live in basements i’d find patrons essentially i went into an enormous amount of debt
    0:05:08 credit card debt credit cards and you know i couldn’t pay my taxes the problem is they tax grants
    0:05:12 which prior to reagan they didn’t do so when artists got grants if i got guggenheim let’s say
    0:05:17 which i was fortunate enough to get one then i would use that money to try to pay some of my debt
    0:05:21 the grants were a huge boon and then suddenly it became the bane of my existence because i was like
    0:05:26 oh my god i’m running from the tax man you also go into a little bit of denial like i’ve got all this
    0:05:31 money hooray and then you want to go out and celebrate and it’s like oh no i’ve got this albatross
    0:05:36 of these taxes that makes me sad because i feel like someone should have said to you hey the first thing
    0:05:41 you need to do is take 30 of that and just set it aside but nobody said that to you nobody said it
    0:05:46 but i also think maybe i wouldn’t have listened because i wanted to experience the ecstasy of money
    0:05:54 were you somewhat hedonistic yes on what well i took myself out for nice dinners maybe i bought a little
    0:05:59 outfit here and there that doesn’t sound hedonistic for me it was it’s so funny because people thought
    0:06:05 i was so rich i remember having dinner with a professor of mine from college for my undergraduate
    0:06:10 after my first play opened in new york and she’s like you must be doing so well now financially and
    0:06:15 i said they paid me seven thousand dollars what was she a professor of she taught literary theory
    0:06:19 and literature i would have thought she would understand the economics of theater a little bit
    0:06:25 she had not the vaguest idea i saw her recently we had dinner again a couple months ago and she said i
    0:06:29 remembered that day really vividly because it was such a shock to my system people don’t understand
    0:06:35 that playwrights make literally nothing and just how broken it is and of course now it’s just we’re
    0:06:39 going down even a darker black hole which i didn’t even think was possible but of course it always is
    0:06:47 during the 10 or 11 year gestation period of stereophonic which is the show that people now
    0:06:53 know you for talk about how close you came or how many times you came close to quitting playwriting
    0:06:59 what i realized making stereophonic was that i couldn’t give up this is the kind of torture i think
    0:07:05 that gets crystallized in the play itself because i think people realize i love this too much and the
    0:07:11 thing that i love is killing me and i will never stop loving it that’s why the play rings i think with
    0:07:18 the intensity that it has because i was really living it for real i made the play over 10 years i thought it
    0:07:26 was never going to get done at some point i mean it’s hilarious in a dark way because it does mirror the
    0:07:30 trajectory of the play because the play is about this album that’s like never getting finished and everyone’s going
    0:07:37 insane and people are wondering like am i going to make it alive out of this studio to see this record
    0:07:42 come out and i was really feeling that and yet that was the thing that kept you in it didn’t make you run
    0:07:48 from it it was a bit of a beckett situation you know i think about the end of strindberg’s play i think it’s
    0:07:54 a dream play where the character says you want to stay and you want to go and wild horses are tearing you
    0:08:00 apart in both directions simultaneously and i really felt those two opposite emotions with equal intensity
    0:08:04 i learned how to be quite disciplined during that period
    0:08:06 and very very rigorous
    0:08:08 and
    0:08:13 just put my emotions to the side as much as possible but there were times when i really thought
    0:08:17 i was losing my mind i had holes in my clothes and i couldn’t afford anything i mean
    0:08:19 it got really really bad for me
    0:08:22 and my director daniel walken was actually quite worried about me
    0:08:24 even to the point where
    0:08:28 when we were in previews at playwrights horizons i made sort of a dark joke
    0:08:34 we were up in the roof he was smoking a cigarette and i sort of alluded to the fact that
    0:08:37 well if it doesn’t go so great maybe i’ll just you know and i kind of
    0:08:41 nodded downward and he just burst into tears because i think he was so worried about me
    0:08:46 the relationship you two have along with will butler is i think quite remarkable because you
    0:08:50 were collaborators for years and years and years before there was a play yeah
    0:08:53 yeah i mean you were a team you formed a band essentially
    0:08:58 we just sort of decided that we would have unconditional faith in each other it was some
    0:09:03 sort of spiritual contract that we made i don’t know how we made it or why we did it
    0:09:08 but we intuitively just knew that we could trust each other and that we were going to be
    0:09:14 really decent with each other and that i was going to learn how to be civilized which i
    0:09:20 maybe wasn’t prior to this process because i am quite controlling and i am very demanding
    0:09:26 daniel sat me down prior to the process and said listen you have a reputation of being very demanding
    0:09:30 this is how i need to work can you work this way and i said yeah
    0:09:33 just to be clear you drafted these guys into your band
    0:09:37 several years before anyone would have ever heard of stereophonic
    0:09:43 and they worked for essentially free for years for 10 years so this is will butler who was at the
    0:09:50 point still in arcade fire he was in arcade fire this was 2013 he’s so smart he’s so dramaturgical will
    0:09:56 he has the mind for theater and that was something i did not know it’s an accident you went to him
    0:10:01 because you were able to find a connection yes or you reached out and he said yes i reached out to
    0:10:06 arcade fire period i was like i want arcade fire to do it just because you love them i love arcade
    0:10:09 fire and i just thought there was something about the anthemic quality of some of the songs
    0:10:14 especially in their first album i was like there’s something about the intensity of this and the sort
    0:10:20 of fever of some of these songs that i think will rhyme with what i want for this show and i love them
    0:10:25 and then they were all busy no no no i can’t do it and will was like well i’ll meet with you
    0:10:30 and i just thought i like this guy he’s a bit like peter pan or something i mean he’s kind of
    0:10:37 iconoclastic for a rock star he’s a sweet sweet soul he’s goofy and he’s silly and he’s really fun
    0:10:43 and he’s very very brainy when we were doing my show he moved to cambridge and got a degree in
    0:10:50 public policy from harvard in the middle of recording for arcade fire he’s a unicorn in the world of rock
    0:10:56 music and then daniel auken is a working director in new york his father i think was head of the
    0:11:02 national theater here in london for a time yeah he was yeah so when you say you know we all made this
    0:11:07 contract where we agreed to be good to each other and to collaborate in a certain way i could see why
    0:11:14 you would want to do that right you’re the writer and you need them a director and a musician to write
    0:11:20 what is a very essential piece of this play but what was in it for them i have no idea i think
    0:11:25 daniel you know we went to sundance together they have this theater lab and i developed my first
    0:11:30 real play there called the evildoers daniel saw the reading which was quite extraordinary michael
    0:11:34 stubert was in it and it was great he got really jazzed about it and thought i want to work with
    0:11:40 this guy so we had been talking about doing something together and i remember thinking this is the play for
    0:11:43 daniel like i saw it in my mind’s eye and then i just went that’s for daniel
    0:11:50 what did your script look like over the years and how much archival stuff is there are there
    0:11:55 cartons full of paper versions was it all on a computer i’m really bad at archiving my stuff
    0:12:00 because i’m so disorganized what i was doing in the beginning was just taking notes of every single
    0:12:07 thing that i could learn about a recording process in the 70s jargon equipment what they would say to
    0:12:12 each other what their problems would be then i would riff on it and make dialogue it was a very
    0:12:17 batter shot process my assistant now is saying like what’s your process explain to me so i can
    0:12:20 help you and i’m like i can’t explain it because i don’t know what i’m doing i’m just following my
    0:12:25 intuitions did all the characters already exist when all this is going on no no no they didn’t exist i
    0:12:30 didn’t have an engineer for the first part because i didn’t i was just like oh it’s a band they go into
    0:12:35 the studio i didn’t know anything and then i said okay i’ll have an engineer and then i showed it to
    0:12:40 john kilgore who is this very famous engineer producer who worked for philip glass and steve reich and all these
    0:12:45 people and john was amazing and we said could you be our advisor he read through what i had and he said
    0:12:50 why is there only one engineer he needs an assistant and so that opened up the dramaturgical thing of
    0:12:55 like oh there’s two guys and now it becomes like rosencrantz and guildenstern so then that became the next
    0:13:01 draft i developed it in workshop so i do it like 10 or 15 pages at a time 20 pages here and there
    0:13:07 i think for people who aren’t accustomed to making things especially over a really long period of time
    0:13:12 they show up they buy a ticket they see it and in the case of your play it’s a long play so maybe you
    0:13:17 feel like you’re getting money’s worth it’s three hours long but i think it’s not natural to think
    0:13:22 about the ingredients or the process you know if you and i were to go to have a really nice dinner
    0:13:30 somewhere we don’t stop to think about all the growing and planting harvesting preparing education
    0:13:35 that goes into that one meal but it’s years and years and years and years and similarly what you’re
    0:13:40 describing now is years and years of minute work that’s gone into this thing that people will show
    0:13:46 up and buy a ticket and love it or not love it whatever and then it’s over does that get to you
    0:13:51 that people don’t generally think about or understand what it takes to make something like this
    0:13:55 well that’s where i wrote the play i heard an interview i think it was about barbara streisand
    0:14:01 barbara streisand was in the studio and they were playing these violins and she said one of these it’s
    0:14:06 flat and they were like what are you talking about there were like 12 violins and she goes which one play
    0:14:13 it you that’s the kind of expertise that when you hear the anecdote you’re like oh my god barbara
    0:14:17 streisand doesn’t brag about this hey do you know what i do i have to listen to all these flat
    0:14:24 instruments she’s just focused on the work at hand i find there’s such nobility in that for me
    0:14:31 that artists often don’t have to display their expertise they just do their work i find that very
    0:14:38 beautiful there are romantic relationships among the characters in your play that ebb and flow but
    0:14:42 even among those for whom there’s no romantic relationship being in a band is a little bit
    0:14:47 like being married to several people simultaneously right i like the idea that you’re getting to
    0:14:52 there’s something in there but i don’t understand it the reason i’m asking is that i was in a band and
    0:14:59 i quit as we were kind of at the brink we’d gotten a record deal we were in pre-production on our first
    0:15:06 record and i decided this was not the life that i wanted we were on arista records it was oh my god
    0:15:13 i’d been working toward it for clive davis yeah clive came to cbgb’s to see us play and then he led us out to
    0:15:19 his stretch limousine it was very cold he put his silk scarf around my neck oh my god oh my god and
    0:15:24 we went up to his office the next day and he had aretha franklin get on the phone with us to tell us
    0:15:32 how great oh my what it was but anyway once we got into the making of the record and once i had
    0:15:38 exposure to people who were successful i realized it was not the healthy lifestyle for me because it’s
    0:15:44 too much fun but the band i deeply loved every individual in that band it’s just a very hard
    0:15:50 relationship which is one of many reasons i loved your play i think it’s a dynamic that your play helps
    0:15:54 people understand about themselves maybe the thing that i started out with when i was writing the play
    0:16:01 was collaboration and working together and being together and functioning as a collective and also
    0:16:07 as individuals inside of a collective like that tension how do you do it how do you partner where
    0:16:13 are the nightmares because i do have trouble with that i’m much better one-on-one than i am working
    0:16:21 inside of a group however ironically with this play with this group i can’t tell you how harmonious it is
    0:16:28 it’s very beautiful and very magical and we do fight and sometimes i want to fight more probably
    0:16:32 should be fighting more but i just love them so much i don’t want to fight with them i don’t like
    0:16:37 conflict i want to be loved and just everything to be nice with everybody but i sometimes push things
    0:16:43 into conflict because of that but not gratuitously i don’t think it’s ever gratuitous because i love
    0:16:48 harmony and i don’t like to fight with people but then i will sometimes push things one particularly
    0:16:54 compelling element of this play to me and i think to many people is peter he ends up being the leader
    0:17:02 of the band by merit but it wasn’t a vote it just happened because he was the most let’s say driven and
    0:17:10 talented i’m just curious if that dynamic that reality of you know a leader emerging and everyone
    0:17:15 is kind of bitchy about his being the leader in the way that he is the leader because he is very
    0:17:22 exacting but they also benefit hugely by his being that kind of leader and so he’s in this kind of
    0:17:27 difficult situation where he too wants to be loved like you just said he wanted to be invited over for
    0:17:34 that chicken dinner does that have a connection to you or anyone in your life i think that’s like
    0:17:40 the obverse that’s like the dark night version of me that’s where it could have gone but i think peter
    0:17:45 couldn’t have survived and doing theater because theater you can’t control it every night and you
    0:17:49 can’t record it and get all the levels exactly right which is sort of what i want to do is that
    0:17:54 why you don’t go to the performances then that’s part of it because i am compulsive i literally sometimes
    0:17:59 spasm when the actors don’t do something the way i want them so if you’re sitting in the audience you
    0:18:05 might shout what are you doing it’s kind of what i’m doing the whole time in my head and and i think i would
    0:18:12 just my energy no but it is dark comedy i am compulsive and peter is compulsive i am an
    0:18:18 obsessive person and i hear things at a frequency daniel keeps saying my director he just goes you hear
    0:18:23 things at a frequency that normal people can’t and i’m like going well that doesn’t help like he thinks
    0:18:28 that like oh it’s not a big deal that we don’t do that because you hear it and so specific but no one
    0:18:34 else will know all i can do is tell you what i need to hear but i have a really good bedside manner
    0:18:41 i can be charming i’ve cultivated this new york jewish persona that i work the room with it’s not just a
    0:18:46 persona i actually do have this sort of sense of comedy about myself and my own obsessiveness and my
    0:18:52 neuroses and i have a light touch and a kind of weird hovering overview of the absurdity of everything
    0:18:59 that we’re doing all the time so that i don’t get so you know annoying about things i try anyway i mean
    0:19:03 i did like say to will this song needs a bridge and this song needs that and i want it more intense and
    0:19:07 blah blah blah and he’d be trying and at some point will would just be like god damn it and he just
    0:19:13 started screaming at me and i was like will what can i do calm down it’s gonna be good what can i do
    0:19:21 stereophonic was good it won all those tony awards and sold out night after night in new york
    0:19:27 so why did it close after just nine months that’s coming up after the break i’m stephen dubner
    0:19:30 and this is freakonomics radio
    0:19:45 stereo phonic opened on broadway in april 2024 and it was a runaway hit some hits play on for years
    0:19:54 but stereophonic closed in january 2025 after just nine months i asked david adjmi why well we were
    0:19:59 kicked out of the house it’s not up to me or the producers we were trying to fight for more time
    0:20:04 but the schubert people wanted to put in another show the schubert organization is the biggest
    0:20:10 landlord on broadway they own 17 of the 41 theaters they made a promise to another show and
    0:20:15 we had maybe the opportunity to move to another theater but then that’s a whole other expense
    0:20:20 we just decided let’s just end on a high the good thing about closing when we did was like
    0:20:25 we had sold out houses through the entire run but i can imagine that the producers must be saying
    0:20:29 there’s so much money we’re leaving on the table yeah i mean we had just
    0:20:33 recouped like a couple of weeks before we close and i think that it would have been nice for the
    0:20:37 investors and everyone to make a little bit of money from it can you explain that to someone who
    0:20:43 doesn’t know the economics of broadway how can one of the biggest hits in a long time only recoup
    0:20:48 after eight or nine months and not make money well because there are running costs every week they’re
    0:20:52 paying the actors they’re paying the stage fans but it’s a relatively cheap cast and you were able to
    0:20:58 charge quite a bit for tickets as it became a hit we were and yet we had to pay back the investors
    0:21:02 it was something like a three or four million dollar production so we had to pay all that back
    0:21:08 and also pay for the running costs every week i don’t understand exactly like the compass of how
    0:21:13 that all works because i kept saying when are we going to recoup i can’t wait and my agents were like
    0:21:18 well it’s happening soon we don’t know but also they put in money for advertising and then they put in
    0:21:22 money for this and then these campaigns and i don’t know it just all costs money somehow
    0:21:27 much more money in new york than here in london though right every producer talks about
    0:21:33 the huge spike in costs in new york everything from building sets to advertising to union labor
    0:21:38 it’s a unions really in america they’re very hardcore in america and maybe not so much here
    0:21:42 they’re definitely not i’m guessing you’re the kind of person who politically aligns with
    0:21:48 union i do i do but i do think it might end up being the death of the american theater
    0:21:53 it’s so intense the demands of the unions and it’s so expensive to put on shows so then you know
    0:21:57 they put on these shows with movie stars and then they charge five hundred dollars eight hundred dollars
    0:22:05 for a seat that’s not going to help us build a theater culture in the united states and it’s
    0:22:12 heartbreaking for me do you see a way around that a way forward right now i’m feeling very very lost
    0:22:17 and you haven’t even spoken about the regional theaters they’re in even worse shape i think
    0:22:21 they’re in worse shape i think covid really struck a blow to so many regional theaters and so many
    0:22:27 non-profit theaters in america and then now what’s happening with the new priorities of this particular
    0:22:32 administration new plays isn’t really something they care about is that why you’re planning to move to
    0:22:37 london i don’t know if that’s for public consumption yet i haven’t announced it but i’ve told my friends
    0:22:43 they have a special visa it’s called a global talent visa out here and if you are talented enough
    0:22:48 that’s a humble title i don’t know what to do i’m not blaming you i know but when i found out about it
    0:22:53 i thought well i’m going to avail myself of this if i’m globally talented enough to qualify i’m going to do
    0:23:00 it did you decide this before you were over here for stereophonic we were out here for auditions
    0:23:04 and i kept telling my music director i really think you should move out here you would love it here
    0:23:09 look how great it is here and then i realized i was kind of doing some freudian thing where really i was
    0:23:15 saying it to myself and then i went to a party and this woman who’s american she told me about this special
    0:23:19 visa that i could get because i was thinking well maybe i could live out here but i don’t know if i could
    0:23:24 get a visa she said no no i think you can get one why do you want to move here i’m a little bit
    0:23:30 disconcerted by some of the political goings-on in the united states right now but also i just like it
    0:23:37 here i think new york has become crazily expensive and such a luxury playground for the rich and tech
    0:23:43 people you know i grew up there i’ve seen the city change and change and change i suddenly realized like
    0:23:49 maybe i feel a little alien here i was looking for a new apartment i was looking in guanis which is not
    0:23:53 necessarily the most you know glam i mean they’re trying to build it up and turn it into tribeca
    0:23:58 for those who don’t know just describe guanis most famous for its toxic canal well they have the toxic
    0:24:04 canal and so you probably get cancer and everything but it can be nice i remember growing up there’s
    0:24:09 park slope and then there’s guanis in between and then there’s carol gardens if there was a party at
    0:24:13 park slope but then we wanted to go to carol gardens we just run through guanis because we were so
    0:24:18 petrified because there was just nothing there except for this toxic canal and maybe muggers but
    0:24:22 then they said oh let’s build this up and turn it into a playground for the rich so that’s where
    0:24:26 you’re looking i was looking and i thought i’d like to have an office i’ll get a two-bedroom
    0:24:32 and they were so expensive i was like do i really want to spend this kind of money and live here
    0:24:37 i don’t know that i do so when i came out to london i just thought actually it’s a little bit less
    0:24:43 expensive here and i kind of like it and maybe i’m ready for something new so so let’s talk if you
    0:24:49 don’t mind about the state of theater in general let’s say new york versus london no you make a sad
    0:24:54 face the ft ran a piece i don’t know how much you might agree with it or disagree with it but it said
    0:25:02 that the west end has maybe surprisingly become a better place to do good theatrical work it’s
    0:25:08 definitely cheaper to produce here than it is on broadway and that broadway has become as we all
    0:25:16 know the redoubt of celebrity casting and or sitcom ish shows etc etc so in that way stereophonic stood
    0:25:23 out have you sensed any significant ways in which writing for the stage in england is significantly
    0:25:28 different than writing for the states and is that part of why you want to be here it’s not actually a
    0:25:34 factor in my coming here no i did a show at the rsc about 20 years ago that was like one of my first
    0:25:38 ever production royal shakespeare at the royal shakespeare company in stratford it came to london
    0:25:43 as well as let’s just like a one person show that the royal court commission when i was like a graduate
    0:25:49 student and that was really fun what i’ve noticed just in general is that it’s a very humane place in
    0:25:55 a lot of ways the funding is not what it was let’s get that straight right now in england anywhere the
    0:26:01 arts are underfunded it’s bad everywhere although here there’s much more from the state much much more
    0:26:05 and i’m sure that’s going to be more pronounced once we lose you know our national endowment of the
    0:26:11 arts which will probably happen very soon in america so that’s absolutely true i think there’s a theater
    0:26:17 culture here that does not exist in america in general there’s a certain kind of value placed on
    0:26:24 the arts in england and that is the thing about this tradition right we’re part of a history this is part
    0:26:28 of how we do things it’s very codified and there’s constricting elements of that and then there’s very
    0:26:34 wonderful elements to it so you really do feel that the theater going is part of our culture and
    0:26:39 that’s why like you know in the royal court they have seats in the bleachers for like 10 pence so
    0:26:44 everyone can come because it’s part of the democracy that is part of the democracy that’s how the greeks
    0:26:51 thought of it as well i thought of you and this play the other day we were up in chester england it’s an old
    0:26:58 roman city they’ve still got intact roman walls and there’s a thousand year old cathedral and while we were
    0:27:03 there we went to the races the oldest horse racing track in the world is there it’s almost 500 years old
    0:27:11 it’s fun and it’s also weirdly identical to what it must have been almost 500 years ago you’ve got animals
    0:27:17 you’ve got people on them and other than like the hats that the ladies wear they call fascinators them
    0:27:22 being made of things that i’m sure materials that didn’t exist 500 years ago otherwise it’s pretty
    0:27:28 much the same i was thinking that that’s a tradition that carries on maybe it’s because it’s a form of
    0:27:33 entertainment where you can also bet but it’s social right people get together in the sunshine you drink
    0:27:37 and i was thinking about well theater you know the same time that chester was happening like
    0:27:42 shakespeare probably went to the chester race course at some point right and i’m just thinking
    0:27:46 about the trajectories of these two things in some ways are very similar they’re analog things that are
    0:27:53 events but the theater sadly to me and i gather to you as what would seem to be a different trajectory
    0:28:01 going forward what do you think is lost for humankind oh my god listen i’m a playwright so clearly i like
    0:28:06 it i think there are a lot of bad plays i think it’s a very hard medium i think some of the curators
    0:28:11 are a little bit boring but i think in terms of people getting together in a shared space and having
    0:28:18 a collective experience it can be breathtakingly beautiful and important and you know again i go
    0:28:24 back to the earliest democracies i mean it was a democratic requirement to go to the theater
    0:28:31 in ancient greece not for women because they weren’t considered people or slaves but still okay there was
    0:28:37 this idea that theater and democracy they go together and the theater was often about the
    0:28:41 ideas of the day it wasn’t pure entertainment we should say yes yeah there were ideas of the day but
    0:28:46 then it was also who knows people were stabbing each other and killing the sheep and going crazy i guess
    0:28:52 those are the ideas of the day we’re all going mad but you know there was a kind of psychic penetration
    0:29:01 that those plays engaged there was a shadow side of human behavior and what it meant to be part of
    0:29:08 a social contract and also to be a leader of some kind or to be disenfranchised those are the plays
    0:29:15 that really move and interest me sometimes we go into phases of history where boulevard plays i guess
    0:29:20 they’re called that are just lovely and entertaining and kind of throw away but fine in the moment
    0:29:26 become more the order of the day and then i think there are moments in history where
    0:29:34 the work can get more difficult speaking of work that can be difficult the street that we’re on
    0:29:39 today old compton in soho central london do you happen to know anything about who lived on the street
    0:29:44 in the past gay people i’m guessing that’s all i know it’s like a gay area yeah i’m guessing that’s
    0:29:51 true who lived here well many people but the most noteworthy when i looked up was wagner richard
    0:29:57 wagner lived here oh my god i asked my favorite ai search engine what wagner and david ajmi have in
    0:30:02 common oh no we’re both control freaks didn’t give me that it may not know you well enough yet
    0:30:09 says david ajmi and richard wagner share several notable commonalities rooted in their contributions to the
    0:30:14 performing arts you like it so far this is crazy particularly in how they both innovated within
    0:30:21 their respective mediums okay so this is legit ready therefore pioneering theatrical storytelling
    0:30:26 ricard wagner as a composer and libretticist to revolutionize opera with his concept of
    0:30:32 that word i can never say the sum constant yeah i love that and david ajmi as a contemporary playwright
    0:30:36 known for pushing the boundaries of dramatic form and content i don’t know what you call the face
    0:30:40 you just made it’s all right it’s like a jewish it’s like my larry david okay if you say so
    0:30:48 number two focus on music as central to their work okay not a bad point i mean he was a musician but um
    0:30:54 okay number three exploration of artistic process and creative tension wagner’s works often depict
    0:31:01 artists gods and mortals struggling with creation ambition and interpersonal conflict while ajmi’s
    0:31:08 stereophonic similarly dramatizes the intense often fraught dynamics and number four influence and
    0:31:14 controversy both have attracted controversy wagner for his personal views and the revolutionary nature
    0:31:21 of his art ajmi for legal disputes over the sources and inspirations for plays including stereophonic
    0:31:26 and its alleged parallels to fleetwood mac’s history so all right that’s what the ai machine has to say
    0:31:31 about you and wagner what do you think no comment can you give me some kind of response to this
    0:31:38 the lawsuit that the ai brings up this was a fleetwood mac adjacent lawsuit there was a settlement i
    0:31:44 understand say what you can or will i can’t say anything you know i’m not allowed we settled it i’m so
    0:31:50 glad we settled it the play did not have to change as a result of the lawsuit i assume or am i wrong no
    0:31:55 was there serious concern at some point that you might have to either shut down the show or rewrite parts
    0:32:02 well we couldn’t do anything with the lawsuit hanging over us we wouldn’t have been able to go to london or do a tour or anything like that
    0:32:08 it was too fraught i know the settlement amount is not made public as it never is in these cases
    0:32:15 but i would assume that might have been a contribution to why it took a little while to recoup yeah a chunk must have gone there
    0:32:17 i mean i don’t think i’m allowed to say but no
    0:32:24 the case had been brought by ken calais a producer and engineer who worked on fleetwood mac’s record
    0:32:31 rumors and who wrote a memoir called making rumors there are as i mentioned earlier a lot of fleetwood
    0:32:37 mac parallels in stereophonic from the makeup of the band itself to the way that the peter character
    0:32:42 like lindsey buckingham in real life winds up taking over the project there’s also the fact that both
    0:32:48 peter and lindsey have a brother who’s an olympic swimmer but now that the lawsuit has been cleared
    0:32:55 stereophonic is playing in london with sold out houses and rave reviews and there will be a u.s tour
    0:33:00 later this year i’m stephen dubner this is freakonomics radio we’ll be right back
    0:33:13 so what’s different about the london production of stereophonic from the new york production
    0:33:19 the cast is three of them came from new york and they all had the option to come but the rest of
    0:33:23 them said no we don’t want to come okay so we recast it all did have the option they all had the option
    0:33:31 listen it’s a very very draining play to do they were just like we’ve done it we came out in january
    0:33:37 and we recast the four other roles and it was very very hard because it’s not just about getting
    0:33:42 people playing instruments and who are good actors they have to feel a certain way i mean i really cast
    0:33:48 for the quality first and then it’s like okay how can you act and can you play instruments what do you
    0:33:53 mean cats for quality first i wanted people who felt like artists and that they were a little bit weird
    0:34:00 i didn’t want people that felt like actors a lot of actors are really good actors but they feel like actors
    0:34:07 acting i didn’t want that for this show and i really wanted to give the audience a very easy ramp into
    0:34:13 the kind of naturalism that we’re asking in the play and we found these actors but there were like one or two
    0:34:20 like okay you could play that role you’re the only one you could do it all of england kind of but that’s
    0:34:21 what happened in america too
    0:34:31 several cast members of stereophonic in new york weren’t really musicians tom pasinka who played the
    0:34:35 peter character it told me that before he started training for rehearsals he only played what he called
    0:34:42 garbage guitar but some of the london cast members are experienced musicians at playwrights horizons it was
    0:34:45 like you know what’s that movie where they were getting the ship up the hill
    0:34:51 fitz carraldo that’s what that was it was a little bit like oh my god this is going to kill me whereas
    0:34:55 you know three days in they were playing all the songs and it sounded great they’re musicians they can
    0:35:02 do this with zero disparagement toward american cast would it have been a different experience had you cast
    0:35:08 actors who were also musicians for the american version i’m sure it would have been different would it have
    0:35:13 been better not necessarily because so much of the charm and the deliciousness of that experience
    0:35:20 was the meta story of can we make ourselves a band can we do this can we play instruments
    0:35:28 it was wild seeing them step up to that plate for will brill to learn how to play bass and for tom to
    0:35:40 learn the riff for masquerade they were so petrified but inside of that fear was a kind of laser focus like
    0:35:47 i’m in it to win it and it brought out something very primal and thrilling that made its way into the
    0:35:51 performance so i actually think it helped us in a certain way i understand there’s a new song
    0:35:58 for the london production yeah it’s not in the production in the play diana speaks about this song
    0:36:04 which is from the first album and it’s the song that starts creeping back up the charts and then
    0:36:10 propels their album into success so will said i’m gonna write that song and then he said i’m gonna give
    0:36:16 the cast something to do that’s their own to let the british cast shine for themselves and they kill it
    0:36:31 i read that brad pitt’s film production company has acquired rights to stereophonic true i don’t know
    0:36:37 if they acquired the rights they’re just my producers for the film which i’m writing right now oh so you’re
    0:36:42 writing the film i’m writing the film i just decided not to sell it to a studio quite yet because i’d like
    0:36:48 to take my time and get it right and not have to take notes part of the problem is like okay you like
    0:36:54 the play now what do you imagine the hollywood version of it to be i don’t even know what it is
    0:36:59 yet i have to redo the whole thing in my mind is this going to take another 10 years roughly i hope to
    0:37:06 god not i mean i am working on it right now and i can’t rush it but i don’t want to do a bad movie
    0:37:12 i really want it to have the integrity that the play had but it can’t be a play can you give a couple
    0:37:17 ideas just of how the film would be different from the play i can’t talk too much about the film
    0:37:22 because i don’t want to jinx it there are talky speeches that will never be in this film i love
    0:37:27 them and they’re central to the play and they can’t have anything to do with it there’s a character who
    0:37:33 is alluded to this receptionist who is an aspiring singer model person who sort of works her way through
    0:37:39 the band who becomes a character in the film i love writing her it’s a big thing in the play this
    0:37:44 demarcation between public and private those spaces are quite collapsed in the play everything becomes
    0:37:49 public because they’re just in the studio and there’s no escape it’s inspiring to me that you’re
    0:37:54 so confident about this because it’s a different kind of writing it’s totally different and you have
    0:37:59 to embrace it but i don’t have an ego about it all so i think that’s where playwrights get in trouble
    0:38:05 like oh my wonderful play it’s like no no i’ve got to kill it’s like oedipus kill the play marry the movie
    0:38:10 you know what i mean that’s how i’m approaching it i can’t deify this play this play is its own
    0:38:15 thing and there’s things that i’m going to keep because they’re going to work in the movie but i
    0:38:19 have to figure out the proportions and stuff it’s just different what about other plays what are you
    0:38:26 working on i’m doing a play for the public theater that i can’t really talk about it’s a two-part play
    0:38:32 is it contemporary it is but it also spans something like 50 years it’s very different
    0:38:39 from stereophonic it couldn’t be more different and i can’t talk about it i can’t i’m gonna get in
    0:38:46 trouble does it engage more with the outside world than stereophonic does whether that’s political
    0:38:53 engagement or whatnot yeah it does but not because i felt an obligation to i think that’s where artists
    0:38:58 get into trouble when they’re being pointed oh let me write about the issue of the day because it’s
    0:39:03 very important and i need to speak to it i never do that i don’t like those kind of plays and yet
    0:39:10 i’ve written one despite the fact that i dislike it it came from a place of obsession and not
    0:39:16 understanding what i was examining that’s when i trust myself when i’m coming from a place of rational
    0:39:22 inquiry that’s when i know i’m on the wrong track i’ve heard you talk about this notion of an event
    0:39:29 a thing that happens in a given place in time and that there’s less and less appreciation of that and
    0:39:34 i will say as a human that worries me a little bit because we’ve lived the entirety of our civilization
    0:39:43 with that notion so i don’t know open thread on digital versus analog i just think it’s very
    0:39:49 troubling that it was so controversial that i had a play that was three hours it was such an object of
    0:39:57 controversy that people couldn’t bear to have the attention span to sit with a play like that it was
    0:40:01 so daunting for them you sure your play was really singled out it’s just that you paid more attention
    0:40:06 because it was your play maybe i was paying more attention i think that feels to me more like a
    0:40:13 symptom of a kind of tiktokification of people’s attention span and that worries me that people don’t
    0:40:22 know what it is to really pay attention and to devote sustained attention to a work of art on the other hand
    0:40:27 the way you just described it there no offense makes it sound a little bit like homework whereas the point
    0:40:32 of a piece of theater is that you become so immersed that you kind of are holding your breath
    0:40:38 everard alby once said to me that’s a good sentence however it ends i know right he once said entertainment
    0:40:47 isn’t just about you being entertained it’s about what you are willing to entertain i think there is a
    0:40:54 fine line between edification you might call it homework and a certain kind of devotion and attention
    0:41:01 that really does pay dividends and pay rewards but that it’s not always instant gratification
    0:41:08 and there’s something about that ethos i guess that’s sort of how i was raised a little bit when
    0:41:14 i read hegel and kant in college i wasn’t going oh my god this is so riveting except ultimately it was
    0:41:21 riveting to me i assume that this play has brought you already and will bring more financial security that
    0:41:29 is a little bit surprising and unusual to you yes yes up to a point it’s not like i’m set for life
    0:41:37 the money has been unbelievably helpful for me and has kind of healed me poverty is just no fun feeling
    0:41:41 like you’re constantly trying to figure out how am i going to pay my rent next month how am i going
    0:41:46 to pay my rent i have three months of rent i can pay okay now what about this that’s a drag and that
    0:41:53 has been alleviated and i’m very grateful for that talking today you seem pretty normal you seem like
    0:41:59 you’ve i’m not adjusted no no you’re just i’m faking it because i know you’re very shy i am shy is that
    0:42:05 where the sunglasses came from the sunglasses came from when i was at playwrights horizons and i was
    0:42:11 starting to get extremely anxious about having to do press not even press it started on the first
    0:42:17 rehearsal something happened to me maybe i’m getting more neurotic as i get older but i feel really naked
    0:42:26 and i feel very nervous and shy and embarrassed i feel so flayed more than other plays yeah why do you
    0:42:33 think it was for this show i think this is the most nakedly honest thing that i’ve ever written even
    0:42:40 though from the outside there’s nothing or anyone in the play that remotely resembles david adjmi
    0:42:46 right but there were times in auditions actors were reading scenes over and over that i thought i was
    0:42:50 going to have a nervous breakdown because i couldn’t keep hearing the lines anymore i was like i can’t
    0:42:58 handle this play okay so you write this play it does as well as one could possibly wish you win the
    0:43:03 awards you’re selling out all kinds of real rock stars are coming to see the play people like jeff
    0:43:10 bezos are coming to see it how did this whole experience change your self-image your self-identity
    0:43:16 i don’t really think it has i just think i have so much to prove that’s how i look at it it’s like i
    0:43:24 have so much to prove and i have so much to myself and to the world do you wish you were able to kind
    0:43:30 i don’t want to say normalize more but respond in the way that most people might think you would
    0:43:36 respond or are you very satisfied having the same gestalt you’ve got i feel like dolly parton is like
    0:43:43 a good north star she’s totally who she is she’s self-possessed she respects herself she’s an artist
    0:43:48 and that’s the end of it that’s the end of the conversation and now it’s like let’s get to work
    0:43:55 and be humane and be a good citizen that’s my goal i will say this i hope theater continues to exist and
    0:44:02 thrive if only so that future people who are as obsessive and compulsive will have a productive
    0:44:08 thing to do with their lives those people are going to find their way into this no matter what because
    0:44:15 when you are really driven to do this and this is your life you are going to do it no matter what
    0:44:19 you will lay down whatever you need to lay down to make sure that it happens i feel like that’s what
    0:44:25 i learned about myself like this is what i have to do i know it there’s no other life for me i’m going
    0:44:34 to do this the end that again was david ajmi in a london recording studio on the street where
    0:44:40 wagner used to live i’d like to thank ajmi for the conversation and i’d like to thank you as always
    0:44:46 for listening please let us know what you think our email is radio at freakonomics.com coming up next
    0:44:53 time on the show we head back to the real world at one point early on after the russian invasion of
    0:44:58 ukraine before i could actually get into ukraine i decided that i would meet my ukrainian counterpart
    0:45:03 dmitry kuleba on the border between poland and ukraine and technically set foot into ukraine
    0:45:10 i talked to former secretary of state tony blinken on the fragility of democracy the care
    0:45:18 and feeding of autocrats and how diplomats like him do what they do that’s next week until then take
    0:45:23 care of yourself and if you can someone else too freakonomics radio is produced by stitcher and
    0:45:29 renbud radio you can find our entire archive on any podcast app also at freakonomics.com
    0:45:35 where we publish transcripts and show notes this episode was produced by alina kullman with help
    0:45:41 from zach lapinski it was mixed by eleanor osborne with help from jeremy johnston the freakonomics radio
    0:45:47 network staff also includes augusta chapman dalvin abuaji ellen frankman elsa hernandez jasmine
    0:45:53 clinger gabriel roth greg rippon morgan levy sarah lily and teo jacobs our theme song
    0:45:57 is mr fortune by the hitchhikers and our composer is luis guerra
    0:46:05 it’s not like we’re completely extirpated good vocabulary you sir oh thank you thank you
    0:46:13 the freakonomics radio network the hidden side of everything
    0:46:18 stitcher

    For years, the playwright David Adjmi was considered “polarizing and difficult.” But creating Stereophonic seems to have healed him. Stephen Dubner gets the story — and sorts out what Adjmi has in common with Richard Wagner.

     

     

     

  • Should We Forgive Student Loans? How to Stop Comparing Yourself, and When to Change Your Mind

    AI transcript
    0:00:02 There’s a lot nobody tells you about running a small business,
    0:00:08 like the pricing, the marketing, the budgeting, the accidents,
    0:00:13 the panicking, and the things, and the things, and the non-stop things.
    0:00:17 But having the right insurance can help protect you from many things.
    0:00:20 Customize your coverage to get the protection you need
    0:00:22 with BCAA Small Business Insurance.
    0:00:28 Use promo code PROTECT to receive $50 off at bcaa.com slash smallbusiness.
    0:00:32 Welcome to Office Hours with Prop G.
    0:00:34 This is the part of the show where we answer your questions
    0:00:37 about business, big tech, entrepreneurship, and whatever else is on your mind.
    0:00:40 If you’d like to submit a question for next time,
    0:00:43 you can send a voice recording to officehoursofproptimedia.com.
    0:00:46 Again, that’s officehoursofproptimedia.com.
    0:00:49 Or post your question on the Scott Galloway subreddit,
    0:00:52 and we just might feature it in our next episode.
    0:00:58 The first question comes from Star Hardgrove on Reddit.
    0:00:59 They say,
    0:01:04 Student loan debt in the U.S. has ballooned to $1.8 trillion,
    0:01:07 and I personally carry $145,000 of that burden.
    0:01:12 Estimates suggest that it would take anywhere from $50 billion to $680 billion a year
    0:01:13 to make public college free for all.
    0:01:17 What’s your honest prediction for the future of student loan debt in this country
    0:01:19 for those of us earning a moderate salary?
    0:01:22 Is there a smart, realistic way out of this hole?
    0:01:25 Okay, I think a lot of people are dealing with this.
    0:01:28 The Trump administration resumed collections in May of this year.
    0:01:31 According to the Federal Reserve Bank of New York,
    0:01:32 in the first three months of 2025,
    0:01:36 2.2 million student loan recipients saw their credit scores drop by 100 points,
    0:01:40 and an additional 1 million had drops of 150 points or more.
    0:01:43 Delinquencies are spiking as of March 2025.
    0:01:47 One in four people with student loans were over 90 days late in payments.
    0:01:50 Okay, so I may not have the answer you want here,
    0:01:54 and I find there’s a lot of populism around student debt and let’s cancel it,
    0:01:56 or a lot of empathy, which I understand.
    0:02:02 I think the president’s plan to reduce substantially student debt,
    0:02:04 I think it was going to cost $600, $700 billion.
    0:02:05 I thought that was bad policy.
    0:02:10 I don’t think you can offer that kind of unilateral executive action
    0:02:14 that’s going to cost that much money without it being an investment, not a bailout.
    0:02:17 This was a bailout, and it was a bailout of the third of America
    0:02:22 that was fortunate enough to go to college being paid for by not only them,
    0:02:25 but the two-thirds that didn’t have the opportunity to go to college.
    0:02:29 So I think it creates a situation where there’s moral hazard,
    0:02:34 and that is right now young people don’t feel as if they need to pay back their student loan debts,
    0:02:38 and I wonder if it means they think they might not have to pay back their credit card debt
    0:02:39 because they signed this paperwork,
    0:02:43 and basically for three or four years now they haven’t had to pay it back.
    0:02:44 So what to do?
    0:02:48 In some, I think that student loan collection should begin again,
    0:02:51 and I think the real culprit here is universities
    0:02:56 where some nice woman in a pantsuit with a big university logo over her head saying
    0:03:02 you should always invest in yourself is willing to issue paperwork on cheap credit and student loans
    0:03:06 such that she can cash your $72,000 tuition check to NYU
    0:03:09 and give you a philosophy degree at the end of four years
    0:03:13 that you can’t get a job that helps pay back your student loans.
    0:03:15 And NYU is actually one of the better places
    0:03:17 because the majority of people who come out of NYU can find a job
    0:03:18 where they can manage their student loan debt.
    0:03:22 And the vast majority of people can manage their student loan debt.
    0:03:24 I think the average payment is $200 or $220.
    0:03:27 So what do we do moving forward?
    0:03:30 One, if you were going to spend that kind of money, it would need to be an investment.
    0:03:34 And I think the investment should have been something along the following.
    0:03:37 Say to our five or 700 biggest public universities,
    0:03:43 which educate two thirds of our students will give you a size adjusted a billion dollars.
    0:03:47 So UCLA gets $5 billion, Cal State Northridge gets $200 million and say,
    0:03:50 all right, in exchange for this grant, you’re going to do three things.
    0:03:54 One, you’re going to reduce tuition 2% a year through scale.
    0:03:59 You’re going to expand your freshman class 3% a year through use of technology.
    0:04:05 And you’re going to offer 20% of your certificates are going to be in non-traditional degrees,
    0:04:11 nursing, specialty construction, cybersecurity, because there’s a lot of jobs in the real economy
    0:04:13 that don’t require a four-year liberal arts degree.
    0:04:16 And there’s a lot of people, young people, especially young men,
    0:04:20 who don’t have the inclination, the money, or the desire to go get a traditional liberal arts
    0:04:21 college education for four years.
    0:04:22 Where does that get us?
    0:04:24 That means on an inflation-adjusted basis in 10 years,
    0:04:28 we double the number of freshman seats at colleges, still think it’s a fantastic on-ramp
    0:04:29 to the middle class.
    0:04:33 We reduce costs on an inflation-adjusted basis, we cut them in half.
    0:04:39 And we have more formal on-ramps into the middle class using the infrastructure of our great public
    0:04:40 universities.
    0:04:45 This is a forward-leaning investment that helps all youth and takes us back to where we were
    0:04:48 in the 90s in terms of cost and admission rates.
    0:04:54 My colleagues have become drunk on the self-aggrandizement and exclusivity and rejectionist culture.
    0:04:58 of artificially creating scarcity around freshman seats.
    0:04:59 It is immoral.
    0:05:03 It’s tantamount to the head of a homeless shelter bragging that he or she turned away 90% of the
    0:05:07 people last night by saying we have an admissions rate of 10%.
    0:05:09 Now, there’s some losers here.
    0:05:15 There’s some people who, in my opinion, were sold a bill of goods around taking on too much
    0:05:15 student debt.
    0:05:18 But look, I’m a bit of a hard-ass here.
    0:05:19 I think it sucks to be a grown-up.
    0:05:20 You took on the debt.
    0:05:21 You owe it.
    0:05:22 You need to pay it back.
    0:05:26 Programs to help you work it down for certain industries.
    0:05:29 Absolutely dischargeable in bankruptcy.
    0:05:34 And schools need to be on the hook such that they stop loaning money to people who they know
    0:05:36 will have a difficult time paying it back.
    0:05:39 Very much appreciate the question.
    0:05:42 It’s a difficult and nuanced problem.
    0:05:46 Our second question comes from BitterSample7760 on Reddit.
    0:05:53 They ask, hey, Scott, how do you go about not comparing yourself to others as a young male
    0:05:54 in your 20s?
    0:05:58 Look, I was very insecure.
    0:06:03 I think I was more secure than most 20-something-year-old males, and I was highly insecure.
    0:06:11 I struggled with my professional success, even though I had registered more than most people.
    0:06:16 I really wanted to be perceived as professionally successful and was constantly insecure about
    0:06:16 that.
    0:06:20 I was very insecure about my economic background.
    0:06:23 I was raised, I was sort of upper-lower middle class, single mother.
    0:06:28 I remember someone, this is probably too much information, someone complimented me on my teeth.
    0:06:29 I have nice teeth.
    0:06:35 I have probably spent $100,000 or $150,000 on my teeth.
    0:06:37 I grew up with really bad teeth.
    0:06:38 My parents are British.
    0:06:40 Dental care was not a big priority.
    0:06:44 While my friends were getting braces, it wasn’t even a conversation in my household.
    0:06:47 My mom couldn’t afford braces, and my mom had bad teeth, and my dad had bad teeth.
    0:06:48 I just didn’t even notice.
    0:06:52 And I literally looked, I wasn’t a freak show, but I had bad teeth.
    0:06:57 And it was always for me a constant reminder, when I looked in the mirror and then I smiled,
    0:07:02 that I wasn’t worthy, that I came from a lower-income background.
    0:07:04 And it made me feel very insecure.
    0:07:06 And so when I was in graduate school, I got braces.
    0:07:08 That’s fun, to be in grad school and have braces.
    0:07:09 That was a real good wrap.
    0:07:13 And then I still didn’t like my teeth, so I got veneers.
    0:07:19 I have spent so much time and money on my teeth because I’m very insecure about my teeth
    0:07:21 and what it says about my economic status.
    0:07:25 I also had body dysmorphia when I was in my 20s.
    0:07:28 I grew up very skinny, painfully skinny.
    0:07:29 I had bad acne.
    0:07:35 And when I joined crew at UCLA and I put on a bunch of weight, all of a sudden I started
    0:07:36 getting attention from women.
    0:07:39 My skin cleared up thanks to this wonder drug called Accutane.
    0:07:46 And for the first time in my life, it wasn’t just my humor that got me social capital.
    0:07:50 And that was such an unlock for me that for the rest of my life, I’ve always conflated
    0:07:55 being bigger or having some muscle with really good things happening to me.
    0:07:59 So when I look in the mirror, and I’m 6’2″, 190, when I look in the mirror, I see someone
    0:08:00 who’s emaciated.
    0:08:01 I have body dysmorphia.
    0:08:06 So, and by the way, I talk about this transparently because I don’t think I’m that fucked up.
    0:08:09 I think all of us have this shit that we deal with.
    0:08:11 And how did I deal with it?
    0:08:12 I worked on it.
    0:08:14 One, I talked about it.
    0:08:15 I understood it.
    0:08:18 I understood there is something called body dysmorphia.
    0:08:23 I understood the link between feeling bad about my teeth and economic insecurity.
    0:08:29 And the moment you sort of understand something and feel like you can address it, either by
    0:08:34 getting braces or understanding it’s normal or developing other skills or feeling bad about
    0:08:36 your body so you start working out.
    0:08:41 You know, my means of trying not to compare myself to people was, yeah, I think over time
    0:08:44 maturity and people who love you will help you get past that.
    0:08:48 But my way of addressing it was to just try and be a better version of me, to work out,
    0:08:51 to be more economically successful.
    0:08:56 One of my unlocks as I’ve gotten older, and I think this is hard for people in their 20s,
    0:09:02 but one of my biggest unlocks around comparing myself to others and being disappointed, I’m
    0:09:03 worried about being shamed by people.
    0:09:09 I hate being wrong or saying something stupid and being called out or not being liked.
    0:09:13 And as I’ve gotten older, I’m much less sensitive to it for the following reason.
    0:09:15 I’m going to be dead soon, and so are you.
    0:09:20 And that, when you’re in your 20s, for good reason, you can’t wrap your head around your
    0:09:21 mortality.
    0:09:24 You literally don’t believe you or anyone in your life is going to die.
    0:09:29 And the first time that you start to believe that, in fact, is a reality is when you lose
    0:09:29 a parent.
    0:09:34 That was sort of an awakening for me, the brutality and finality of that.
    0:09:38 And also, as I’ve gotten older and have lost a couple of close friends, I am now squarely
    0:09:40 in touch with the finite nature of life.
    0:09:45 I’m an atheist, I believe at some point I’ll look into my kid’s eyes and know our relationship
    0:09:46 is coming to an end.
    0:09:52 But it’s a huge unlock, because if you can establish a sense of the finite nature of life in your
    0:09:58 20s, what you realize is that as embarrassed as you are about your teeth or not being a size
    0:10:03 two or not having the professional success of your friends, you’re mostly embarrassed.
    0:10:06 You might be disappointed a little bit in yourself because you need to make a certain amount of
    0:10:10 money, but most of the shame comes from your perception of other people’s perception of you.
    0:10:15 And what has really helped me, I went to dinner last night with a bunch of impressive people,
    0:10:17 and I remember thinking, the guy next to me, I really wanted to like me, and I could just
    0:10:18 tell he just didn’t like me.
    0:10:23 And that would have rattled my world 20 years ago.
    0:10:27 And now it’s sort of like, he’s going to be dead soon and so am I.
    0:10:30 And it just doesn’t, I mean, it’s meaningful, but it’s not profound.
    0:10:35 And if there’s anything I would want to give someone in their 20s is a sense of their mortality
    0:10:38 responsibility and just how fast it’s going to go.
    0:10:42 And you’re going to realize like, do your best, work hard, work out, try and look good.
    0:10:47 I think it’s important to be mindful of your dress and your aesthetics and feeling strong
    0:10:53 and wanting to look good naked and wanting to dress well and wanting to be smart and wanting
    0:10:54 to make money.
    0:10:59 I think those are wonderful things to aspire to, but also a recognition that the people you’re
    0:11:02 doing this for are going to be dead soon.
    0:11:08 And it really does in three, in 30, 40 years, none of them are going to be around or three
    0:11:09 generations.
    0:11:10 No one’s going to remember them.
    0:11:11 No one’s going to remember you.
    0:11:13 So this is how you win.
    0:11:19 The best means of achieving self-esteem, the best means of revenge, if you feel people have
    0:11:22 wronged you, is to just live a fucking amazing life.
    0:11:27 And that is to try and express your emotions with abandon, to try and be nice to yourself, to
    0:11:32 forgive yourself, to appreciate the good things you have going for you, to tell people how
    0:11:37 much they mean to, to embrace shit, to say yes, to go out, to laugh out loud, to enjoy
    0:11:41 friendship, to tell your friends how much you’re enjoying their friendship, to tell your parents
    0:11:42 how much you love them.
    0:11:46 And also just let the other shit just go away.
    0:11:47 Because guess what?
    0:11:48 Guess what?
    0:11:53 Anyone you’re worried about, what they think of you, anyone who doesn’t return your affection,
    0:11:58 your romantic interest, any business that fires you, any investment that goes wrong, guess
    0:11:58 what?
    0:12:00 They’re all going to be dead or meaningless.
    0:12:03 So why not just enjoy it?
    0:12:06 Why not just look at the glasses half full?
    0:12:07 Do your best.
    0:12:08 Wake up every morning.
    0:12:08 Create a list.
    0:12:10 Make progress.
    0:12:14 Success is a small set of disciplined actions every day.
    0:12:16 But for God’s sakes, forgive yourself.
    0:12:20 At the end of your life, at the end of your life, you’re going to look back and think in
    0:12:23 your 20s, you know, I was better looking than I gave myself credit for.
    0:12:27 I was trying harder than I gave myself credit for.
    0:12:30 I was more successful than I gave myself credit for.
    0:12:33 And you’re not going to be upset about the things that happened to you in your 20s.
    0:12:36 You’re going to be upset at how hard you were on yourself.
    0:12:38 Forgive yourself.
    0:12:41 We’ll be right back after a quick break.
    0:12:50 Support for the show comes from SoFi Small Business Lending.
    0:12:51 You’re a small business owner.
    0:12:53 You need capital to find new opportunities and grow.
    0:12:56 And you can do that with help from SoFi.
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    0:13:01 But now they help small businesses, too.
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    0:13:20 you’re approved.
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    0:13:49 Visit SoFi.com slash PropGPod and see your options in minutes.
    0:13:52 It’s Today Explained.
    0:13:54 What’s going on, my boys and in some cases, gals?
    0:13:57 Recently, one of you emailed us with this request.
    0:13:58 You’ve got mail.
    0:13:59 Hello.
    0:14:04 I’m an avid listener, and I strongly believe you should cover the story of Curtis Yarvin.
    0:14:09 It’s important to explore who he is and how he has influenced the MAGA and the tech bros
    0:14:09 movement.
    0:14:16 Curtis Yarvin is a very online far-right philosopher whose ideas include the fascinating, the esoteric,
    0:14:19 the absurd, the racist, and so on.
    0:14:23 Six months into the Trump administration, there’s evidence that he is influencing the MAGA movement
    0:14:25 and even President Trump.
    0:14:25 J.D.
    0:14:27 Vance knows him and likes him.
    0:14:30 Elon consulted him about this third-party idea.
    0:14:36 Yarvin can take some credit for inspiring Doge, and as you’ll hear ahead, one of Trump’s most
    0:14:42 controversial, doesn’t even begin to cover it, ideas may have come from Yarvin or someone
    0:14:43 who reads his substack.
    0:14:46 I can almost guarantee you that Trump does not.
    0:14:47 Everything’s computer.
    0:14:49 Today Explained, weekday afternoons.
    0:14:58 Hey, this is Peter Kafka, the host of Channels, a show about media and tech and what happens
    0:14:59 when they collide.
    0:15:05 And this may be hard to remember, but not very long ago, magazines were a really big deal.
    0:15:10 And the most important magazines were owned by Condé Nast, the glitzy publishing empire
    0:15:13 that’s the focus of a new book by New York Times reporter Michael Grinbaum.
    0:15:19 The way Condé Nast elevated its editors, the way they paid for their mortgages so they
    0:15:24 could live in beautiful homes, there was a logic to it, which was that Condé Nast itself
    0:15:28 became seen as this kind of enchanted land.
    0:15:33 You can hear the rest of our chat on Channels, wherever you listen to your favorite media podcast.
    0:15:39 Welcome back.
    0:15:42 On to our final question from CookingWithFire2030 on Reddit.
    0:15:44 God, I love these titles.
    0:15:50 What would it take to change your mind on a fundamental idea you have when presented with
    0:15:52 information that contradicts the old data?
    0:15:55 How do you balance between recency bias and traditionalism?
    0:15:57 I’ve tried to get better at this.
    0:16:03 If I find, when I go into conversations with people, I just did a podcast called Lost Boys
    0:16:08 with Anthony Scaramucci and he had a friend of his, I forget her name.
    0:16:09 She was, oh, I know she was a real housewife.
    0:16:13 That’s our recruiting pool now for podcasts as we bring on real housewives.
    0:16:17 Anyways, we were talking about men and women and she was saying the patriarchy has hurt everybody
    0:16:19 and she and I just have a different view on this.
    0:16:28 But when I do go into these situations, I do try and listen and I find that the key, one of
    0:16:33 the keys are things are zeitgeist or themes I want to promote moving forward in my life
    0:16:36 is the restoration and refurbishment of alliances.
    0:16:42 And I think a good way to establish common ground is to acknowledge good points on the other side.
    0:16:46 And even I’ll even say sometimes in a podcast, like your takes better than mine.
    0:16:50 You’ve changed my mind or you’ve influenced the way I look at this.
    0:16:57 And I also think it’s important that we do have something resembling a truth that Jim Barksdale,
    0:17:02 the CEO of AT&T, and then went on to be the CEO of Netscape, said, if we’re going with opinions,
    0:17:03 let’s go with mine.
    0:17:05 If we have data, let’s look at the data.
    0:17:08 One of the things that worries me about our society is the intersection between our perceptions
    0:17:10 and information.
    0:17:13 And that is none of us are willing to acknowledge when actual data comes in.
    0:17:17 The Congressional Budget Office is saying that the big, beautiful bill will add three and
    0:17:19 a half trillion dollars to the deficit.
    0:17:19 And what happens?
    0:17:26 The Secretary of the Treasury, Scott Bessent, comes out and says, oh, no, that’s traditional
    0:17:27 Washington insider scoring.
    0:17:32 So let’s shitpost the experts and diminish the government of which we’re a part of and say
    0:17:33 that the scoring is wrong.
    0:17:37 It used to be that when the CBO weighed in, both sides would acknowledge those are the numbers.
    0:17:39 That’s it.
    0:17:40 We got to acknowledge those are the numbers.
    0:17:46 And now we’ve decided we don’t even want to try and develop something resembling a truth
    0:17:48 between our perceptions and the data.
    0:17:54 So when I hear really compelling data, I think it’s the right thing.
    0:17:59 And I think it means you’re evolving as a human to say, I didn’t know that.
    0:18:00 That is super interesting.
    0:18:06 And, you know, my general sort of view was, oh, the poor pay too much in taxes.
    0:18:10 I was very much a, you know, I believe I’m an income inequality guy.
    0:18:14 And the reality is the bottom half of our population in the United States pay almost no federal
    0:18:14 taxes.
    0:18:15 That’s just not true.
    0:18:21 And I saw the data on the near wealthy or the kind of workhorses that is people who make
    0:18:23 between, say, $200,000 and $2 million a year.
    0:18:26 They pay more than their fair share of taxes because it’s all current income.
    0:18:31 It’s the people that are the super owners that make the majority of their income from buying
    0:18:33 and selling assets that pay the lowest taxes.
    0:18:38 25 wealthiest Americans in America is supposed to pay about a 6% income tax rate.
    0:18:43 Anyways, I find comfort and resolution in the data.
    0:18:48 And I think at some point, one, we need to restore trust in institutions.
    0:18:54 And two, our role in that is to acknowledge when we see data that contradicts our own beliefs,
    0:19:01 to acknowledge the point and even acknowledge that that data or that individual has influenced
    0:19:01 you.
    0:19:05 And what I find is that’s an effective way to restore alliances because they’re willing to
    0:19:06 give a little bit too.
    0:19:12 The fastest way to diffuse an argument, I find, is to acknowledge the other’s points to some
    0:19:14 degree and see if there’s some middle ground.
    0:19:23 I find that we have this unfortunate zeitgeist in our society where you say something stupid
    0:19:26 and you feel like you have to double down and keep going as opposed to saying, you know,
    0:19:29 I’ve said a couple of times in conversations, I’m like, I would draw the comment.
    0:19:30 I don’t know where I was going with that.
    0:19:31 And you’re right.
    0:19:32 Your data is better than mine.
    0:19:33 And what you’re saying makes a lot of sense.
    0:19:39 And I find when you say that, it disarms them and they’re much more likely to agree with
    0:19:40 you and come together.
    0:19:42 Anyways, appreciate the question.
    0:19:44 That’s all for this episode.
    0:19:49 If you’d like to submit a question, please email a voice recording to officehoursofprofgmedia.com.
    0:19:51 That’s officehoursofprofgmedia.com.
    0:19:55 Or if you prefer to ask on Reddit, just post your question on the Scott Galloway subreddit
    0:19:58 and we just might feature it in an upcoming episode.
    0:20:04 This episode was produced by Jennifer Sanchez.
    0:20:06 Drew Burrows is our technical director.
    0:20:09 Thank you for listening to the Prof G Pod from the Box Media Podcast Network.
    0:20:12 Thanks for listening to the Prof G Pod from the Box Media Podcast Network.
    0:20:14 Thank you for listening to the Prof G Pod from the Box Media Podcast Network.
    0:20:16 Thank you for listening to the Prof G Pod.

    Scott breaks down his thoughts on the student loan crisis. He then offers perspective to a young man in his 20s struggling with comparison, and closes with thoughts on how to stay open-minded while holding onto core beliefs.

    Want to be featured in a future episode? Send a voice recording to officehours@profgmedia.com, or drop your question in the r/ScottGalloway subreddit.

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  • Most Replayed Moment: Tim Dillon’s Brutal Truth About Gen‑Z

    AI transcript

    In today’s Moments episode, comedian Tim Dillon offers his candid perspective on how different generations approach life and work. From Gen Z’s growing rejection of traditional success, to his sharp critique of fame, Dillon cuts through the contradictions that shape today’s culture.

    Tim Dillon is a comedian, actor, and host of The Tim Dillon Show podcast, known for his unapologetic takes on culture and politics. In 2022, he released his first Netflix special, Tim Dillon: A Real Hero, followed by I’m Your Mother in 2025. 

    Listen to the full episode here!

    Spotify: https://g2ul0.app.link/2hFDeAJJ4Ub

    Apple: https://g2ul0.app.link/rOBImYPJ4Ub

    Watch the episodes on YouTube: https://www.youtube.com/c/%20TheDiaryOfACEO/videos

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  • 684: $500 Per Client Per Month: Why Local SEO Should Be Your Next Side Hustle

    AI transcript
    0:00:06 All right, I’ve got a relatively simple recurring revenue side hustle you could start today even.
    0:00:11 The idea is to help local businesses gain more visibility in Google so they can make more money.
    0:00:16 And the market is huge. Think millions of potential small business customers here.
    0:00:22 Today’s guest runs a six-figure digital agency while traveling the world with his family and
    0:00:28 says if he was starting over, he’d focus on selling a simple local SEO service. This might
    0:00:34 be the last bastion of SEO, local SEO. From ericdingler.com, Eric Dingler, welcome to the
    0:00:39 Side Hustle Show. Thanks for having me. I’m excited to unpack this with you for your audience.
    0:00:44 You bet. Stick around in this one. I’m excited as well. We’re going to figure out how do we find
    0:00:48 customers, how are we going to deliver this service quickly and effectively, and maybe how to remove
    0:00:55 yourself from being the hands-on technician in the business. But kick us off with what do you see as
    0:01:03 the opportunity here in local SEO? Well, for me, and especially as somebody that every three weeks to
    0:01:09 three months, I’m moving into a completely new city with my wife and our four teens, we’re constantly
    0:01:15 going to Google Maps or Apple Maps looking for restaurant, barber, you know, grocery store,
    0:01:23 dentist, whatever it is we need. And I don’t see people stopping that. People are still looking for that
    0:01:30 local service. I don’t see it going away. And everybody in the entire world uses Google Maps,
    0:01:37 Google My Business, and Apple Maps. Yeah, where regular SEO, article SEO, website SEO is all being
    0:01:44 eroded away by AI and maybe Reddit in the search results. Local SEO is maybe a less competitive game,
    0:01:49 and it still works by the old rules, more or less. Whereas like, if I want a restaurant near me,
    0:01:54 it’s not being eaten by AI just yet. Yeah. The thing about Google, they have invested
    0:02:01 millions and millions upon millions of dollars, mapping every city, every country, every road
    0:02:09 in the world, adding all of the businesses that they can find to it, working to ensure that we have access
    0:02:16 to a business’s hours, contact information, all these things. Yeah. And they don’t charge for this.
    0:02:22 They don’t charge you and me as the end user trying to find a place. And they don’t charge the businesses
    0:02:29 to be on it. But even with that, only about, according to Google’s most recent numbers in the USA,
    0:02:37 only about 20, 25% of businesses have claimed their Google business profile and have optimized it.
    0:02:46 So 75% of the local businesses around you haven’t done this yet. And they all already know about Google.
    0:02:53 They already know about SEO. And if you can learn a few key phrases and use those when you’re talking
    0:03:00 to businesses, it’s a very easy service to sell. In fact, Nick, today is our oldest son’s 18th
    0:03:01 birthday. Oh, okay.
    0:03:06 And he is an outdoor kid through and through. Computer’s not his thing. You know, he wants
    0:03:11 to be outside all the time. He wants to play soccer and stuff like that. But if he was to come to me today
    0:03:18 and say, okay, dad, I want to start my own thing. You know, what, what should I do? And my agency,
    0:03:24 we do, we do web design development, app work. We focus a lot on helping businesses meet accessibility
    0:03:29 standards. We do paid ads, social media, like we do all those things.
    0:03:33 Yes. And this is in transit studios. If anybody wants to go check that out, that’s all right. Go
    0:03:37 ahead. Thanks. Yeah. But if my 18 year old came to me today and said, I want to start my own thing,
    0:03:43 I would give him a checklist to start a local SEO business. And I would say, this is what you need to
    0:03:47 go do. All right. Coach me through this. We’ll worry about like the technical skills. I don’t know.
    0:03:49 I don’t know the first thing about local, we’ll worry about that in a second, but like,
    0:03:54 okay, let’s say I’m your, I’m your son. You know, like you talk me through this. What do I do first?
    0:04:00 Great. The first thing you’re going to do is you’re going to go sell it. I do this a lot. I often sell
    0:04:07 services that I don’t know how I’m going to deliver it. In fact, my very first local SEO client,
    0:04:17 I sold them local SEO. I collected the money and then I use that money to go pay for somebody to
    0:04:24 teach me how to do what I need to do. Because you can tell your customer, this is going to take me
    0:04:27 four weeks, six weeks, eight weeks. They don’t know.
    0:04:30 Yeah. Yeah. You set up expectations. Sure.
    0:04:36 Exactly. So you set those expectations. So what I like to do in this case, and this is so kind of
    0:04:42 take going step by step, really breaking this down. The first thing I would do is I would write a,
    0:04:47 what we call beta test social media post. And later at the end of the episode, Nick,
    0:04:53 we can give people a link to, I have this written out in an actual checklist with links and everything
    0:04:55 that can, people can follow. Perfect.
    0:05:01 But for, for the conversation, the thing I like to do is I like to create a beta social media post.
    0:05:08 People that are listening, they probably have friends that are business owners or they use local
    0:05:15 businesses. They have a dentist. They probably have a barber or hair salon. They have a favorite
    0:05:21 restaurant. That’s not a chain. You have your local mom and pop favorite places, landscape or whatever it
    0:05:28 might be. You have friends that have these businesses. So what I like to do is create a social media post
    0:05:35 that says, Hey, fellow business owners or Hey, business owners who are friends. I’m testing a new piece
    0:05:48 of software or I’m testing a new system that lets me help local businesses be found more often when somebody
    0:05:57 searches for them. I’m looking for three businesses that I can use that would be willing to let me use their
    0:06:06 business as an experiment. You’ll get an increased visibility on Google and I’ll share all the results
    0:06:11 with you in exchange for helping me out. If you’re interested, let me know. So that’s kind of the
    0:06:18 gist, something, something like that. You put that out there and then you tell every business owner the
    0:06:22 next time you talk to them, you know, if you’ve got a neighbor that has a local business, you go knock on
    0:06:26 the door and you’re going to tell them you’re going to do this. And then you can say when they
    0:06:32 respond to the Facebook ad or when you go talk to them, you say it’s $500. You know, the first time
    0:06:38 I did it, I sold it for $1,300 had never sold it before. Sold it for $1,300. Okay. If you’re as
    0:06:44 arrogant as I am, you can do that. But if you’re a little more like, uh, I don’t know, that makes me
    0:06:52 nervous. Start lower. That’s okay. Yeah. But there is a guy, Sam Sarston, and he has a, a coaching
    0:07:02 program. It’s $49 without the community aspect, $99 if you want into the community and that’s monthly.
    0:07:09 And he teaches exactly how to do all this. I don’t have a course, but I know Sam, Sam’s course is great.
    0:07:16 Okay. You can go sell this and then go sign up for Sam’s course. And he’ll, he’ll show you exactly
    0:07:23 how to do this. And what you’re selling specifically is a one-time SEO boost. So that’s what you’re going
    0:07:28 to sell. It’s your, your foot in the door offer. That’s why I’d sell it for 500. One-time SEO boost.
    0:07:33 And you tell them, I’m going to improve your position in Google maps and Apple maps within three
    0:07:38 months. Okay. Within three months, you’re going to be ranking higher, which means, and here’s that,
    0:07:43 one of those key phrases, Nick, I was telling you, I like to use. Yeah. We’re going to increase
    0:07:50 your customer activity. I’m not promising more leads because I can’t promise. I can’t deliver on
    0:07:55 that. I’m not promising specifically more website visitors or more phone calls. I’m just promising
    0:08:02 more customer activity. And every local business owner understands that. And a restaurant is never
    0:08:08 going to use the term leads. Restaurants aren’t looking for leads. A barbershop’s not looking for
    0:08:15 leads. They’re looking for appointments or walk-ins. A roofer is looking for leads. And so to me,
    0:08:18 the most universal phrase that I have found is customer activity.
    0:08:22 Okay. And this allows you to not worry, because that was kind of the next thing I was going to ask
    0:08:28 about, do you worry about niche? So like, well, I’m only going to target roofers, but then it becomes
    0:08:33 maybe a potential conflict of interest if I sign up five roofers in the same town. And now I’m like
    0:08:38 competing. Well, who do I, who’s my favorite? Like, how do I figure out who I want to rank the
    0:08:42 highest? Yeah. So you’re going to go, you go, you go kind of broad. It sounds like, because this is the
    0:08:46 same skill set or the same toolbox can apply across any number of different businesses.
    0:08:53 Yeah, absolutely. And the fastest way to a sale is the face-to-face conversation. For a side hustle,
    0:09:00 especially to just get started, you’re just talking about finding three or four local businesses that are
    0:09:05 going to do this SEO boost, $500, because here’s what happens. You’re going to do the local SEO
    0:09:10 boost. And then within that three months, you’re going to get results. And here’s what you’re going
    0:09:16 to do. Okay. When they say, yeah, I’ll do this. This sounds great. I’d love to do it. Okay. It’s $500.
    0:09:21 So, you know, here’s, you know, set up a Stripe account, take PayPal, take check. You’re starting
    0:09:25 out as a side hustle. Like cash is fine. Like however you can get them to pay you.
    0:09:28 Yeah. Yeah. Somebody can Venmo you. Sure. Don’t, don’t, don’t let that be the bottleneck.
    0:09:34 Exactly. Exactly. Like there’s lots of ways to get people’s money from them. So receive the money
    0:09:40 and then say, Hey, listen, I need 24 pictures of your business, people in your business behind the
    0:09:48 scenes, the front of the place. I need 24 pictures. And that’s what you need to send to me. And if
    0:09:54 they’re like, Oh, I don’t have them. Do you have a 17 year old, an 18 year old, a 25 year old on your
    0:09:58 team? Like everybody on your team’s got an iPhone. That’s all I need. I need somebody to take out their
    0:10:04 phone and get 24 pictures. Then they’re going to send you those pictures. You’re going to take
    0:10:12 those pictures. You’re going to create 12 posts with those pictures about their business. And this
    0:10:19 is a great place to leverage AI. AI is really fast, fantastic at this. And then every week you’re going
    0:10:23 to go in and you’re just going to post to their Google business profile that so they’re going to,
    0:10:28 they’re going to give you access. It’s, it’s super easy to get access to their Google business profile.
    0:10:31 You’re going to get access to the Google business profile. You’re going to go in once a week.
    0:10:34 You’re going to post a picture for 12 weeks.
    0:10:39 And maybe this is for these 75% of businesses that haven’t even claimed theirs. Maybe that’s step one.
    0:10:42 Like, Hey, here, here’s an easy quick win for you, Mr. and Mrs. Business owner. Let’s,
    0:10:46 let’s do that first. And then we’ll go do this one-time boost.
    0:10:49 Right? Well, this is part of the one-time boost. Yeah, this is, this is it. This is part of the one-time
    0:10:54 boost. So for the one-time boost, you’re going to use AI to rewrite their description.
    0:10:59 You’re going to use AI to help you create those 12 posts. And then you’re going to go in and you’re
    0:11:05 going to schedule those. Now down the road, there are tools you can get to automate this. We now,
    0:11:12 when we do an SEO boost, we, we create all the content takes us about two hours. We pre-schedule
    0:11:15 it for three months and we’re done. We move on to the next one. Yeah.
    0:11:19 But you’re going to grow into this as a side hustle. I was, I didn’t start there. And so
    0:11:22 to keep it simple, you don’t need a fancy automation tool.
    0:11:27 Why does the description need to be rewritten or what are, what are some of like the checkboxes
    0:11:29 you want to see in that rewritten description?
    0:11:34 Yeah. Well, they probably haven’t done it if, especially if they’ve never claimed their Google
    0:11:40 business profile, or if the business owner wrote a, wrote it, the business owner talks about
    0:11:48 how they’ve been in business since 1985 and grandpa gave it to dad and dad gave it to me. And we’ve
    0:11:54 got six employees and we’re so proud of our community and we love serving dah, dah, dah. And nobody
    0:12:01 cares. They want to know, are you the place for them? You know, if you’re a barbershop, you want to,
    0:12:07 you want to answer what we call their pre-qualifying questions. You can walk in, you can pay with cash,
    0:12:15 credit card. You can book an appointment. We do kids, we do fade ins, we do beards. Like
    0:12:21 what are the common questions people ask you about your business? And that’s what has to go in the
    0:12:25 description. And so most business owners talk about themselves and not their customer and their
    0:12:31 customers needs. So real easy fix. Plus you want to make sure that you mentioned, you know,
    0:12:39 the business type you are, you know, AJ’s barber, proudly serving Columbus, Ohio, men, kids,
    0:12:44 short hair, you know, then you, then you list the things, walk-ins, welcome, all that kind of stuff.
    0:12:50 So that’s in the description. I got it. Got it. Okay. Then, and this is in that, the checklist I have
    0:12:55 a lot of businesses, local businesses, they go to set up their Google business profile, Nick, and they’re
    0:13:00 like, I want to serve everybody. So they put their service areas, the United States of America.
    0:13:10 Okay. Huge mistake. Huge mistake. Because when Google decides who to show to somebody in Google
    0:13:16 maps, and when Apple decides in Apple maps, the first thing they’d look at is the geographic location of
    0:13:22 that phone. So I’m in Budapest, Hungary right now. If I get my phone and I search
    0:13:29 barber near me, it’s going to show me a couple of the closest barbers right here to me in Budapest.
    0:13:38 But if I turn my VPN on, and I say I’m in Miami, and then I open Google maps, and I ask for a barber,
    0:13:45 it’s going to start showing me barbers in Miami. If you say you’re in the United States, that puts your
    0:13:50 business geographic location out in the middle of the Pacific Ocean, because it goes clear up past
    0:13:55 Alaska down around Hawaii. And the only people that’s going to see your pizza shop barbershop
    0:14:01 mechanic is somebody trolling for fish out in the middle of the Pacific Ocean, not what you’re going
    0:14:07 for. More with Eric in just a moment, including the exact type of posts you should be creating for
    0:14:12 local businesses. Plus, how to scale this thing into a six figure recurring revenue business with a remote
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    0:16:41 All right. So another quick win. Sounds like, okay, narrow down that service area location. And you
    0:16:47 kind of draw a perimeter and, okay. The service area. Yeah. All kinds of ways to do that. You know,
    0:16:54 just the city or a couple of towns. But I just start with that one central space. And so you do that.
    0:17:02 That’s optimizing. Optimizing the description. Optimizing the service location. You get those
    0:17:07 things optimized. And a lot of people, they haven’t, business owners, they haven’t bothered filling in
    0:17:14 all the little boxes about parking, accessibility. Is it, you know, veteran owned, woman owned,
    0:17:20 you know, something like, there’s all these things. And it’s because Google keeps adding these questions
    0:17:26 and information every few months, they add a new one. And most businesses aren’t updating that.
    0:17:30 So you’re just going to go through the Google business profile. And, and here’s the thing,
    0:17:37 if you’re like, Oh, I don’t know the answer, make a list and send an email to the, say, Hey,
    0:17:40 just wanted to follow up with a couple more questions. Do you do this, this, and this, and
    0:17:45 this? They’re going to answer it. You’re going to put it on their Google business profile. Super
    0:17:49 simple. Yeah. So that’s optimizing. You’re just going to do it one time. Then you’re going to create
    0:17:55 the 12 pieces of content and you’re going to go in once a week and add those. So one day added on
    0:18:00 Monday, one day added on Tuesday, you want it to seem kind of natural. And then once, once a week,
    0:18:05 you’re going to add a picture, those things right there, you’re going to start to see their rankings
    0:18:11 improve. You’re going to see increased customer activity. We like to use a tool called local
    0:18:18 Falcon. I think I pay around $29 a month for local Falcon. It’s a super inexpensive tool.
    0:18:25 You go into local Falcon, you go to reports and you, you, you find the business. If they’ve got a
    0:18:32 Google business profile, local Falcon is going to find them. And then you, you said a geographic region.
    0:18:37 We normally start with like two miles and then you put in a search term or a couple of search terms,
    0:18:44 barber, men’s haircut, pizza, pizza, delivery, pizza pickup, depending on the business.
    0:18:54 Okay. And what local Falcon does is it goes and it scans the entire area because I can be a quarter mile
    0:19:03 to the East of a business and it’s in 20th place on Google. I can go a quarter mile to the right or to,
    0:19:10 to the West. And it’s going to be in first place. Your position on Google changes street by street.
    0:19:16 Yeah. What this does is it creates a heat map and it shows you all of these dots and it puts the right
    0:19:21 position of where you are. So you’re going to have some areas that are green, some areas that are red,
    0:19:28 some that are in between in the yellow and orange. Now some businesses may be all green. This whole
    0:19:34 lit expand out, look for a different search term, expand the radius. Okay. Some businesses it’s all red
    0:19:39 except for right where their business is. It’s green. And those are the business owners that go,
    0:19:44 well, we thought we were in first place on Google. Yeah. You are. If you’re searching from your front
    0:19:50 door. Yeah. Yeah. In your business, but you can either get in a car and drive around town and refresh
    0:20:00 your search every street, or we just create this geo grid for you. Now down the road, you can offer this
    0:20:06 geo grid as a freebie. This is a good way. Once you start getting some clients, as you’re getting
    0:20:11 established and you start to promote some things, this is a great lead magnet because a lot of business
    0:20:16 owners see this map and they’re like, Oh, I want, I want to see that for my business. You don’t need
    0:20:22 to do that starting out. That’s kind of a 2.0 kind of strategy. Okay. Right now you’re going to just talk
    0:20:26 to a couple of businesses, get a couple of people to hire you. You’re going to go in and do these things.
    0:20:30 You’re going to create one of those maps every month. You’re going to run the scan. Again,
    0:20:36 a local Falcon has this whole list of suggestions after it runs the report, AI generated suggestions
    0:20:40 that’ll tell you a wealth of information of things to do to improve your rank.
    0:20:46 Do you have an example or two of, of, of like the type of post that you’re posting on behalf of these
    0:20:50 different businesses to their Google profile? Sure. Give me an industry. It’s just any industry
    0:20:56 you want. We can go with the barbershop example again. Barbershop. Great. So they give you a picture
    0:21:00 of a kid getting a haircut. You’re just going to, you know, take that and you’re going to say,
    0:21:06 depending on the type of year, maybe it’s another one of our, you know, customers in getting ready
    0:21:12 for the summer, getting a haircut before vacation, back to school seasons coming up, getting ready to
    0:21:19 head back to school here in Pittsburgh. Talk about, you know, vacation coming up, just whatever you can,
    0:21:24 or maybe it’s the barber that’s cutting their hair. Maybe they’ve been there five years, you know,
    0:21:29 Hey, here’s Tony been with us for five years, cutting one of our favorite little customers hair again,
    0:21:34 helping them get ready for vacation. Okay. But you don’t know, you don’t always have that insight.
    0:21:38 So you got to like kind of probe the business owner for what’s, what’s the occasion. You don’t want to
    0:21:43 just make stuff up. Oh, Tony’s Tony’s Tony really just started last month. That’s always a little
    0:21:48 weird. I wouldn’t make up anything like that. I wouldn’t make anything like that. But, but here’s
    0:21:53 the thing that can be a little annoying with this. Very few people read these. That’s what’s annoying.
    0:21:59 Sure. No, I get it. It’s like you need to feed the machine, even though nobody’s realistically
    0:22:02 reading. It’s like, but you got to give it some data. You got to give it some stuff to chew on.
    0:22:10 Yes. People read reviews and people look at the pictures, but very few people read the post,
    0:22:17 but Google does. And Google wants to make sure that if it’s going to recommend you,
    0:22:20 somebody’s there turning the lights on. Yeah.
    0:22:26 Because if Google sends somebody to a closed business, they’re going to lose their trust
    0:22:32 in Google. They may start, they may switch to another tool. If Google starts losing eyeballs,
    0:22:40 Google starts losing advertising. Google will not lose advertising. I mean, that’s, that’s how
    0:22:42 they make their money is advertising. Yeah.
    0:22:48 So they want to keep the eyeballs. They want to make sure that they’re giving you and me when we
    0:22:56 look for a business, a business that’s open, a business that other people use, a business that
    0:23:03 keeps their hours up to date. Google will reward you by what these, these are called signals.
    0:23:07 Yeah. Yeah. Giving positive signals, make it look active, right? It’s active and engaged. They’re,
    0:23:10 they’re using our tools and helping people in that way.
    0:23:14 Yes. And right now, again, for those that are listening, they’re just trying to get started.
    0:23:22 You’re just doing a one-time local SEO boost. So you’re doing a minimal viable product here
    0:23:27 to get results. You’re, when you run that first local Falcon scan, you’re going to take a screenshot.
    0:23:31 Each time you run it, you’re going to take another screenshot and suddenly you’re going to get before
    0:23:37 and afters, you know, had very little green, two months later, all of this green, they’re showing up
    0:23:43 all over the top of Google. Okay. Because then what you can do, you’ve got these first few
    0:23:50 seed clients. They’ve given you the money that’s given you the money to invest in higher, you know,
    0:23:56 into a training and the getting some tools, but now you can go back to them and say, here’s the
    0:24:02 results we got. This is great. Here’s what it’s going to take to keep you at the top of this.
    0:24:07 You’re going to need to keep posting once a week and you can do this. And we got to get into
    0:24:12 eventually what there’s these things called directories. There’s some great tools that help
    0:24:19 with this mods local is one. Yext is another. These are tools. A business owner can go and pay
    0:24:27 for themselves to do it. And the business starts getting added to directories. Directories are
    0:24:34 websites that link to businesses. So this is how you get those backlinks. They’re still gold,
    0:24:40 even in local SEO. This is still a big thing. This was NAP listing, name, address, phone number
    0:24:44 listings, like all across the internet, all pointing back to your, your home base, your website.
    0:24:51 Exactly. And some of these directories now power voice search. So it’s important to have these
    0:24:58 directories up to date because Google looks for consistency of NAP, name, address, phone number.
    0:25:05 If you’re listed on 20 websites, but sometimes the name is spelled out one thing. Sometimes it’s this,
    0:25:09 sometimes that the address is a little bit, sometimes the phone number is different because
    0:25:13 you had it, you got a new phone number. So that that’s a signal to Google. Like, um, do they have
    0:25:18 their act together? Can they really be trusted? But this is an advanced and this isn’t, we don’t,
    0:25:25 we don’t touch directories for a local SEO boost. I don’t have to. Okay. But for our monthly recurring,
    0:25:31 where we go and we say, Hey, listen, we can manage this for you and we can write content.
    0:25:38 We need to have a strategy session once a quarter where I come in and I interview you about your
    0:25:42 bar. How long have they been here? How long have they been like, this is where you get into the
    0:25:47 nitty gritty and we do a quarterly strategy session. And we have, you got any specials coming up next
    0:25:52 three months, anything you want to put, like you have a seasonality to your business in the next three
    0:25:56 months. This is where somebody like, Oh, back to school is big for us. Valentine’s day is big.
    0:26:02 Okay, great. So then you create that content calendar. And at this point you’ll get a tool
    0:26:06 where like, now you’re going to create the content and post it. So it’s automated and done for three
    0:26:14 months and things like that. Or better yet, how I do it is I now have a team that does this. I’ve got
    0:26:21 an amazing person on my team from El Salvador. She’s a rock star and this is all she does for us.
    0:26:27 She only does local SEO content. She creates it, but she meets with the clients once a quarter,
    0:26:36 does a strategy session, maps out their content. She can do two of these a day. And we typically charge
    0:26:44 around $750 a month for the ongoing monthly recurring revenue. Wow. But again, I grew into
    0:26:50 that. So this is local SEO. It’s not going away. But that’s no, that’s like really, really cool to
    0:26:57 see what is potentially possible down the road with a trained up team member who is taking half a day
    0:27:04 to service this customer that you’re charging $750 a month for. You imagine the margins on that are quite
    0:27:09 healthy. Yes. Even if you hired somebody in the States, I have one person on my team in the States,
    0:27:14 but the rest of my team are remote. We’re an entire remote. I’m remote. Yeah, yeah, yeah.
    0:27:19 You know, so my team is remote. Yeah. And, and we just, that’s how we, we operate because we are able
    0:27:24 to keep them very high margins. We’re able to keep our costs very competitive that way. And it’s fun to be
    0:27:31 able to travel around the world and meet your staff. Do you worry, you know, this is the Bezos line of,
    0:27:35 you know, your margin is my opportunity. Do you see clients getting poached from under you
    0:27:42 from other competing services? It was just like the number of small businesses is so vast,
    0:27:46 so massive. That’s like, well, even if we lose a client, it’s fine. We’ll go find somebody else.
    0:27:52 Like it’s, we try to play this game of churn versus retention and margins versus like, well,
    0:27:55 wait a minute. How much does this really cost them to fulfill?
    0:28:02 Yeah. If you show up every month with a report that’s showing results, Hey, we got you these
    0:28:08 results. That’s you. Most business owners, that’s the number one complaint I get when we get a new
    0:28:13 customer, we were spending all this money. I never knew if it was working. Got it. You know, I didn’t
    0:28:20 know where the results were because in the agency world, we’re known for just sending a report,
    0:28:26 expecting our clients to read it. They don’t have time for that. We show up proactively. Hey,
    0:28:30 we just looked, you’re at it. And we just tell people we’ll, we might call a client and say, Hey,
    0:28:36 we just ran your report. And you know, on average, we’ve dropped three positions and we use that. We
    0:28:42 We use we, not you, not, you know, it’s, it’s, we’re in this together. Hey, we dropped three points.
    0:28:47 And so we looked and here’s what we’d like to do. We’d like to do this and this and this over the next
    0:28:53 six weeks. And they’re just like, Hey man, you’ve got our back, whatever you need to do. Like, cause it
    0:29:00 just, you build trust, you build trust. And for us then, how this led to then the, I had no intentions
    0:29:07 to own an agency. I was pastoring a church and my wife and I decided to adopt a sibling group from
    0:29:12 Bulgaria. We had two biological children and we just felt like the next thing we were being called
    0:29:18 to do was adopt. And I had to come up with an extra $50,000 because we wanted to adopt debt free.
    0:29:18 Okay.
    0:29:24 I didn’t know how I was going to come up with $50,000. So I had to come up with a side hustle
    0:29:32 and I knew how to build websites. And so I started building websites and that kind of got a little
    0:29:40 bit of traction and I got a couple dozen clients. And then I learned about this local SEO and I just
    0:29:46 went back and I upsold my very first client to do it. I was like, Hey, I’m testing this thing and you
    0:29:51 know, and they’re like, yeah, okay, sure. And I was like, it’s $1,300. And they’re like, yeah,
    0:29:54 sure. Let’s do it. I’m like, great. And then I went to some businesses I didn’t even know. I did
    0:30:01 the same thing and I did that. And then I started, then I worked through my network, my local business
    0:30:07 network, onboarded all the low hanging fruit. And then we started to learn how to do another service.
    0:30:12 And so I just went back through and I said, Hey, we’re now doing reviews as a server. We can help you
    0:30:16 get more five-star reviews from your satisfied customers. Oh yeah, Eric, let’s do that.
    0:30:21 Yeah. I was going to, I was going to ask if the reviews were a part of this like ongoing monthly
    0:30:26 package review, uh, uh, reputation management, collecting reviews, reputation management. Yes,
    0:30:32 it is now. It is now. Absolutely. But it is really its own separate kind of monster,
    0:30:38 if you will. And that’s okay. So we packages it as a separate service because I can either sell
    0:30:43 somebody reputation management or I can sell them a local SEO boost. We always start with the boost
    0:30:48 and then I can come back and say, Hey, we can add this. We’re constantly trying to figure out how can
    0:30:55 we increase wallet share? You know, how do I increase that monthly recurring revenue per customer? When I
    0:31:02 first started out, my average monthly recurring revenue per customer was $49 a month. Okay. Yeah. You come
    0:31:09 a long ways. Yes. We’re now more like $490 average per customer per month with a whole lot more
    0:31:17 customers. Now, some of our customers are $2,000 a month. Some of our customers are still $99 a month,
    0:31:22 but you know, it averages out across the board about $495 a month. More with Eric in just a moment,
    0:31:29 including why accessibility compliance could be the next big service opportunity. Plus his fastest path
    0:31:36 to $25,000 a month in recurring revenue coming up right after this. Let me know if this sounds familiar.
    0:31:41 You’ve got more ideas than you’ve got hours in the day. And that to-do list is never quite done.
    0:31:46 That’s why finding the right tool to stay on top of everything and simplify things is such a game changer.
    0:31:52 For millions of businesses, including dozens of side hustle show guests, that tool is Shopify.
    0:31:57 One thing I love about our partner Shopify is you don’t have to start from scratch.
    0:32:01 They’ve got hundreds of ready to use templates that help you build a beautiful online store to match
    0:32:07 your brand’s style. Plus Shopify makes it easy to create email and social media campaigns to capture
    0:32:12 customers wherever they’re scrolling or strolling. And they’re not sleeping on AI either. I’m talking
    0:32:16 tools to write product descriptions, page headlines, and even enhance your product photography. If you’re
    0:32:22 ready to sell, you’re ready for Shopify. Turn those dreams into and give them the best shot at success
    0:32:27 with Shopify. Sign up for your $1 per month trial and start selling today at shopify.com
    0:32:35 slash side hustle. Go to shopify.com slash side hustle. Shopify.com slash side hustle.
    0:32:41 For such an important channel like phone, the software powering this important channel was
    0:32:47 super outdated and clunky. We wanted to make it delightful and make it very easy for businesses
    0:32:53 to connect with their customers through voice and text. That’s Darina Kulia, co-founder of our sponsor
    0:32:58 OpenPhone. Trusted by more than 60,000 customers, this is the number one business phone system that
    0:33:04 streamlines and scales your customer communications. I like to think of it like a centralized hub to receive
    0:33:10 and respond to calls and texts in your business. And I asked Darina about who’s typically signing up
    0:33:17 for this kind of service. We definitely have a lot of folks who come to us and their personal cell phone
    0:33:22 has become their company phone number and they’ve hired a team or they’re starting to scale their
    0:33:28 business and they just find themselves as a business owner, as a founder being the bottleneck. So we see
    0:33:35 that all the time. And then we also see folks much further along where they’re using some legacy
    0:33:40 complicated tools that are just not really made for how communication happens these days.
    0:33:48 We also just recently launched Sona, which is our voice AI agent that can handle any missed calls.
    0:33:54 If you have clients calling outside of business hours, instead of them going to voicemail, it can go
    0:34:01 into Sona, which is capable to handle any replies and can also take a message. So you are capturing that
    0:34:06 lead information. And it’s like, and it’s a robot, like it responds like on the fly with some
    0:34:12 pre-programmed responses. It does such a great job. This way they can handle questions 24 seven.
    0:34:18 Now here’s, here’s a scenario for you. So let’s say I’ve committed to a certain business phone number
    0:34:24 and I’ve distributed flyers. It’s printed on my business cards. It is on my local business listings,
    0:34:30 on directories throughout the internet. Like what’s the process to now have that ring open phone system
    0:34:35 versus the current system? Totally. So we see this all the time. This process is called
    0:34:41 phone number porting. We port numbers from all kinds of carriers. So basically no matter what
    0:34:47 provider you’re using, we can take that number and move it over to open phone. It is free. We handle
    0:34:51 the whole thing. And if you want to try out open phone, we have a free trial. You can try it out,
    0:34:57 see how you like it. And if you like it, you can then decide to port your existing number over and
    0:35:02 handle the whole process. Now open phone has automatic AI call summaries. So you don’t have
    0:35:06 to worry about taking notes while you’re on the call. But another cool feature is what Darina called
    0:35:13 AI call tagging, basically allowing you to quickly filter for the calls that were sales objections or
    0:35:19 customer complaints or requests for a discount. So you can review those and see what worked, what didn’t
    0:35:25 and train team members on the most effective tactics and language in those cases. And it’s all in the name of
    0:35:30 building a better, faster and friendlier customer experience. I want all open phone customers to
    0:35:36 five stars only. Right now open phone is offering side hustle show listeners 20% off your first six
    0:35:45 months at open phone.com slash side hustle. That’s O P E N P H O N E.com slash side hustle. And like we
    0:35:49 talked about, if you’ve got an existing phone number with another service, open phone will port it over
    0:35:57 at no extra charge, open phone, no missed calls, no missed customers. What’s your take on this? I’ve
    0:36:03 seen some people advocating this as a potential foot in the door strategy. And it’s to say, thanks to
    0:36:09 these AI website building tools, you know, type in a quick little prompt, you know, spins up this really
    0:36:15 nice looking website for local business XYZ. You could send that straight to the, Hey, look, I noticed
    0:36:19 your website was maybe looking a little dusty, a little outdated. I made you this new one. You could
    0:36:25 have it for 200 bucks. It took you all of three minutes to create with AI. Like, and people using
    0:36:29 that as a potential foot in the door one for, okay, I could sell that website as a quick little revenue
    0:36:34 hit, but maybe this guy clearly knows what he’s doing on the tech side. Maybe I can hire him for this
    0:36:38 local SEO and potentially this recurring revenue. Holy grail down the road.
    0:36:43 I think that’s totally doable. You can do that first. There’s a whole lot more people doing that.
    0:36:49 And you’re running up against ads for Wix and Squarespace that run during the Superbowl. That’s
    0:36:56 what you’re competing against. And so I have found it’s become a little bit harder to sell websites
    0:37:03 because there’s a lot more, well, I think I can just do this tomorrow. You know, business owners move
    0:37:10 towards the squeaky wheel. They’re always going to want more customers and they all use Google.
    0:37:15 A lot of times I’ve even had some clients start to tell me like, oh, I can’t Eric. I can’t remember
    0:37:20 the last time I looked at a website if I’m not doing research. And so I’m not saying websites aren’t
    0:37:25 going to always be important, but for a local bit, like when’s the last time you went and looked at
    0:37:28 the barbershop? I’m kind of bald. I don’t look at a lot of barbershop.
    0:37:32 That’s a funny example for two bald guys to be using here.
    0:37:38 Maybe barbershop’s not the right one, but you know, for a barbershop, even a landscape or something
    0:37:45 like that, like I’m not going to go look. I might go look at a dentist website, but I don’t know.
    0:37:54 Sure. Absolutely. I would rather help somebody because it’s hard to qualify the win of a website.
    0:37:58 Like, hey, I got your new website up. Now, if they’re vain, they’re going to, oh, look at me.
    0:38:02 I got my nice new website. They’re going to like that. But if you can show up and say,
    0:38:08 this is why I like reputation management is actually another foot in the door offer because I can show
    0:38:15 up four weeks after we launch and I can read you three five-star reviews. Hey, Nick, let me show you
    0:38:20 what this customer said about you. They said, you’re the best and you’re great. You know, and then this
    0:38:27 customer said this and you’re able to give them that feedback. Then you can say, now I was looking
    0:38:31 at your website. Now that we’re getting more reviews, your website needs a little bit of work.
    0:38:39 They’re going to trust you and say, oh yeah, let’s redo it. It’s easier in my opinion to go that way
    0:38:42 than to start with the website. And that’s been my experience.
    0:38:46 Right. That’s fair. No, I was just curious to get your take on that as somebody who’s in the space.
    0:38:50 All right. What else do we need to know? So we’ve kind of covered, we’re going to start with this
    0:38:56 local SEO boost. We can hopefully transition into an ongoing monthly maintenance package. We could
    0:39:01 layer on reputation management, collecting reviews, and there’s software tools to help you do really
    0:39:06 all of this stuff and hopefully make it a little more automated and potentially sell websites down the
    0:39:10 road. Like, you know, getting your foot in the door and hopefully, you know, business owners,
    0:39:14 no other business owners, right? So the word of mouth starts to spread. Do you want anything else
    0:39:18 proactive on the marketing side to try and build up that client base?
    0:39:27 Yes. Accessibility. Accessibility is both a social justice issue as well as a good for business.
    0:39:37 In every business, unless it is a religious organization or a private club, every business has to legally
    0:39:45 meet the standards and requirements of the Americans with Disabilities Act. And just this last week,
    0:39:52 the European Union’s new accessibility laws rolled out. So this is becoming very, very universal.
    0:39:59 20 to 25% of people that use the internet have some type of barrier. Could be a disability,
    0:40:07 could be slow internet. It could be they use a SIM card with limited data. So they have images turned
    0:40:14 off. If you can design a website or social media content that is super easy to read, or you make
    0:40:22 sure you use what’s called the alt text, you’re opening up a business to about 20 to 25% more customers.
    0:40:29 So accessibility is huge. It’s never going to go away. And that’s the other problem with all of these
    0:40:34 places that are spinning up webs. None of them yet are spinning up websites that meet accessibility.
    0:40:41 So you can spin up a website for a foot in the door offer, but you’ve just put a legal target on them.
    0:40:47 And not only that, you’re not being a good neighbor to people with disabilities. So that’s how we talk about
    0:40:52 it with our agency. Like, we want to help you be a good neighbor. Accessibility is a whole nother new
    0:40:56 fascinating world. But I don’t think I would try to get into it as a side hustle.
    0:41:03 Okay, so this is another add on service. Like, hey, by the way, did you know a websites? You know, I think
    0:41:09 it’s all businesses over a certain size, something like their website has to be ADA compliant, according to the
    0:41:14 like, yours is not, but we can help get it there. And, and here’s what it’s going to take.
    0:41:23 Yeah. So the confusion that comes in on the size of business is there are a couple different articles
    0:41:28 of the Americans with Disabilities Act, the part of the article that deals with the physical
    0:41:35 and employment accessibility, making accommodations for that, but specifically to the physical property
    0:41:43 depends upon the size of your business. There are zero exceptions for your web content. Your way it
    0:41:50 does not matter how many employees, it doesn’t matter your revenue. If you’re selling $3,000 a
    0:41:56 month, and you’re a business, your web content technically has to be accessible. Now, there’s no
    0:42:03 enforcement, unless somebody chooses to bring a lawsuit. But last year, this changed, the Department
    0:42:09 of Justice came out with some new regulations last April, that said if you receive any money from the
    0:42:16 government through a grant, through a grant, maybe you’re a doctor’s office and you accept Medicaid or
    0:42:25 Medicare, maybe you’re the local garbage company, and you have a contract with the state to, or I’m sorry,
    0:42:35 the city to provide garbage pickup within the city. If you get any federal or state money, or local money,
    0:42:41 in exchange, you’re providing a service to continue to be eligible after April next year,
    0:42:46 you must have your website compliant. And we’re starting to get clients that are coming to us
    0:42:52 saying, Eric, we’re filling out our application for our state funding for next year, and they’re asking
    0:42:59 for a website compliance certificate. So that is happening in a very specific industry. So that’s a little
    0:43:04 bit different. But here’s the beautiful thing about it. I tell people this all the time. Real estate agents
    0:43:10 don’t build the houses they sell. Nick, I have no clue how to go in and set up what’s called ARIA
    0:43:15 tags on a website. I don’t know how to do it. I don’t even know what that is. Yeah. But my developers
    0:43:23 do, and they do it every day, you know. And so I’ve never ran a Google ad. I’ve never logged into the
    0:43:28 Google business platform area, whatever, I forget it. I mean, it’s struggling, but you can think of what
    0:43:32 it’s called right now. But the Google ads platform, I’ve never, I’ve never done it. I don’t have no
    0:43:41 idea. But we run Google ads every day for, for customer. Eventually, from a side hustle, team
    0:43:47 building becomes key to it. And again, if my son was wanting to start a business, this would be
    0:43:52 something I would try to get him to do from the, from the very beginning is to find somebody that can
    0:43:57 do fulfillment and then go out and sell it and then pay that person to do the fulfillment.
    0:44:03 Got it. Is there a sweet spot in terms of metro area size or is there markets that are just like,
    0:44:08 this is too competitive? I wouldn’t trust myself to sell a one-time SEO boost because I don’t think
    0:44:13 we can move the needle here. No, because even in a very competitive market, there are plenty of
    0:44:18 businesses that those other brands are not even going to give the time of day to. They’re going to
    0:44:23 judge them based upon their location or the condition of the business or something like
    0:44:29 that. And they’re looking for mass. They’re marketing broad strokes, running ads, you know,
    0:44:35 cold calling, cold, I can’t stand cold calling, cold emailing. So they’re getting bombarded with cold
    0:44:40 emails, cold calls. In my experience, Nick, and I don’t know what your thoughts are on this or what
    0:44:50 you’ve seen. In my experience, the fastest way to $25,000 a month in recurring revenue is local
    0:44:55 networking. And sometimes we go into new markets and by geographic markets. I just recently hired
    0:45:02 somebody in Kent, Ohio, and we’re following our process in Kent. It’s a US-based employee. We needed
    0:45:07 a new person. The last person was leaving. I found somebody in Kent. It’s always good for me to have
    0:45:12 somebody in the US. And we just started the same thing. Signed up. This person started going to all
    0:45:18 the local networking events. We found a local business association and went to them and said,
    0:45:23 hey, we’d like to host a podcast for you. You’re the producer of it. It’s under your branding.
    0:45:31 We’ll interview your members and it becomes a member benefit for you to give to your members for free and
    0:45:36 help you recruit more members. This is the fourth or fifth local area business podcast we’ve done.
    0:45:42 And they’re like, they love it. And so we just, Katie started going around and interviewing all
    0:45:47 of Main Street Kent. That’s the business, that’s the business association. She just started interviewing
    0:45:52 all of their businesses. And at the end of it, she’s just like, she’s built a relationship. And she says,
    0:45:58 hey, can I add you? I actually am with In Transit Studios. Can I add you to our weekly email newsletter?
    0:46:02 And they’re always like, oh yeah, that would be great. We’d love to get that. And we’ve signed on
    0:46:07 all kinds of clients that way. So over and over and over again, it’s hard to beat. I’m not saying
    0:46:13 the Chamber of Commerce or BNI. Those are great and they have their places. But I’m talking about
    0:46:19 going to the local community business association and getting in there and then finding some of the
    0:46:25 strategic partnerships. When I was in Oceanview, Virginia, one of my best strategic partnerships was
    0:46:33 a commercial real estate agent because Duncan knew every single time a new business was coming in to
    0:46:40 town. And he was able to make referrals for me over and over and over again for, you know, hey, so-and-so
    0:46:45 starting this business. Hey, did you hear so-and-so is going to try to open up an ice cream shop? Oh, no,
    0:46:49 I hadn’t heard that. You know, I’d reach out and build. Hey, I heard you’re going to start an ice cream
    0:46:56 shop. You know, how can I help? And stuff like that. So it’s hard to beat that there’s no money
    0:47:02 hiding behind your computer, especially starting out in a side hustle with a local business. It’s just
    0:47:08 hard to be getting out there, hitting the pavement and meeting people, having a face-to-face conversation
    0:47:14 and getting those first few clients in. Like you said, they start talking to others. You get a couple
    0:47:19 case studies. Now you can start to branch out. Now you can start to grow. And it’s just,
    0:47:25 to me, the fastest way to $25,000 a month in recurring revenue is local networking.
    0:47:30 All right. That’s fantastic. You heard it here first. The digital nomad life comes second.
    0:47:35 What comes first is this? Boots on the ground, local effort. There’s no money hiding behind your
    0:47:40 computer. I love that line. Eric, you’ve got the agency. What’s next for you? You got the family,
    0:47:45 you got the travels. What’s got you excited these days? We are trying to figure out where in the world
    0:47:50 we’re going to live. We need to settle down as our children are turning 18. We have another one
    0:47:57 will be 18 next year. It’s time for them to start transitioning to young adult life. And literally,
    0:48:04 the world is open. In three and a half years, we’ve lived in over 20 countries. And we’ve just learned
    0:48:09 that we love all the places. And so what’s exciting for us is trying to figure out that.
    0:48:11 Give me like your top three. Like where are your favorite spots?
    0:48:19 Oh my goodness. Our favorite spot. So London would be a great to live in. We really love Buenos Aires,
    0:48:26 Argentina. Argentina’s fantastic. We really like that. And let’s see a third one. Istanbul,
    0:48:30 Turkey. We wouldn’t settle there. But if you’re looking for someplace to visit,
    0:48:35 check out Istanbul, Turkey. It’s a great city. Very good. I’ve been fortunate enough to have
    0:48:40 visited all three of those. So I will all vouch for those all very cool places. So okay, there you go.
    0:48:45 This has been awesome. I’ve got a ton of notes. I know people will hopefully take a lot of action
    0:48:50 based on this episode and go sell some of this service on their own. If you would like to grab
    0:48:56 Eric’s local SEO side hustle checklist, I would encourage you to do that. It’s at ericdingler.com
    0:49:02 slash side hustle with all the details that we talked about in this episode. That’s Eric with a
    0:49:09 C, ericdingler.com slash side hustle for that local SEO side hustle checklist. Let’s wrap this up with
    0:49:14 your number one tip for side hustle nation. Real estate agents don’t build the houses they sell.
    0:49:20 So don’t fall into the trap that you have to be the one doing it. There are some side hustles where it
    0:49:26 makes sense and things like that. But if your long-term kind of desire is to start a side hustle
    0:49:33 to escape the nine to five with it, then figure out how to be a leader. If I was starting over,
    0:49:39 the two things I would study starting over, and I’m talking like I’m 50. If I was going back to my 20s,
    0:49:44 the two things I would study to start over is leadership and list building.
    0:49:47 Okay. Well, you heard it here first. Leadership and list building.
    0:49:52 Real estate agents don’t build the houses they sell. My interpretation is don’t find yourself
    0:49:56 getting stuck in fulfillment. You don’t want to be the technician doing the work all day,
    0:50:00 every day. You want to be building client relationships. You want to be leading the team
    0:50:06 rather than getting stuck in the freelancer’s trap of selling your skills. You don’t even need to know
    0:50:10 necessarily how to do this. You just need to be able to play matchmaker with the people who need
    0:50:15 the service and the people who know how to get it done. That’s absolutely right. I have a 90-day
    0:50:19 accelerator. I do every quarter where I take a group of people through the process of
    0:50:26 gearing up to hire, onboard, and lead a remote team. If that’s something somebody would be interested in,
    0:50:31 go ericdingler.com forward slash side hustle. They’ll download that. They’ll be able to reach
    0:50:37 me from there and be more than happy to help somebody navigate hiring a remote team.
    0:50:44 Very cool. Go check it out, ericdingler.com slash side hustle. My other note that I have here is,
    0:50:48 you know, you want recurring revenue. You got to solve a recurring problem. Businesses needing to
    0:50:53 increase their customer activity, like Eric said, hey, that’s a recurring problem. It’s never going
    0:50:57 to go away, right? So sell that result. And if you want recurring revenue, you got to keep selling it.
    0:51:00 Give those follow-up reports. Hey, before and after, here’s what we did. Here’s what we’re able to get
    0:51:05 done. Here’s where we want to go next. So really cool stuff. Again, ericdingler.com.
    0:51:10 The Side Hustle Show, as you may or may not know, just had its 12th birthday. And whether it’s your
    0:51:14 first time listening or you’ve been here since the beginning, I appreciate you spending some time
    0:51:19 with us in your earbuds today. If you’re newer to the show and you want to go a little bit deeper,
    0:51:22 hey, what else you got here? It’s been around for this long. You can actually get a personalized
    0:51:28 playlist at hustle.show. All you have to do is answer a few short, multiple choice questions,
    0:51:32 and it’s going to recommend eight to 10 of our greatest hits to start with based on your answers.
    0:51:38 Totally free. Hustle.show for that personalized playlist. Big thanks to Eric for sharing his
    0:51:41 insight. And can I shout out our sponsors for helping make this content free for everyone?
    0:51:46 Sidehustlenation.com slash deals is where to go for all the latest offers from our sponsors in one place.
    0:51:51 Thank you for supporting the advertisers that support the show. That’s it for me. Thank you so much for
    0:51:56 tuning in. If you’re finding value in the show, the greatest compliment is to share it with a friend.
    0:52:01 Fire off that text message. I know you got at least one friend who can take Eric’s model and run with it.
    0:52:04 Until next time, let’s go out there and make something happen. And I’ll catch you in the
    0:52:07 next edition of the Side Hustle Show. Hustle on.

    What if you could help local businesses get more customers while building a six-figure recurring revenue business from anywhere in the world?

    Eric Dingler from EricDingler.com runs a successful digital agency, In Transit Studios, while traveling with his family across 20+ countries. But if he was starting over today, he’d focus on one simple service: local SEO.

    While traditional SEO gets eaten alive by AI and Reddit, local search remains a goldmine. When someone searches “barber near me” or “pizza delivery,” Google still shows real local businesses — not AI-generated answers.

    Tune in to Episode 684 of the Side Hustle Show to learn:

    • Why 75% of local businesses haven’t even claimed their Google Business Profile
    • How to sell a $500 “SEO boost” before you know how to deliver it
    • The path from one-time service to $750/month recurring revenue clients

    Full Show Notes: $500 Per Client Per Month: Why Local SEO Should Be Your Next Side Hustle

    New to the Show? Get your personalized money-making playlist ⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠⁠⁠!

    Sponsors:

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  • Essentials: Healthy Eating & Eating Disorders – Anorexia, Bulimia, Binging

    中文
    Tiếng Việt
    AI transcript
    0:00:02 – Welcome to Huberman Lab Essentials,
    0:00:04 where we revisit past episodes
    0:00:07 for the most potent and actionable science-based tools
    0:00:10 for mental health, physical health, and performance.
    0:00:12 I’m Andrew Huberman,
    0:00:15 and I’m a professor of neurobiology and ophthalmology
    0:00:17 at Stanford School of Medicine.
    0:00:20 Today, we are going to talk all about healthy
    0:00:21 and disordered eating.
    0:00:23 And indeed, we are going to talk about
    0:00:24 clinical eating disorders,
    0:00:29 such as anorexia, bulimia, and binge eating disorder,
    0:00:32 as well as some other related eating disorders.
    0:00:34 However, before we get into this material,
    0:00:38 I want to emphasize that today’s discussion will include
    0:00:41 what it is to have a healthy relationship with food.
    0:00:44 We are going to talk about metabolism.
    0:00:46 We are going to talk about how eating frequency
    0:00:51 and what one eats influences things like appetite and satiety,
    0:00:54 as well as whether or not we have
    0:00:57 a healthy psychological relationship to food
    0:01:00 and our body weight and so-called body composition,
    0:01:04 the ratio of muscle to fat to bone, et cetera.
    0:01:07 So as we march into this conversation,
    0:01:09 I’d like to share with you some interesting
    0:01:11 and what I believe are important findings
    0:01:15 in the realm of nutrition and human behavior.
    0:01:18 I know these days, many people are excited about
    0:01:21 or curious about so-called intermittent fasting.
    0:01:24 Intermittent fasting is, as the name implies,
    0:01:28 simply restricting one’s feeding behavior, eating,
    0:01:31 to a particular phase of the 24-hour
    0:01:33 or so-called circadian cycle.
    0:01:37 Other forms of intermittent fasting involve not eating
    0:01:40 for extended periods of time, for entire days,
    0:01:43 or some people will extend to two days or three days.
    0:01:46 Typically, and hopefully, they will drink water
    0:01:50 during those times, sometimes referred to as water fasting,
    0:01:52 which means that they are ingesting fluids,
    0:01:55 and hopefully they are ingesting electrolytes,
    0:01:57 such as salt, potassium, and magnesium as well,
    0:02:02 because while one can survive for some period of time
    0:02:04 without ingesting calories,
    0:02:06 it is extremely important to continue
    0:02:10 to ingest plenty of fluids and electrolytes.
    0:02:12 And the reason for that is that the neurons
    0:02:14 of your brain and body that control your movements,
    0:02:18 your thoughts, clarity of thinking in general, et cetera,
    0:02:22 is critically dependent on the presence of adequate levels
    0:02:26 of sodium, potassium, and magnesium, the electrolytes.
    0:02:28 And that’s because neurons can only be electrically active
    0:02:31 by way of movement of particular ions,
    0:02:34 which include things like sodium, potassium, and magnesium.
    0:02:37 So without those, you can’t think, you can’t function,
    0:02:39 and it actually can be quite dangerous.
    0:02:42 So why all the excitement about intermittent fasting?
    0:02:45 Well, a lot of the excitement relates to work
    0:02:47 that was done by a former colleague of mine
    0:02:50 down at the Salk Institute for Biological Studies
    0:02:51 in San Diego named Sachin Panda.
    0:02:55 Sachin’s lab identified some very important
    0:02:57 and impactful health benefits
    0:03:00 of restricting one’s feeding window
    0:03:02 to particular times within the 24-hour cycle,
    0:03:07 or even to having extended fasts that go for a day
    0:03:08 or two days or maybe even three days.
    0:03:13 What they saw was an improvement in liver enzymes,
    0:03:15 an improvement in insulin sensitivity,
    0:03:17 which is something that is good.
    0:03:20 It means that you can utilize the calories
    0:03:23 and the blood sugar that you happen to have.
    0:03:25 Being insulin insensitive is not good
    0:03:28 and is actually a form of diabetes.
    0:03:33 What Sachin’s lab and subsequently other labs showed
    0:03:35 was that restricting one’s feeding window
    0:03:39 to anywhere from four to eight or even 12 hours
    0:03:42 during each 24-hour cycle was beneficial in mice.
    0:03:45 And some studies in humans have also shown
    0:03:47 that it can be beneficial for various health parameters.
    0:03:51 However, the excitement about intermittent fasting
    0:03:56 seems to be related to the foundational truth
    0:03:59 about metabolism and weight loss
    0:04:01 and weight maintenance and weight gain,
    0:04:04 which is that regardless of whether or not
    0:04:05 you intermittent fast
    0:04:08 or whether or not you eat small meals all day long
    0:04:10 or you eat one meal in the evening
    0:04:11 and snack up until then,
    0:04:15 it really doesn’t matter in the sense
    0:04:19 that the calories that you ingest from whatever source
    0:04:23 are going to be filtered through the calories
    0:04:26 that you burn by way of exercise,
    0:04:27 basal metabolic rate,
    0:04:29 which is just the calories that you happen to burn,
    0:04:32 just being alive and thinking and breathing
    0:04:33 and your heart beating, et cetera.
    0:04:38 And the reason why many people prefer intermittent fasting
    0:04:41 to other forms of, let’s just call it what it is,
    0:04:43 diet or nutritional framework,
    0:04:47 is that many people find it easier to not eat
    0:04:50 than to limit their portion size.
    0:04:53 And here I’m not talking necessarily about eating disorders,
    0:04:54 I’m talking about the general population.
    0:04:56 So why are we talking about this?
    0:04:59 And in particular, why are we talking about this
    0:05:01 during an episode that includes a discussion
    0:05:02 about eating disorders?
    0:05:07 The reason is nobody, not the government,
    0:05:09 no nutritionists, no individual,
    0:05:13 no matter how knowledgeable they are about food
    0:05:14 and nutrition and food intake,
    0:05:19 can define the best plan for eating for any one individual.
    0:05:21 I’m going to repeat that.
    0:05:25 Nobody knows what truly healthy eating is.
    0:05:27 We only know the measurements we can take,
    0:05:31 liver enzymes, blood lipid profiles, body weight,
    0:05:34 athletic performance, mental performance,
    0:05:36 whether or not you’re cranky all day,
    0:05:37 whether or not you’re feeling relaxed.
    0:05:39 Nobody knows how to define these.
    0:05:43 And these have strong cultural and familial
    0:05:46 and socio-societal influence.
    0:05:50 So if you hang out with people that intermittent fast all day,
    0:05:51 that will seem normal.
    0:05:52 If you spend time with people
    0:05:54 that have never heard of intermittent fasting,
    0:05:57 intermittent fasting is going to seem very abnormal.
    0:05:59 Now, we are going to talk about eating disorders
    0:06:01 that really fall into the category
    0:06:04 of clinically diagnosable eating disorders
    0:06:07 for which there’s actually serious health hazards
    0:06:09 and even the serious risk of death.
    0:06:12 There are clear criteria in the psychiatric
    0:06:13 and psychological communities
    0:06:17 to define things like anorexia, bulimia,
    0:06:18 binge eating disorder,
    0:06:19 all of which we will talk about.
    0:06:21 But as we have that discussion,
    0:06:24 I want to emphasize that self-diagnosis
    0:06:28 can be both a terrific but also a very precarious thing.
    0:06:30 There’s always a temptation
    0:06:33 as one learns about the symptomology of a given disorder,
    0:06:35 doesn’t really matter what the disorder is,
    0:06:37 to ask the question,
    0:06:38 well, do I have that?
    0:06:40 Does so-and-so that I know have that?
    0:06:42 It’s tempting to diagnose them and or ourselves
    0:06:45 as either having or not having a particular disorder.
    0:06:50 However, diagnoses really need to be carried out
    0:06:53 by people who are trained in that particular field
    0:06:54 and that have deep expertise
    0:06:56 in recognizing the symptomology,
    0:06:59 including some of the more subtle symptomology
    0:07:00 of eating disorders.
    0:07:03 So if any of the symptoms resonate with you
    0:07:06 by way of you thinking
    0:07:07 that you have this particular disorder
    0:07:09 or someone that you know has a disorder,
    0:07:11 I would take that seriously,
    0:07:13 but I would take that information
    0:07:15 to a qualified healthcare professional
    0:07:18 that could diagnose or rule out
    0:07:19 any of these possible disorders.
    0:07:21 I’d like to take a quick break
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    0:07:35 for optimal brain and body function.
    0:07:37 Even a slight degree of dehydration
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    0:08:53 So what is an eating disorder?
    0:08:56 Well, we have to take a step back
    0:08:58 and confess to the fact
    0:09:00 that every society, every culture,
    0:09:01 every family,
    0:09:02 and every individual
    0:09:04 has a different relationship to food.
    0:09:06 Eating disorders, however,
    0:09:08 have particular criteria
    0:09:10 that allow us to define them
    0:09:13 and to think about different modes of treatment
    0:09:15 as it relates
    0:09:17 to the particular symptoms,
    0:09:18 in particular,
    0:09:20 the psychological and biological symptoms
    0:09:21 of those disorders.
    0:09:23 What are the major eating disorders?
    0:09:26 Anorexia nervosa,
    0:09:29 most commonly referred to as anorexia,
    0:09:32 is perhaps the most prevalent
    0:09:34 and the most dangerous
    0:09:35 of all eating disorders.
    0:09:37 In fact,
    0:09:39 anorexia is the most dangerous
    0:09:40 psychiatric disorder of all,
    0:09:42 even more than depression.
    0:09:45 the probability of death
    0:09:47 for untreated anorexia
    0:09:48 is very high.
    0:09:50 And sadly,
    0:09:51 the prevalence of anorexia
    0:09:52 is very high.
    0:09:54 If you look it up online
    0:09:55 or you talk to a qualified professional,
    0:09:57 it’s essentially a failure
    0:09:58 to eat enough
    0:09:59 to maintain a healthy weight.
    0:10:01 You can see all sorts
    0:10:04 of very troubling symptoms
    0:10:05 of somebody who’s been anorexic
    0:10:06 for some period of time,
    0:10:10 a general loss of muscle mass
    0:10:12 because they’re ingesting fewer calories
    0:10:13 than they burn.
    0:10:15 They will have a low heart rate.
    0:10:17 This is the body
    0:10:18 and brain’s attempt
    0:10:19 to lower energy output.
    0:10:21 They will have low blood pressure.
    0:10:23 They will sometimes have symptoms
    0:10:24 like fainting,
    0:10:26 loss of bone density,
    0:10:28 osteoporosis,
    0:10:29 loss of periods
    0:10:31 in girls and women,
    0:10:35 and all sorts of disrupted gut
    0:10:36 and immune functions.
    0:10:38 So there are just tons
    0:10:39 of terrible symptoms
    0:10:40 of anorexia
    0:10:41 that really place
    0:10:42 the anorexic
    0:10:45 into a very risky state,
    0:10:47 which is why mortality
    0:10:49 from anorexia gone untreated
    0:10:50 is extremely high.
    0:10:53 Now, one of the misconceptions
    0:10:55 about anorexia
    0:10:57 is that it stems
    0:10:58 from an overemphasis
    0:10:59 on perfectionism
    0:11:00 or that because
    0:11:02 of all the images
    0:11:03 in social media
    0:11:05 and in advertising
    0:11:07 of extremely thin
    0:11:07 and fit
    0:11:07 and fit
    0:11:08 or muscular people
    0:11:10 that individuals
    0:11:11 are looking at themselves
    0:11:12 and comparing themselves
    0:11:13 to those images
    0:11:14 and thinking
    0:11:15 that they don’t match up
    0:11:17 and developing anorexia.
    0:11:19 That turns out
    0:11:20 to not be the case.
    0:11:21 If you look
    0:11:22 at the prevalence
    0:11:23 or the rates
    0:11:24 of anorexia
    0:11:26 in the last 10 years
    0:11:27 or 20 years
    0:11:28 and you compare that
    0:11:29 to when anorexia
    0:11:30 was first identified,
    0:11:32 which was in the 1600s
    0:11:33 and perhaps even earlier,
    0:11:34 what you find
    0:11:36 is that rates
    0:11:36 of anorexia
    0:11:37 are not going up.
    0:11:39 Classically defined anorexia
    0:11:40 has existed
    0:11:41 at essentially
    0:11:42 the same prevalence
    0:11:45 for the last 100,
    0:11:45 200,
    0:11:46 300,
    0:11:47 and 400 years,
    0:11:48 which is incredible
    0:11:49 and really speaks
    0:11:50 to the likelihood
    0:11:52 that there’s a strong
    0:11:53 biological contribution
    0:11:54 to what we call
    0:11:55 anorexia nervosa.
    0:11:57 Anorexia nervosa
    0:11:58 is extremely common.
    0:11:59 It’s anywhere
    0:12:02 from 1% to 2%
    0:12:03 of women
    0:12:05 and the typical onset
    0:12:06 is in adolescence,
    0:12:07 close to puberty,
    0:12:09 but it can show up
    0:12:10 later in life as well.
    0:12:11 In fact,
    0:12:13 the identification
    0:12:14 and diagnosis
    0:12:15 of anorexia
    0:12:15 tends to be
    0:12:17 in the early 20s,
    0:12:19 but if you look back
    0:12:19 at the history
    0:12:20 of those individuals,
    0:12:21 there were typically
    0:12:23 signs of anorexia
    0:12:23 that stem back
    0:12:24 into their early teens
    0:12:26 or maybe even before that.
    0:12:27 Now, of course,
    0:12:28 men can be anorexic
    0:12:29 as well,
    0:12:30 but anorexia nervosa
    0:12:31 does seem to occur
    0:12:33 at 10 times
    0:12:33 the rate
    0:12:34 in women
    0:12:35 and young girls
    0:12:36 than it does
    0:12:37 in men
    0:12:38 and young boys.
    0:12:40 So what is hunger
    0:12:41 and what is satiety?
    0:12:41 Satiety,
    0:12:42 of course,
    0:12:43 being sated
    0:12:43 or feeling
    0:12:44 like we’ve had
    0:12:45 enough food.
    0:12:46 I want to remind people
    0:12:48 of the basic mechanisms
    0:12:49 by which the brain
    0:12:50 and body communicate.
    0:12:51 The body
    0:12:52 is communicating
    0:12:53 two types of information
    0:12:53 to the brain
    0:12:55 on a regular basis,
    0:12:56 but in particular
    0:12:57 around feeding.
    0:12:58 and those two types
    0:12:59 of information
    0:13:00 are mechanical information
    0:13:03 and chemical information.
    0:13:04 When your stomach
    0:13:05 is full,
    0:13:06 it sends signals
    0:13:07 to your brain
    0:13:08 that are purely based
    0:13:09 on this mechanical fullness.
    0:13:10 That’s nothing
    0:13:11 to do with nutrients
    0:13:12 that says,
    0:13:13 I’m full
    0:13:15 and therefore
    0:13:17 don’t be as hungry.
    0:13:17 Don’t motivate
    0:13:18 to find
    0:13:19 or ingest food.
    0:13:20 Whereas when our gut
    0:13:21 is empty,
    0:13:22 even if we have plenty
    0:13:23 of nutrients
    0:13:25 or plenty of body fat stores,
    0:13:26 we tend to focus
    0:13:27 on food a bit more.
    0:13:29 So volume
    0:13:31 and mechanical influences
    0:13:32 have a profound effect
    0:13:33 on how we think
    0:13:34 and what we consider
    0:13:35 doing or not doing.
    0:13:36 Likewise,
    0:13:37 chemical effects.
    0:13:39 When we ingest food,
    0:13:40 our blood glucose goes up.
    0:13:41 That information
    0:13:42 is signaled to the brain
    0:13:45 via neuronal pathways
    0:13:46 and hormonal pathways.
    0:13:48 And in particular,
    0:13:49 there are neurons
    0:13:50 within our gut
    0:13:51 that signal to areas
    0:13:52 of our brainstem
    0:13:52 that are involved
    0:13:53 in satiety
    0:13:54 in our sense
    0:13:54 of having enough
    0:13:55 that there’s food
    0:13:56 in our system.
    0:13:58 So that’s chemical information.
    0:14:01 So how are hunger
    0:14:02 and feeding
    0:14:03 and satiety regulated?
    0:14:05 By way of mechanical
    0:14:06 and chemical signaling.
    0:14:08 You have,
    0:14:08 I have,
    0:14:09 we all have
    0:14:11 neurons in our hypothalamus
    0:14:12 that trigger eating
    0:14:14 and neurons
    0:14:15 that trigger
    0:14:16 cessation
    0:14:17 or stopping of eating.
    0:14:18 Your hypothalamus
    0:14:19 at the base
    0:14:19 of your forebrain
    0:14:20 sits more or less
    0:14:21 above the roof
    0:14:21 of your mouth.
    0:14:22 The hypothalamus
    0:14:23 contains lots
    0:14:24 of different kinds
    0:14:24 of neurons.
    0:14:25 including neurons
    0:14:26 that stimulate
    0:14:27 sexual activity
    0:14:28 and desire,
    0:14:30 regulate your body temperature
    0:14:32 and control appetite
    0:14:33 and ceasing
    0:14:34 of eating
    0:14:35 and appetite.
    0:14:38 There are two types
    0:14:38 of neurons
    0:14:39 within a particular area
    0:14:40 of your hypothalamus
    0:14:41 that are relevant here.
    0:14:42 There are the so-called
    0:14:45 POMC neurons.
    0:14:46 Okay?
    0:14:48 Pro-opioid melanocortin neurons
    0:14:50 that tend to act
    0:14:51 as more of a break
    0:14:53 on appetite
    0:14:55 by way of another hormone
    0:14:56 called melanocyte
    0:14:57 stimulating hormone.
    0:14:58 And you have a class
    0:14:58 of neurons
    0:15:00 called the AGRP neurons.
    0:15:01 The AGRP neurons
    0:15:01 are the ones
    0:15:03 that stimulate feeding
    0:15:04 and they create
    0:15:05 a sort of anxiety
    0:15:06 or excitement
    0:15:07 about food.
    0:15:09 If you eliminate
    0:15:10 or kill these neurons,
    0:15:11 which has been done
    0:15:13 in experimental mouse models
    0:15:14 in the laboratory,
    0:15:15 but also there are humans
    0:15:15 that have lesions
    0:15:17 or neurotoxic effects
    0:15:18 on these AGRP neurons.
    0:15:20 And what you find
    0:15:21 is that they don’t want to eat.
    0:15:22 They have no appetite
    0:15:23 for food whatsoever.
    0:15:25 Whereas if you stimulate
    0:15:26 these AGRP neurons
    0:15:27 or in humans
    0:15:28 that have say
    0:15:29 a small tumor
    0:15:30 near these AGRP neurons,
    0:15:32 they become hyperphagic.
    0:15:32 They will eat
    0:15:33 to the point of bursting.
    0:15:35 Now there are signals
    0:15:36 coming back
    0:15:37 from the body
    0:15:38 to inform the brain
    0:15:39 about presence
    0:15:40 of different levels
    0:15:41 of nutrients.
    0:15:41 And that generally
    0:15:43 comes from three sources.
    0:15:44 first of all
    0:15:46 is body fat.
    0:15:48 The more body fat we have,
    0:15:49 the more we secrete
    0:15:50 a hormone called leptin,
    0:15:51 L-E-P-T-I-N,
    0:15:53 leptin from body fat.
    0:15:55 Leptin goes to the brain
    0:15:57 and suppresses appetite.
    0:15:58 Not incidentally,
    0:16:00 leptin signaling
    0:16:01 is disrupted
    0:16:02 in people
    0:16:03 that have bulimia
    0:16:04 and obesity
    0:16:05 and certain forms
    0:16:07 of binge eating disorder.
    0:16:08 The body fat
    0:16:09 is doing something else
    0:16:09 really interesting
    0:16:11 that relates to anorexia.
    0:16:13 When there’s sufficient levels
    0:16:13 of body fat
    0:16:15 and leptin circulating
    0:16:16 in the blood
    0:16:17 and that leptin signal
    0:16:18 gets to the brain,
    0:16:20 the hypothalamus
    0:16:21 and the pituitary gland
    0:16:22 register that signal
    0:16:24 and in a completely
    0:16:25 subconscious way
    0:16:26 trigger
    0:16:28 the deployment
    0:16:28 of eggs
    0:16:30 in females
    0:16:31 and the production
    0:16:32 of sperm
    0:16:32 in males.
    0:16:34 So when body fat stores
    0:16:35 are very low,
    0:16:36 the reason why
    0:16:37 periods shut off
    0:16:38 or sperm production
    0:16:39 is reduced
    0:16:40 or even shut off
    0:16:41 is because there’s
    0:16:42 not enough leptin
    0:16:44 getting to the hypothalamus
    0:16:45 and to the pituitary
    0:16:47 and they shut off
    0:16:48 the signals,
    0:16:49 the hormones,
    0:16:50 things like gonadotropin,
    0:16:50 releasing hormone,
    0:16:51 luteinizing hormone,
    0:16:52 follicle stimulating hormone
    0:16:54 that travel to the ovary
    0:16:55 or to the testes
    0:16:56 and cause the ovary
    0:16:56 and testes
    0:16:57 to ovulate
    0:16:58 or to produce
    0:17:00 more sperm.
    0:17:00 So you’ve got
    0:17:01 two categories of neurons,
    0:17:02 one that acts
    0:17:03 as an accelerator,
    0:17:04 the AGRP neuron
    0:17:05 saying eat,
    0:17:05 eat
    0:17:07 and gets you excited
    0:17:07 to eat
    0:17:08 and then you have
    0:17:09 a category of neurons,
    0:17:10 the PMOC neurons
    0:17:13 that are suppressing hunger,
    0:17:14 they’re acting like a brake
    0:17:15 and the body
    0:17:16 is informing the brain
    0:17:17 all the time
    0:17:17 about the status
    0:17:18 of the body
    0:17:18 and whether or not
    0:17:19 it needs more food.
    0:17:20 So you might ask,
    0:17:21 why is it
    0:17:22 that people who are overweight
    0:17:23 and have a lot of body fat,
    0:17:24 why they would continue
    0:17:25 to eat a lot?
    0:17:26 It seems like
    0:17:27 that just shouldn’t happen.
    0:17:29 From an evolutionary standpoint,
    0:17:31 it makes sense
    0:17:32 that we should eat
    0:17:34 as often as we can,
    0:17:35 as much as we can
    0:17:37 and as fast as we can.
    0:17:38 There are circuits
    0:17:38 in the brain
    0:17:40 to reward eating often,
    0:17:41 eating fast
    0:17:43 and cramming
    0:17:43 as much food
    0:17:44 into you as possible
    0:17:46 because from a purely
    0:17:47 evolutionary standpoint,
    0:17:49 food was scarce
    0:17:50 and seeking food
    0:17:51 was dangerous
    0:17:52 whether or not
    0:17:53 it was from animal sources
    0:17:53 or not
    0:17:55 and it’s always
    0:17:56 been competitive.
    0:17:57 Every animal,
    0:17:58 including humans,
    0:18:00 has a hardwired
    0:18:00 circuit
    0:18:01 that we were born
    0:18:03 with that pays attention
    0:18:04 to how much food
    0:18:05 is available,
    0:18:06 how much we are getting
    0:18:07 now and how much
    0:18:08 we are likely to get
    0:18:09 in the future
    0:18:11 and without going down
    0:18:12 the rabbit hole
    0:18:14 of arcuate nucleus biology,
    0:18:17 in two sentences,
    0:18:19 you have a hypothalamic area
    0:18:20 called the arcuate nucleus.
    0:18:21 It’s actually the area
    0:18:22 that houses
    0:18:23 these PMOC neurons
    0:18:24 and these other types
    0:18:24 of neurons
    0:18:25 that regulate hunger
    0:18:26 and satiety
    0:18:29 and these neurons
    0:18:30 in the arcuate nucleus
    0:18:31 start getting active
    0:18:33 when we see food
    0:18:34 and think about food
    0:18:35 and they drive hunger
    0:18:36 in a way
    0:18:36 that’s responsive
    0:18:37 to what the food
    0:18:38 looks like,
    0:18:40 what it smells like,
    0:18:42 but also our prior history
    0:18:43 of interactions
    0:18:43 with that food
    0:18:45 and it takes into account
    0:18:47 social context.
    0:18:48 What’s the pathway?
    0:18:48 How does this work?
    0:18:52 Well, you can frame
    0:18:53 all of behavior,
    0:18:55 good decision-making
    0:18:56 and bad decision-making
    0:18:57 in a pretty simple
    0:18:59 box diagram model.
    0:19:01 We have knowledge
    0:19:02 of what we should do
    0:19:03 in one box, okay?
    0:19:04 We should eat that,
    0:19:05 we shouldn’t eat that,
    0:19:06 we should wait for dinner,
    0:19:07 we shouldn’t wait for dinner
    0:19:08 and then we have
    0:19:09 what we actually do
    0:19:11 in another box.
    0:19:13 In between those two boxes
    0:19:15 are two intervening forces
    0:19:16 and those intervening forces
    0:19:18 are critically important.
    0:19:19 those intervening forces
    0:19:21 are homeostatic processes
    0:19:23 that regulate the balance
    0:19:25 of different systems
    0:19:25 in your body,
    0:19:26 hot and cold,
    0:19:27 awake or asleep,
    0:19:30 dopamine and the desire
    0:19:31 to pursue things,
    0:19:32 serotonin and the desire
    0:19:34 to just relax and chill.
    0:19:36 So homeostatic processes
    0:19:38 and reward systems
    0:19:40 and as we now move
    0:19:41 into discussion
    0:19:42 about anorexia
    0:19:43 and bulimia specifically,
    0:19:45 what you’ll see
    0:19:47 is that anorexia and bulimia
    0:19:49 are not a breaking
    0:19:51 of the mindset
    0:19:52 of what one should do
    0:19:53 or shouldn’t do.
    0:19:55 It’s a disruption
    0:19:56 of these homeostatic
    0:19:57 and reward processes
    0:20:00 such that decision-making
    0:20:01 is completely disrupted
    0:20:02 and in many cases
    0:20:03 is not available
    0:20:05 to the anorexic or bulimic.
    0:20:06 Now, I don’t want
    0:20:07 to be abstract here.
    0:20:07 What I’m saying is
    0:20:09 that the person
    0:20:11 who starves themselves
    0:20:11 to the point
    0:20:12 where they might die
    0:20:13 and in some cases
    0:20:14 sadly do die,
    0:20:16 they can know perfectly well
    0:20:17 that their behavior
    0:20:20 is leading to bad outcomes
    0:20:22 and possibly even death
    0:20:24 and yet they are not able
    0:20:25 to intervene
    0:20:26 unless they get
    0:20:28 particular clinical help
    0:20:31 because the homeostatic processes,
    0:20:32 the signals from the body
    0:20:33 and brain that say
    0:20:34 you need food,
    0:20:36 those aren’t registering
    0:20:37 in the same way
    0:20:38 that they are
    0:20:39 for other individuals
    0:20:40 and just as a little teaser
    0:20:41 of where we’re headed,
    0:20:44 anorexics have a sort of switch
    0:20:45 that’s been flipped
    0:20:48 such that their decision-making
    0:20:50 is actually pretty darn good.
    0:20:51 It might even be better
    0:20:51 than yours
    0:20:52 in terms of evaluating
    0:20:54 food nutritional content
    0:20:55 but their habits
    0:20:56 are disrupted
    0:20:57 so they’re not even
    0:20:59 consciously aware
    0:20:59 of the fact
    0:21:00 that they’re making terrible
    0:21:01 and in some cases
    0:21:03 very dangerous food choices.
    0:21:04 It turns out habits
    0:21:06 and the way that we build
    0:21:07 and break
    0:21:09 and rebuild new habits
    0:21:10 is one of the most
    0:21:11 effective treatments
    0:21:11 for anorexia.
    0:21:13 I’d like to take
    0:21:13 a quick break
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    0:22:49 So now let’s talk
    0:22:50 about anorexia,
    0:22:51 this failure
    0:22:52 to consume enough energy
    0:22:53 such that the individual
    0:22:55 is at risk of death
    0:22:56 and if not death,
    0:22:58 then severe metabolic disorders,
    0:23:00 lack of bone density,
    0:23:01 et cetera.
    0:23:02 A careful analysis
    0:23:04 through medical epidemiology
    0:23:05 has shown
    0:23:06 that you find anorexia
    0:23:07 even in cultures
    0:23:08 and societies
    0:23:09 where food is scarce.
    0:23:11 So that really speaks
    0:23:13 to biological mechanism.
    0:23:13 Typically,
    0:23:14 anorexia starts
    0:23:15 in adolescence
    0:23:16 right around puberty.
    0:23:17 Puberty
    0:23:19 at a very broad level
    0:23:21 is the most significant
    0:23:23 and dramatic developmental step
    0:23:24 anyone goes through
    0:23:24 in their lifespan.
    0:23:25 The body changes,
    0:23:26 the brain changes,
    0:23:27 perceptions change,
    0:23:29 one’s own self-perception
    0:23:30 changes.
    0:23:32 And most of those changes
    0:23:33 are driven by changes
    0:23:34 in circuitry
    0:23:36 within the hypothalamus.
    0:23:37 So neurons
    0:23:37 that are controlling
    0:23:38 the production
    0:23:39 of the so-called
    0:23:40 sex steroid hormones,
    0:23:41 things like testosterone,
    0:23:41 estrogen,
    0:23:42 and related hormones,
    0:23:43 prolactin,
    0:23:43 et cetera,
    0:23:45 those are all changing
    0:23:46 at very rapid rates.
    0:23:48 Let’s look under the hood.
    0:23:50 Let’s look at what’s known
    0:23:51 about the neural circuitry
    0:23:52 and the sorts of perceptions
    0:23:53 and behaviors
    0:23:54 of the neural circuitry
    0:23:55 is driving
    0:23:56 in order to understand
    0:23:58 what they are truly
    0:23:59 suffering from
    0:24:00 at the level of cause,
    0:24:01 not just symptoms.
    0:24:03 First of all,
    0:24:04 there’s a challenge
    0:24:05 in studying anorexia
    0:24:06 because in anorexia,
    0:24:07 what you’re essentially studying
    0:24:09 is the absence
    0:24:09 of a behavior.
    0:24:10 It’s very hard
    0:24:11 to study
    0:24:12 the absence
    0:24:12 of a behavior
    0:24:13 as opposed
    0:24:14 to a behavior.
    0:24:15 So they did
    0:24:16 some experiments
    0:24:17 with anorexics,
    0:24:17 giving them
    0:24:19 a gallery
    0:24:19 of pictures
    0:24:20 of different foods
    0:24:21 and allowing
    0:24:23 those anorexic patients
    0:24:25 to arrange those foods
    0:24:26 according to preference
    0:24:28 about what they would select,
    0:24:31 about food nutrient content,
    0:24:32 about caloric content.
    0:24:33 They essentially
    0:24:34 asked these anorexics
    0:24:36 to evaluate food
    0:24:37 and in doing so,
    0:24:38 they were able
    0:24:38 to identify
    0:24:39 something that’s
    0:24:40 very unique
    0:24:41 to anorexics
    0:24:42 at the level
    0:24:43 of their perception
    0:24:44 of food.
    0:24:45 Anorexics,
    0:24:47 rather than being anxious
    0:24:48 in the presence
    0:24:48 of food,
    0:24:50 have a hyperacuity,
    0:24:51 a hyperawareness
    0:24:52 of the fat content
    0:24:53 of foods,
    0:24:54 almost to the point
    0:24:55 of being sort of
    0:24:56 fat content savants.
    0:24:57 Now,
    0:24:58 it’s a well-known
    0:24:59 symptom of anorexia,
    0:25:02 especially young anorexics
    0:25:02 that they have
    0:25:04 kind of an obsession
    0:25:05 with food,
    0:25:06 caloric contents,
    0:25:07 macronutrient ratios,
    0:25:08 meaning fat,
    0:25:08 protein,
    0:25:10 and carbohydrate ratios.
    0:25:12 They are actively
    0:25:13 avoiding
    0:25:15 high-fat content foods,
    0:25:16 calorie-rich foods,
    0:25:17 and defaulting
    0:25:18 towards
    0:25:19 very low-calorie foods
    0:25:21 if they have to eat.
    0:25:23 And that’s very important
    0:25:24 because what that means
    0:25:25 is that we need
    0:25:25 to look at
    0:25:26 the areas of the brain
    0:25:27 that drive
    0:25:29 habit formation
    0:25:31 and habit execution.
    0:25:32 In the case
    0:25:32 of the anorexic,
    0:25:34 those habits
    0:25:35 are exactly
    0:25:36 the place
    0:25:36 where things
    0:25:37 start to go awry
    0:25:39 and that drive
    0:25:39 this very
    0:25:41 dysfunctional,
    0:25:41 under-eating behavior
    0:25:43 that sadly
    0:25:43 often leads
    0:25:44 to death
    0:25:45 or certainly
    0:25:46 bad medical outcomes.
    0:25:47 And it turns out
    0:25:49 that the brain areas
    0:25:50 associated with
    0:25:51 habit formation
    0:25:52 and execution
    0:25:53 are the best
    0:25:54 point of intervention.
    0:25:55 So
    0:25:57 you have reflexes
    0:25:59 and you have
    0:26:01 neural processes
    0:26:02 that include
    0:26:03 what are called
    0:26:04 duration path
    0:26:04 and outcome
    0:26:05 type processes.
    0:26:06 A duration path
    0:26:07 outcome type process
    0:26:08 we can shorten
    0:26:09 with DPO.
    0:26:11 DPO is
    0:26:13 for all types
    0:26:14 of goal-related behaviors.
    0:26:16 So for instance,
    0:26:17 if you want
    0:26:17 to go to the grocery store
    0:26:18 and pick some stuff up
    0:26:20 and then head home,
    0:26:21 you’re going to think
    0:26:22 duration,
    0:26:23 how long do I have?
    0:26:23 Okay,
    0:26:24 do I have 45 minutes
    0:26:25 to get to the store?
    0:26:25 How long does it take
    0:26:26 to get to the store?
    0:26:27 Path,
    0:26:28 which way am I going
    0:26:28 to drive there?
    0:26:29 Which way am I going
    0:26:29 to navigate
    0:26:30 through the grocery store?
    0:26:31 Outcome,
    0:26:32 was I able to get in
    0:26:33 and get the items
    0:26:33 I need
    0:26:34 and get home in time?
    0:26:35 Okay?
    0:26:35 DPO,
    0:26:36 duration path outcome.
    0:26:37 It’s a very conscious
    0:26:39 process that requires
    0:26:40 decision-making
    0:26:41 and it’s reward-based.
    0:26:42 You use these
    0:26:44 DPO type processes
    0:26:45 in the short term
    0:26:47 to pick up groceries
    0:26:48 and pick a line
    0:26:49 at the grocery store
    0:26:50 and decide which
    0:26:52 trajectory to take home
    0:26:53 and you use them
    0:26:54 for navigating
    0:26:56 long extended processes
    0:26:56 in life,
    0:26:57 trying to get a degree
    0:26:58 or raise children
    0:26:59 or get through
    0:27:00 a particularly
    0:27:01 challenging year,
    0:27:02 et cetera.
    0:27:04 So duration path outcome
    0:27:06 and that entire process
    0:27:07 relies on your
    0:27:08 forebrain,
    0:27:09 this prefrontal cortex.
    0:27:11 The prefrontal cortex
    0:27:13 is what allows you
    0:27:14 to take information
    0:27:14 from memory,
    0:27:15 combine it
    0:27:16 with information
    0:27:17 about what’s happening
    0:27:18 in the present context
    0:27:20 and then to direct
    0:27:20 your behavior,
    0:27:22 your speech,
    0:27:23 et cetera,
    0:27:24 toward particular outcomes.
    0:27:25 Reflexes,
    0:27:26 on the other hand,
    0:27:28 don’t involve
    0:27:28 the prefrontal cortex
    0:27:29 in the same way.
    0:27:31 Habits and reflexes,
    0:27:32 like once you know
    0:27:32 how to walk,
    0:27:34 that doesn’t rely
    0:27:34 on prefrontal cortex.
    0:27:35 It’s subconscious
    0:27:37 as it’s sometimes called,
    0:27:37 but basically
    0:27:38 you don’t have
    0:27:39 to use the parts
    0:27:39 of the brain
    0:27:40 that are involved
    0:27:41 in duration path
    0:27:42 and outcome type analyses.
    0:27:44 But basically
    0:27:45 you have a brain area
    0:27:46 and anorexics
    0:27:46 have a brain area
    0:27:47 that’s involved
    0:27:48 in evaluating
    0:27:49 and decision-making
    0:27:49 around food
    0:27:51 and then another brain area
    0:27:52 that’s involved
    0:27:53 in the reflexive
    0:27:54 consumption
    0:27:55 of particular foods
    0:27:56 and the reflexive
    0:27:57 avoidance
    0:27:58 of other foods.
    0:27:59 There are always
    0:28:00 homeostatic
    0:28:02 and reward systems
    0:28:03 influencing
    0:28:04 this kind of thing.
    0:28:05 well,
    0:28:07 in the brain
    0:28:07 of the anorexic,
    0:28:09 it turns out
    0:28:10 that the reward systems
    0:28:11 have been attached
    0:28:13 to the execution
    0:28:14 of habits
    0:28:15 in a way
    0:28:16 that is unhealthy
    0:28:17 for body weight,
    0:28:18 but at least
    0:28:19 from a purely
    0:28:20 neural circuit perspective,
    0:28:22 the reward
    0:28:23 is now given,
    0:28:24 this chemical reward
    0:28:25 in the brain
    0:28:25 is given
    0:28:26 for avoiding
    0:28:27 particular foods
    0:28:29 and only approaching
    0:28:30 these very low-calorie,
    0:28:32 low-fat foods.
    0:28:33 so there really
    0:28:34 does seem
    0:28:35 to be a flip
    0:28:36 in the switch
    0:28:38 in the anorexic brain
    0:28:39 that rewards
    0:28:39 them internally.
    0:28:41 They feel good
    0:28:42 when they avoid
    0:28:43 certain foods
    0:28:44 and they approach
    0:28:44 others.
    0:28:45 So it’s not
    0:28:46 a deprivation-based
    0:28:47 model where
    0:28:48 they are
    0:28:49 flagellating themselves
    0:28:50 or masochistic
    0:28:51 or actively
    0:28:52 avoiding food
    0:28:53 in order to punish
    0:28:54 themselves,
    0:28:55 which is interesting
    0:28:56 because a lot
    0:28:57 of psychological theories
    0:28:58 support that idea.
    0:28:59 rather,
    0:29:01 once this transitions
    0:29:02 into a set
    0:29:03 of habits,
    0:29:04 they are actually
    0:29:05 getting a sense
    0:29:05 of reward.
    0:29:07 They feel good,
    0:29:07 presumably from
    0:29:08 the release
    0:29:08 of a different
    0:29:09 neuromodulator
    0:29:10 called dopamine,
    0:29:12 by approaching
    0:29:13 foods that are
    0:29:14 low-fat,
    0:29:15 low-calorie content,
    0:29:16 and so their
    0:29:17 whole brain circuitry
    0:29:18 is skewed
    0:29:19 toward avoiding
    0:29:20 particular things
    0:29:21 and they actually
    0:29:22 are rewarded
    0:29:22 for that
    0:29:24 and they feel good.
    0:29:25 they feel better
    0:29:26 than if they were
    0:29:27 eating in a healthy
    0:29:28 weight-supporting way.
    0:29:29 So how do you
    0:29:30 break a habit?
    0:29:31 How do you rewire
    0:29:32 the brain circuitry
    0:29:32 that’s literally
    0:29:33 causing a reflex
    0:29:34 and in this case
    0:29:35 causing a reflex
    0:29:36 that is killing
    0:29:37 the individual
    0:29:38 or at least leading
    0:29:40 to very bad
    0:29:40 health outcomes?
    0:29:42 The way that you
    0:29:44 do that is
    0:29:45 through a cognitive
    0:29:46 mechanism where
    0:29:47 you teach the
    0:29:48 individual what
    0:29:49 is leading up
    0:29:49 to the habit.
    0:29:50 So let’s talk
    0:29:51 about what those
    0:29:53 things are that lead
    0:29:53 into a habit.
    0:29:54 because those
    0:29:55 turn out to be
    0:29:56 the exact points
    0:29:57 of entry for
    0:29:58 changing and
    0:29:59 eliminating and
    0:30:00 rewiring habits
    0:30:01 toward more
    0:30:02 healthy behaviors.
    0:30:02 There are two
    0:30:03 main features of
    0:30:04 thinking that go
    0:30:05 into the sorts
    0:30:06 of habits that
    0:30:07 anorexics execute.
    0:30:09 The first is
    0:30:10 something called
    0:30:10 weak central
    0:30:11 coherence.
    0:30:12 Weak central
    0:30:13 coherence is
    0:30:14 essentially an
    0:30:15 inability to see
    0:30:16 the forest through
    0:30:17 the trees.
    0:30:18 It’s a hyper
    0:30:19 acuity and focus
    0:30:21 on details within
    0:30:21 a given environment.
    0:30:22 You miss the
    0:30:23 big picture.
    0:30:24 The other
    0:30:24 is a challenge
    0:30:25 in set shifting
    0:30:26 that once you
    0:30:27 identify something
    0:30:28 that’s of particular
    0:30:30 interest and that’s
    0:30:31 driving some sort
    0:30:33 of reward for the
    0:30:33 anorexic, that would
    0:30:34 be identifying the
    0:30:36 high fat foods or
    0:30:37 identifying the one
    0:30:37 food on the table
    0:30:38 that one could eat
    0:30:39 without anyone
    0:30:40 hopefully noticing
    0:30:41 that they’re eating
    0:30:43 just the green beans
    0:30:44 and not touching any
    0:30:45 of the other food.
    0:30:46 If you ever had a meal
    0:30:47 with an anorexic,
    0:30:48 they become masterful
    0:30:49 actually at trying
    0:30:50 to keep people’s
    0:30:51 awareness away
    0:30:52 from what they’re
    0:30:53 doing, which is to
    0:30:53 home in on these
    0:30:54 low-fat, low-calorie
    0:30:55 foods.
    0:30:57 What’s amazing and
    0:30:58 frankly also important
    0:31:00 are these findings that
    0:31:01 once you teach
    0:31:02 anorexics what’s
    0:31:03 happening to them,
    0:31:04 that they’re doing
    0:31:06 this, they are able
    0:31:06 to intervene.
    0:31:07 Now, they need
    0:31:09 support, right?
    0:31:10 And another form of
    0:31:11 therapy that seems
    0:31:12 to work well for
    0:31:14 anorexics that ideally
    0:31:15 is combined with this
    0:31:18 habit rewiring is a
    0:31:19 family-based model.
    0:31:21 Family-based models are
    0:31:22 starting to surface a lot
    0:31:23 now in various therapy
    0:31:24 settings.
    0:31:26 Therapy-based models in
    0:31:27 short are basically
    0:31:29 where the entire family
    0:31:30 is made aware of the
    0:31:31 individual’s challenges
    0:31:32 with a particular eating
    0:31:33 disorder or other
    0:31:35 disorder and in
    0:31:36 understanding some of
    0:31:36 the biology and
    0:31:37 psychology around it,
    0:31:39 they stop condemning
    0:31:40 the individual, they
    0:31:41 start to support that
    0:31:42 individual through
    0:31:44 queuing them towards
    0:31:45 their own habits that
    0:31:46 they observe, they
    0:31:46 give them some
    0:31:47 autonomy, they realize
    0:31:48 that none of this
    0:31:49 changes overnight, but
    0:31:50 they’re taught about
    0:31:50 things like
    0:31:51 neuroplasticity and
    0:31:52 the ability to change
    0:31:53 one’s brain in response
    0:31:54 to experience.
    0:31:55 And so there’s a whole
    0:31:57 internal support network.
    0:31:58 All of these things
    0:31:59 fall under the umbrella
    0:32:01 of cognitive behavioral
    0:32:02 therapy, and I should
    0:32:02 mention that cognitive
    0:32:03 behavioral therapies
    0:32:05 are often done in
    0:32:06 conjunction with
    0:32:07 pharmacologic therapies.
    0:32:09 before we move on to
    0:32:10 talking about bulimia and
    0:32:11 some related disorders, I
    0:32:12 want to talk about an
    0:32:13 aspect of anorexia that’s
    0:32:15 very interesting, quite
    0:32:17 troubling, in fact, but
    0:32:18 that has received a lot of
    0:32:21 attention, and that’s the
    0:32:23 distorted self-image.
    0:32:26 Now, in the episode on
    0:32:27 depression, we talked about
    0:32:30 a very powerful aspect of
    0:32:32 major depression, which is
    0:32:33 this anti-self-confabulation
    0:32:34 that people who are depressed
    0:32:37 seem to genuinely believe
    0:32:38 and even confabulate about
    0:32:39 the fact that they are
    0:32:41 performing poorly in life and
    0:32:42 that they are no good or
    0:32:43 worthless, et cetera.
    0:32:45 It’s literally a lie that
    0:32:47 they believe, and their
    0:32:48 statements and their
    0:32:49 feelings and their behaviors
    0:32:51 start to reflect that lie.
    0:32:52 They’re not conscious of it.
    0:32:53 That’s why we call it a
    0:32:54 confabulation.
    0:32:58 Anorexics often will see
    0:33:00 themselves as overweight or
    0:33:02 imperfect in ways that are
    0:33:04 of an obsession for them.
    0:33:04 In the case of the
    0:33:06 anorexic, the problem seems
    0:33:08 to be that they have a
    0:33:11 genuine distortion of their
    0:33:13 self-image, so much so that
    0:33:15 they don’t actually see
    0:33:16 themselves accurately.
    0:33:18 Their visual perceptions are
    0:33:20 off, and the reason we know
    0:33:21 this is because of some
    0:33:22 really important and
    0:33:23 beautiful studies that were
    0:33:25 done in my colleague Jeremy
    0:33:27 Balenson’s lab at Stanford.
    0:33:28 What’s really interesting
    0:33:29 about these studies is they
    0:33:30 give us a window into the
    0:33:32 perceptual defect that
    0:33:33 anorexics have.
    0:33:34 I’ve actually done one of
    0:33:35 these experiments.
    0:33:36 I’m fortunate to not be
    0:33:38 anorexic, but I’ve done some
    0:33:39 work with the VR lab over
    0:33:40 there, and what you get to
    0:33:41 do is you get to adjust this
    0:33:43 avatar of yourself to the
    0:33:44 point where you think it’s as
    0:33:46 accurate as it could possibly
    0:33:48 be, and anorexics really
    0:33:50 distort this avatar.
    0:33:52 In other words, they create
    0:33:54 this serious mismatch between
    0:33:55 their perception of
    0:33:56 themselves and the reality.
    0:33:58 So, indeed, it does seem to
    0:33:58 be the case.
    0:34:01 Now, what’s relieving, or I
    0:34:02 should say, what’s encouraging
    0:34:05 about some of the therapies that
    0:34:06 we talked about before, the
    0:34:08 family-based model, the cognitive
    0:34:10 behavioral treatments, yes, and the
    0:34:12 drug treatments as well, but this
    0:34:15 habit intervention model is that as
    0:34:18 one starts to shift those things, it
    0:34:19 does appear that the perception of
    0:34:22 self seems to follow, that the
    0:34:24 perception of self seems to shift
    0:34:26 along with the change in habits.
    0:34:28 So it doesn’t seem that trying to
    0:34:29 tell someone, oh my gosh, you’re so
    0:34:31 thin, you really need to eat, that
    0:34:32 doesn’t seem to work.
    0:34:35 They just don’t see themselves the
    0:34:36 same way that you see them.
    0:34:39 And so I offer that as a point of
    0:34:40 consideration if you know someone
    0:34:42 that’s anorexic or if you look at an
    0:34:43 anorexic and you think, how is it
    0:34:45 that they are still critical of the
    0:34:48 small, even non-existent amount of
    0:34:49 body fat on their triceps or
    0:34:50 something?
    0:34:51 How is that?
    0:34:52 Well, it’s literally that their
    0:34:54 brain, as it relates to perceptions,
    0:34:56 visual perceptions in particular,
    0:34:58 they’re completely off.
    0:35:00 And fortunately by changing habits, you
    0:35:01 rewire those circuits as well.
    0:35:04 I’d like to take a quick break and
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    0:36:45 Okay, so let’s talk about bulimia, which
    0:36:49 is overeating and then purging, typically
    0:36:52 by self-induced vomiting or by ingestion
    0:36:53 of laxatives.
    0:36:54 And then we’ll also talk about binge
    0:36:56 eating disorder, which has a lot of
    0:36:59 the same features as bulimia, but
    0:37:00 typically no purging.
    0:37:02 The criteria that were described to
    0:37:05 me is that if somebody is doing this at
    0:37:07 least once a month over a period of
    0:37:08 anywhere from two to three months, then
    0:37:10 one, it likely would qualify.
    0:37:12 They’re not making the decision to
    0:37:13 overeat.
    0:37:16 They are driven from the inside to
    0:37:19 ingest far more food than they need.
    0:37:21 And in some cases than they would want
    0:37:21 to eat.
    0:37:24 So it’s a lot like the habit that we
    0:37:26 described for anorexia.
    0:37:28 It’s almost like it’s turned into a
    0:37:29 reflex once they get going.
    0:37:32 All the homeostatic signals are being
    0:37:33 overridden.
    0:37:35 All the signals from the body, the
    0:37:38 leptin, the insulin, the glucose, all
    0:37:40 that stuff is cosmically sky high.
    0:37:42 And yet they’re just what we, you
    0:37:45 know, the nerds call hyperphagic.
    0:37:46 They’re just eating like crazy.
    0:37:49 There’s a lot of shame associated with
    0:37:53 bulimia, oftentimes because people are
    0:37:55 vomiting and it’s hard to hide that
    0:37:56 vomiting behavior.
    0:37:58 People are aware of it.
    0:38:00 The hallmark feature of bulimia that
    0:38:03 distinguishes it from anorexia, aside
    0:38:04 from the fact that it’s overeating as
    0:38:06 opposed to under eating, is a lack of
    0:38:08 what they call inhibitory control.
    0:38:10 And that might come as no surprise.
    0:38:15 But first of all, the bulimic, unlike the
    0:38:21 anorexic is hyper impulsive and oftentimes has
    0:38:22 other types of impulse behaviors.
    0:38:25 And for that reason, many of the treatments
    0:38:26 that you see for bulimia and binge eating
    0:38:29 disorder are the sorts of treatments that
    0:38:32 don’t seem to work so well, or at least most of
    0:38:33 the time for anorexia.
    0:38:36 So the drugs that increase the neuromodulator
    0:38:41 serotonin, for instance, fluoxetine, also called
    0:38:45 Prozac, Paxil, et cetera, those things oftentimes can be
    0:38:47 effective in bulimia.
    0:38:49 Some of the drugs that are used to treat attention
    0:38:52 deficit hyperactivity disorder and ADD, some of those
    0:38:56 same drugs like Adderall, Vyvanse, and things of that sort
    0:39:01 can also be used to treat bulimia and binge eating disorder.
    0:39:02 Why would that work?
    0:39:05 Well, now you are familiar with the prefrontal cortex.
    0:39:08 Prefrontal cortex is involved in this analysis of duration,
    0:39:09 path, and outcome.
    0:39:13 Duration, path, and outcome is how we avoid impulsivity.
    0:39:15 It’s how we think, okay, if this, then that, if that,
    0:39:18 then this, you can imagine how for the obsessive compulsive
    0:39:22 or for the anorexic, these are circuits that are overactive.
    0:39:26 For the bulimic, this is the circuit that’s going to
    0:39:27 essentially be underactive.
    0:39:30 So really the polar opposite of what you see in anorexia.
    0:39:35 So this lack of impulsivity implies a lack of prefrontal
    0:39:37 control, what we call top-down control.
    0:39:38 They become more impulsive.
    0:39:45 So bulimics have an issue with impulsivity and therefore drugs
    0:39:48 that can increase serotonin and sometimes these drugs that
    0:39:52 increase dopamine and norepinephrine levels in the brain
    0:39:54 allow for more top-down control.
    0:39:57 And that’s also why they’re used to treat ADHD and attention
    0:39:58 deficit disorder.
    0:40:01 These drugs tend to create a hyper-focus and tend to push the
    0:40:04 brain and general mode of processing into one in which you
    0:40:06 think, if this, then that, if this, then that.
    0:40:07 So anticipating outcomes.
    0:40:10 Do behavioral interventions work for bulimia?
    0:40:14 In some cases, yes, provided that those interventions are done
    0:40:15 early enough.
    0:40:20 Regardless, behavioral interventions coupled with drug-based
    0:40:22 interventions are always more effective than either one alone.
    0:40:27 Fortunately, there is a decent-sized kit of drugs that can help
    0:40:27 with bulimia.
    0:40:30 We have, on the one hand, anorexia, which seems to be a
    0:40:35 disruption in habit and a coupling of unhealthy habits, in this
    0:40:38 case, food restriction, to the reward pathway.
    0:40:42 And on the flip side, we have binge eating disorder and bulimia,
    0:40:46 where a very unhealthy habit of gorging oneself with food, sometimes
    0:40:49 followed by purging, is not necessarily coupled to reward.
    0:40:51 They feel terrible when they do that, right?
    0:40:54 The anorexic feels great about restricting their food intake.
    0:40:56 They feel like they’re winning some sort of game.
    0:40:59 The circuitry is flipped somehow that way.
    0:41:04 With bulimia, they feel horrible about the fact that they’re binging.
    0:41:05 There’s immense shame.
    0:41:07 They can’t control themselves.
    0:41:10 The reward is set up before the behavior.
    0:41:16 The reward is set up in drawing them to food and in making food look like
    0:41:21 something that’s incredibly appetizing, and there’s no impulse break.
    0:41:23 There’s no way for them to stop that kind of behavior.
    0:41:27 I think for those of us that know anorexics or have observed anorexia,
    0:41:31 it’s so hard to see somebody starve themselves to near death or to death.
    0:41:36 Equally disturbing is somebody who has an abundance of food and is gorging
    0:41:38 themselves and then feels terrible about it.
    0:41:41 So these are heavy topics.
    0:41:47 These are topics that, frankly, no one really wants to talk about unless they know
    0:41:49 someone who’s suffering from them or they themselves suffer from them.
    0:41:55 What I’ve tried to do today is try and give you a window into what really underlies these
    0:41:57 things that we call eating disorders.
    0:42:03 I hope I’ve done that at the level of biology, neurocircuitry, mechanism, endocrinology, and
    0:42:04 some of the psychology.
    0:42:10 As with any episode of this podcast, but especially where we’re talking about mental health issues
    0:42:15 and mental health disorders, behavioral disorders, there’s no way that I can exhaustively cover
    0:42:17 all the different forms of treatment.
    0:42:21 The major takeaways today are we should all be asking the question, what is healthy eating
    0:42:22 for us?
    0:42:28 How do we develop a relationship to food that we can enjoy food, hopefully both socially and
    0:42:32 on our own, but that we are not neurotic and compulsive about it?
    0:42:39 Today, we focused on the extremes of food-related behaviors that really qualify as genuine disorders.
    0:42:47 They are in the psychiatric manuals and they are diagnosable and they are serious health concerns.
    0:42:51 They’re not just mentally troubling and concerning for the people suffering from them and the people
    0:42:53 around them, but they are genuine health concerns.
    0:43:01 Just want to reiterate that anorexia nervosa is the most deadly psychiatric disorder by a huge margin.
    0:43:06 And if you look statistically at the number of people with eating disorders and that die
    0:43:11 of eating disorders, it’s not far off from the number of people that die from automobile accidents.
    0:43:17 I would love for you to take away this model that was handed off to me that I think is so powerful
    0:43:21 for thinking about all sorts of things, not just eating, but all kinds of behaviors and perceptions
    0:43:28 that you have one box for what you think, one box for what you do, and what is intervening
    0:43:28 between those?
    0:43:31 Why is it that you can know better and not do better?
    0:43:37 Well, it’s because you also have to cope with the subconscious homeostatic processes and reward
    0:43:38 processes.
    0:43:45 And those oftentimes can be disrupted in ways that we find ourselves doing things that are
    0:43:46 not good for us or not good for other people.
    0:43:52 But fortunately, there is this great gift, which is that knowledge of knowledge can allow
    0:43:59 you to do better without question, and that knowledge of knowledge allowing you to do better
    0:44:04 over time leads to this incredible phenomenon called neuroplasticity, which essentially is translated
    0:44:09 into doing better over time, even if difficult, eventually makes doing better reflexive.
    0:44:15 And last but not least, I want to thank you for your time and attention, and thank you for
    0:44:16 your interest in science.
    0:44:25 And as mentioned at the beginning of today’s episode, we are now partnered with Momentus
    0:44:29 supplements because they make single ingredient formulations that are of the absolute highest
    0:44:31 quality, and they ship international.
    0:44:36 If you go to livemomentus.com slash Huberman, you will find many of the supplements that have
    0:44:40 been discussed on various episodes of the Huberman Lab podcast, and you will find various protocols
    0:44:41 related to those supplements.
    – Chào mừng bạn đến với Huberman Lab Essentials, nơi chúng tôi xem lại các tập trước để tìm ra những công cụ khoa học mạnh mẽ và có thể áp dụng nhất cho sức khỏe tâm thần, sức khỏe thể chất và hiệu suất. Tôi là Andrew Huberman, và tôi là giáo sư thần kinh sinh học và nhãn khoa tại Trường Y tế Stanford. Hôm nay, chúng ta sẽ nói về việc ăn uống lành mạnh và rối loạn ăn uống. Thực sự, chúng ta sẽ thảo luận về các rối loạn ăn uống lâm sàng, như chán ăn, biếng ăn và rối loạn ăn uống vô độ, cũng như một số rối loạn ăn uống liên quan khác. Tuy nhiên, trước khi đi vào nội dung này, tôi muốn nhấn mạnh rằng cuộc thảo luận hôm nay sẽ bao gồm những gì liên quan đến việc có một mối quan hệ lành mạnh với thực phẩm. Chúng ta sẽ nói về chuyển hóa. Chúng ta sẽ nói về tần suất ăn uống và những gì bạn ăn ảnh hưởng đến cảm giác thèm ăn và sự no, cũng như liệu chúng ta có mối quan hệ tâm lý lành mạnh với thực phẩm và cân nặng cơ thể, cũng như được gọi là thành phần cơ thể, tỷ lệ giữa cơ, mỡ và xương, v.v. Vì vậy, khi chúng ta bước vào cuộc trò chuyện này, tôi muốn chia sẻ với bạn một số phát hiện thú vị và theo tôi là quan trọng trong lĩnh vực dinh dưỡng và hành vi con người. Tôi biết rằng những ngày này, nhiều người cảm thấy hào hứng hoặc tò mò về cái gọi là nhịn ăn định kỳ. Nhịn ăn định kỳ, như tên gọi đã chỉ ra, đơn giản là hạn chế hành vi ăn uống của một người vào một giai đoạn cụ thể của chu kỳ 24 giờ hoặc còn gọi là chu kỳ nhịp sinh học. Các hình thức nhịn ăn định kỳ khác liên quan đến việc không ăn trong thời gian dài, cả ngày hoặc một số người sẽ kéo dài tới hai hoặc ba ngày. Thông thường, và hy vọng, họ sẽ uống nước trong những khoảng thời gian đó, đôi khi được gọi là nhịn ăn bằng nước, có nghĩa là họ đang hấp thụ chất lỏng, và hy vọng họ đang hấp thụ các chất điện giải, chẳng hạn như muối, kali và magiê, bởi vì trong khi một người có thể sống mà không cần tiếp nhận calo trong một khoảng thời gian, thì rất quan trọng để tiếp tục bổ sung đủ chất lỏng và các chất điện giải. Lý do là các nơron trong não và cơ thể của bạn kiểm soát các chuyển động của bạn, suy nghĩ của bạn, sự rõ ràng khi suy nghĩ nói chung, v.v., phụ thuộc vào sự hiện diện của các mức natri, kali và magiê đầy đủ, các chất điện giải. Và đó là bởi vì các nơron chỉ có thể hoạt động về mặt điện bằng cách di chuyển các ion đặc biệt, bao gồm những thứ như natri, kali và magiê. Vì vậy, không có những thứ đó, bạn không thể nghĩ, bạn không thể hoạt động, và thực sự có thể rất nguy hiểm. Vậy tại sao lại có sự hào hứng về nhịn ăn định kỳ? À, nhiều sự hào hứng liên quan đến công việc mà một đồng nghiệp cũ của tôi tại Viện Nghiên cứu Sinh học Salk ở San Diego tên là Sachin Panda đã thực hiện. Phòng thí nghiệm của Sachin đã xác định một số lợi ích sức khỏe rất quan trọng và có ảnh hưởng của việc hạn chế thời gian ăn uống của một người vào những thời điểm cụ thể trong chu kỳ 24 giờ, hoặc thậm chí là có những khoảng thời gian nhịn ăn kéo dài đi một ngày hoặc hai ngày hoặc thậm chí ba ngày. Những gì họ thấy là sự cải thiện về các men gan, sự cải thiện về độ nhạy insulin, điều này rất tốt. Điều đó có nghĩa là bạn có thể sử dụng calo và đường trong máu mà bạn có. Cảm giác không nhạy cảm với insulin không tốt và thực sự là một dạng bệnh tiểu đường. Những gì phòng thí nghiệm của Sachin và sau đó là các phòng thí nghiệm khác chỉ ra là việc hạn chế thời gian ăn uống của một người từ 4 đến 8 giờ hoặc thậm chí 12 giờ trong mỗi chu kỳ 24 giờ là có lợi cho chuột. Và một số nghiên cứu ở người cũng đã chỉ ra rằng điều này có thể có lợi cho nhiều chỉ số sức khỏe khác nhau. Tuy nhiên, sự hào hứng về nhịn ăn định kỳ dường như liên quan đến sự thật căn bản về chuyển hóa và giảm cân và duy trì cân nặng và tăng cân, đó là bất kể bạn có nhịn ăn định kỳ hay không, hoặc liệu bạn có ăn những bữa nhỏ suốt cả ngày hay bạn ăn một bữa vào buổi tối và ăn nhẹ cho đến lúc đó, thì thực sự không quan trọng theo nghĩa là những calo mà bạn tiêu thụ từ bất kỳ nguồn nào sẽ được lọc qua những calo mà bạn đốt cháy bằng cách tập thể dục, tỷ lệ trao đổi chất cơ bản, chỉ là calo mà bạn tiêu thụ, chỉ cần sống và nghĩ và thở và tim bạn đập, v.v. Lý do nhiều người thích nhịn ăn định kỳ hơn các hình thức khác được gọi là chế độ ăn kiêng hay khung dinh dưỡng là rằng nhiều người cảm thấy dễ dàng hơn để không ăn hơn là hạn chế kích thước phần ăn của họ. Và ở đây tôi không nhất thiết nói về các rối loạn ăn uống, tôi đang nói về dân số nói chung. Vậy tại sao chúng ta lại nói về điều này? Và đặc biệt, tại sao chúng ta lại nói về điều này trong một tập mà có cuộc thảo luận về các rối loạn ăn uống? Lý do là không ai, không chính phủ, không các chuyên gia dinh dưỡng, không cá nhân nào, bất kể họ thông thái đến mức nào về thực phẩm và dinh dưỡng và lượng thực phẩm tiêu thụ, có thể định nghĩa kế hoạch ăn uống tốt nhất cho bất kỳ cá nhân nào. Tôi sẽ lặp lại điều đó. Không ai biết chế độ ăn uống lành mạnh thực sự là gì. Chúng ta chỉ biết các phép đo mà chúng ta có thể thực hiện, các men gan, hồ sơ lipid trong máu, cân nặng cơ thể, hiệu suất thể thao, hiệu suất tinh thần, liệu bạn có khó chịu cả ngày hay không, liệu bạn có cảm thấy thư giãn hay không. Không ai biết cách định nghĩa những điều này. Và những điều này có ảnh hưởng mạnh mẽ từ văn hóa, gia đình và xã hội. Vì vậy, nếu bạn kết bạn với những người nhịn ăn định kỳ suốt cả ngày, điều đó sẽ có vẻ bình thường. Nếu bạn dành thời gian với những người chưa bao giờ nghe về nhịn ăn định kỳ, thì nhịn ăn định kỳ sẽ có vẻ rất bất thường. Bây giờ, chúng ta sẽ nói về các rối loạn ăn uống thực sự thuộc loại các rối loạn ăn uống có thể được chẩn đoán lâm sàng mà trong đó thực sự có những nguy cơ sức khỏe nghiêm trọng và thậm chí là nguy cơ tử vong nghiêm trọng.
    Có những tiêu chí rõ ràng trong cộng đồng tâm thần học và tâm lý học để định nghĩa các rối loạn như biếng ăn, cuồng ăn, rối loạn ăn uống do ăn uống thái quá, tất cả những điều này chúng ta sẽ nói đến. Nhưng khi chúng ta thảo luận về vấn đề này, tôi muốn nhấn mạnh rằng việc tự chẩn đoán có thể là một điều tích cực nhưng cũng rất mong manh. Luôn có cám dỗ khi một người tìm hiểu về triệu chứng của một rối loạn nào đó, không quan trọng đó là rối loạn gì, để đặt câu hỏi, ôi, liệu tôi có bị như vậy không? Ai đó mà tôi biết có bị như vậy không? Rất hấp dẫn để chẩn đoán cho họ hoặc cho chính mình là có hoặc không có một rối loạn cụ thể nào đó. Tuy nhiên, việc chẩn đoán thực sự cần phải được thực hiện bởi những người đã được đào tạo trong lĩnh vực cụ thể đó và có chuyên môn sâu sắc trong việc nhận diện triệu chứng, bao gồm cả một số triệu chứng tinh tế hơn của các rối loạn ăn uống. Vì vậy, nếu bất kỳ triệu chứng nào khiến bạn đồng cảm bằng cách bạn nghĩ rằng bạn có rối loạn cụ thể này hoặc ai đó mà bạn biết có một rối loạn, tôi sẽ rất nghiêm túc về điều đó, nhưng tôi sẽ mang thông tin đó đến một chuyên gia y tế có đủ năng lực có thể chẩn đoán hoặc loại trừ bất kỳ rối loạn nào có thể có. Tôi muốn nghỉ một chút và công nhận một trong những nhà tài trợ của chúng tôi, Element. Element là một loại nước điện giải có đầy đủ những gì bạn cần và không có gì bạn không cần. Điều đó có nghĩa là các điện giải, natri, magie và kali ở mức đúng, nhưng không có đường. Làn nước phù hợp là rất quan trọng cho chức năng não và cơ thể tối ưu. Ngay cả một mức độ thiếu nước nhẹ cũng có thể làm giảm hiệu suất nhận thức và thể chất. Điều này cũng quan trọng rằng bạn cần đủ điện giải. Các điện giải, natri, magie và kali là rất quan trọng cho chức năng của tất cả các tế bào trong cơ thể bạn, đặc biệt là các neuron hoặc tế bào thần kinh của bạn. Uống Element hòa tan trong nước giúp bạn dễ dàng đảm bảo rằng bạn đang nhận đủ nước và đủ điện giải. Để chắc chắn rằng tôi nhận đủ lượng nước và điện giải, tôi hòa tan một gói Element trong khoảng 16 đến 32 ounce nước khi tôi mới dậy vào buổi sáng và tôi uống nó ngay lập tức vào sáng sớm. Tôi cũng sẽ uống Element hòa tan trong nước trong bất kỳ loại thể dục nào tôi đang thực hiện, đặc biệt vào những ngày nóng khi tôi đổ mồ hôi rất nhiều và mất nước cùng điện giải. Element có nhiều hương vị ngon miệng. Tôi yêu hương vị mâm xôi. Tôi thích hương vị chanh. Hiện tại, Element có một hương vị chanh phiên bản giới hạn cực kỳ ngon. Tôi không thích nói rằng tôi yêu một hương vị hơn tất cả những hương vị còn lại, nhưng hương vị chanh này thực sự nằm trong số những hương vị yêu thích khác của tôi, đó là mâm xôi hoặc dưa hấu. Một lần nữa, tôi không thể chọn chỉ một hương vị. Tôi yêu tất cả. Nếu bạn muốn thử Element, bạn có thể vào drinkelement.com/huberman, được đánh vần là drink L-M-N-T dot com slash Huberman để nhận một gói mẫu miễn phí Element cùng với bất kỳ mua hàng nào của loại nước pha Element. Một lần nữa, đó là drinkelement.com/huberman để nhận gói mẫu miễn phí. Vậy rối loạn ăn uống là gì? Chà, chúng ta phải lùi một bước và thừa nhận thực tế rằng mỗi xã hội, mỗi nền văn hóa, mỗi gia đình và mỗi cá nhân đều có mối quan hệ khác nhau với thức ăn. Tuy nhiên, rối loạn ăn uống có những tiêu chí cụ thể cho phép chúng ta định nghĩa chúng và suy nghĩ về các phương pháp điều trị khác nhau liên quan đến các triệu chứng cụ thể, đặc biệt là các triệu chứng tâm lý và sinh học của các rối loạn đó. Các rối loạn ăn uống chính là gì? Anorexia nervosa, thường được gọi là biếng ăn, có lẽ là rối loạn ăn uống phổ biến nhất và nguy hiểm nhất trong tất cả các rối loạn ăn uống. Trên thực tế, biếng ăn là rối loạn tâm thần nguy hiểm nhất trong tất cả, thậm chí còn hơn cả trầm cảm. Xác suất tử vong cho biếng ăn không được điều trị là rất cao. Và thật đáng buồn, tỷ lệ phổ biến của biếng ăn rất cao. Nếu bạn tra cứu trên mạng hoặc nói chuyện với một chuyên gia đủ điều kiện, nó về cơ bản là sự thất bại trong việc ăn đủ để duy trì trọng lượng cơ thể khỏe mạnh. Bạn có thể thấy đủ loại triệu chứng rất đáng lo ngại của một người đã bị biếng ăn trong một khoảng thời gian nào đó, một sự mất mát tổng thể về khối lượng cơ bắp vì họ tiêu thụ ít calo hơn số lượng họ đốt cháy. Họ sẽ có nhịp tim thấp. Đây là cơ thể và não đang cố gắng giảm mức năng lượng. Họ sẽ có huyết áp thấp. Thỉnh thoảng họ sẽ có triệu chứng như ngất xỉu, mất mật độ xương, loãng xương, mất kinh ở các cô gái và phụ nữ, và đủ loại chức năng ruột và miễn dịch bị rối loạn. Vì vậy, có rất nhiều triệu chứng khủng khiếp của biếng ăn thực sự đặt những người biếng ăn vào một trạng thái rất nguy hiểm, đó là lý do tại sao tỷ lệ tử vong từ biếng ăn không được điều trị cực kỳ cao. Bây giờ, một trong những hiểu lầm về biếng ăn là nó xuất phát từ sự nhấn mạnh quá mức vào chủ nghĩa hoàn hảo hoặc rằng vì tất cả những hình ảnh trên mạng xã hội và trong quảng cáo về những người cực kỳ gầy và săn chắc hoặc cơ bắp, mà những cá nhân đó đang nhìn vào bản thân và so sánh mình với những hình ảnh đó và nghĩ rằng họ không đủ tốt và phát triển biếng ăn. Thực tế là điều đó không đúng. Nếu bạn xem xét tỷ lệ mắc biếng ăn trong 10 năm hoặc 20 năm qua và so sánh điều đó với thời điểm biếng ăn lần đầu tiên được xác nhận, đó là vào thế kỷ 1600 và có thể thậm chí sớm hơn, điều bạn sẽ nhận thấy là tỷ lệ mắc biếng ăn không tăng. Anorexia được định nghĩa cổ điển đã tồn tại với tỷ lệ gần như giống nhau trong suốt 100, 200, 300 và 400 năm qua, điều này thật đáng kinh ngạc và thực sự cho thấy khả năng có một yếu tố sinh học mạnh mẽ trong cái mà chúng ta gọi là anorexia nervosa. Anorexia nervosa cực kỳ phổ biến. Nó ảnh hưởng từ 1% đến 2% phụ nữ và sự khởi phát điển hình xảy ra trong giai đoạn dậy thì, gần đến tuổi dậy thì, nhưng nó cũng có thể xuất hiện muộn hơn trong cuộc sống.
    Thực tế là, việc nhận diện và chẩn đoán chứng chán ăn thường xảy ra ở độ tuổi đầu 20, nhưng nếu nhìn lại lịch sử của những cá nhân này, thường có những dấu hiệu của chứng chán ăn bắt đầu từ tuổi thiếu niên hoặc thậm chí sớm hơn. Dĩ nhiên, nam giới cũng có thể mắc chứng chán ăn, nhưng chứng chán ăn tâm thần dường như xảy ra với tỉ lệ gấp 10 lần ở phụ nữ và các cô gái trẻ so với nam giới và các bé trai.
    Vậy cơn đói là gì và cảm giác no là gì? Cảm giác no, tất nhiên, là khi ta đã cảm thấy đủ hay đã ăn đủ. Tôi muốn nhắc nhở mọi người về những cơ chế cơ bản mà não bộ và cơ thể giao tiếp với nhau. Cơ thể đang truyền tải hai loại thông tin đến não bộ một cách thường xuyên, nhưng đặc biệt là liên quan đến việc ăn uống. Hai loại thông tin đó là thông tin cơ học và thông tin hóa học. Khi dạ dày của bạn đầy, nó gửi tín hiệu đến não bộ dựa hoàn toàn vào sự no bụng cơ học này. Điều đó không liên quan đến các chất dinh dưỡng mà chỉ nói rằng, “Tôi đã no” và do đó không cần cảm thấy đói. Không thấy cần phải tìm kiếm hoặc tiêu thụ thức ăn. Trong khi khi ruột của chúng ta rỗng, ngay cả khi chúng ta có nhiều chất dinh dưỡng hoặc dự trữ mỡ cơ thể, chúng ta thường có xu hướng tập trung nhiều hơn vào thức ăn. Vì vậy, thể tích và ảnh hưởng cơ học có tác động sâu sắc đến cách chúng ta suy nghĩ và những gì chúng ta xem xét làm hay không làm.
    Tương tự, có những tác động hóa học. Khi chúng ta tiêu thụ thức ăn, glucose trong máu của chúng ta tăng lên. Thông tin đó được truyền đến não bộ qua các con đường thần kinh và con đường hormon. Đặc biệt, có các tế bào thần kinh trong ruột của chúng ta gửi tín hiệu đến các khu vực của thân não liên quan đến cảm giác no, cảm giác đã đủ thức ăn trong hệ thống của chúng ta.
    Vậy cơn đói, việc ăn uống và cảm giác no được điều chỉnh như thế nào? Thông qua cách truyền thông cơ học và hóa học. Bạn có, tôi có, tất cả chúng ta đều có các tế bào thần kinh trong vùng dưới đồi (hypothalamus) kích thích việc ăn và các tế bào thần kinh kích thích ngừng ăn. Vùng dưới đồi của bạn nằm ở đáy não trước, ở trên và gần mái miệng của bạn. Vùng dưới đồi chứa nhiều loại tế bào thần kinh khác nhau, bao gồm các tế bào thần kinh kích thích hoạt động tình dục và ham muốn, điều chỉnh nhiệt độ cơ thể và kiểm soát cảm giác thèm ăn cũng như ngừng ăn. Có hai loại tế bào thần kinh trong một khu vực cụ thể của vùng dưới đồi có liên quan ở đây. Đó là các tế bào thần kinh được gọi là POMC. Đúng vậy? Các tế bào thần kinh pro-opioid melanocortin có xu hướng hoạt động như một phanh cho cảm giác thèm ăn thông qua một hormon khác có tên là hormon kích thích tế bào sắc tố (melanocyte stimulating hormone). Và bạn có một lớp tế bào thần kinh được gọi là các tế bào thần kinh AGRP. Các tế bào thần kinh AGRP là những tế bào thần kinh kích thích việc ăn uống và chúng tạo ra một loại cảm giác lo âu hoặc hứng khởi về thức ăn. Nếu bạn loại bỏ hoặc tiêu diệt những tế bào thần kinh này, điều này đã được thực hiện trong các mô hình chuột thí nghiệm trong phòng lab, nhưng cũng có con người có tổn thương hoặc tác động độc thần kinh lên các tế bào thần kinh AGRP này. Và điều bạn thấy là họ không muốn ăn. Họ hoàn toàn không có cảm giác thèm ăn. Ngược lại, nếu bạn kích thích các tế bào thần kinh AGRP này hoặc ở những con người có những khối u nhỏ gần các tế bào thần kinh AGRP này, họ sẽ ăn nhiều đến mức không thể chịu nổi.
    Bây giờ, có những tín hiệu quay trở lại từ cơ thể để thông báo cho não bộ về sự hiện diện của mức độ khác nhau của các chất dinh dưỡng. Và điều đó chủ yếu đến từ ba nguồn. Đầu tiên là mỡ cơ thể. Càng nhiều mỡ cơ thể, chúng ta càng tiết ra một hormon gọi là leptin. Leptin từ mỡ cơ thể đi đến não và ức chế cảm giác thèm ăn. Không phải ngẫu nhiên, sự tín hiệu của leptin bị rối loạn ở những người mắc chứng bulimia, béo phì và một số dạng rối loạn ăn uống khi bị ăn bành. Mỡ cơ thể đang thực hiện một điều gì đó thật thú vị liên quan đến chứng chán ăn. Khi có đủ mức độ mỡ cơ thể và leptin lưu thông trong máu và tín hiệu leptin này đến được não, vùng dưới đồi và tuyến yên ghi nhận tín hiệu đó và theo một cách hoàn toàn tiềm thức kích hoạt quá trình rụng trứng ở nữ giới và sản xuất tinh trùng ở nam giới. Vậy nên khi dự trữ mỡ cơ thể rất thấp, lý do mà chu kỳ kinh nguyệt ngừng lại hoặc sản xuất tinh trùng giảm đi hoặc thậm chí ngừng lại là vì không có đủ leptin đến vùng dưới đồi và tuyến yên và chúng đã ngừng các tín hiệu, các hormon như hormon kích thích sinh dục, hormon luteinizing, hormon kích thích nang trứng đi đến buồng trứng hoặc tinh hoàn và làm cho buồng trứng và tinh hoàn rụng trứng hoặc sản xuất nhiều tinh trùng hơn.
    Vậy bạn có hai loại tế bào thần kinh, một hoạt động như một bộ tăng tốc, tế bào thần kinh AGRP nói ăn, ăn và kích thích bạn ăn, và sau đó bạn có một loại tế bào thần kinh khác, tế bào thần kinh PMOC đang ức chế cơn đói, chúng hoạt động như một phanh và cơ thể thông báo cho não bộ liên tục về trạng thái của cơ thể và liệu nó có cần thêm thức ăn hay không.
    Vì vậy, bạn có thể tự hỏi, tại sao những người thừa cân và có nhiều mỡ cơ thể vẫn tiếp tục ăn nhiều? Dường như điều đó không nên xảy ra. Từ góc độ tiến hóa, điều đó có lý khi chúng ta nên ăn thường xuyên như chúng ta có thể, ăn nhiều nhất có thể và ăn nhanh nhất có thể. Có các mạch trong não để thưởng cho việc ăn uống thường xuyên, ăn nhanh và nhồi nhét nhiều thức ăn vào người càng nhiều càng tốt vì từ góc độ tiến hóa thuần túy, thực phẩm rất khan hiếm và việc tìm kiếm thực phẩm thì nguy hiểm, dù đó là từ nguồn động vật hay không, và luôn luôn cạnh tranh.
    Mỗi động vật,
    bao gồm cả con người,
    đều có một mạch
    được lập trình sẵn
    mà chúng ta sinh ra
    với nó, mạch này chú ý
    đến lượng thức ăn
    có sẵn, bao nhiêu thức ăn
    chúng ta đang nhận
    hiện tại và bao nhiêu
    chúng ta có thể nhận
    trong tương lai,
    và không đi sâu vào
    các khía cạnh sinh học
    của nhân hạt cong,
    trong hai câu,
    bạn có một vùng hypothalamus
    gọi là nhân hạt cong.
    Thực tế là khu vực này
    chứa đựng
    các tế bào thần kinh PMOC
    và các loại tế bào thần kinh khác
    điều chỉnh cảm giác đói
    và sự no.
    Và các tế bào thần kinh
    trong nhân hạt cong
    bắt đầu hoạt động
    khi chúng ta nhìn thấy thức ăn
    và nghĩ về thức ăn,
    chúng thúc đẩy cảm giác đói
    theo cách
    phản hồi với hình dạng
    của thực phẩm,
    mùi vị của thực phẩm,
    nhưng cũng tính đến lịch sử
    trước đó
    của các tương tác
    với thức ăn đó
    và nó cũng xem xét
    bối cảnh xã hội.
    Con đường nào?
    Cách thức này hoạt động như thế nào?
    Thực ra, bạn có thể khung
    tất cả hành vi,
    quyết định đúng
    và quyết định sai
    trong một mô hình
    hộp khá đơn giản.
    Chúng ta có kiến thức
    về những gì chúng ta nên làm
    trong một hộp, được chứ?
    Chúng ta nên ăn cái đó,
    không nên ăn cái đó,
    nên chờ bữa tối,
    không nên chờ bữa tối,
    và sau đó chúng ta có
    những gì chúng ta thực sự làm
    trong một hộp khác.
    Giữa hai hộp đó
    là hai lực tác động
    và những lực tác động đó
    quan trọng một cách quyết định.
    Những lực tác động đó
    là các quá trình ổn định nội môi
    điều chỉnh sự cân bằng
    của các hệ thống khác nhau
    trong cơ thể bạn,
    nóng và lạnh,
    thức hoặc ngủ,
    dopamine và mong muốn
    theo đuổi điều gì đó,
    serotonin và mong muốn
    chỉ thư giãn và nghỉ ngơi.
    Vì vậy, các quá trình ổn định nội môi
    và hệ thống thưởng
    và khi chúng ta tiến
    vào thảo luận
    về chứng chán ăn
    và bệnh ăn uống cuồng loạn cụ thể,
    những gì bạn sẽ thấy
    là chứng chán ăn và bệnh ăn uống cuồng loạn
    không phải là sự phá vỡ
    trong tâm lý
    của những gì người ta nên làm
    hoặc không nên làm.
    Đó là sự gián đoạn
    của các quá trình ổn định nội môi
    và thưởng
    đến mức mà quyết định
    hoàn toàn bị gián đoạn
    và trong nhiều trường hợp
    không có sẵn
    cho người bị chứng chán ăn hay cuồng ăn.
    Bây giờ, tôi không muốn
    trở nên trừu tượng ở đây.
    Điều tôi đang nói là
    người tự nhịn ăn
    đến mức
    họ có thể chết
    và trong một số trường hợp
    thật đáng buồn là họ đã chết,
    họ có thể biết rõ ràng
    rằng hành vi của họ
    đang dẫn đến kết quả xấu
    và thậm chí có thể là cái chết
    và thế mà họ không thể
    can thiệp
    trừ khi họ nhận được
    hỗ trợ lâm sàng đặc biệt
    bởi vì các quá trình ổn định nội môi,
    các tín hiệu từ cơ thể
    và não nói rằng
    bạn cần thức ăn,
    những tín hiệu đó không được ghi nhận
    theo cách giống như chúng
    đối với những cá nhân khác
    và chỉ như một gợi ý nhỏ
    về hướng đi của chúng ta,
    người bị chứng chán ăn có một loại công tắc
    đã được bật
    đến mức mà quyết định của họ
    thực sự khá tốt.
    Thậm chí nó có thể tốt hơn
    của bạn
    về đánh giá
    nội dung dinh dưỡng của thực phẩm
    nhưng thói quen của họ
    bị gián đoạn
    nên họ thậm chí không còn
    nhận thức một cách rõ ràng
    về thực tế
    rằng họ đang đưa ra những
    lựa chọn thực phẩm tồi tệ
    và trong một số trường hợp
    rất nguy hiểm.
    Hóa ra, thói quen
    và cách mà chúng ta xây dựng
    và phá vỡ
    và xây dựng lại thói quen mới
    là một trong những
    phương pháp điều trị
    hiệu quả nhất
    cho chứng chán ăn.
    Tôi muốn nghỉ ngơi
    một chút
    và công nhận
    nhà tài trợ của chúng tôi AG1.
    AG1 là một loại nước uống vitamin khoáng
    probiotic
    cũng bao gồm
    các prebiotic và adaptogen.
    Là một người đã tham gia
    nghiên cứu khoa học
    gần ba thập kỷ
    và trong lĩnh vực sức khỏe và thể hình
    cũng lâu như vậy,
    tôi liên tục tìm kiếm
    những công cụ tốt nhất
    để cải thiện sức khỏe tinh thần,
    sức khỏe thể chất
    và hiệu suất của mình.
    Tôi đã phát hiện AG1
    vào năm 2012,
    rất lâu trước khi tôi từng
    có một podcast
    và tôi đã sử dụng nó
    mỗi ngày kể từ đó.
    Tôi thấy rằng nó cải thiện
    tất cả các khía cạnh của sức khỏe của tôi,
    năng lượng của tôi,
    sự tập trung của tôi
    và tôi cảm thấy
    tốt hơn rất nhiều
    khi tôi sử dụng nó.
    AG1 sử dụng những thành phần
    có chất lượng cao nhất
    trong những sự kết hợp đúng
    và họ liên tục
    cải thiện công thức của mình
    mà không làm tăng chi phí.
    Thực tế,
    AG1 vừa ra mắt
    công thức nâng cấp mới nhất của họ.
    Công thức thế hệ tiếp theo này
    dựa trên nghiên cứu mới
    về ảnh hưởng của probiotic
    đến hệ vi sinh đường ruột
    và giờ đây nó bao gồm
    nhiều chủng probiotic
    được nghiên cứu lâm sàng
    cho thấy hỗ trợ
    cả sức khỏe tiêu hóa
    và sức khỏe hệ miễn dịch
    cũng như cải thiện
    độ đều đặn của ruột
    và giảm đầy hơi.
    Mỗi khi tôi được hỏi
    nếu tôi chỉ có thể sử dụng
    một bổ sung duy nhất,
    bổ sung đó sẽ là gì,
    tôi luôn nói là AG1.
    Nếu bạn muốn thử AG1,
    bạn có thể vào
    drinkag1.com
    slash Huberman.
    Trong một khoảng thời gian giới hạn,
    AG1 đang tặng miễn phí
    một tháng sử dụng
    dầu cá omega-3
    cùng với một chai
    vitamin D3
    cộng với K2.
    Như tôi đã nhấn mạnh
    trước đây trên podcast này,
    dầu cá omega-3
    và vitamin D3
    đã được chứng minh
    có lợi cho mọi thứ
    từ tâm trạng và sức khỏe não,
    đến sức khỏe tim mạch,
    đến trạng thái hormone khỏe mạnh
    và nhiều hơn nữa.
    Một lần nữa,
    đó là drinkag1.com
    slash Huberman
    để nhận một tháng sử dụng miễn phí
    dầu cá omega-3
    cộng thêm một chai
    vitamin D3
    cộng với K2
    với đăng ký của bạn.
    Bây giờ hãy cùng nói về
    chứng chán ăn,
    sự từ chối
    tiêu thụ đủ năng lượng
    đến mức cá nhân
    có nguy cơ tử vong
    và nếu không phải chết,
    thì là những rối loạn chuyển hóa nghiêm trọng,
    thiếu mật độ xương,
    v.v.
    Một phân tích cẩn thận
    thông qua dịch tễ học y tế
    đã cho thấy
    rằng bạn tìm thấy chứng chán ăn
    thậm chí trong các nền văn hóa
    và xã hội
    nơi thực phẩm khan hiếm.
    Điều đó thực sự nói lên
    cơ chế sinh học.
    Thông thường,
    chứng chán ăn bắt đầu
    trong giai đoạn tuổi thanh thiếu niên
    xung quanh tuổi dậy thì.
    Tuổi dậy thì
    trên mức độ rất rộng
    là bước phát triển quan trọng
    và nổi bật nhất
    mà bất kỳ ai trải qua
    trong suốt cuộc đời của họ.
    Cơ thể thay đổi,
    não bộ thay đổi,
    nhận thức thay đổi,
    nhận thức về bản thân thay đổi.
    Và hầu hết các thay đổi đó
    đều do sự thay đổi
    trong mạch điện
    trong vùng hypothalamus.
    Vì vậy, các tế bào thần kinh
    kiểm soát
    sự sản xuất
    các hormone steroid giới tính
    được gọi là,
    những thứ như testosterone,
    estrogen,
    và các hormone liên quan,
    prolactin,
    v.v.
    tất cả đều thay đổi
    với tốc độ rất nhanh.
    Hãy cùng nhìn vào
    các khía cạnh bên trong.
    Hãy cùng xem những gì được biết về mạch thần kinh và những loại cảm nhận cũng như hành vi mà mạch thần kinh đang điều khiển, nhằm hiểu rõ điều gì mà họ thực sự đang phải chịu đựng ở mức độ nguyên nhân, không chỉ là triệu chứng. Trước hết, có một thách thức trong việc nghiên cứu chứng biếng ăn (anorexia) vì ở đó, những gì bạn đang nghiên cứu về cơ bản là sự vắng mặt của một hành vi. Rất khó để nghiên cứu sự vắng mặt của một hành vi so với một hành vi. Vì vậy, họ đã thực hiện một số thí nghiệm với những bệnh nhân biếng ăn, cho họ một bộ sưu tập hình ảnh của các loại thực phẩm khác nhau và cho phép những bệnh nhân biếng ăn này sắp xếp các loại thực phẩm theo sở thích của họ về những gì họ sẽ chọn, về thành phần dinh dưỡng của thực phẩm, về hàm lượng calo. Họ đã hỏi những người biếng ăn này đánh giá thực phẩm và khi làm như vậy, họ có thể xác định được điều gì rất độc đáo đối với những người biếng ăn ở mức độ cảm nhận thực phẩm của họ. Những người biếng ăn, thay vì cảm thấy lo lắng khi có thực phẩm, lại có sự nhạy bén cao độ, một sự nhận thức vượt trội về hàm lượng chất béo của thực phẩm, gần như đạt đến mức độ như là những người có tài năng thiên bẩm về hàm lượng chất béo. Bây giờ, đó là một triệu chứng đã được biết đến của chứng biếng ăn, đặc biệt là những người biếng ăn trẻ tuổi, rằng họ có một nỗi ám ảnh với thực phẩm, hàm lượng calo, tỷ lệ chất dinh dưỡng vĩ mô, tức là tỷ lệ chất béo, protein và carbohydrate. Họ đang tích cực tránh những thực phẩm có hàm lượng chất béo cao, thực phẩm giàu calo và mặc định chọn những thực phẩm có hàm lượng calo rất thấp nếu họ phải ăn. Và điều này rất quan trọng bởi vì điều đó có nghĩa là chúng ta cần nhìn vào những vùng của não bộ điều khiển việc hình thành thói quen và thực hiện thói quen. Trong trường hợp của người biếng ăn, những thói quen ấy chính là nơi mà mọi thứ bắt đầu đi sai lệch và thúc đẩy hành vi ăn uống không lành mạnh, điều mà đáng buồn là thường dẫn đến cái chết hoặc ít nhất là kết quả y tế xấu. Và hóa ra, các vùng não liên quan đến việc hình thành và thực hiện thói quen là điểm can thiệp tốt nhất.
    Vì vậy, bạn có các phản xạ và bạn có các quá trình thần kinh bao gồm những gì được gọi là các quá trình về đường đi và kết quả. Chúng ta có thể viết tắt quá trình về đường đi và kết quả thành DPO. DPO là cho tất cả các loại hành vi liên quan đến mục tiêu. Ví dụ, nếu bạn muốn đến cửa hàng tạp hóa để mua sắm một số đồ và sau đó trở về nhà, bạn sẽ nghĩ đến thời gian, mình có bao nhiêu thời gian? Ờ, mình có 45 phút để đến cửa hàng? Mất bao lâu để tới cửa hàng? Đường đi, mình sẽ lái xe theo hướng nào để đến đó? Mình sẽ điều hướng như thế nào trong cửa hàng tạp hóa? Kết quả, mình có thể vào và lấy được những món đồ mình cần và về nhà kịp thời không? Được chứ? DPO, đường đi, kết quả. Đó là một quá trình rất có ý thức mà yêu cầu ra quyết định và dựa vào phần thưởng. Bạn sử dụng các quá trình kiểu DPO này trong ngắn hạn để mua sắm đồ ăn và chọn một hàng tại cửa hàng tạp hóa và quyết định đường nào để trở về nhà, và bạn cũng sử dụng chúng để điều hướng trong các quá trình dài trong cuộc sống, cố gắng lấy bằng cấp hoặc nuôi dạy trẻ em hoặc vượt qua một năm đầy thử thách, v.v. Vậy thì đường đi và kết quả và toàn bộ quá trình đó phụ thuộc vào não trước của bạn, vỏ não trước. Vỏ não trước cho phép bạn lấy thông tin từ trí nhớ, kết hợp nó với thông tin về những gì đang xảy ra trong bối cảnh hiện tại và sau đó điều hướng hành vi, lời nói, v.v., của bạn hướng tới những kết quả nhất định. Ngược lại, các phản xạ không liên quan đến vỏ não trước theo cùng một cách. Thói quen và phản xạ, như một khi bạn đã biết cách đi bộ, không phụ thuộc vào vỏ não trước. Nó là tiềm thức như được gọi đôi khi, nhưng về cơ bản bạn không cần sử dụng các phần của não liên quan đến phân tích đường đi và kết quả. Nhưng về cơ bản, bạn có một vùng não và những người biếng ăn có một vùng não có liên quan đến việc đánh giá và ra quyết định xung quanh thực phẩm và sau đó một vùng não khác có liên quan đến việc tiêu thụ thực phẩm theo phản xạ và tránh những loại thực phẩm khác. Luôn có các hệ thống thân nhiệt và phần thưởng ảnh hưởng đến loại việc này.
    Chà, trong não của người biếng ăn, hóa ra các hệ thống phần thưởng đã được gắn liền với việc thực hiện thói quen theo cách mà không tốt cho trọng lượng cơ thể, nhưng ít nhất từ góc độ mạch thần kinh thuần túy, phần thưởng bây giờ được dành cho việc tránh các loại thực phẩm nhất định và chỉ tiếp cận những thực phẩm rất ít calo và ít chất béo. Vậy thực sự có vẻ như có một chuyển đổi trong não của người biếng ăn mà thưởng cho họ bên trong. Họ cảm thấy tốt khi họ tránh một số thực phẩm và tiếp cận những loại thực phẩm khác. Vì vậy, đó không phải là một mô hình dựa trên sự thiếu thốn mà họ tự hành hạ bản thân hay ma sát (masochism) hay đang tích cực tránh thực phẩm để trừng phạt bản thân, điều đó rất thú vị bởi vì nhiều lý thuyết tâm lý học ủng hộ ý tưởng đó. Thay vào đó, một khi điều này chuyển thành một tập hợp thói quen, họ thực sự cảm thấy được thưởng. Họ cảm thấy tốt, có lẽ là từ sự giải phóng một chất điều chỉnh thần kinh khác gọi là dopamine, khi tiếp cận các thực phẩm có hàm lượng chất béo và calo thấp, và toàn bộ mạch não của họ đã bị lệch hướng để tránh những điều nhất định và thực sự họ được thưởng vì điều đó và họ cảm thấy tốt hơn rất nhiều so với việc họ ăn theo cách hỗ trợ trọng lượng khỏe mạnh.
    Vậy làm thế nào để bạn phá vỡ một thói quen? Làm thế nào để bạn lập lại mạch não đang thực sự gây ra một phản xạ và trong trường hợp này là gây ra một phản xạ đang giết chết cá nhân đó hoặc ít nhất dẫn đến những kết quả về sức khỏe rất xấu? Cách mà bạn làm điều đó là thông qua một cơ chế nhận thức nơi bạn dạy cho cá nhân đó điều gì đang dẫn đến thói quen.
    Vậy hãy cùng nói về những điều dẫn đến thói quen. Bởi vì những điều đó hóa ra lại chính là những điểm vào chính xác để thay đổi, loại bỏ và tái cấu trúc thói quen hướng tới những hành vi lành mạnh hơn. Có hai đặc điểm chính trong suy nghĩ liên quan đến các thói quen mà những người bị chán ăn thực hiện. Thứ nhất là điều được gọi là sự liên kết trung tâm yếu. Sự liên kết trung tâm yếu về cơ bản là một sự thiếu khả năng nhìn thấy cả bức tranh lớn qua những chi tiết nhỏ. Nó thể hiện sự nhạy bén và tập trung cao độ vào các chi tiết trong một môi trường nhất định. Bạn sẽ bỏ lỡ bức tranh toàn cảnh. Điều thứ hai là một thách thức trong việc chuyển đổi trạng thái; khi bạn xác định được một điều gì đó mà bạn đặc biệt quan tâm và điều đó tạo ra một phần thưởng nhất định cho người bị chán ăn, điều đó sẽ là xác định các thực phẩm có nhiều chất béo hoặc xác định món ăn duy nhất trên bàn mà người đó có thể ăn mà không ai hy vọng nhận ra rằng họ chỉ ăn đậu xanh và không động vào bất kỳ món ăn nào khác. Nếu bạn từng ăn một bữa với người bị chán ăn, họ thực sự trở thành bậc thầy trong việc cố gắng giữ cho mọi người không chú ý đến những gì họ đang làm, nghĩa là tập trung vào những thực phẩm ít béo, ít calo này. Điều thật đáng ngạc nhiên và cũng thực sự quan trọng là những kết quả này cho thấy rằng một khi bạn dạy cho những người bị chán ăn biết điều gì đang xảy ra với họ, rằng họ đang làm việc này, họ có thể can thiệp. Giờ đây, họ cần được hỗ trợ, đúng không? Một dạng trị liệu khác có vẻ hiệu quả với những người bị chán ăn, lý tưởng là kết hợp với việc tái cấu trúc thói quen này, là mô hình dựa trên gia đình. Các mô hình dựa trên gia đình đang bắt đầu nổi lên khá nhiều trong các môi trường trị liệu khác nhau. Các mô hình dựa trên trị liệu ngắn gọn về cơ bản là nơi mà toàn bộ gia đình được thông báo về những thách thức của cá nhân với một rối loạn ăn uống đặc biệt hoặc rối loạn khác và trong việc hiểu một số điều về sinh học và tâm lý xung quanh nó, họ ngừng lên án cá nhân đó, họ bắt đầu hỗ trợ cá nhân đó bằng cách chỉ dẫn họ đến những thói quen của chính họ mà họ quan sát, họ cho họ một số quyền tự chủ, họ nhận ra rằng không có gì thay đổi ngay lập tức, nhưng họ được dạy về những thứ như tính thần kinh linh hoạt và khả năng thay đổi não bộ của mình đáp ứng với trải nghiệm. Và vì thế tồn tại một mạng lưới hỗ trợ nội bộ hoàn chỉnh. Tất cả những điều này nằm dưới khái niệm trị liệu hành vi nhận thức, và tôi nên đề cập rằng các liệu pháp hành vi nhận thức thường được thực hiện kết hợp với các liệu pháp dược lý. Trước khi chúng ta chuyển sang nói về chứng bulimia và một số rối loạn liên quan, tôi muốn nói về một khía cạnh của chứng chán ăn mà rất thú vị, thực sự gây lo lắng, nhưng đã nhận được rất nhiều sự chú ý, đó là hình ảnh bản thân bị bóp méo. Trong tập về trầm cảm, chúng tôi đã nói về một khía cạnh rất mạnh mẽ của trầm cảm nặng mà đó là sự tự suy diễn chống lại bản thân mà những người bị trầm cảm dường như tin tưởng một cách chân thành và thậm chí tự suy diễn rằng họ đang hoạt động kém trong cuộc sống và rằng họ không có giá trị hoặc không đáng gì cả, v.v. Thực sự đó là một lời nói dối mà họ tin tưởng và các phát ngôn, cảm giác và hành vi của họ bắt đầu phản ánh lời nói dối đó. Họ không có ý thức về điều đó. Đó là lý do tại sao chúng tôi gọi đó là một sự tự suy diễn. Những người bị chán ăn thường sẽ thấy bản thân mình thừa cân hoặc không hoàn hảo theo những cách mà họ bị ám ảnh. Trong trường hợp của người bị chán ăn, vấn đề dường như là họ có một sự bóp méo chân chính về hình ảnh bản thân, đến mức họ không thực sự nhìn thấy bản thân một cách chính xác. Những nhận thức thị giác của họ sai lệch, và lý do chúng tôi biết điều này là nhờ một số nghiên cứu thực sự quan trọng và đẹp đẽ đã được thực hiện trong phòng thí nghiệm của đồng nghiệp tôi, Jeremy Balenson, tại Stanford. Điều thú vị thực sự về những nghiên cứu này là chúng cho chúng tôi cái nhìn sâu sắc vào khuyết tật cảm nhận mà những người bị chán ăn gặp phải. Tôi thực sự đã tham gia một trong những thí nghiệm này. Tôi may mắn không bị chán ăn, nhưng tôi đã thực hiện một số công việc với phòng thí nghiệm VR ở đó, và những gì bạn sẽ làm là điều chỉnh hình đại diện của chính mình đến mức mà bạn nghĩ rằng nó chính xác nhất có thể, và những người bị chán ăn thực sự bóp méo hình đại diện này. Nói cách khác, họ tạo ra một sự không phù hợp nghiêm trọng giữa nhận thức của họ về bản thân và thực tế. Thật vậy, điều đó dường như là đúng. Giờ đây, điều làm nhẹ nhõm, hoặc tôi nên nói là điều khuyến khích về một số liệu pháp mà chúng tôi đã nói trước đây, mô hình dựa trên gia đình, các phương pháp điều trị hành vi nhận thức, vâng, và cả các phương pháp điều trị bằng thuốc nữa, nhưng mô hình can thiệp thói quen này là khi một người bắt đầu thay đổi những điều đó, dường như rằng nhận thức về bản thân cũng theo sau, rằng nhận thức về bản thân dường như thay đổi cùng với sự thay đổi trong thói quen. Vì vậy, có vẻ như không hiệu quả khi cố gắng nói với ai đó, ôi trời ơi, bạn thật gầy, bạn thực sự cần ăn, điều đó không dường như có tác dụng. Họ просто không nhìn thấy bản thân theo cùng một cách mà bạn thấy họ. Và vì vậy, tôi đưa ra điều đó như một điểm để xem xét nếu bạn biết một ai đó bị chán ăn hoặc nếu bạn nhìn một người bị chán ăn và bạn nghĩ, làm thế nào mà họ vẫn còn phê phán lượng mỡ cơ thể nhỏ nhặt, thậm chí không tồn tại trên cánh tay của họ hoặc điều gì đó? Làm thế nào để điều đó xảy ra? Thực tế là não của họ, liên quan đến nhận thức, đặc biệt là những nhận thức thị giác, hoàn toàn sai lệch. Và may mắn thay, bằng cách thay đổi thói quen, bạn cũng tái cấu trúc những mạch não đó. Tôi muốn nghỉ ngắn và công nhận một trong những nhà tài trợ của chúng tôi, Function. Năm ngoái, tôi đã trở thành thành viên của Function sau khi tìm kiếm cách tiếp cận toàn diện nhất về xét nghiệm lab. Function cung cấp hơn 100 xét nghiệm lab tiên tiến giúp bạn có bức tranh tổng quan về sức khỏe toàn thân của mình. Bức tranh này cung cấp cho bạn cái nhìn về sức khỏe tim mạch của bạn, sự cân bằng hormone, chức năng miễn dịch, mức độ dinh dưỡng và nhiều hơn thế nữa.
    Chức năng không chỉ cung cấp việc kiểm tra hơn 100 dấu hiệu sinh học quan trọng cho sức khỏe thể chất và tinh thần của bạn, mà còn phân tích kết quả và cung cấp những hiểu biết từ các bác sĩ hàng đầu có chuyên môn trong các lĩnh vực liên quan.
    Ví dụ, trong một trong những bài kiểm tra đầu tiên của tôi với Chức năng, tôi đã phát hiện ra rằng mức thủy ngân trong máu của tôi tăng cao. Chức năng không chỉ giúp tôi phát hiện điều đó, mà còn cung cấp những hiểu biết về cách tốt nhất để giảm mức thủy ngân của tôi, trong đó có việc hạn chế tiêu thụ cá ngừ.
    Tôi đã ăn rất nhiều cá ngừ, đồng thời cũng cố gắng ăn nhiều rau lá xanh hơn và bổ sung NAC và acetylcystein, cả hai đều có thể hỗ trợ sản xuất glutathione và giải độc. Và tôi phải nói rằng, qua bài kiểm tra thứ hai với Chức năng, cách tiếp cận đó đã phát huy hiệu quả.
    Kiểm tra máu toàn diện là rất quan trọng. Có rất nhiều điều liên quan đến sức khỏe tâm lý và thể chất của bạn chỉ có thể được phát hiện qua xét nghiệm máu. Vấn đề là xét nghiệm máu luôn rất đắt đỏ và phức tạp. Ngược lại, tôi rất ấn tượng với sự đơn giản của Chức năng và mức chi phí của nó. Nó thực sự rất phải chăng.
    Vì vậy, tôi đã quyết định tham gia vào ban cố vấn khoa học của họ, và tôi rất vui vì họ đang tài trợ cho podcast. Nếu bạn muốn thử Chức năng, bạn có thể truy cập vào functionhealth.com/huberman. Chức năng hiện đang có danh sách chờ với hơn 250.000 người, nhưng họ đang cung cấp quyền truy cập sớm cho các thính giả của podcast Huberman. Một lần nữa, đó là functionhealth.com/huberman để nhận quyền truy cập sớm vào Chức năng.
    Được rồi, bây giờ hãy nói về chứng cuồng ăn, đó là việc ăn uống thái quá và sau đó là việc thanh lọc, thường bằng cách tự gây nôn hoặc bằng cách sử dụng thuốc nhuận tràng. Và sau đó chúng ta cũng sẽ nói về rối loạn ăn uống cưỡng bức, có nhiều đặc điểm tương tự như chứng cuồng ăn, nhưng thường không có việc thanh lọc.
    Các tiêu chí được mô tả cho tôi là nếu ai đó thực hiện điều này ít nhất một lần một tháng trong khoảng từ hai đến ba tháng, thì điều đó có thể đủ điều kiện. Họ không đưa ra quyết định để ăn uống thái quá. Họ bị thúc đẩy từ bên trong để tiêu thụ nhiều thức ăn hơn mức họ cần. Và trong một số trường hợp, nhiều hơn cả điều họ muốn ăn.
    Vì vậy, điều này rất giống với thói quen mà chúng tôi đã mô tả cho chứng biếng ăn. Nó gần như đã biến thành một phản xạ khi họ bắt đầu. Tất cả các tín hiệu homeostatic đều bị vượt qua. Tất cả các tín hiệu từ cơ thể, leptin, insulin, glucose, tất cả các thứ đó đều ở mức cao ngất ngưởng. Nhưng họ vẫn, như chúng ta đã biết, những người mà các nhà khoa học gọi là hyperphagic. Họ ăn như điên.
    Có rất nhiều sự xấu hổ liên quan đến chứng cuồng ăn, thường là vì mọi người nôn mửa và thật khó để che giấu hành vi nôn mửa đó. Mọi người đều nhận thức được điều đó. Đặc điểm nổi bật của chứng cuồng ăn mà khiến nó khác biệt với chứng biếng ăn, ngoài thực tế là nó là ăn uống thái quá thay vì không ăn đủ, là sự thiếu kiểm soát mà họ gọi là kiểm soát ức chế. Và điều đó có thể không gây ngạc nhiên. Nhưng trước tiên, người mắc chứng cuồng ăn, khác với người mắc chứng biếng ăn, có tính chất bốc đồng cao và thường có những hành vi bốc đồng khác.
    Vì lý do đó, nhiều phương pháp điều trị mà bạn thấy cho chứng cuồng ăn và rối loạn ăn uống cưỡng bức là những loại phương pháp điều trị mà dường như không hoạt động tốt, hoặc ít nhất là phần lớn thời gian cho chứng biếng ăn. Vì vậy, các loại thuốc làm tăng chất truyền đạt thần kinh serotonin, chẳng hạn như fluoxetine, còn được gọi là Prozac, Paxil, v.v., thường có thể hiệu quả trong việc điều trị chứng cuồng ăn.
    Một số loại thuốc được sử dụng để điều trị rối loạn tăng động giảm chú ý và ADD, một số loại thuốc tương tự như Adderall, Vyvanse và những thứ tương tự cũng có thể được sử dụng để điều trị chứng cuồng ăn và rối loạn ăn uống cưỡng bức.
    Tại sao điều đó có thể hiệu quả? Chà, bây giờ bạn đã quen thuộc với vỏ não trước trán. Vỏ não trước trán liên quan đến phân tích về thời gian, con đường và kết quả. Thời gian, con đường và kết quả là cách chúng ta tránh tính bốc đồng. Đó là cách chúng ta nghĩ, nếu điều này, thì điều kia; nếu điều đó, thì điều này, bạn có thể tưởng tượng rằng đối với những người mắc chứng ám ảnh cưỡng chế hoặc cho người mắc chứng biếng ăn, những mạch này quá hoạt động. Đối với người mắc chứng cuồng ăn, chính là mạch đó sẽ không hoạt động đủ.
    Vì vậy, thực sự, nó hoàn toàn đối lập với những gì bạn thấy trong chứng biếng ăn. Thiếu tính bốc đồng này có nghĩa là thiếu kiểm soát vỏ não trước trán, điều mà chúng tôi gọi là kiểm soát từ trên xuống. Họ trở nên bốc đồng hơn. Vì vậy, những người mắc chứng cuồng ăn gặp vấn đề với sự bốc đồng và do đó, các loại thuốc có thể làm tăng serotonin và đôi khi là những loại thuốc làm tăng dopamine và norepinephrine trong não, cho phép kiểm soát từ trên xuống tốt hơn. Và đó cũng là lý do tại sao chúng được sử dụng để điều trị ADHD và rối loạn thiếu chú ý.
    Những loại thuốc này có xu hướng tạo ra sự tập trung cao và có xu hướng đẩy não và chế độ xử lý chung về một hướng mà bạn nghĩ, nếu điều này, thì điều kia; nếu điều này, thì điều kia. Vì vậy, dự đoán các kết quả. Liệu các can thiệp hành vi có hiệu quả đối với chứng cuồng ăn không? Trong một số trường hợp, có, với điều kiện rằng các can thiệp đó được thực hiện đủ sớm. Dù sao thì, can thiệp hành vi kết hợp với các can thiệp dựa trên thuốc luôn hiệu quả hơn bất kỳ một trong hai loại riêng lẻ.
    May mắn thay, có một bộ thuốc đủ lớn có thể giúp đỡ với chứng cuồng ăn. Chúng ta có, một mặt, chứng biếng ăn, có vẻ như là sự gián đoạn trong thói quen và sự kết hợp của những thói quen không lành mạnh, trong trường hợp này là hạn chế thực phẩm, với con đường thưởng. Còn ở mặt trái, chúng ta có rối loạn ăn uống cưỡng bức và chứng cuồng ăn, trong đó một thói quen rất không lành mạnh của việc ăn uống thái quá, đôi khi theo sau bởi việc thanh lọc, không nhất thiết phải kết hợp với phần thưởng.
    Họ cảm thấy khủng khiếp khi làm điều đó, đúng không? Người mắc chứng biếng ăn cảm thấy tuyệt vời về việc hạn chế lượng thực phẩm của họ. Họ cảm thấy như họ đang thắng một loại trò chơi nào đó. Mạch dây bị lật ngược theo một cách nào đó. Với chứng cuồng ăn, họ cảm thấy khủng khiếp về việc ăn uống thái quá. Có sự xấu hổ to lớn. Họ không thể kiểm soát bản thân. Phần thưởng được thiết lập trước hành vi.
    Phần thưởng được tạo ra bằng cách thu hút họ đến với thức ăn và làm cho thức ăn trông giống như một cái gì đó vô cùng hấp dẫn, và không có sự ngắt quãng nào của sự thôi thúc. Không có cách nào để họ ngừng loại hành vi đó. Tôi nghĩ rằng đối với những ai biết về người mắc chứng chán ăn hoặc đã quan sát chứng chán ăn, thật khó để chứng kiến ai đó tự nhịn ăn đến gần cái chết hoặc chết. Cũng không kém phần đáng lo ngại là một người có một lượng thức ăn dồi dào mà lại ăn uống thái quá và sau đó cảm thấy tồi tệ về điều đó. Vì vậy, đây là những chủ đề nặng nề. Đây là những chủ đề mà, thực sự thì, không ai muốn nói đến trừ khi họ biết ai đó đang phải chịu đựng hoặc chính bản thân họ đang phải chịu đựng. Những gì tôi đã cố gắng làm hôm nay là cố gắng cho bạn một cái nhìn sâu sắc về những gì thực sự ẩn sau những thứ mà chúng ta gọi là rối loạn ăn uống. Tôi hy vọng tôi đã làm được điều đó ở cấp độ sinh học, mạch thần kinh, cơ chế, nội tiết học và một phần nào đó của tâm lý học. Như với bất kỳ tập nào của podcast này, nhưng đặc biệt là khi chúng ta nói về các vấn đề sức khỏe tâm thần và rối loạn sức khỏe tâm thần, rối loạn hành vi, không có cách nào tôi có thể bao quát một cách toàn diện tất cả các hình thức điều trị khác nhau. Những điểm chính hôm nay là chúng ta nên đặt câu hỏi, ăn uống lành mạnh là gì đối với chúng ta? Làm thế nào để chúng ta phát triển một mối quan hệ với thực phẩm để chúng ta có thể thưởng thức thực phẩm, hy vọng là cả về mặt xã hội và một mình, nhưng không được ám ảnh và cưỡng bức về nó? Hôm nay, chúng tôi đã tập trung vào các hành vi liên quan đến thực phẩm cực đoan thực sự được coi là các rối loạn chính thức. Chúng có trong các tài liệu tâm thần học và có thể được chẩn đoán và chúng là những mối lo ngại sức khỏe nghiêm trọng. Chúng không chỉ gây ra những rắc rối tâm lý và lo lắng cho những người mắc phải và những người xung quanh họ, mà chúng thật sự là những mối lo ngại về sức khỏe. Tôi muốn nhấn mạnh rằng chứng chán ăn tâm thần (anorexia nervosa) là rối loạn tâm thần chết người nhất với một khoảng cách lớn. Và nếu bạn xem xét thống kê về số lượng người mắc chứng rối loạn ăn uống và số người chết vì rối loạn ăn uống, không cách xa lắm so với số người chết do tai nạn ô tô. Tôi rất muốn bạn ghi nhớ mô hình mà tôi đã được truyền dạy mà tôi nghĩ là rất mạnh mẽ cho việc suy nghĩ về mọi loại vấn đề, không chỉ về ăn uống, mà còn tất cả các loại hành vi và nhận thức mà bạn có một hộp cho những gì bạn nghĩ, một hộp cho những gì bạn làm, và cái gì đang can thiệp giữa chúng? Tại sao bạn có thể biết điều tốt hơn mà không làm tốt hơn? Vâng, đó là vì bạn cũng phải đối phó với các quá trình sinh lý chuẩn xác tiềm thức và các quá trình thưởng. Và những điều đó thường bị gián đoạn theo những cách mà chúng ta thấy bản thân làm những điều không tốt cho chúng ta hoặc không tốt cho người khác. Nhưng may mắn thay, có một món quà tuyệt vời, đó là kiến thức về kiến thức có thể cho phép bạn làm tốt hơn mà không có nghi ngờ gì, và rằng kiến thức về kiến thức cho phép bạn làm tốt hơn theo thời gian dẫn đến hiện tượng tuyệt vời này được gọi là tính dẻo thần kinh (neuroplasticity), về cơ bản được dịch thành việc làm tốt hơn theo thời gian, ngay cả khi khó khăn, cuối cùng sẽ làm cho việc làm tốt hơn trở thành một phản xạ. Cuối cùng nhưng không kém phần quan trọng, tôi muốn cảm ơn bạn vì thời gian và sự chú ý của bạn, và cảm ơn bạn vì sự quan tâm đến khoa học. Và như đã đề cập ở phần đầu của tập hôm nay, chúng tôi hiện đã hợp tác với các sản phẩm bổ sung Momentus vì họ tạo ra các công thức với một thành phần xác định có chất lượng tuyệt đối cao nhất, và họ giao hàng quốc tế. Nếu bạn vào livemomentus.com slash Huberman, bạn sẽ tìm thấy nhiều loại thực phẩm bổ sung đã được thảo luận trong các tập khác nhau của podcast Huberman Lab, và bạn sẽ tìm thấy các giao thức khác nhau liên quan đến những thực phẩm bổ sung đó.
    – 歡迎來到 Huberman Lab Essentials,在這裡我們重溫過去的集數,以獲得對心理健康、身體健康和表現最具影響力和可行性的科學工具。我是安德魯·胡伯曼,我是斯坦福醫學院的神經生物學和眼科教授。今天,我們將全方位討論健康和失調飲食。確實,我們將討論臨床飲食失調,例如厭食症、暴食症和暴食飲食失調,以及一些其他相關的飲食失調。然而,在我們深入這些材料之前,我想強調今天的討論將包括與食物建立健康關係的概念。我們會談論新陳代謝。我們會討論進食頻率以及吃什麼對食慾和飽腹感的影響,以及是否擁有健康的心理關係來看待食物、體重和所謂的身體組成,即肌肉、脂肪和骨骼的比率等。所以在我們展開這次談話時,我想與你分享一些有趣的,以及我認為在營養和人類行為領域中重要的發現。我知道如今許多人對所謂的間歇性禁食感到興奮或好奇。間歇性禁食正如其名,即在24小時或所謂的晝夜節律循環中的某一特定階段限制進食行為。其他形式的間歇性禁食包括在延長的時間內不進食,甚至一些人會延長到兩天或三天。通常,且希望在這段期間他們會喝水,有時被稱為水禁食,這意味著他們在攝取液體,並希望他們也能攝取電解質,如鈉、鉀和鎂,因為雖然人可以在一段時間內不攝入卡路里而生存,但持續攝取足夠的液體和電解質是極其重要的。原因在於大腦和身體控制你運動、思考的一些神經元,通常需要有足夠的鈉、鉀和鎂等電解質的存在。因為神經元只能通過特定離子的運動而保持電活動,包括鈉、鉀和鎂等。因此,如果沒有這些物質,你無法思考,無法運作,這實際上可能相當危險。那么間歇性禁食為何引起如此興奮呢?這種興奮與我以前的同事之一 Sachin Panda 在聖地亞哥索克生物研究所的工作有關。他的實驗室確定了一些非常重要且有影響力的健康益處,即限制進食時間在24小時循環中的特定時間內,甚至進行一天、兩天或甚至三天的長時間禁食。他們觀察到肝酶的改善、胰島素敏感性的改善,這是好的,意味著你可以有效利用你擁有的卡路里和血糖。胰島素不敏感是不好的,實際上是糖尿病的一種形式。Sachin的實驗室以及隨後的其他實驗室顯示,將進食時間限制在每24小時循環中的四到八小時甚至12小時對小鼠是有益的。而一些人類研究也表明,這對各種健康參數也是有益的。然而,對間歇性禁食的興奮似乎與關於新陳代謝、減肥、體重維持和增肥的基本真理有關,這就是無論你是否進行間歇性禁食,或者你是否整天吃小餐,或者你在晚上吃一餐並在此之前吃零食,實際上並不重要,因為你從任何來源攝入的卡路里都會通過你進行運動、基礎代謝率篩選而過濾,基礎代謝率即是你隨著單純活著、思考、呼吸、心臟跳動等所燃燒的卡路里。很多人更喜歡間歇性禁食而非其他形式的飲食或營養框架的原因在於,很多人發現不進食比限制食物份量更容易。這裡我並不是在談論飲食失調,而是在談論普通民眾。那么,為什麼我們要討論這個?尤其是在這一集中為什麼要討論這個,還包括關於飲食失調的討論?原因在於,無論是政府、營養師,還是任何個人,無論他們對食物和營養有多麼專業,沒有誰能為任何個體定義最佳的飲食計劃。我再重申一次,沒有人知道什麼才是真正健康的飲食。我們只知道我們可以進行的測量,例如肝酶、血脂檔案、體重、運動表現、心理表現,以及你一天是否容易煩躁,是否感覺放鬆。沒有誰能定義這些,而這些受強烈的文化、家庭和社會影響。所以,如果你和全日進行間歇性禁食的人在一起,這將看起來很正常。如果你花時間和從未聽說過間歇性禁食的人在一起,間歇性禁食會看起來非常不正常。現在,我們將談論真正屬於臨床可診斷飲食失調的飲食失調,這對健康存在實際的嚴重危害,甚至有死亡的嚴重風險。
    精神科和心理學界有明確的標準來定義像厭食症、暴食症、暴飲暴食症等問題,這些都是我們會討論的。但在我們進行討論時,我想強調的是,自我診斷既可以是件很棒的事情,也可以是非常危險的事情。當人們了解某一特定疾病的症狀時,無論這種疾病是什麼,都會有一種誘惑,去問自己:“我有這個嗎?”或者,“我認識的某某有這個嗎?”我們容易將自己或他人診斷為有或沒有特定的疾病。然而,診斷真的需要由受過專業訓練的人來進行,並且必須具備豐富的專業知識,能夠識別症狀,特別是一些更微妙的飲食失調症狀。如果你覺得自己可能有這種特定疾病,或者你認識的人有這種疾病,我會認真看待這一點,但我建議你把這些資訊帶給一位合格的醫療專業人員,他們能夠進行診斷或排除可能的疾病。
    我想暫時休息一下,並介紹我們的贊助商之一,Element。Element是一種電解質飲料,擁有你所需的一切,而沒有你不需要的東西。這意味著電解質,鈉、鎂和鉀的含量正確,但不含糖。適當的水分補充對於最佳的腦部和身體功能至關重要。即使是輕微的脫水也可能降低認知和身體表現。獲得足夠的電解質也很重要。電解質,鈉、鎂和鉀對於全身細胞的正常功能至關重要,尤其是神經元或神經細胞。飲用溶解在水中的Element使確保你獲得充足的水分和電解質變得非常簡單。為了確保我獲得足夠的水分和電解質,我會在早上剛醒時將一包Element溶解在約16到32盎司的水中,並且基本上是早晨第一件事就飲用。我還會在任何運動過程中飲用溶解在水中的Element,尤其是在熱天時,當我大量出汗並失去水分和電解質的時候。Element有很多美味的口味。我喜歡覆盆子口味和柑橘口味。目前,Element有一款限量版的檸檬口味,味道絕對美味。我不想說我特別喜歡某一款,但這款檸檬口味和我最喜歡的那款,覆盆子或西瓜,差不多。因此,我無法只挑選一種口味,我都喜歡。如果你想試試Element,你可以去drinkelement.com slash Huberman,拼寫為drink L-M-N-T dot com slash Huberman,領取一個免費的Element樣品包,前提是你購買任何Element飲品。再次重申,網址是drinkelement.com slash Huberman,以領取免費樣品包。
    那麼,什麼是飲食失調呢?我們需要退後一步,並承認每個社會、每個文化、每個家庭和每個人在食物方面都有不同的關係。然而,飲食失調有特定的標準,讓我們能夠定義它並考慮不同的治療模式,這是針對特定症狀,特別是這些疾病的心理和生物症狀。
    主要的飲食失調有哪些呢?厭食症,即通常所稱的厭食症,或許是所有飲食失調中最流行和最危險的。事實上,厭食症是所有精神疾病中最危險的,甚至比抑鬱症更危險。未經治療的厭食症死亡機率非常高。令人難過的是,厭食症的患病率是非常高的。如果你在網上查詢或者諮詢合格的專業人士,基本上可以認為是無法攝取足夠的食物來維持健康體重。你會看到許多非常令人擔憂的症狀,特別是那些已經厭食一段時間的人,由於他們攝取的熱量少於消耗的熱量,通常會導致肌肉質量的一般損失。他們的心率會很低,這是身體和大腦試圖降低能量消耗的表現。他們可能會有低血壓,有時會發生暈厥、骨密度下降、骨質疏鬆、女性月經失調以及各種腸道和免疫功能的障礙。因此,厭食症有許多可怕的症狀,這真的將厭食者置於一個非常危險的狀態,這也是為什麼未經治療的厭食症的死亡率極高。
    現在,有關厭食症的一個誤解是,它源於對完美主義的過度強調,或者因為在社交媒體和廣告中有著極其纖細和健康或肌肉發達人物的形象,個人看著自己並與那些形象進行比較,並認為自己無法達到標準,從而產生厭食症。然而,結果卻並非如此。如果你查看近10年或20年的厭食症患病率,並將其與厭食症第一次被識別(約在1600年代甚至更早)時的情況進行比較,你會發現,厭食症的患病率並沒有上升。經典定義的厭食症在過去100年、200年、300年和400年中幾乎保持相同的患病率,這令人難以置信,也真實地說明了生物學因素對所謂的厭食症有強烈貢獻的可能性。厭食症在女性中非常常見,大約佔1%到2%,且典型的發病年齡是在青春期附近,但也可能在以後的人生中出現。
    事實上,對於厭食症的識別和診斷往往發生在二十出頭,但如果回顧這些個體的歷史,通常會發現早在青少年早期甚至更早時期就有厭食症的徵兆。當然,男性也可能患有厭食症,但厭食症神經症在女性和年輕女孩中的發生率似乎是男性和年輕男孩的十倍。那麼,什麼是饑餓,什麼是飽足呢?飽足,當然,就是感到滿足或覺得我們已經吃夠了。我想提醒大家關於大腦和身體之間進行溝通的基本機制。身體定期向大腦傳達兩種信息,尤其是在進食方面,而這兩種信息是機械信息和化學信息。當你的胃部飽滿時,它會向你的大腦發送純粹基於這種機械性飽滿的信號。這與營養無關,它只是說:“我飽了,因此不必再感到餓。”不會驅使你去尋找或攝取食物。而當我們的腸道空的時候,即使我們擁有足夠的營養或身體脂肪儲備,我們往往會更加關注食物。因此,體積和機械影響深刻影響著我們的思維以及我們考慮是否行動的方式。同樣,化學影響也是如此。當我們攝取食物時,我們的血糖上升。這種信息通過神經通路和荷爾蒙通路傳送到大腦。尤其是,我們腸道內有神經元會向腦幹的某些區域發送信號,這些區域涉及飽足感,讓我們感覺到我們的系統中有足夠的食物。所以這就是化學信息。那麼,饑餓、進食和飽足是如何調節的呢?通過機械和化學信號來實現。你有,我有,我們都有下丘腦中的神經元,這些神經元觸發進食,還有神經元觸發進食的停止或中斷。你的下丘腦位於大腦前部的底部,坐落於你的上顎上方。下丘腦包含許多不同類型的神經元,包括刺激性活動和欲望的神經元,調節體溫的神經元,以及控制食慾和停止進食的神經元。在你下丘腦的某個特定區域有兩種類型的神經元是相關的。所謂的POMC神經元,這些是前催腦啡色素神經元,傾向於通過另一種激素——黑色素刺激激素來抑制食慾。而你還有一類稱為AGRP神經元的神經元。AGRP神經元是刺激進食的神經元,它們會對食物產生一種焦慮或興奮感。如果你消除或殺死這些神經元,在實驗鼠模型中已有所實踐,但也有一些人類擁有對這些AGRP神經元的病變或神經毒性影響。你會發現他們沒有食慾,完全不想吃東西。相反,若刺激這些AGRP神經元,或在一些人類中有小腫瘤靠近這些AGRP神經元,他們會變得暴飲暴食,吃到快要爆炸的地步。現在,身體傳回的信號告訴大腦有不同水平的營養物質存在。這一般來自三個來源。第一個是體脂肪。我們擁有的體脂肪越多,分泌的激素——瘦素(leptin)就越多。瘦素從體脂肪中分泌,進入大腦並抑制食慾。並且值得注意的是,瘦素信號在患有厭食症、肥胖症和某些形式的暴食症的人中被破壞。體脂肪還有另一個相當有趣的作用,與厭食症有關。當體內的脂肪水平和瘦素濃度足夠,瘦素信號到達大腦時,下丘腦和腦垂體能夠註冊到這種信號,並在完全潛意識的狀態下觸發女性卵子的釋放和男性精子的生成。因此,當體脂儲備非常低時,月經停止或精子生成減少甚至停止的原因在於瘦素無法足夠到達下丘腦和腦垂體,而它們則會停止信號的傳遞,包括促性腺激素釋放激素、黃體生成素、濾泡刺激素等,這些激素會傳送到卵巢或睪丸,導致卵巢和睪丸排卵或生成更多的精子。因此,你擁有兩類神經元,一類擔任加速器,即AGRP神經元,告訴你“吃,吃”,並讓你感到對食物的興奮,另一類則是PMOC神經元,抑制飢餓,像是一個剎車,而身體也在不斷地告訴大腦身體的狀態,以及是否需要更多的食物。所以你可能會問,為什麼那些超重且擁有大量體脂肪的人,還是會繼續吃得很多?這似乎不應該發生。從進化的角度來看,這就意味著我們應該儘可能多地、頻繁地、迅速地進食。大腦中有電路獎勵經常進食、快速進食以及儘可能多地攝取食物,因為從純粹的進化角度來看,食物是稀缺的,尋找食物是危險的,無論是來自動物來源還是其他來源,並且一直都是競爭性的。
    每一種動物,包括人類,都有一個與生俱來的電路,這個電路會關注食物的可獲得量、我們現在得到的食物量,以及未來可能獲得的食物量。且不談弓狀核生物學的複雜性,簡單來說,你有一個叫做弓狀核的下丘腦區域。這實際上是容納這些PMOC神經元和其他類型神經元的地方,這些神經元會調節飢餓和飽腹。當我們看到食物並思考食物的時候,這些弓狀核中的神經元開始活躍,它們以一種對食物外觀、氣味的反應方式來驅動飢餓,還會考慮到我們過去與該食物的互動歷史,並考慮社交背景。這個過程是怎麼運作的呢?其實,可以將所有行為、良好的決策和不良的決策用一個相當簡單的方框圖來框架。我們在一個方框中擁有應該怎麼做的知識,對嗎?我們應該吃這個,不應該吃那個,該等晚餐,不該等晚餐;然後在另一個方框中是我們實際上所做的。在這兩個方框之間是兩個介入力量,這些介入力量至關重要。這些介入力量是調節你身體內不同系統之間平衡的穩態過程,熱與冷、清醒或睡眠、以及多巴胺與追求事物的渴望、血清素與放鬆和平靜的渴望。因此,穩態過程和獎勵系統在這裡扮演重要角色。當我們接下來專門討論厭食症和暴食症時,你會看到,厭食症和暴食症並不是對「應該做什麼或不應該做什麼」心態的崩壞,而是對這些穩態和獎勵過程的干擾,導致決策過程完全中斷,在許多情況下,對於厭食症或暴食症患者來說,這種決策能力是不可用的。
    現在,我不想說得太抽象。我的意思是,那些讓自己饑餓到可能會死的人,在某些情況下可悲地死亡,他們可以明確地知道自己的行為會導致糟糕的結果,甚至可能會死亡,但卻無法干預,除非得到特定的臨床幫助,因為穩態過程、身體和大腦發出的需要食物的信號,並不像對其他人那樣清晰。而且,厭食症患者的思維中好像有一個開關被翻轉,導致他們的決策能力實際上相當好。在評估食物的營養成分方面,甚至可能比你更出色,但他們的習慣被干擾,所以他們甚至無法意識到自己正在做出可怕的,甚至在某些情況下非常危險的食物選擇。事實證明,習慣以及我們建立、打破和重建新習慣的方式是治療厭食症最有效的方法之一。我想稍作休息,并感謝我們的贊助商AG1。AG1是一種維他命、礦物質和益生菌飲品,還包含益生元和適應原。作為一名參與研究科學近三十年的人,並且在健康和健身領域也有同樣長的經驗,我不斷尋找改善心理健康、身體健康和表現的最佳工具。我在2012年發現了AG1,那時候我還沒有播客,從那以後我每天都在服用。我發現這改善了我所有的健康面向、我的能量和專注力,當我服用它時我感覺要好得多。AG1使用最高品質的成分、最佳的組合,並不斷改善他們的配方而不提高價格。事實上,AG1剛剛推出了他們最新的配方升級。這個下一代配方是基於對益生菌對腸道微生物組影響的新研究,現在包括幾種臨床研究過的益生菌菌株,顯示能支持消化健康和免疫系統健康,並改善腸道規律性,減少腹脹。每當有人問我如果只能選擇一種補充劑,那會是什麼時候,我總是說AG1。如果你想試試AG1,可以訪問drinkag1.com/slash Huberman。在有限的時間內,AG1還贈送一個月的免費omega-3魚油,並附上一瓶維他命D3加K2。正如我之前在這個播客中強調的,omega-3魚油和維他命D3已被證明有助於改善情緒和大腦健康、心臟健康、健康的荷爾蒙狀態等等。再一次,請訪問drinkag1.com/slash Huberman,以獲得一個月的免費omega-3魚油加一瓶維他命D3加K2作為您的訂閱獎勵。現在讓我們談談厭食症,這是一種未能攝取足夠能量的情況,以至於個體面臨死亡風險。如果不至於死亡,則可能面臨嚴重的代謝障礙、缺乏骨密度等。透過醫學流行病學的仔細分析顯示,即使在食品短缺的文化和社會中也可以發現厭食症。這真的是反映了一種生物機制。通常,厭食症在青少年時期開始,正好在青春期期間。青春期,從非常廣義的層面來看,是任何人一生中最重要且最戲劇性的發展步驟。身體改變,大腦改變,認知改變,自我認知改變,而這些變化大多都是由下丘腦中神經回路的變化驅動的。因此,控制所謂的性類固醇激素(比如睾酮、雌激素及相關激素、催乳素等)生成的神經元都在以非常快的速度改變。讓我們深入了解一下這些變化。
    讓我們來看看已知的
    有關神經電路的資訊,
    以及這些神經電路所驅動的
    知覺和行為,
    以便了解
    他們在根源層面上真正
    所遭受的痛苦,
    而不僅僅是症狀。
    首先,
    研究厭食症面臨挑戰,
    因為在厭食症中,
    你基本上研究的是
    行為的缺失。
    研究行為的缺失
    與研究行為相比
    是非常困難的。
    因此,他們對厭食症患者
    進行了一些實驗,
    給他們呈現一系列
    不同食物的圖片,
    並允許這些厭食症患者
    根據偏好排列這些食物,
    關於他們會選擇的食物,
    關於食物的營養成分,
    以及熱量含量。
    他們基本上要求這些厭食症患者
    評估食物,
    通過這樣的方式,
    他們能夠
    識別出一些
    在食物知覺層面上
    對厭食症患者來說
    非常獨特的東西。
    厭食症患者並不是在食物面前感到焦慮,
    而是對食物的脂肪含量
    有一種超敏感的覺察能力,
    幾乎達到一種
    脂肪含量的才能者的程度。
    現在,眾所周知,
    厭食症,特別是年輕的厭食症患者,
    對食物、熱量含量、
    大營養素比例,
    即脂肪、蛋白質和碳水化合物的比例,
    有一種類似癡迷的情況。
    他們積極避免
    高脂肪食物、
    高熱量食品,
    而一旦不得不吃的時候,
    則偏向選擇
    非常低熱量的食物。
    這一點非常重要,
    因為這意味著
    我們需要關注
    驅動習慣形成
    和習慣執行的大腦區域。
    在厭食症的情況下,
    這些習慣正是
    問題開始出現的地方,
    並驅動這種
    非常功能障礙的、
    飲食不足的行為,
    而可悲的是,
    這往往導致死亡,
    或至少
    嚴重的醫療後果。
    結果發現,
    與習慣形成
    和執行相關的大腦區域
    是最佳的介入點。
    因此,
    你有反射作用,
    而且有神經過程,
    這些過程包括
    所謂的
    持續時間路徑
    和結果類型過程。
    持續時間路徑的
    結果類型過程
    我們可以用DPO來簡化。
    DPO是
    適用於所有類型
    目標相關行為的縮寫。
    例如,
    如果你想
    去雜貨店
    買一些東西
    然後回家,
    你會考慮
    持續時間,
    我還有多長時間?
    好吧,
    我有45分鐘
    可以到達商店嗎?
    到商店需要多長時間?
    路徑,
    我將以哪條路
    駕駛去那裡?
    我將以哪種方式
    在雜貨店裡導航?
    結果,
    我能否進去
    購買我需要的物品
    並及時回家?
    好嗎?
    DPO,持續時間路徑結果。
    這是一個非常有意識的
    過程,需要
    決策,
    並且以獎勵為基礎。
    你在短期內使用這些
    DPO類型的過程
    來購買雜貨,選擇
    在雜貨店裡的排隊,
    並決定回家的
    行駛路線,
    而且你也在生活中使用它們
    來導航
    那些漫長的過程,
    比如獲得學位
    或撫養孩子
    或度過
    特別具挑戰性的一年,
    等等。
    所以持續時間路徑結果
    以及整個過程
    依賴於你的
    前額葉,
    這個前額葉皮層。
    前額葉皮層
    使你能夠
    從記憶中
    提取資訊,
    將其與
    當前情境下
    發生的事情的資訊
    結合起來,
    然後指導
    你的行為、
    說話等等,
    朝著特定的結果。
    另一方面,
    反射作用
    並不以相同的方式
    涉及前額葉皮層。
    習慣和反射,
    一旦你知道
    如何走路,
    就不依賴
    前額葉皮層。
    這是一種被稱為
    潛意識的狀態,
    但基本上你不必使用
    參與持續時間路徑
    和結果類型分析的大腦部位。
    但基本上
    你擁有一個大腦區域,
    而厭食症患者則有一個
    參與評估
    和飲食决策的
    大腦區域,
    以及另一個大腦區域
    參與特定食物的
    反射性攝取
    和其他食物的
    反射性避免。
    這種事情總是
    受到內穩態
    和獎勵系統的影響。
    而在
    厭食症患者的大腦中,
    發現獎勵系統
    已經與
    習慣執行
    相連接,
    以對身體重量
    不健康的方式,
    但至少
    從純粹的神經電路角度來看,
    獎勵現在是
    給予的,
    這種化學獎勵
    在大腦中
    是因為避免
    特定食物,
    而只能接近
    這些非常低熱量、
    低脂肪的食物。
    所以,的確
    似乎在厭食症患者的大腦中
    有一個內部獎勵
    的開關翻轉。
    當他們避免
    某些食物時,
    他們感覺良好,
    而當他們接近
    其他食物時,
    他們也感覺良好。
    所以這不是
    基於剝奪的模型,
    他們並不是
    在鞭策自己,
    或施加苦痛,
    或主動
    避免食物
    以懲罰自己,
    這點很有趣,
    因為許多
    心理學理論
    都支持這一觀點。
    相反,
    一旦這種情況轉變為一組
    習慣,
    他們其實
    會得到一種
    獎勵的感覺。
    他們感覺良好,
    大概是因為
    釋放了一種不同的
    神經調節物質
    叫多巴胺,
    當他們接近
    低脂肪、
    低熱量含量的食物時,
    所以他們
    整個大腦電路
    都偏向於避免
    特定的事物,
    而且他們實際上
    因為這個而獲得獎勵,
    而他們感覺良好。
    他們感覺比
    以健康的
    支持體重的方式進食時
    要好。
    那麼你如何
    打破一個習慣?
    如何重塑
    引起反射的
    大腦電路,
    在這種情況下
    引起一種反射,
    正在殺害
    個體,
    或者至少導致
    非常糟糕的
    健康後果?
    你這樣做的方法是
    通過一種認知
    機制,
    那就是
    教導個體
    到底是什麼
    導致了習慣的形成。
    讓我們來談談那些導致習慣形成的要素,因為這些恰好是改變、消除和重塑習慣以朝著更健康行為的關鍵切入點。
    涉及厭食症者的習慣時,有兩個主要的思維特徵。第一是被稱為「弱中心一致性」。弱中心一致性本質上是一種無法看清全局的能力。它是一種對特定環境中的細節過度專注和敏銳的狀態。你會錯過大局。另一個特徵是轉換思維的挑戰,當你辨識出那些對厭食症者特別感興趣且能帶來某種獎勵的事物時,比如辨識出高脂肪的食物,或者找出桌上唯一可以在不引起旁人注意情況下食用的食物, 厭食症者可能只會吃青豆而不碰其他食物。
    如果你曾經與一位厭食症者共進餐,他們實際上在努力使他人對他們所做的事保持警覺,這就是專注於這些低脂低卡路里的食物。驚人且重要的是,當你告訴厭食症者他們正在經歷的事情時,他們其實可以介入。現在,他們需要支持,對吧?另一種似乎對厭食症者有效的治療形式是家庭為基礎的模型,理想上這種方法應與習慣重塑相結合。家庭為基礎的模型現在在各種治療設置中開始得到廣泛應用。簡而言之,治療模型基本上是讓整個家庭了解個體在某種飲食失調或其他障礙中所面臨的挑戰,並理解其背後的一些生物學和心理學,使得他們開始停止譴責,轉而支持這個個體,引導他們觀察自己的習慣,給予他們一定的自主權。他們意識到這一切的改變不會一夜之間發生,但同時他們也學會了神經可塑性等知識,以及如何根據經驗改變大腦。
    因此,整個內部支持網絡應運而生。所有這些都納入了認知行為療法的範疇,我應該提到,認知行為療法往往與藥物療法結合進行。在我們開始談論貪食症和一些相關的障礙之前,我想談談厭食症的一個非常有趣且令人擔憂的方面,那就是扭曲的自我形象。現在,在談到抑鬱症的那一集中,我們提到了一個非常強大的重度抑鬱症特徵,即這種反自我的捏造,患有抑鬱的人似乎真心相信並甚至會捏造自己在生活中表現不佳、毫無價值等事實。這是一種他們相信的謊言,他們的陳述、感受和行為開始反映這個謊言。他們並未意識到這一點,因此我們稱之為捏造。
    厭食症者通常會將自己視為過重或不完美,這種觀點在他們心中形成一種強烈的癡迷。以厭食症者為例,問題似乎在於他們自我形象的真正扭曲,甚至達到無法準確看清自己。這種視覺感知是錯誤的,我們知道這一點是因為我同事Jeremy Balenson在斯坦福大學的實驗室進行了一些非常重要且美麗的研究。這些研究非常有趣,因為它們讓我們窺見了厭食症者的知覺缺陷。
    我實際上參加過其中一個實驗。我很幸運不患厭食症,但我曾在他們的虛擬實境實驗室完成了一些工作,而你能做的就是根據自己的感知調整這個化身(虛擬角色),直到你認為它能夠最準確地反映自己的樣貌,而厭食症者在這方面實際上是大幅扭曲這個化身。換句話說,他們在自我感知與現實之間創造了一個嚴重的不匹配。因此,事情的確似乎是這樣的。
    現在,令人安慰或應該說令人鼓舞的是,我們之前提到的幾種療法,包括家庭為基礎的模式、認知行為治療,以及藥物治療,還有這些習慣干預模型,似乎當人們開始改變這些事物時,自我感知也會隨之而改變,這種自我感知似乎與習慣的變化同步而變化。因此,僅僅告訴某人「哎呀,你真瘦,你真的需要吃東西」似乎不起作用。他們根本無法像你那樣看待自己。
    如果你認識厭食症者,或者看著一位厭食症者,心想他們怎麼對自己三頭肌上微薄甚至不存在的脂肪如此挑剔?這是怎麼回事?這是因為他們的大腦與知覺,特別是視覺知覺方面,完全錯誤。幸運的是,通過改變習慣,你也在重塑那些電路。
    我想先休息一下,感謝我們的一位贊助商——Function。去年,我成為Function的會員,因為我在尋找最全面的實驗室檢測方法。Function提供超過100項先進的實驗室檢測,為你提供身體健康的關鍵快照。這個快照讓你了解心臟健康、荷爾蒙健康、免疫功能、營養水平等等。
    功能不僅提供對超過100種關鍵生理和心理健康生物標記的測試,還分析這些結果並提供來自相關領域專家的頂尖醫生的見解。例如,在我第一次使用功能的測試中,我了解到我的血液中汞的濃度偏高。功能不僅幫助我發現這一點,還提供了如何最好地降低我的汞水平的見解,包括限制我的金槍魚消費。我之前吃了很多金槍魚,同時也努力多吃綠葉蔬菜,並補充NAC和乙醯半胱氨酸,這兩者都可以支持穀胱甘肽的生成和排毒。我應該說,通過進行第二次功能測試,這種方法很有效。全面的血液測試至關重要。有許多與你的心理和生理健康相關的東西只能透過血液測試檢測出來。問題是血液測試一直非常昂貴且複雜。相比之下,功能的簡便性和成本水平讓我印象深刻。它非常實惠。因此,我決定加入他們的科學顧問委員會,我很高興他們贊助了這個播客。如果你想嘗試功能,可以訪問functionhealth.com/Huberman。功能目前有超過25萬人的候補名單,但他們正在為Huberman播客的聽眾提供提前訪問的機會。再次提醒,訪問functionhealth.com/Huberman以獲得功能的提早訪問。
    好的,那麼我們來談談暴食症,這是一種過度進食然後清除,通常是通過自我催吐或吞服瀉藥來實現。接下來,我們也會談談暴食飲食障礙,它有很多與暴食症相同的特徵,但通常不會進行清除。根據我所了解的標準,如果一個人這樣做大約每月至少一次,持續兩到三個月,那麼它很可能符合條件。他們不是主動決定過度進食,而是內心驅動著他們攝入遠超過他們所需的食物。在某些情況下,甚至超過他們想要吃的食物。因此,這與我們為厭食症描述的習慣非常相似。一旦開始下來,幾乎就變成了一種反射行為。所有的恆定信號都被覆蓋了。來自身體的所有信號,如瘦素、胰島素、葡萄糖,所有這些指標都高得驚人。然而,他們就像我們所謂的「食慾過度」一樣,吃得異常。與暴食症相關的羞愧感非常強烈,通常因為人們會嘔吐,而這種嘔吐行為很難隱藏,別人會注意到。暴食症的典型特徵是與厭食症不同,除了過度進食而非飲食不足之外,還缺乏所謂的抑制控制。這或許也不足為奇。但是首先,暴食症患者與厭食症患者不同,通常是一種過度衝動的行為,往往還伴隨其他類型的衝動行為。因此,許多針對暴食症和暴食飲食障礙的治療往往是不太有效的,或者至少大多數時間不適用於厭食症。比如,增加神經調節劑血清素的藥物,比如氟西汀(Prozac)和百憂解(Paxil)等,這類藥物通常對暴食症有效。一些用於治療注意力缺陷多動障礙(ADHD)和注意力缺陷障礙(ADD)的藥物,比如阿莫達非尼(Adderall)、維伐西(Vyvanse)等同樣也可以用於治療暴食症和暴食飲食障礙。
    為什麼這樣會有效呢?現在你已經熟悉了前額葉皮層。前額葉皮層參與這種持續時間、路徑和結果的分析。持續時間、路徑和結果是我們避免衝動性的方式。這就是我們如何思考「如果這樣,那麼那樣;如果那樣,那麼這樣」,你可以想像對於強迫症患者或厭食症患者,這些電路是過度活躍的。對於暴食症患者,這是基本上會低於正常活躍水平的電路。因此,這與你在厭食症中看到的完全相反。因此,這種缺乏衝動性意味著缺乏前額葉控制,即我們所稱的由上而下的控制。他們變得更加衝動。因此,暴食症患者面臨衝動性問題,因此能增加血清素的藥物,以及有時也能增加多巴胺和去甲腎上腺素水準的藥物,可以增強由上而下的控制。這也是為什麼它們用於治療ADHD和注意力缺陷障礙。這些藥物往往會創造出一種超集中狀態,並推動大腦及其一般處理模式進入一種思考「如果這樣,那麼那樣」的模式。那麼行為干預對暴食症有效嗎?在某些情況下是的,前提是這些干預措施早期開始。無論如何,行為干預與基於藥物的干預結合始終會比單獨的任何一種更有效。幸運地是,有一套相當不小的藥物能幫助改善暴食症。在一方面,我們有厭食症,這似乎是行為的破壞以及與獎勵路徑的不健康習慣的結合,這種情況下是食物限制。而在另一方面,我們有暴食飲食障礙和暴食症,這種過度進食的不健康習慣,有時伴隨著清除,並不一定與獎勵相結合。他們在這樣做時感覺很糟對吧?厭食症患者對於限制食物攝入感覺非常好。他們覺得自己在贏得某種遊戲。這種電路以某種方式翻轉了。而對於暴食症患者,他們對自己暴食的行為感到非常糟糕。這是巨大的羞恥感。他們無法控制自己。獎勵在行為之前已經建立好了。
    這段文字翻譯成繁體中文如下:
    獎勵的設置是將他們吸引到食物上,並且讓食物看起來極具吸引力,沒有衝動的中斷。他們無法停止這種行為。對於那些認識厭食症患者或觀察過厭食症的人來說,看到某人將自己餓到接近死亡或死亡是非常困難的。同樣令人不安的是,有些人擁有大量食物卻拼命暴飲暴食,隨後又感到糟糕。因此,這些都是沉重的話題。坦白說,這些話題沒有人真正想談論,除非他們認識一位正在遭受這些痛苦的人,或他們自己也在苦苦掙扎。今天我嘗試做的,是讓大家窺見這些我們所稱之為飲食障礙的現象背後真正的根源。我希望我在生物學、神經回路、機制、內分泌學和一些心理學方面做到了這一點。與這個播客的任何一集一樣,但特別是在我們談論心理健康問題和心理健康障礙、行為障礙時,我無法徹底涵蓋所有不同形式的治療。今天的主要收穫是,我們應該都在問自己,對我們來說,什麼才是健康的飲食?我們如何建立與食物之間的關係,使我們能夠享受食物,希望無論是社交還是自己一個人都能如是,但又不至於神經質和強迫。今天,我們專注於那些真正符合真正障礙標準的食物相關行為的極端情況。它們在精神病學手冊中已列入,並且可以被診斷,這是嚴重的健康問題。它們不僅在精神上讓人困擾和擔憂,而且對於正在遭受這些困擾及周圍的人來說,也是實質性的健康問題。我想重申,厭食症是最致命的精神病障礙,這一點絕對如此。如果你統計那些患有飲食障礙的人數,以及因此而死亡的人數,它與因汽車事故而死亡的人數相差無幾。我希望你能帶走這個模型,這個模型是我接受的,我認為它對於思考各種事物非常有力,不僅僅是飲食,還有你對各種行為和感知的理解:你有一個框架用來思考,另一個框架用來行動,兩者之間的干預是什麼?為什麼你可以知道更好的選擇卻不去實施?這是因為你還必須應對潛意識的穩態過程和獎勵過程。而這些往往可能會以一些我們發現自己做不利於自己的或不利於他人的事情的方式受到擾亂。但幸運的是,有一個偉大的禮物,那就是知識的知識可以讓你在不懷疑的情況下變得更好,這種知識的知識隨著時間進展使這個驚人的現象——神經可塑性成為可能,這基本上是轉化為隨著時間的推移變得更好,即使困難,最終使得做得更好變得反射性。最後但同樣重要的是,我想感謝你們的時間和關注,感謝你們對科學的興趣。如在今天節目的開始所提到的,我們現在已與Momentus補給品合作,因為它們製造單一成分的配方,品質絕對最高,並且可以國際發貨。如果你訪問livemomentus.com/huberman,你將會找到在Huberman Lab播客的各種集數中討論過的許多補給品,以及與這些補給品有關的各種方案。

    In this Huberman Lab Essentials episode, I discuss both healthy eating and clinically recognized eating disorders, including anorexia, bulimia and binge eating disorder.

    I explain how brain circuits, hormones such as leptin and reward systems interact to regulate appetite, satiety and overall eating behaviors. I also discuss the serious health risks associated with anorexia, explain how disrupted eating habits contribute to its development and highlight evidence-based treatments for anorexia. Finally, I explore binge eating and bulimia, discussing the underlying causes and the pharmacological treatments commonly used to support recovery.

    Read the episode show notes at hubermanlab.com.

    Thank you to our sponsors

    AG1: https://drinkag1.com/huberman

    LMNT: https://drinklmnt.com/huberman

    Function: https://functionhealth.com/huberman

    Timestamps

    00:00:00 Eating Disorders

    00:01:05 Fasting, Intermittent Fasting, Healthy Eating

    00:06:10 Self-Diagnosis Caution

    00:07:20 Sponsor: LMNT

    00:08:52 Eating Disorders, Anorexia Nervosa

    00:12:39 Hunger & Satiety; Appetite, Body Fat & Brain

    00:17:20 Homeostasis & Reward Systems, Eating Disorders

    00:21:12 Sponsor: AG1

    00:22:49 Anorexia, Puberty, Hyperacuity & Food

    00:25:55 Decision-Making vs Reflexes/Habits, Anorexia

    00:29:29 Anorexia & Breaking Habits, Therapies & Family-Based Models

    00:32:08 Distorted Self-Image & Anorexia

    00:35:03 Sponsor: Function

    00:36:43 Bulimia & Binge-Eating Disorder, Impulsivity & Prescription Treatments

    00:40:28 Recap & Key Takeaways

    Disclaimer & Disclosures

    Learn more about your ad choices. Visit megaphone.fm/adchoices

  • The Canceling of the American Mind — with Greg Lukianoff

    AI transcript
    0:00:02 There’s a lot nobody tells you about running a small business,
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    0:00:34 Using AI chatbots is pretty easy.
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    0:00:46 to be emotionally handling this type of relationship
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    0:00:50 Our AI companions.
    0:00:52 That’s this week on Explain It To Me.
    0:00:56 New episodes every Sunday, wherever you get your podcasts.
    0:01:06 Episode 357.
    0:01:09 357 is the area code covering parts of Central California.
    0:01:14 In 1957, the baby boom hit its peak with more than 4.3 million births,
    0:01:17 and Sputnik launched, which kicked off the space race.
    0:01:20 I remember when I was a younger man, a boy actually,
    0:01:24 saying to my mom, Mom, someday I’m going to be shot into space.
    0:01:25 To which my mom replied,
    0:01:28 well, if your dad had done his job, that would have happened.
    0:01:31 Go! Go! Go!
    0:01:42 Welcome to the 357th episode of The Prop G Pod.
    0:01:43 I am in Aspen.
    0:01:44 Why am I here?
    0:01:45 Because I can be.
    0:01:46 I absolutely love it here.
    0:01:48 Building a home here.
    0:01:51 This is where I’m going to sit around and wait for the ass cancer,
    0:01:54 meaning this is where I think I’m going to leave feet first,
    0:01:58 where I plan to wind down and give up podcasting when I’m, I don’t know, 93.
    0:01:59 I think that would be a good time.
    0:02:02 I used to think when I was a younger man, when I was in my 40s,
    0:02:06 that I was going to create space or room and go totally dark on social media
    0:02:08 and stop podcasting by the time I was 50.
    0:02:09 But here’s the thing.
    0:02:12 I love the fame, the relevance, and the Benjamins.
    0:02:20 But I am here and our technical director, Drew, rented an apartment called the Aspen Alps
    0:02:23 right on the mountain here and set up this giant studio.
    0:02:25 So I hope you appreciate all the production values here.
    0:02:30 They told me to take off my hat because they didn’t like the way it looked.
    0:02:31 And I took it off and I thought, you know, fuck it.
    0:02:32 It’s my image.
    0:02:33 It’s me.
    0:02:34 They’re AI.
    0:02:34 I’m me.
    0:02:35 I own me.
    0:02:36 I own the digital, Scott.
    0:02:39 I’ve been, it’s been an emotional weekend for me.
    0:02:43 I’ll get back to that later in the episode and I look like shit and I’m self-conscious
    0:02:45 and, you know, all that good stuff.
    0:02:47 But what are we doing here?
    0:02:48 We’re very much enjoying ourselves.
    0:02:53 I think I used to come to Aspen in the winter, put our kids on skis, came here in the summer
    0:02:55 and now just come here in the summer.
    0:02:57 I think mountain towns in the summer are absolutely wonderful.
    0:03:00 I went to this place called Woody’s Creek’s Tavern, Woody Creek Tavern yesterday.
    0:03:05 And a bunch of people rolled up on a horse, which I thought was ridiculously cool.
    0:03:06 Okay, what’s going on?
    0:03:08 The Epstein file.
    0:03:10 I got this wrong.
    0:03:11 I thought it was going to blow over.
    0:03:12 I thought people were sick of hearing about it.
    0:03:17 But it ends up that when you promote conspiracy theory for a good, I don’t know, five or seven
    0:03:21 years and won’t stop hammering on it and then keep talking about this file and this list that
    0:03:24 when you decide, oh no, I’m on the list and I’d rather not come out.
    0:03:28 So nothing to see here, folks keep moving along, that everyone gets angry.
    0:03:33 I did watch, I did enjoy watching Alex Jones cry in his car over the Epstein list.
    0:03:39 But a lot of this comes down to sort of a major theme, I think, or a broader theme, and that
    0:03:40 is one of identity.
    0:03:46 And I think under the auspices of being able to create bots, not being subject to standards
    0:03:52 around moderation, a public, and not taking responsibility for the comments they make, that
    0:03:59 identity or specifically some sort of fidelity or irrational passion for the value of anonymity
    0:04:05 has really hurt our society, and that is whether it’s, look at the most depraved behavior on
    0:04:06 behalf of our government right now.
    0:04:11 I would argue that it’s simply put is, is it the administration cutting food stamps?
    0:04:13 That’s right up there.
    0:04:20 Or the world’s wealthiest man murdering or killing the world’s most vulnerable and poorest
    0:04:20 children?
    0:04:21 That’s right up there.
    0:04:28 But right close, maybe a close third, would be a bunch of individuals who’ve been weaponized
    0:04:34 to create a private army for the president, who separate, rip families apart, are now, I
    0:04:35 guess, rounding up citizens as well.
    0:04:39 When you treat people differently based on identity, that is the definition of racism.
    0:04:44 And these actions are, in fact, racist, where they’re targeting people based on their identity,
    0:04:45 not on their behavior.
    0:04:47 And what do we have?
    0:04:51 We have individuals who realize how depraved this behavior is, so they wear masks.
    0:04:53 They hide their identity.
    0:04:56 And online, we have a lot of people with masks.
    0:05:02 It’s somewhere between 20, 40, 50 percent sometimes of activity on a social media platform are bods
    0:05:06 who have been weaponized by someone who doesn’t want you to know their identity, because what
    0:05:09 they’re saying is either slanderous or they’re too cowardly to live up to it, or they would
    0:05:13 be embarrassed to say such aggressive, inaccurate things.
    0:05:19 And so we tolerate it under some bullshit notion that a civil rights activist in the
    0:05:20 Gulf needs anonymity.
    0:05:24 Well, with the blockchain, you could probably allocate a certain number of accounts for anonymous
    0:05:26 accounts if, in fact, they needed the anonymity.
    0:05:30 But the 99.9 percent of people who are just acting like cowards or being aggressive or tearing
    0:05:34 at the fabric of our society because of anonymity, I don’t buy that bullshit.
    0:05:42 When some idiots at UCLA decide to pass out bans to non-Jews and then we’ll let anyone without
    0:05:46 abandon, i.e. Jewish people, onto certain parts of the UCLA campus and the UCLA leadership does not
    0:05:49 show up to stop that shit right away.
    0:05:51 What do those people do?
    0:05:52 They wear masks.
    0:05:58 So I think it’s pretty easy to spot people with depraved who are about to engage in things that
    0:06:01 they do not want to associate their identity with because they are wrong.
    0:06:06 And whether it’s a stormtrooper for Star Wars, a member of the KKK, a member of ICE,
    0:06:12 or all of these bots online, anonymity has become a real problem in our society.
    0:06:18 And that is, just as an example, I get a lot of really nice messages online.
    0:06:20 I also get some of the vilest shit I’ve ever seen in my life.
    0:06:24 And if I were a woman, I would be really, I would feel physically intimidated.
    0:06:28 And I’ve been forwarded some messages that some of my female friends get online and it
    0:06:29 is just totally unacceptable.
    0:06:31 And it’d be pretty easy.
    0:06:35 Find out who that motherfucker is on the other side of that keyboard and they will stop because
    0:06:40 they will realize what they’re doing not only carries penalties, but just does not acquit
    0:06:41 them very well.
    0:06:45 And, but instead we’ve decided, oh, we need to sell more Nissan ads.
    0:06:48 And under this bullshit notion that anonymity is key to progress.
    0:06:49 No, it’s not.
    0:06:54 And you could have a certain amount of anonymity for people who have a legitimate reason to be
    0:06:54 anonymous.
    0:07:01 But there is an issue here around our love of letting people have no accountability for their
    0:07:06 actions under the auspices of some sort of First Amendment or free speech or protection.
    0:07:10 And it has gone too far and the snake is eating its tail.
    0:07:14 I would like to see, I like the fact that there’s cameras everywhere in New York and London.
    0:07:19 What you also need when you have this kind of surveillance technology is really strong laws
    0:07:26 to ensure, I don’t even think any camera footage or online tracking can be used to prosecute
    0:07:27 someone in a misdemeanor.
    0:07:31 I think it has to be a very serious crime and there has to be a lot of safeguards that err on
    0:07:36 the side of not getting a search warrant for that data such that people feel comfortable being
    0:07:39 their true selves, but at the same time have to represent their identity.
    0:07:42 But where I was headed was some really vile shit online.
    0:07:47 If I’ve been recognized several times in Aspen and people couldn’t be nicer or wherever I
    0:07:50 am in the world, even when people disagree with me, they come up and say, I didn’t like your
    0:07:50 take here.
    0:07:51 This is what I think.
    0:07:52 And they listen and they’re thoughtful.
    0:07:58 And one of the really terrible things about AI and LLMs is LLMs are crawling the online
    0:08:03 world, which is much harsher and much more cowardly and much more mendacious.
    0:08:03 Why?
    0:08:04 Because of anonymity.
    0:08:09 Whereas if these AI LLMs were crawling the real world where people have to take responsibility
    0:08:14 for what they say and you get to look them in the eye when they say something, I think the
    0:08:19 world would be a better place because AI would be training people how to behave in person where
    0:08:23 you have accountability as opposed to training the world to behave the way they behave online.
    0:08:28 And it’s not only people who individually pulse negative behavior.
    0:08:32 There are people who want to create dissent and tear out the fabric of America, i.e.
    0:08:39 the GRU and the CCP, and create millions of bots that manufacture content that doesn’t even reflect
    0:08:44 how any individual feels, but gives you the impression that this is how millions of people
    0:08:44 feel.
    0:08:49 If you wanted, say you were pro-Ukraine, say you were a professor who was constantly talking
    0:08:54 about Putin’s illegal invasion of Europe and how the U.S. should absolutely allocate the funds to
    0:08:59 push back on a murderous autocrat, wouldn’t you be stupid not to create a troll farm in Albania
    0:09:05 and then slowly but surely using AI, try to undermine that professor’s credibility with negative comments
    0:09:10 all of the time about any of his or her content?
    0:09:12 And I believe those lists have been assembled.
    0:09:14 It would be stupid not to weaponize those lists.
    0:09:15 And oh, great.
    0:09:20 We have social media platforms that love the lies because the lies and the aggressive behavior
    0:09:22 create more engagement.
    0:09:24 The algorithms are Tyrannosaurus Rex.
    0:09:26 They’re attracted to movement and violence.
    0:09:29 And it creates more clicks, more engagement, and more Nissan ads.
    0:09:30 So where are we?
    0:09:35 Should an individual have First Amendment rights and be able to say pretty much anything about
    0:09:37 pretty much anybody at pretty much any time?
    0:09:38 Yeah, I think so.
    0:09:41 But should a bot have First Amendment protection?
    0:09:42 I don’t think so.
    0:09:44 Should we be creating this atmosphere?
    0:09:47 And it has gotten much worse over the last 20 years.
    0:09:53 Where anonymity serves as a chaser and an incendiary to take the worst among us
    0:09:56 and absolutely expand that behavior and forgive them for it
    0:09:59 and encourage that behavior and also let bad actors
    0:10:04 pretend to be people who engage in some of the most uncivil conduct
    0:10:07 experienced in our society.
    0:10:12 So I’m a big fan of getting rid of this love of anonymity.
    0:10:16 And if you look at what’s going on, whether it’s ICE, whether it’s troll farms,
    0:10:21 whether it’s people spewing hate speech on campus, what’s the problem?
    0:10:21 Anonymity.
    0:10:24 You want to show up and protest?
    0:10:24 Fine.
    0:10:30 But I don’t think a movement where everyone on your side feels the need to wear a mask,
    0:10:35 I think that says something about what you’re saying and says something about your character.
    0:10:39 Anonymity has been abused and it is tearing at the fabric of our society.
    0:10:41 Okay, moving on.
    0:10:45 In today’s episode, we speak with Greg Lukianoff, a free speech advocate,
    0:10:49 First Amendment attorney, president of FIRE, the Foundation for Individual Rights and Expression,
    0:10:55 and co-author of The Coddling of the American Mind, and most recently, The Cancelling of the American Mind.
    0:10:57 I’m going to bring up some of these topics with Greg.
    0:11:00 We discuss with Greg free speech in a divided country,
    0:11:04 how cancel culture took off, and what today’s campus protests tell us about the state of open debate.
    0:11:09 We also get into how schools are failing to build resilient students.
    0:11:13 So with that, here’s our conversation with Greg Lukianoff.
    0:11:27 Greg, where does this podcast find you?
    0:11:32 Maine, actually. This is my first day up here since last year.
    0:11:34 First day up there. Where are you usually?
    0:11:35 D.C.
    0:11:40 Oh, nice. So let’s bust right into it. Give us your thoughts on cancel culture.
    0:11:47 How did it start? Brief history of it. And how does it differ from accountability, so to speak?
    0:11:53 Sure. I mean, I wrote a book called Canceling of the American Mind when I started the project.
    0:11:59 20-year-old Ricky Schlott, who’s absolutely brilliant, and I feel very lucky to work with her.
    0:12:07 And it definitely was one of those things that was a really striking discontinuity from the rest of my career.
    0:12:11 I started working defending free speech on campus in 2001.
    0:12:17 And back then, you were most likely to get in trouble on campus from administrators.
    0:12:20 Professors were fairly good on freedom of speech.
    0:12:25 Students were great on freedom of speech and freedom to differ, differing opinions.
    0:12:36 But right around 2013, going into 2014, a cohort of students showed up that were much less, you know, just to be blunt, tolerant of difference.
    0:12:41 But essentially, you started seeing a lot more demands that speakers be canceled.
    0:12:44 You started seeing demands for new speech codes.
    0:12:47 And this was a big shift from what I’d seen before.
    0:12:50 But I also started seeing some of this happening off campus.
    0:12:54 So I tried to define cancel culture as a historical period.
    0:13:00 Because all moments in the history of censorship have commonalities.
    0:13:03 But they also have things that make them distinct.
    0:13:13 And I think one of the distinct characteristics of cancel culture is that it was essentially impossible to have it as we understood it without something like social media.
    0:13:22 Something that allows you to create the reality or oftentimes appearance of a sudden mob that’s demanding you fire that one employee.
    0:13:24 And this wasn’t a subtle shift.
    0:13:29 You know, I’d been doing this job for a long time prior to 2014.
    0:13:41 And from 2014 on, you know, I’ve seen more professors lose their job, more tenured professors lose their job than, you know, what I’d seen in my previous half of my career, you know, times 20.
    0:13:44 You know, it was really quite a shift.
    0:13:59 So the way that Ricky and I define cancel culture is the uptick of campaigns to get people fired, punished, penalized, expelled, or otherwise punished for speech that would be protected under the First Amendment.
    0:14:12 There, I’m making an analogy to public employee law, which basically means that there’s some common sense injected in there, but that essentially you’re not supposed to fire people just for their outside speech as a citizen.
    0:14:15 And the culture of fear that resulted from it.
    0:14:19 And one thing you should notice about that definition is there’s no political valence to it.
    0:14:22 So cancel culture is cancel culture, whether it comes from the left or the right.
    0:14:35 Isn’t that one of the deltas, though, that there’s always been shaming or criticism of people if they, you know, if their narrative doesn’t match yours or an opportunity to kind of play into gotcha culture.
    0:14:42 But what I see is the big difference over the last 10, 15 years is the discovery that you could go after people’s livelihood.
    0:14:48 It used to be that that was somewhat isolated, like we’re, I mean, I don’t like what Greg says.
    0:14:49 I’m going to publicly shame him.
    0:14:50 I’m angry at him.
    0:14:51 He’s a bad person.
    0:14:52 You shouldn’t be his friend.
    0:14:53 You shouldn’t be listening.
    0:14:58 But it never jumped the shark to now go after his livelihood.
    0:14:59 Wasn’t that the big difference here?
    0:15:08 Well, that was part of the definition, our campaigns to get people punished in some real material way, like get them fired, expelled, etc.
    0:15:10 It’s not cancel culture if you’re just telling it.
    0:15:16 There was a phenomenon called trashing in the 1960s that Musa Al-Gharbi likes to point to.
    0:15:23 And it’s this really nasty, vitriolic way of going after your political enemies that was everything you’re talking about.
    0:15:24 It’s like the person’s a bad person.
    0:15:25 Don’t listen to the person anymore.
    0:15:31 Or they’re not, you know, they’re not doctrinaire, as I would like to be doctrinaire.
    0:15:34 But it generally didn’t get to the point of, and this professor has to be fired.
    0:15:41 And the biggest shift, the one that kind of shocked me, was the uptick around 2017.
    0:15:46 Because at first, students were focusing on each other and outside speakers.
    0:15:52 But 2017 really marks the moment when they started going after professors in large number.
    0:15:56 Talk a little bit about, quote unquote, de-platforming.
    0:16:15 De-platforming is just the idea that essentially, the way we define de-platforming in our research department at FIRE is essentially getting a speaker, either getting them disinvited or making it so difficult to hear them or otherwise chasing them off campus.
    0:16:23 The ones that scare me, the kind of de-platforming that actually scares me the most are the ones that involve violence or the threat of violence, for obvious reasons.
    0:16:26 It’s primarily targeted at speakers.
    0:16:31 We also consider it de-platforming if you do the same thing to, like, say, playing a movie.
    0:16:34 That essentially you’re showing a documentary that’s not very popular on campus.
    0:16:36 Students show up and shout it down.
    0:16:40 But this is actually one of the areas where a lot of it actually comes from the right as well.
    0:16:49 Because for a lot of speakers on campus, there’ll be off-campus pressure to get that person disinvited.
    0:16:57 And this is particularly true of, say, speakers that could be painted as, like, a pro-choice and sometimes Catholic groups.
    0:16:59 I think the Cardinal Newman Center is big on this.
    0:17:03 Pressure schools to disinvite that person.
    0:17:12 So generally, and this is for fairly obvious reasons, if the threat to free speech and de-platforming comes from the left, it tends to come from on campus.
    0:17:15 If it comes from the right, it tends to come from off campus.
    0:17:19 I saw some of this as a faculty member at NYU.
    0:17:31 I remember about 10, 15 years ago, it became sort of in vogue for department chairs to put out very long emails about how certain microaggressions would not be tolerated.
    0:17:38 And it was, OK, we’re charging kids $280,000 to come here.
    0:17:41 Some of them leave riddled in student debt.
    0:17:44 Two-thirds of the faculty probably isn’t holding their weight.
    0:17:47 So there was an opportunity to step into this virtue circle.
    0:17:50 And no one could ever criticize them.
    0:17:51 I’d do anything but applaud.
    0:17:52 Otherwise, you are a racist.
    0:17:59 And there was this, almost this sort of self-appointed police.
    0:18:12 That, and it was always, quite frankly, and I consider myself a pro-progressive, but people never got counseled for being too progressive.
    0:18:15 And it felt very unhealthy.
    0:18:27 And then, well, comment on that, and then I’m going to play identity politics and just make some anecdotal observations in the classroom and see if there’s any actual data that supports my thesis.
    0:18:43 But talk about how all of a sudden, do you think some of it is, I just saw it as people who weren’t adding any actual value and were trying to find some merit and grab virtue or some sort of relevance and saw this as an easy way to try and grab status, so to speak.
    0:18:47 Yeah, I think it’s a lot of things going on at once.
    0:19:12 Well, one thing from my work with Jonathan Haidt, one chapter we ended up leaving out because I just didn’t have enough research to back it up, was my intuition that a lot of the phenomena we were seeing seemed to be playing out some of the values of the circa 2010 anti-bullying movement.
    0:19:17 If you can get me to have a little time to develop this, I can explain it.
    0:19:31 So in coddling, we talk about there being three great untruths, which are basically terrible advice to give someone that’s inconsistent with either modern psychology or ancient wisdom, and that will make you more miserable if you believe them.
    0:19:37 And so we give this negative advice as what doesn’t kill you makes you weaker, you know, kind of like the opposite of Nietzsche.
    0:19:43 The second one is always trust your feelings, which sounds nice, but it’s just awful advice.
    0:19:54 And three, life is a battle between good people and evil people, which is contrary to a more sophisticated understanding of that everybody has some aspect of good and evil within them, which is more how I was raised.
    0:20:10 And there was a critic who pointed out after coddling came out in 2018 that these were more or less kind of like the way anti-bullying was being taught after sort of like a moral panic about it.
    0:20:14 Not that bullying isn’t real and should be addressed, but things manifest in their own ways.
    0:20:23 And this was primarily due to parents being aware of more of this stuff due to the fact that they could see it on their cell phones, they could see it on their on their screens.
    0:20:27 And this did have an emphasis of, you know, human fragility.
    0:20:31 If you feel that you’ve been wronged, you’ve been wronged.
    0:20:39 And that there’s basically only two types of people, good people and evil people, you know, good people, victims and bullies.
    0:20:43 I think that this wasn’t the only cause by any any stretch of the imagination.
    0:20:51 But to explain why I think young people had such sympathy for this movement, I think they were framing it partially in that way.
    0:20:55 But unfortunately, because the rule of human behavior is that all motives are mixed.
    0:21:07 It also met with something that my very young colleague and co-author on Canceling the American Mind was able to point out that she was part of the first generation of people to grow up with cell phones in her pocket.
    0:21:09 She had them since she was 10.
    0:21:16 And in junior high school, you know, it took on very much the nature of what you would expect.
    0:21:32 A mass communication device given to kids in junior high school, it became a way of showing aggression against your perceived enemies, but doing it within the rules of the time, which you don’t call out someone for being unpopular or ugly.
    0:21:37 You call them out for being something more that makes you allows you to feel more moral.
    0:21:49 So I think these two mixed motives kind of came together for the students when it comes to the utterly crucial role, though, of the administrators, because this one, if administrators looked at this and went, no way.
    0:21:49 No, no, no, no, no.
    0:21:53 You’re not you’re not you’re not getting a professor fired because you don’t like what they said.
    0:21:55 This would have died in the crib.
    0:22:01 But they had met those same administrators we’ve been fighting for fighting against at fire forever.
    0:22:20 And together it created this kind of calamity for for freedom of speech, where these people who already believed it was their job to say what shall be orthodox on this particular campus met a cohort of students that were more willing to play along with that, too.
    0:22:22 And again, as with all things, with mixed motives.
    0:22:27 You said something that I thought was so, I don’t know, puncturing.
    0:22:35 You said that students are being taught the mental habits of anxious and depressed people, which really struck me.
    0:22:42 And I thought we’re teaching the kids to be fragile and actually make them less resilient.
    0:22:45 It’s more than just word.
    0:22:48 These I have seen this evolution where kids in my class.
    0:22:50 They feel weaker.
    0:22:56 It’s not just it’s not just a cool virtue thing and trendy or fashionable.
    0:23:01 They appear to me to be less resilient.
    0:23:03 Talk about that.
    0:23:29 Yeah, I mean, the whole project with me and me and John came out of my observation when I was dealing with my own anxiety and depression and cognitive behavioral therapy is what saved me and utterly transformed my life, which is a process by which you develop all these tools and sort of talking back to the exaggerated voices in your head that tell you things like you’re doomed or you’re a failure or nobody loves you.
    0:23:34 All of these kinds of voices that to a degree, to be clear, everybody except sociopaths have.
    0:23:39 But, you know, when you’re anxious and depressed, they’re louder and they’re harder to ignore.
    0:23:53 The amazing thing about CBT is it teaches you that if you actually rationally not not power of positive thinking stuff, but just rationally interrogate these, you realize you’re overgeneralizing or engaging in fortune telling that.
    0:23:59 You know, you know, you know, you know, you know, you’re overgeneralizing or mind reading all these things that logically don’t really stand up to scrutiny.
    0:24:11 And the observation that I that really brought me to talk to John about a potential collaboration, although actually I just told him the idea that I thought was cool, I didn’t actually think we’d collaborate on it.
    0:24:26 That was a that was a dream come true, was just that it was like we were teaching kids reverse CBT, that we’re teaching them do overgeneralize, do catastrophize, do engage in binary thinking, do do believe, you know, the future.
    0:24:45 And and and and it comes from, I believe, two different places, one, a very well meaning idea from both parents and administrators all through all through K through PhD to sort of and an instinct to sort of protect young people and to insulate them from harm.
    0:24:57 But then a less admirable quality is that essentially if you make people feel guilty or frightened, it’s in theory will motivate them towards political action that you prefer.
    0:25:01 And to me, that’s that that’s the one that makes me pretty angry.
    0:25:06 The first one makes me kind of sad because it’s like, yeah, no, it’s an understandable instinct, but it’s still terrible advice.
    0:25:22 And you should have known that the second one is the idea that we can sort of guilt, shame, anger, upset through telling people that they are more fragile than they are, that they are in greater danger than they are, that that will somehow result in a better world.
    0:25:36 And I always make the point, listen, this is a bad calculation, even just rationally, because people who are filled with despair and anxiety don’t always choose, to say the least, the best course of action to get from point A to point B.
    0:25:41 Yeah, I want to make some observations anecdotal, and you tell me if there’s any data to back it up.
    0:25:56 In terms of, I think, I’m trying to think of that product, was it called JotForm, where all of a sudden someone would get upset by something and spin up an online petition and within a certain amount of time, everybody thought it was cool to join in and the dean had to deal with this bullshit.
    0:26:17 And I do think a lot of it was bullshit, but a couple observations, and you tell me if the nullifier validate them, I would never got in the way, or I was never subject to this sort of scrutiny or blowback, because the first thing I say in class, one, I’m known as being provocative and, quite frankly, a little bit aggressive and obnoxious, so the expectation is there.
    0:26:32 And the first thing I say is, if you think there’s a non-zero probability, something I say is going to trigger you, I curse, I have certain unconscious biases I’m still working on, but if you think something’s really going to emotionally trigger you, you should call your parents and tell them to come get you, because you’re not ready for college.
    0:26:41 So there’s a certain expectation that I’m going to be a little bit out there, and no one ever has, I’ve never gotten run over by this.
    0:26:53 I have some colleagues who are much more thoughtful and considerate than me, 99.9% of the time, and then they make an error.
    0:27:01 They’re inarticulate around something, and it’s shocking because they’re known as these nice, benign people.
    0:27:15 And then they get taken, you know, they get taken out and shot, because it’s almost like those of us who are a little bit more aggressive and provocative regularly are not subject to the same scrutiny as someone who makes one false move.
    0:27:33 And then the second observation I would make, and this is identity politics, but I’m going to do it anyways, the people I have observed in class who get really upset, I mean physically upset, they’re not faking it, it tend to be women, tend to be white women.
    0:27:35 Upper-class white women, yes.
    0:27:37 What’s the data there?
    0:27:48 The data on women, particularly white women, and particularly upper-class white women being more free-speech skeptical is just very apparent.
    0:27:55 And that’s one of those things that, you know, it makes me a little uncomfortable to say it, but it’s a consistent finding.
    0:28:00 And it’s something that we found among the professorate, among students as well.
    0:28:11 And, of course, I think the free-speech skepticism comes from a good place, but so does all of censorship, you know, so I don’t think that that’s a strange observation.
    0:28:25 The observation that the professors who start out more sympathetic tend to be more vulnerable definitely accords with my professional experience, that it certainly seems that way.
    0:28:37 But then there’s also a category of sort of outspoken conservative or outspoken, you know, iconoclastic professors that I’ve definitely seen get targeted quite aggressively over the years.
    0:28:48 So, in some ways, I will say that some of your observations come a little bit from luck, because, like, you get one student or one administrator who decides, I’m getting Scott Galloway, and the whole dynamic changes.
    0:28:52 We’ll be right back after a quick break.
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    0:30:11 President Trump met with the leaders of five African nations at the White House yesterday.
    0:30:16 One oops got all the attention when Trump paid Liberia’s president a compliment.
    0:30:18 Well, thank you.
    0:30:19 It’s such good English.
    0:30:20 Such beautiful.
    0:30:23 Where did you learn to speak so beautifully?
    0:30:26 English is Liberia’s official language.
    0:30:28 Were you educated where?
    0:30:29 Yes, sir.
    0:30:31 In Liberia.
    0:30:32 Yes, sir.
    0:30:33 Well, that’s very interesting.
    0:30:37 Anyway, you know what happened behind closed doors right before that meeting?
    0:30:43 President Trump pushed those African leaders to accept people who are being deported from the U.S.
    0:30:46 That’s according to a Wall Street Journal exclusive.
    0:30:50 In fact, it’s trying all kinds of ideas to increase the pace of deportations.
    0:30:53 And we’re going to tell you about some of them on Today Explained.
    0:30:56 Today Explained is in your feeds every weekday.
    0:31:06 This week on Net Worth and Chill, we’re diving deep into Trump’s one big, beautiful bill,
    0:31:11 the sweeping legislation that promises to reshape America’s economic landscape.
    0:31:15 From tax cuts to student loans, I’m breaking down what this massive piece of legislation
    0:31:19 actually means for your wallet, your investments, and your financial future.
    0:31:22 We’re going to find out who wins and loses in this economic overhaul,
    0:31:25 analyze the market reactions that have investors buzzing,
    0:31:30 and discuss whether this bill will deliver on its promises or create unexpected consequences.
    0:31:34 Just because you’re not on Medicaid doesn’t mean this doesn’t impact you.
    0:31:37 Poor people don’t stop having medical emergencies.
    0:31:39 They just stop being able to afford them.
    0:31:44 Listen wherever you get your podcasts or watch on youtube.com slash yourrichbff.
    0:31:53 What are your thoughts on how the presidents of Harvard, MIT, and Penn handled that situation
    0:32:01 and generally assess their response, Congress’s or the Congressional Committee’s viewpoint on this?
    0:32:03 And this is a difficult one.
    0:32:10 And what is the line between free speech and hate speech from people in masks that creates an environment
    0:32:12 that’s unhealthy for the community?
    0:32:13 Your thoughts?
    0:32:22 Now, there have been critics who have been really critical of those professors when they went to the anti-Semitism hearing in December of 2023.
    0:32:33 There have been people who have been primarily critical of the fact that when asked if calling for genocide was protected or not on their campus,
    0:32:35 they said it depends on context.
    0:32:37 Now, here’s the truth.
    0:32:39 It does depend on context.
    0:32:46 In First Amendment law, if you’re saying something, and particularly academically, if you’re saying something theoretically,
    0:32:52 if you’re saying something in the course of a philosophical discussion, that is different than being like, I’m going to kill you.
    0:32:53 So context is right.
    0:32:58 But the reason why I nonetheless have zero sympathy, actually, to be fair,
    0:33:05 I have sympathy for the president of MIT, because MIT has not been the best, but it sure as hell has not been the worst.
    0:33:17 Penn and Harvard, Claudine Gay, I had no sympathy for them at all, because the reason why I have no sympathy for them is they’d been utterly terrible on freedom of speech prior to that point.
    0:33:26 And definitely your critics, including people like Barry Weiss, have a good point that saying these people who claim to be exquisitely sensitive about fat phobia,
    0:33:34 you know, is the example that she usually uses, were suddenly not caring if someone said something that sounded an awful lot like you,
    0:33:36 your country should be wiped off the map.
    0:33:37 So what is the line?
    0:33:42 The line, as far as fire is concerned, and we think to a large degree the law is,
    0:33:47 is something that actually crosses the line into anti-Semitic or racial or sexual harassment.
    0:33:51 And that’s not as simple as just saying something offensive.
    0:33:56 Actually, it can’t just be saying something offensive, which, by the way, I think is absolutely the right rule.
    0:34:04 I think the situation for free speech would be even worse than it currently is if we didn’t have that bedrock principle,
    0:34:05 which is called in the law.
    0:34:11 It has to be a pattern of discriminatory behavior directed at somebody for it to be harassment.
    0:34:16 But a lot of what we saw on campus after October 7th, you don’t even have to get to that question.
    0:34:24 A lot of what we saw was, you know, violent attempts to intimidate, actual threats, in some cases, physical assault,
    0:34:29 taking over buildings, all of these things that are just not protected, nor should they be.
    0:34:32 And particularly, this is something that I just did a TED Talk.
    0:34:36 And the thing that I, and I probably angered some people by opening up with this example,
    0:34:38 but I want to be really clear here.
    0:34:41 There was a speech, for example, at Berkeley.
    0:34:50 There was an Israeli Defense Force speaker there, and students organized to, and it’s nice to have this actually like in a,
    0:34:54 like in a screenshot of a tweet, of a text message to everybody.
    0:34:56 Shut it down.
    0:35:05 And 200 students stormed where the guy was supposed to speak, you know, broke down a door, broke down a window, and chased the guy off.
    0:35:09 And it’s, and I always have to explain, okay, that’s mob censorship.
    0:35:16 Like, like, like that is an attempt by people to say, 200 people to say to anybody who would want to hear this person,
    0:35:19 you’re not allowed to hear this person because I don’t approve of them.
    0:35:20 That’s not okay.
    0:35:26 That’s the kind of thing that, in my opinion, should get you kicked out of a university because it means you’re not actually understanding the point of a university.
    0:35:32 And one of the reasons why this angered some people is because I also tend to point out that from October 7th on,
    0:35:38 all but about three, and in the two worst years for deplatforming involving violence and involving,
    0:35:44 um, and involving shout downs, as they’re called, um, all but three were pro-Palestinian activists.
    0:35:51 So, like, it was one of these things, we’re spending plenty of time defending the free speech rights of pro-Palestinian students,
    0:35:57 pro-Palestinian professors, but nonetheless, we were also seeing these same students and, uh,
    0:36:02 who expected to be protected by freedom of speech showing no respect whatsoever for the free speech of others.
    0:36:05 So, a lot of these issues are actually not that hard.
    0:36:13 The hardest issue you get into is essentially if it’s not a threat, if it’s not, uh, blocking someone from getting from point A to point B,
    0:36:16 it’s just really, really offensive.
    0:36:22 At what point does that actually become, uh, anti-Semitic or, uh, racial or ethnic harassment?
    0:36:27 And the answer is essentially that, that, that Davis test, um, that we always refer to at FIRE,
    0:36:32 which is, is it severe, persistent, and pervasive such that it causes a reasonable person
    0:36:36 um, to, uh, uh, to be denied effectively in education.
    0:36:43 So, that’s, that’s a high standard, but it should be if you’re dealing with something that has an, an offense aspect in it.
    0:36:47 But again, for a lot of these situations, you didn’t even have to get to that analysis
    0:36:50 because what the students were doing wasn’t protected in the first place.
    0:37:00 So, I’m asking this to learn, not to make a statement, but I struggle with, I feel like anonymity has been conflated with free speech to our detriment.
    0:37:10 That some of the really vile things you see online, you know, I understand how important it is for individuals to have First Amendment free speech rights,
    0:37:12 but I don’t think that applies to bots.
    0:37:20 And I think that an understandable protection for anonymity has morphed into a total lack of accountability
    0:37:22 and a real coarsening of our discourse online.
    0:37:27 And I think it extends into letting government agencies wear masks and things like that.
    0:37:35 But I’m curious, I’d love to just get your thoughts on the fulcrum between the importance of people having the right to say things anonymously
    0:37:39 because what they’re saying could trigger danger or self-harm or harm for them.
    0:37:45 And at the same time, how this reverence for anonymity may have gone too far and resulted in a lack of accountability
    0:37:48 and some really ugly shit spreading online.
    0:37:50 Your thoughts, Greg?
    0:37:54 Well, in terms of First Amendment law, anonymous speech is protected.
    0:37:57 But I don’t think that’s sufficient enough of an answer.
    0:38:03 And I think, I tend to think of the justification for anonymity as like a seesaw.
    0:38:12 That essentially, if we lived in a free and enlightened society in which people welcomed dissent and welcomed disagreement
    0:38:16 and there was no imaginable idea that you’d be punished for it,
    0:38:22 then the justification for anonymity would kind of fall on, bring hollow to people.
    0:38:24 They’d be like, who cares?
    0:38:25 But we don’t live in that world.
    0:38:27 And we live less in that world than we used to.
    0:38:37 Because even, I’d say, 10 years ago or 12 years ago, before cancel culture, the idea of saying something that was your genuinely held opinion
    0:38:46 had a much lower likelihood of ruining your career, add to it the possibility of being actually punished in some way.
    0:38:56 Now, that certainly applies to now, to a much larger degree than I ever thought I’d see, to say, a lot of countries in Western Europe at this point, a lot of countries in the Anglosphere.
    0:39:03 I mean, you know, by different estimates, they’re arresting something like 30 people a day for offense speech in Britain.
    0:39:11 I’ve heard different accounts, but generally they go between 7 and 40 people being arrested a day for that.
    0:39:14 Germany, you know, like that will brag about the fact that they did morning raid.
    0:39:20 They did this on 60 Minutes as well, brag about doing morning raids on someone who called a politician a penis.
    0:39:25 Under that situation, the justification for having an anonymous speech goes way up.
    0:39:27 Can it and is it abused?
    0:39:29 Absolutely.
    0:39:35 But, you know, I think actually I’m going to quote Milton Friedman here, but it’s just a really good quote.
    0:39:37 Something isn’t a right unless it can be abused.
    0:39:39 I like that.
    0:39:52 What about, so Section 230, the idea that these nascent platforms aren’t subject to the same kind of libel, slander, disparagement laws that traditional media platforms.
    0:39:54 What are your thoughts on that?
    0:39:59 I think we toy with Section 30 to our great peril.
    0:40:07 I think that it’s, you know, like democracy, it’s the worst of any system except all the others.
    0:40:13 Now, to be clear, there might be some other system that I haven’t thought of that could be better.
    0:40:23 But when it comes to things and but I do find it particularly almost amusing that conservatives are going after 230 or were going after 230 with such gusto.
    0:40:47 Because if you actually even let’s just take it to the defamation protections that 230 gives to ISPs, to Internet service providers, if suddenly that were to vanish, it would lead to Internet service providers censoring a lot more, like a lot, lot more, because they can be held liable for liable for defamation.
    0:40:57 And I think that given the biases in a lot of social media companies, that would wildly disproportionately affect what conservatives say.
    0:41:02 So I think that 230 is probably I think that overall we benefit so much from 230.
    0:41:04 Of course, it’s going to have downsides.
    0:41:25 But you see you don’t see an issue that traditional media platforms, which are struggling to stay viable and raise the funds to do fact checking and put out, I don’t want to say the truth, but a greater attempt to do the good work of journalism and fact check and do their research.
    0:41:33 You don’t see that a problem with holding traditional media to an entirely different standard, a higher standard than these online platforms.
    0:41:35 Yeah, and that’s generally the way they’re held.
    0:41:40 Essentially, traditional media that’s responsible for the content that they produce.
    0:41:49 I think it makes more sense to hold them liable for not doing the sufficient fact checking for defamation as opposed to something that hosts everything.
    0:42:01 I mean, something that hosts the Wall Street Journal, the New York Times and YouTube and everything else under the sun, you know, is something that’s quite distinct than just, you know, just the New York Times by itself.
    0:42:04 Do you think there’s opportunity for nuance or gray area?
    0:42:08 And I’ll propose a solution or what I think we should think about.
    0:42:09 I think about 230 a lot.
    0:42:24 The idea that people can break through and say things and post something and that a company that creates a lot of economic value, lets a lot of interesting opinions, sometimes the conspiracy view ends up being actually more true than you think.
    0:42:36 There’s been some just wonderful things about these platforms and the ability for viewpoints and consumers or content producers to kind of go direct to consumer and kind of have at it.
    0:42:43 At the same time, I worry that the protection is not consistent in the sense that, well, let me propose a solution.
    0:42:56 So if my co-host on one of my podcasts, Raging Moderates, and she’s the kind of the sole Democrat on this show, which is actually the most watched show on cable news called The Five.
    0:43:15 Someone got upset that she called out Ken Paxson or something and mocked up a picture of her with her previous boyfriend and has, you know, has gone into this tried and true misogynistic, slut-shaming, misinformation, having an affair from her first husband, hasn’t been married to her.
    0:43:16 I mean, just total nonsense, right?
    0:43:39 And the algorithm on Twitter loves that because it creates a lot of comments, a lot of engagement, people weighing in, conspiracy theorists, and also people protecting her creates more Nissan ads because, and the algorithm itself from Twitter is trained to elevate that content and give it broader and further reach than it would organically because it creates Nissan ads.
    0:43:42 In other words, in other words, there’s an economic incentive to spread this information.
    0:43:49 Do you think there’s a solution or some gray area where maybe we say, okay, you’re a bulletin board and you can’t be responsible?
    0:43:54 It’s just, it’s, it’s unrealistic suppression of speech, economic impairment.
    0:43:59 If you were responsible for policing everything, someone pins up on the board.
    0:44:08 But if you as a social media company decide to elevate algorithmically content and give it more spread than it might organically,
    0:44:17 at that point, are you really different than an editor at CNBC or MSNBC or at Fox who’s subject to a different set of standards?
    0:44:25 Shouldn’t they be subject to the same standards if they make the conscious decision to algorithmically elevate content?
    0:44:37 I’m always worried about the distortative impact of government, also regulation sometimes, and liability.
    0:45:00 And so I’m very hesitant to change anything without, and my job is to make the argument for, you know, err on the side of free speech as much as possible and err on the side of as little, as few things being banned and as few things being government regulated as possible.
    0:45:13 So my fear is that essentially if you started having government entanglement with algorithmic choices, you know, you really got to decide, one, you know, which government do you trust?
    0:45:15 Do you trust Biden to do that?
    0:45:16 Do you trust Trump to do that?
    0:45:26 But also, particularly when it’s a liability standpoint, how distortative that actually can be to what gets reported in the first place?
    0:45:32 Because this is, in a sense, kind of like why everybody sues for libel in Britain.
    0:45:46 It’s very, they still, even though they’re, even though they’ve made slight improvements around the edges, it’s still much easier to find people guilty of committing libel in Britain than it is the United States.
    0:46:02 We actually have a shield for the country, basically saying, you know, providing some modicum of protection for people in the U.S. from libel tourism that takes place in, that takes place in the U.K.
    0:46:11 So, you know, I’m always going to be fairly skeptical of that kind of stuff, but it’s also my societal role to be skeptical of that kind of stuff.
    0:46:14 We’ll be right back.
    0:46:26 Foldable phones have been around for a while now, but maybe you’ve never used one.
    0:46:31 This week on The Verge Cast, we take a look at Samsung’s new lineup of foldables.
    0:46:37 This could be a big moment where foldable phones become a lot more interesting to a lot more people.
    0:46:45 Plus, we look at executive shakeups at Apple, Meta, and X, where Grok is going absolutely off the rails.
    0:46:54 Plus, we do our signature microphone test with the latest over-ear headphones, and we get into why it’s so hard to make a great strength training app.
    0:46:56 That’s this week on The Verge Cast.
    0:47:06 We’re back with more from Greg Lukianoff.
    0:47:12 So I want to throw kind of the most difficult stuff at you and get your thoughts.
    0:47:25 So if I were Putin and I’d lost a million men to a war in spending, you know, $70 to $100 billion a year on a losing war,
    0:47:31 and at some point, if this war continued to wreak the kind of economic and human damage,
    0:47:36 if it were to continue to do that, at some point I might find myself falling out of a window.
    0:47:43 So I think he would be stupid not to weaponize and spin up troll farms in Albania
    0:47:48 and then create a list of the 10,000 most influential people online who are pro-Ukraine
    0:47:54 and start attacking their reputation with millions of bots in a very thoughtful way.
    0:47:56 Is he already doing that, though?
    0:47:57 Well, yeah, I think he is.
    0:48:01 And that’s my question, and that is, do bots have First Amendment rights,
    0:48:04 and do these platforms have some sort of obligation,
    0:48:09 which I think would only be registered or adhered to through some sort of regulation,
    0:48:14 to protect us against bad actors that might be, quite frankly,
    0:48:18 raising a generation of military, civic, and nonprofit leaders who don’t like America
    0:48:20 or begin to have their views shaped,
    0:48:27 and ultimately our votes and our military decisions shaped on outside forces
    0:48:34 that are taking advantage of a very porous and lightly regulated tech ecosystem and platforms.
    0:48:35 Your thoughts?
    0:48:38 The question of whether or not bots have First Amendment rights,
    0:48:42 of course they don’t, but do bot creators have First Amendment rights?
    0:48:46 At least when they’re in the United States, absolutely, certainly they do.
    0:48:50 When you’re talking about the kind of propaganda, kind of warfare,
    0:48:55 and targeting that is possible in the age of the Internet, in the age of social media,
    0:49:00 when you’ve kind of fall down this rabbit hole of how you actually address it
    0:49:05 without actually devastating, without having huge government encroachment,
    0:49:08 which will end in bad places as well,
    0:49:12 or without creating massive unintended consequences,
    0:49:18 the best way to do this historically has simply to have authorities that people actually trust.
    0:49:23 And we have blown giant holes in the only thing that really can protect you
    0:49:25 from disinformation and misinformation.
    0:49:32 And you have to start figuring out ways to get authorities that people essentially trust.
    0:49:36 Because one of the ways we could potentially address some of this stuff
    0:49:43 is by having institutions pointing out what is troll farms and what isn’t.
    0:49:46 But under the current environment, there’s going to be a lot of like,
    0:49:47 sure, they are.
    0:49:51 You just don’t like what they’re saying is going to be the response there.
    0:49:55 And in a situation where these institutions had better societal trust,
    0:49:56 it’d be like, oh my God, you’re right.
    0:49:59 So you’re a First Amendment attorney.
    0:50:02 What are we not paying attention to in the courts?
    0:50:05 Have there been any legal decisions that you think are
    0:50:11 especially important to the future of First Amendment or speech or its regulation or lack thereof?
    0:50:15 What have you seen come down the pike that you think has not gotten enough attention?
    0:50:17 Yeah, I mean, I think it got good attention,
    0:50:20 but I think people haven’t thought through all the ramifications of it.
    0:50:26 And this gets to your point on anonymity where we may disagree to some degree.
    0:50:39 But the change in the law to say that you can’t actually require verification for kids
    0:50:44 and actually really for anybody to use porn sites in Texas
    0:50:50 is a case that could really have some serious bad ramifications
    0:50:54 unless it stays relatively cabined.
    0:50:57 Now, I was definitely among the First Amendment people saying,
    0:51:01 listen, there’s a case called New York v. Ginsburg from the late 1960s
    0:51:06 that says you can require store owners to put the, you know,
    0:51:09 put the nudie mags, you know, on the back shelves
    0:51:12 and to make sure that that miners don’t get them.
    0:51:19 But then we had decade after decade of the Supreme Court and other courts basically saying,
    0:51:23 but online that can’t possibly apply for all sorts of,
    0:51:25 and to be clear, very serious reasons.
    0:51:28 I knew that wouldn’t last forever.
    0:51:33 And then eventually Texas passed a verification regime
    0:51:36 that was actually more complex than I originally understood,
    0:51:41 but was first marketed as something where you had to basically show like a driver’s license
    0:51:46 if you want to see porn that would also include that they had to have disclaimers
    0:51:51 saying that, you know, porn is harmful to your mental health and all this kind of stuff,
    0:51:53 which has compelled speech issues.
    0:51:59 I think they made some efforts to sort of improve the law and make it clear that there’s other ways to verify.
    0:52:04 Anyway, so that fight was something that I predicted we were going to lose in the Paxon case.
    0:52:05 Now, here’s the question.
    0:52:09 Are we then going to, with the best of intentions,
    0:52:15 create an environment where you essentially can’t use the Internet without identifying yourself in some way?
    0:52:20 And that scares me, because I do actually think that the situation for free speech,
    0:52:25 even in the so-called free world, is dodgier than it’s ever been in my lifetime.
    0:52:33 And the idea that at this precise moment we’d also make it harder for people to hide what they’re looking at
    0:52:35 or what they’re reading scares me.
    0:52:40 So our efforts at FIRE are definitely going to be to make sure that that decision,
    0:52:46 as much as possible, stays cabined to kids’ access to adult materials.
    0:52:48 Don’t you think the platforms are already doing that?
    0:52:52 Don’t the platforms already know exactly what we’re doing, saying, and when?
    0:52:58 But as long as they use it to monetize advertising, it seems to be there’s a tolerance for it.
    0:53:01 I think the cat’s already out of the bag.
    0:53:02 I think they already know everything we do and what we say.
    0:53:04 We don’t seem that worried about that.
    0:53:11 But then we have this, do we have this tremendous fidelity for protecting them
    0:53:17 when it comes to any, I don’t know, forward-facing viewpoints that might result in more,
    0:53:22 I don’t know, just more, it seems like we’re just protecting them in the wrong areas
    0:53:24 and not looking at them in others.
    0:53:26 I apologize for the word salad there, Greg.
    0:53:28 Do you see any inconsistency?
    0:53:30 Yeah, no, I definitely get the concern.
    0:53:37 But I do think that there are tools that people badly underutilize that can actually protect your privacy.
    0:53:38 Well, they’re purposely made complicated to utilize.
    0:53:42 Have you tried to regulate your kid’s content on Face, on Meta?
    0:53:48 I mean, they are not, I would argue, they are not readily accessible purposefully,
    0:53:49 or they’re not easily used.
    0:53:55 Yeah, no, and I definitely ask for help to make, with my kid’s stuff.
    0:53:59 But now we have, you know, we have Signal, you know, for example.
    0:54:02 We do DuckDuckGo, you know, like that.
    0:54:05 I have Custodial installed on my kid’s phones.
    0:54:09 Yeah, there are some basic steps you can do to somewhat protect your privacy.
    0:54:13 And of course, when it comes to private corporations doing bad things,
    0:54:18 and this is something that I feel like we have an entire generation of young Americans
    0:54:22 sort of brainwashed to believe that you should be more afraid of corporations
    0:54:23 than you should be of governments.
    0:54:30 And I just think that’s absolute nonsense, particularly foreign governments,
    0:54:33 but also, frankly, the U.S. government.
    0:54:39 And that corporations, you know, people talk about that evil profit motive.
    0:54:43 And I’m kind of like, I prefer the profit motive to a lot of the other motives you can have
    0:54:45 for finding this stuff out.
    0:54:50 And profit motive often lends itself to, and by the way, we protect our users’ privacy
    0:54:56 in a way that, you know, the Chinese, the CCP, or Russia, or even our own government,
    0:55:00 it’s like, no, we want this information for other reasons.
    0:55:06 So just so you know, I’m very good at turning this podcast into, it’s really just an excuse
    0:55:07 for me to talk about me.
    0:55:14 Steve Bannon suggested that the president, that the administration sue me for some of the things
    0:55:14 I’ve said about him.
    0:55:16 I called him a rapist.
    0:55:23 And do you feel that the president is, in different ways, trying to suppress free speech?
    0:55:26 And if and what laws, or what do you think should be done about it?
    0:55:32 What are your views on, it feels to me like free speech has been chilled from the administration.
    0:55:34 And I’m just curious, curious to get your thoughts on it.
    0:55:35 Sounds like you agree with it.
    0:55:38 But what can and should be done to push back on that?
    0:55:44 Well, it’s tough because the, okay, so the ways in which it’s being chilled, just really
    0:55:48 quickly, there’s been, you know, attacks on mainstream media.
    0:55:52 People can argue that it’s deserved, but that doesn’t mean you get to violate the First
    0:55:52 Amendment.
    0:55:54 There’s attacks on higher education.
    0:55:58 Again, you can feel like it’s deserved, but it doesn’t mean you get to violate the First
    0:56:00 Amendment or existing laws.
    0:56:05 And then there’s the attack on the law firms, which probably is the one that I think gets
    0:56:07 the least attention, but probably scares me the most.
    0:56:11 When it comes to the media, for example, like, were the group defending Ann Selzer?
    0:56:18 Ann Selzer is the pollster in Iowa who got the poll really wrong right before the election,
    0:56:21 having Kamala up by two points in Iowa.
    0:56:23 And of course, that was way off.
    0:56:25 She was like 11 points off.
    0:56:28 But when it came out, she apologized.
    0:56:33 She explained how she got it wrong, saying that she was using methodology that was really
    0:56:39 effective maybe 10 years ago, but has gotten increasingly ineffective as fewer people have
    0:56:40 landlines and that kind of stuff.
    0:56:43 Because she used to be considered like the gold standard of pollsters.
    0:56:47 But she was nonetheless sued by Trump himself, actually.
    0:56:49 This is before Inauguration Day.
    0:56:55 For under a Consumer Protection Act in Iowa.
    0:57:03 And the Consumer Protection Act was really designed for preventing false advertising, like as in
    0:57:07 in commercial speech, saying that, you know, these pills will help you lose 40 pounds a day
    0:57:12 type things, not getting a poll wrong, which is, you know, good faith reporting.
    0:57:14 So we’re defending her in that case.
    0:57:19 Then there’s also like the 60 Minutes situation, the ABC News.
    0:57:25 The 60 Minutes one, I think of as particularly bad because it really seemed like the administration
    0:57:36 was dangling a proposed merger with Skydance in front of CBS to saying, kind of implying, we’re not going to agree
    0:57:39 to this unless you play ball, which is good.
    0:57:45 The university stuff, nobody’s been a bigger critic of Harvard, for example, than I’ve been.
    0:57:51 They have finished dead last in our campus free speech rankings, one of the best and most data intensive
    0:57:54 things that FIRE does, or the most data intensive thing that FIRE does.
    0:57:57 And Harvard was dead last two years in a row.
    0:58:02 But we’re currently defending Harvard because the letter the administration sent to Harvard
    0:58:07 was basically saying, because you’re probably in violation of Title VI, which they may be,
    0:58:17 and Title VII, which when it comes to admissions, probably are, that we essentially have to
    0:58:19 nationalize Harvard.
    0:58:24 Like basically, the government gets to decide all of the key things about what Harvard would
    0:58:27 decide on its own, which is not a power the government’s been granted.
    0:58:32 And when it comes to the law firms, I mean, like that, that’s the one that I really, I wrote
    0:58:38 on this, my substack, the Eternally Radical Idea, about the, about all of these, these cases.
    0:58:45 And it started with them just going after attorneys who had opposed the Trump administration, even
    0:58:50 like people like Robert Mueller, and where they had law firms and, and saying that they
    0:58:55 would be denied their secret service protection, and not secret service, their-
    0:58:56 Yeah, their security details.
    0:58:57 Repackage violence.
    0:59:03 If you’re someone who ordered a strike on Suleiman, the head of the Iranian security forces, and
    0:59:07 you take away a general’s security detail, you’re putting that person in harm’s way, in my view.
    0:59:12 And get rid of their security clearance, and then also deny them access to federal buildings,
    0:59:15 which of course include court, uh, uh, uh, courtrooms.
    0:59:19 And that’s, that’s to me like some of the most chilling stuff.
    0:59:20 Now, what can be done about it?
    0:59:25 Uh, the most, the, the thing that’s happening consistently is that Trump is losing in court.
    0:59:30 And so far, he’s mostly been abiding by those rulings.
    0:59:35 Um, I’m a little bit concerned, given how fast and loose sometimes this administration
    0:59:40 plays with the rules, that that might not hold up when push really comes to shove.
    0:59:42 Um, but, you know, fingers crossed.
    0:59:47 In terms of, like, what else people can do about it, I think it really is a question of what
    0:59:51 happens in the next, uh, in the midterms, and then, of course, in the presidential election.
    0:59:56 Um, but, uh, it’s, it’s, it’s troubling, but not unexpected.
    0:59:58 Yeah, shocking, but not surprising.
    1:00:04 Uh, just as we wrap up here, Greg, a lot of young men listen to this podcast, um, based
    1:00:08 on some of the many challenges, all young people, but especially, I would argue, some young men
    1:00:10 in our society are facing right now.
    1:00:14 A lot of them are struggling with their own mental health, and I appreciate how transparent
    1:00:18 and vulnerable you were at the beginning of the podcast, talking about your own struggles,
    1:00:22 and you had said that cognitive behavioral therapy really helped you.
    1:00:28 Can you share, uh, some thoughts on your struggles with your own anxiety and depression and any
    1:00:31 advice you might have for young people who are facing their own challenges?
    1:00:37 Sure, um, and that’s, you know, and, and it’s tough because, like, you know, everyone struggles
    1:00:43 kind of differently, and I, I really understand people’s kind of concern about, well, one, of
    1:00:48 course, the expense of getting a therapist, uh, but also the fear that’s given that therapy
    1:00:54 has to some degree become politicized, that they don’t want to end up someone with a therapist
    1:00:58 who’s going to judge them, you know, for, for, for, in some cases, just for being a male
    1:01:01 for having, um, and, you know, non-conforming political views.
    1:01:08 Um, so I, I get all of that, but I, I did hear from one, uh, friend about their, about
    1:01:15 their kid who basically said he didn’t need therapy because he watches a lot of podcasts.
    1:01:22 Um, and he, he’s on YouTube a lot getting advice and it’s, and it’s just not the same thing.
    1:01:23 Yeah, that’s not the fix.
    1:01:30 Yeah, so there’s people out there like Camilo Ortiz, uh, Ortiz, sorry, um, who is trying
    1:01:37 to put together apolitical therapists, you know, um, who, or ones who won’t judge you, you know,
    1:01:41 who won’t let their political opinion interfere with their therapy, which is amazing that you
    1:01:42 have to do that, but you do, unfortunately.
    1:01:49 Um, and, and within, so looking for people who are, who are recommended that way for CBT,
    1:01:54 there’s also some, you know, some approaches to CBT that actually lend themselves fairly well
    1:01:59 to even apps, um, which is, I don’t think it’s sufficient, uh, but it can help.
    1:02:01 Uh, but here’s the thing.
    1:02:06 It may be simple, but it’s not easy because you have to do it several times a day.
    1:02:11 You have to actually do it when those, um, self-hating voices come up in your head,
    1:02:12 those catastrophizing voices.
    1:02:17 Otherwise your brain will never get in the habit of talking back to those and you have
    1:02:23 to do it every time they come up and you have to do it for pretty much, like I would say probably
    1:02:27 you’re not really going to see much change, uh, for the first six months even.
    1:02:31 But I remember about nine months in suddenly being like, wait a second, all these things that
    1:02:34 used to pop up in my head, they’re not, they don’t sound convincing anymore.
    1:02:36 And it was really dramatic after that.
    1:02:39 So I, I definitely believe looking to CBT.
    1:02:44 I think that, you know, um, one thing that I do a lot when I’m having a hard time is I
    1:02:46 go reread Seneca’s letters to a young man.
    1:02:52 I, I, I find that they’re really approachable, uh, meditation is very helpful to people, but
    1:02:54 don’t forget things like things.
    1:02:55 Exercise is really key.
    1:02:59 And if you’re in it, um, there is something there.
    1:03:02 My favorite book is Upward Spiral by Alex Korb.
    1:03:07 I highly recommend, I have like a whole thing, I have a whole, like a, a, a sub stack, um,
    1:03:09 on, on, on this very issue.
    1:03:11 Cause it’s, I get asked it so much and I give kind of all of my advice.
    1:03:13 And what’s that sub stack called or what’s that post called?
    1:03:18 Well, I don’t remember what that post is called, but my sub stack is the eternally radical idea.
    1:03:21 Uh, but also, you know, talk to people about it, talk to friends.
    1:03:26 Um, the, when you’re in a really bad way, there’s a sense that nobody’s going to want to hear
    1:03:29 your, hear your whining about it, but that’s just not true.
    1:03:34 Um, and, and, and in most cases, cause you know, as, as hard as it may be, may be, may
    1:03:38 be to believe sometimes when you’re really deep down and dark, um, there are people out
    1:03:39 there who love you.
    1:03:44 Greg Lukianoff is a free speech advocate, first amendment attorney, president of FIRE, the
    1:03:49 foundation for individual rights and expression and coauthor of the coddling of the American
    1:03:55 mind, which has probably had more impact on my parenting than any book I have read.
    1:04:01 Uh, and also the canceling of the American mind, his latest book war on words, 10 arguments
    1:04:05 against free speech and why they fail is out next week.
    1:04:07 He joins us from Maine.
    1:04:11 Greg, I’ve wanted, I wanted to meet you and speak to you for a couple of years because one
    1:04:18 of my role models, uh, Jonathan Heights, whenever he talks about you, he speaks about you in such
    1:04:19 reverence and with such respect.
    1:04:23 Uh, so I was really excited to, uh, have this conversation.
    1:04:24 Very much appreciate your time.
    1:04:30 Also very much appreciate, uh, what you said, um, at the end about cognitive behavioral therapy.
    1:04:37 Uh, and I, the, the takeaway I have and that I hope people take away from this podcast is when
    1:04:41 you’re really down and you think everyone’s sick of you and sick of hearing from you and doesn’t
    1:04:43 have time for you that that that’s just not true.
    1:04:45 Uh, so anyways, thank you for sharing that, Greg.
    1:05:14 My father passed away last week and it’s been a rough few days for me as it is for anybody
    1:05:15 who loses a parent.
    1:05:20 Uh, our species, our competitive advantage is that is our brain.
    1:05:24 It’s so big that we’re expelled from the human body prematurely and our brain is exactly the
    1:05:25 wrong size.
    1:05:30 It’s big enough to ask very complicated questions, but not big enough to answer them.
    1:05:35 And death is something our brain still hasn’t come, uh, to grips with.
    1:05:39 And that is, um, especially with a parent, this is someone who is your first protector.
    1:05:44 And then when you lose that person, the idea that all of a sudden that protector isn’t
    1:05:45 around is devastating.
    1:05:47 It’s a mirror.
    1:05:52 You see a lot of yourself in this person and, uh, you immediately think about all the different
    1:05:55 things in your life that developed good and bad with this person.
    1:05:59 And you have to deal with those and come to attempt to come to grips with them, which
    1:06:00 sometimes can be painful.
    1:06:03 Our brains are used to continuity and patterns.
    1:06:07 We’re used to having that person in our life and we assume they’re going to be around
    1:06:09 forever and it’s impossible to believe they’re not going to be around forever.
    1:06:14 So the finality of death is just very shocking and very difficult to wrap your head around.
    1:06:20 The biggest or most profound moments in my life have involved, uh, birth and death.
    1:06:26 Uh, the death of my mother, my mother passed away when I was 39 after what was a pretty ugly
    1:06:32 model with a smoking related illness, um, specifically cancer, breast cancer, uh, twice.
    1:06:33 And then it metastasized in her stomach.
    1:06:40 Uh, and it was just the finality and the harshness of it and the brutality of the way she died kind
    1:06:46 of really, um, it’s sort of, you know, these things change you.
    1:06:50 They, they, they, they really, I think for most people, you’re sort of never the same.
    1:06:54 I was much lighter and funnier before that happened.
    1:06:59 And I think something kind of died in me, but at the same time, I developed a wonderful sense
    1:07:00 of the finite nature of life.
    1:07:03 And then when my kids were born, that changed everything for me.
    1:07:09 I became much more responsible, uh, much more anxious, but, uh, started for the first time
    1:07:12 in my life thinking about other people, which was an enormous unlock.
    1:07:13 And I’ll come back to that.
    1:07:19 And then the death of my father is a debt, a different sort of feeling, not nearly as close
    1:07:21 to my father as I was to my mother.
    1:07:26 So my dad, George Thomas Galloway was born in 1930 in Sydney, Australia to a woman who was
    1:07:28 a domestic servant for a wealthy family.
    1:07:30 He was born out of wedlock.
    1:07:36 And the deal was that the family found out my grandmother was pregnant and they had a daughter
    1:07:39 who did not have any children of her own and was in her thirties, which was
    1:07:40 considered a, you know, a tragedy.
    1:07:46 And they agreed to adopt her child, her unborn baby and would give her enough money.
    1:07:48 But the deal was she had to, to leave.
    1:07:52 And I think they even gave her some money, uh, cause they didn’t want the biological mother
    1:07:52 around.
    1:07:54 And my, my grandmother agreed.
    1:07:58 And then, uh, my grandmother gave birth to my father in Sydney, Australia.
    1:08:03 And I don’t know the full story, but convinced her boyfriend or the father of the child, which
    1:08:05 is obviously very upset to meet her at the docks.
    1:08:09 And they got on a ship for, for Scotland.
    1:08:14 I can’t even imagine what the, the ship route was like from Sydney to Glasgow.
    1:08:17 And so my father always jokingly said, I could have been a McVicar.
    1:08:20 It was the McVicar family that built like battleships or something.
    1:08:21 And he says that he’s pissed off.
    1:08:25 He would have much rather stay in, in Sydney, Australia than the son of a rich family.
    1:08:32 Anyways, uh, raised in depression era, Scotland and world war two, Scotland, he says his first
    1:08:34 memory is watching the Clydes bank rate.
    1:08:41 I think it’s called where Henkel Henkels and Messerschmitts dropped bombs on, uh, munitions
    1:08:45 factories or shipbuilding factories, uh, just outside, I believe of Glasgow.
    1:08:49 And he jokes that, uh, they were obviously very patriotic.
    1:08:55 He was nine when the war broke out, 15 when it ended and that anyone with an accent in
    1:08:59 Glasgow, his, him and his 10 year old buddies would follow around and take notes on them
    1:09:00 because they assumed they were spies.
    1:09:07 And then, uh, uh, after the war ended, he was 15, but at the age of 17, he lied about
    1:09:11 his age and went to a recruitment office and wanted to be a pilot for the IRF.
    1:09:14 And the recruiter said, you’re too tall to be a pilot.
    1:09:17 So he went across the street or somewhere to where they were recruiting for the Royal Navy
    1:09:20 and joined the Navy at a very young age.
    1:09:26 And before he knew it was on, uh, I believe it was an aircraft carrier and my father could
    1:09:29 repair, they do an assessment, a skills assessment test.
    1:09:32 And he disclosed that he could repair things.
    1:09:35 He repaired motorcycles and that he was a good swimmer.
    1:09:41 And so the next day he was no joke in a helicopter, in a wetsuit, in the North Atlantic,
    1:09:44 practicing what he found out later was pilot rescue.
    1:09:49 They kind of informed him what he was going to do while he was in the helicopter in a poorly
    1:09:50 fashioned wetsuit.
    1:09:52 And they said, okay, this is the deal.
    1:09:53 You’re going to jump out into the water.
    1:09:56 We’re going to throw out 150 pound dummy, not in that order.
    1:09:58 Then we’re going to lower a basket.
    1:10:04 And your job is to get this 150 pound dummy into a basket as if it was a pilot in the North
    1:10:04 Atlantic.
    1:10:08 Oh, and by the way, even with your wetsuit, in about 14 minutes, you’re going to die of
    1:10:08 exposure.
    1:10:09 So there’s some motivation.
    1:10:16 So my dad jumps into the North, wavy North Atlantic when it was dark out and tries to get
    1:10:18 this dummy into this basket.
    1:10:23 And then he said the scariest moment was he got the dummy into the basket, most exhausting
    1:10:23 thing he’s ever done.
    1:10:24 They pull it up.
    1:10:28 And he said the current started taking him away from the helicopter.
    1:10:32 And he was worried they were no longer even going to be able to see him and get him out.
    1:10:33 And they drop a winch.
    1:10:35 He connects it and they pull him up.
    1:10:38 His first week, he got his pay.
    1:10:42 He put it in a locker at the foot of his cot.
    1:10:44 And the entire locker was stolen.
    1:10:49 I guess this was sort of something that the freshman recruits were stupid and would put
    1:10:51 money in their locker thinking it would be secure.
    1:10:54 So there was a service where he could send money home.
    1:10:58 So he would send all of his money from the Navy, all of his pay home to his mother.
    1:11:02 And after two years, he calculated he had enough money to get to America.
    1:11:07 And he came home to find out that his mother had spent his money on whiskey and cigarettes.
    1:11:12 And in her defense, she claimed that, what did you expect me to do?
    1:11:13 I was bored.
    1:11:18 So my father has always had a very unhealthy relationship with money.
    1:11:22 I mean, it really scarred him growing up in the Depression-era Scotland and I think acts
    1:11:23 like that.
    1:11:30 But he did get some money together and got to America and led what could arguably be called
    1:11:31 the American dream.
    1:11:36 My favorite story about him first arriving in America was he and my mom met in Canada.
    1:11:37 They got pregnant.
    1:11:38 They hated the weather.
    1:11:39 They bought a newspaper.
    1:11:43 And there was an article saying that the nicest weather in North America was in San Diego.
    1:11:49 So they loaded up my seven-month pregnant mom into an Austin mini-metro and drove from
    1:11:51 Toronto to San Diego.
    1:11:54 My dad’s first job interview was to be a salesman for a candle company.
    1:11:58 And the head of HR there said, you’ve got to stay here.
    1:11:59 She asked him how long he’d been in the country.
    1:12:00 And he said, just two weeks.
    1:12:01 And she said, that’s incredible.
    1:12:03 She said, just wait right here.
    1:12:07 And she went and got her boss and said, you need to meet this guy, Tom Galloway.
    1:12:11 He’s only been in the country for two weeks from Scotland and he can already speak the language.
    1:12:12 I love that.
    1:12:19 Anyways, my dad was aggressive, smart, and charming and got jobs.
    1:12:23 And at his peak, we had a home in Laguna Niguel.
    1:12:28 I was thriving and they were living what could best be described as an upper middle-class home.
    1:12:33 And unfortunately, my dad was not a high-character person.
    1:12:34 Married and divorced four times.
    1:12:39 A handsome man with a strong jaw and a Glaswegian accent in 70s California.
    1:12:42 Did not only think with his dick, he could listen to it.
    1:12:49 And my dad rifled through four marriages and four divorces, including his last one where he decided to leave his fourth wife when she had late-stage Parkinson’s.
    1:13:01 So he was never able to really connect with people or ever really develop a sense outside of kind of the survival instinct of investing in other people and other people’s relationships with other people.
    1:13:03 He was broken that way.
    1:13:06 And there’s just no not acknowledging that.
    1:13:17 However, what has helped me or some of the learnings here is that what has helped me process this is I love that Dr. Sue saying, don’t cry because it’s over.
    1:13:18 Laugh or smile because it happened.
    1:13:27 I’m thinking about all the things I’m grateful for, being the son of George Galloway, on very basic things.
    1:13:27 I am tall.
    1:13:29 I have broad shoulders.
    1:13:30 I have a good voice.
    1:13:32 And I have made an exceptional living communicating.
    1:13:34 None of those things are my fault.
    1:13:36 I got all of those things from my father.
    1:13:41 And just because maybe he didn’t purposely work to give them, give me those things, there’s no reason I can’t be grateful for them.
    1:13:50 I think the ultimate test of evolution and the most basic box you need to check as a man is the following.
    1:13:56 And that is, are you a better father to your son than your father was to you?
    1:13:59 And my dad checked that box in indelible ink.
    1:14:03 His father, I found out later in life, used to physically abuse him.
    1:14:05 I can’t even imagine what that would be like.
    1:14:10 The person you’re supposed to trust most in the world, the person you’re supposed to protect you, physically abuses you.
    1:14:12 And he never did that for me.
    1:14:17 And he did try after my mom and dad got divorced, he would try and meet me in places and take me to museums.
    1:14:22 And there’s a lot for me to be grateful for.
    1:14:35 What has helped me in terms of my relationship with my father that has been one of the biggest unlocks in my life, hands down, was I really struggled with my relationship with my father.
    1:14:47 Because every time I thought I was being a good son, and I remember back to the fact that he kind of left me and my mom and wasn’t very kind to us, was I would get resentful and angry and kind of cut him out of my life for small periods of time.
    1:14:55 And then an enormous unlock, and my biggest piece of advice, if you’ve made it this far, is I decided, okay, what kind of son do I want to be?
    1:15:05 I don’t think about the relationship as a transaction and what he owes you or what you owe him or base my behavior on what he did or did not do for me.
    1:15:08 But just simply put, what kind of son do I want to be?
    1:15:13 And the reality is I wanted to be a loving, generous son, and I wanted to have a great relationship with my dad.
    1:15:17 And I had all of the qualities and resources to do that.
    1:15:22 And from that moment on, I put away the scorecard, I put away the bullshit, and I was a great son.
    1:15:25 And it was not only wonderful for him, it was wonderful for me.
    1:15:29 I’ve loved these last 20 years of just having a great relationship with my father.
    1:15:30 He’s charming.
    1:15:30 He’s funny.
    1:15:31 He does love me.
    1:15:36 And it’s just been a huge lesson for me in life.
    1:15:48 You know, not is my partner as good to my parents or is nice and generous to me based on how I should behave around her, but what kind of partner do I want to be?
    1:15:49 What kind of business person do I want to be?
    1:15:52 What kind of employer do I want to be?
    1:15:55 I used to look at every employee as, are they adding as much value as I’m paying them?
    1:15:57 And if they’re not, I’m going to fire them.
    1:15:59 Now I think, how can I be just an amazing employer?
    1:16:01 How can I be an amazing friend?
    1:16:05 How can I be, what kind of investor do I want to be known as?
    1:16:08 And then live to that standard and put away the scorecard.
    1:16:13 Don’t base your behavior on what you did or didn’t get from that person, but on the person you want to be.
    1:16:16 And that’s just been such an enormous unlock for me.
    1:16:25 So as I sit here and I think about my dad and I try to process his death, you know, I think this guy lived the American dream.
    1:16:27 He came to America.
    1:16:32 The biggest gift he gave me was that he took this enormous risk and got to America.
    1:16:45 And so much of my success, so much of the ability to have a wonderful family is based on something that was not my fault, specifically my dad having the courage and taking the risk to get to America.
    1:16:47 And I’m very appreciative of that.
    1:16:52 George Thomas Galloway was 95 when he died.
    1:16:53 He was very much a man.
    1:16:55 He was a protector.
    1:16:58 He wanted to protect his country.
    1:16:59 He was a provider.
    1:17:01 He provided for two families.
    1:17:04 And he was a procreator.
    1:17:07 He had two kids and four grandkids.
    1:17:26 His son and his daughter will miss him terribly.
    1:17:52 This episode was produced by Jennifer Sanchez.
    1:17:55 Our assistant producer is Laura Janair.
    1:17:57 Drew Burrows is our technical director.
    1:18:01 Thank you for listening to the Prop G Pod from the Vox Media Podcast Network.
    1:18:47 Thank you.

    Greg Lukianoff, a free speech advocate, first-amendment attorney, and president of FIRE, joins Scott to break down the rise of cancel culture and its chilling effect on free speech. 

    They discuss why social media supercharged censorship, how college campuses became ground zero for speech suppression, and why younger generations may be more fragile and less free. Greg also opens up about his own struggles with anxiety and how cognitive behavioral therapy helped rewire his thinking.

    Follow Greg, @glukianoff.

    Algebra of Happiness: in memory of George Thomas Galloway (1930 – 2025)

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  • Vitamin D Expert: The Fastest Way To Dementia & The Dangerous Lie You’ve Been Told About Sunlight!

    中文
    Tiếng Việt
    AI transcript
    0:00:02 He was literally two days away from dying.
    0:00:06 So this is a story where a 15-year-old boy was diagnosed with blood cancer,
    0:00:09 but he developed a flesh-eating infection in his lung.
    0:00:11 He wasn’t going to make it.
    0:00:12 So he has one request.
    0:00:15 He wants to go outside, and that’s exactly what they do.
    0:00:17 And this was actually mind-blowing to me.
    0:00:21 After the second day, the infection is probably 60%, 70% gone.
    0:00:25 And it became clear to me that sunlight has so many important benefits.
    0:00:27 For instance, if you’re the bed closer to the window,
    0:00:29 you get discharged from the hospital faster.
    0:00:34 So I want you to give me any information you have as it relates to light health.
    0:00:36 For example, do you recommend these kinds of things?
    0:00:41 Dr. Roger Seaholt is a board-certified critical care physician
    0:00:45 who breaks down complex science into clear, life-saving advice.
    0:00:47 I see people at the very end of their lives,
    0:00:51 so I know what prevents them from getting this ill and how to extend life.
    0:00:53 So let’s distill it down into eight pillars.
    0:00:55 The first thing, exercise.
    0:00:56 It reduces stroke.
    0:00:57 It reduces depression.
    0:00:58 Next, sunlight.
    0:01:03 Did you know that infrared light from the sun is able to penetrate up to about eight millimeters
    0:01:08 and stimulate and upregulate melatonin, which prevent a lot of diseases like dementia,
    0:01:10 cardiovascular disease, diabetes.
    0:01:11 What if you live in a cloudy country?
    0:01:15 There’s some very actionable things that you can do, and we’ll talk about that.
    0:01:16 Next one, water.
    0:01:21 For instance, people who use sauna are more likely to have less death from cardiovascular disease.
    0:01:22 Next, air.
    0:01:28 There are studies that show that just going out one day a week can elevate our immune system and make us more relaxed.
    0:01:29 And then there’s…
    0:01:31 But finally, trust.
    0:01:38 This is something that can’t be ignored because studies have shown that people who have a good faith and trust in a God are…
    0:01:44 Quick one, before we get back to this episode, just give me 30 seconds of your time.
    0:01:46 Two things I wanted to say.
    0:01:51 The first thing is a huge thank you for listening and tuning into the show week after week.
    0:01:56 It means the world to all of us, and this really is a dream that we absolutely never had and couldn’t have imagined getting to this place.
    0:02:00 But secondly, it’s a dream where we feel like we’re only just getting started.
    0:02:08 And if you enjoy what we do here, please join the 24% of people that listen to this podcast regularly and follow us on this app.
    0:02:10 Here’s a promise I’m going to make to you.
    0:02:15 I’m going to do everything in my power to make this show as good as I can now and into the future.
    0:02:21 We’re going to deliver the guests that you want me to speak to, and we’re going to continue to keep doing all of the things you love about this show.
    0:02:23 Thank you.
    0:02:33 Dr. Roger Schwelt, with the work that you do, what is it that you’re aiming to accomplish?
    0:02:49 Outside of my clinical duties, and maybe even part of that, I would like to clearly explain very easily graspable tools that can be implemented to make people live their best life.
    0:02:52 And it’s specifically in terms of their health and their well-being.
    0:03:00 And as we dig down into health and well-being, because that’s quite a broad basket, what is it within health and well-being that you’ve spent your career, your life focusing on?
    0:03:04 So I’m a board-certified internal medicine specialist.
    0:03:09 Then I did an extra three years of training here in the United States on pulmonary and critical care.
    0:03:13 So I deal with all of the issues that are related to the lungs and the critical care aspect.
    0:03:21 So if you are admitted to hospital and you’re critically ill, you go to the intensive care unit, I’m the doctor that you see.
    0:03:25 So I’m putting in the lines, putting on vasopressors, intubating them.
    0:03:27 I worked in the clinic this morning.
    0:03:31 And what are some of the unappreciated things that most people don’t think of?
    0:03:34 Because we think of, you know, don’t eat processed food and exercise.
    0:03:39 But is there things outside of that that you don’t think the average person appreciates enough?
    0:03:40 Yes, absolutely.
    0:03:41 What are those things?
    0:03:52 So if we look at those things that extend life and are beneficial, we could put them into what I call eight pillars of health.
    0:04:02 If you can imagine your life is a chain with a bunch of links, okay, and I’m talking medically, each one of those links is an organ system.
    0:04:08 So your heart is a link, your lungs are a link, your liver is a link, your kidneys, et cetera, et cetera.
    0:04:21 As you go through life, imagine those links starting to erode so that at some point in your life, you’re going to get some sort of a disease or a diagnosis that focuses on one organ system of your life.
    0:04:24 For many here in the United States and in the UK, it’s the heart.
    0:04:32 And as that link gets more eroded, we can see very clearly that this is going to be the link that’s going to break first.
    0:04:34 And therefore, attention is paid to that link.
    0:04:38 For many, that diagnosis comes with medications.
    0:04:42 So here is one of the first truisms that I would say going forward.
    0:04:45 All medications have side effects.
    0:04:59 And what the aim is to do in modern medicine is to utilize the knowledge of those medicines and their effect on the human body so that we leverage the other links to protect that weakest link.
    0:05:09 So I could go through a bunch of medications that I give all the time to patients in the intensive care unit where I’m focused on saving their life because I can clearly see which link is the weakest.
    0:05:15 But I’m doing it knowing that there’s side effects because I’m trying to save that link to save that life.
    0:05:18 And I’m leveraging those other things.
    0:05:20 For instance, somebody comes in with a stroke.
    0:05:29 And they’ve lost weakness on the right side of their body or on the left side, whichever side.
    0:05:36 I can give them a medication immediately that will break up all of the clots in their body.
    0:05:37 It’s called TPA or TNK.
    0:05:40 And it will restore blood flow to the brain.
    0:05:42 And it will reverse many of their symptoms.
    0:05:44 If they come in soon enough, we can do this.
    0:05:50 What’s amazing is that that medication has an effect that can do that.
    0:05:55 But it also has a pretty significant side effect in that it could break up clots somewhere else and cause bleeding.
    0:05:59 So we have to be careful about what it is that we’re doing.
    0:06:04 Clearly there, what we’re doing is we’re saving one link at the expense of other links.
    0:06:06 But that’s what you have to do in an emergency situation.
    0:06:13 But if after that, I simply send that patient home without telling them why they had that stroke
    0:06:17 and what they need to do to prevent themselves from getting that stroke again
    0:06:22 and what are the lifestyle factors that cause that to happen, I haven’t done my job.
    0:06:27 So what are the interventions that we can do, hopefully early on in life,
    0:06:32 so that we don’t have those links eroding, so that all of the links are strong?
    0:06:35 And as we get older, we can continue to strengthen all of the links.
    0:06:36 Here are the eight.
    0:06:38 So nutrition, that’s nutrition.
    0:06:43 Basically, you know, we know there are studies that have done that show that
    0:06:49 depending on what we put into our bodies as food can have a dramatic impact in terms of our well-being.
    0:06:50 Okay, so that’s nutrition.
    0:06:51 Exercise.
    0:06:56 As I was saying, exercise not only, I mean, drugs and things have side effects.
    0:06:57 Exercise have side benefits.
    0:07:00 So exercise obviously is going to make you more fit.
    0:07:02 It’s going to make you have better endurance.
    0:07:05 But did you know that it reduces stroke?
    0:07:08 Did you know that it improves well-being?
    0:07:10 It reduces depression.
    0:07:11 There’s so many benefits.
    0:07:14 So all of these links are actually improving.
    0:07:15 There’s no leveraging here.
    0:07:17 Exercise is incredible.
    0:07:18 Water.
    0:07:20 So this may sound obvious, right?
    0:07:22 Like you drink because you’re thirsty.
    0:07:28 Where I would like to go today is to talk a little bit about what the effect of water externally on your body can do.
    0:07:31 And you’re talking there about like hot and cold usage.
    0:07:32 Exactly.
    0:07:34 In terms of showers or cold plunges, saunas, that kind of thing?
    0:07:35 Exactly.
    0:07:37 And we’ll get into the actual evidence for this.
    0:07:38 We’ll get into it later.
    0:07:39 But what is the potential problem?
    0:07:40 This affects your immune system.
    0:07:43 Which changes your probability of diseases and stuff like that?
    0:07:44 Absolutely.
    0:07:45 Especially in the acute setting.
    0:07:46 Especially.
    0:07:54 So not only in the acute setting, but we also have pretty good data from Finland where they have more saunas than, almost than people.
    0:08:00 Where they’ve actually done the research and shown with dose response curves that this is actually very beneficial.
    0:08:01 We won’t get into too much of that.
    0:08:10 But what I want to focus a little bit more on because of my job in the intensive care unit and what we’re seeing right now with viruses and mutations in the innate immune system.
    0:08:16 Why something like this may actually be very important as we look forward.
    0:08:23 Interestingly, as we look forward to future things, pandemics, we can look backward and see what we had done in the past.
    0:08:25 And we’ve got some really, actually, really good information on that.
    0:08:28 Let’s go to sunlight.
    0:08:36 This is something that I’ve really become more and more involved with because of some of the benefits that this can do.
    0:08:42 A very big misconception that people have is that sunlight equals vitamin D.
    0:08:46 And therefore, if you take a vitamin D supplement, you don’t need to go in the sun.
    0:08:51 This is really something that’s now being debunked.
    0:08:55 Sunlight has far more benefits than just vitamin D.
    0:08:59 Not saying that vitamin D is not something that you want to supplement with.
    0:09:01 I supplement with vitamin D.
    0:09:04 I think there’s a benefit to supplementing with vitamin D, no question.
    0:09:08 But sunlight has so many important things.
    0:09:12 And I really would like to spend the bulk or the lion’s share of the time talking about this because this is really important.
    0:09:17 This is amazing.
    0:09:21 And it really made me think about sunlight.
    0:09:26 So this is a story by a lady by the name of Amy Hahnmeyer.
    0:09:35 Her 15-year-old boy was diagnosed with lymphoblastic leukemia, went into the hospital, actually started chemotherapy for it.
    0:09:36 Which is blood cancer.
    0:09:37 It’s a blood cancer, yeah.
    0:09:42 And so this – the treatment for blood cancer is chemotherapy, which he started.
    0:09:46 The side effect of chemotherapy is suppressing the immune system.
    0:09:57 And unfortunately, he didn’t realize it, but he developed – he didn’t realize it immediately, but he developed a fungus flesh-eating infection in his lung.
    0:10:01 And went into the hospital in June of 2024.
    0:10:05 This was in Minnesota, tertiary care hospital.
    0:10:17 And he got worse and got worse and got worse to the point where the only way that they could control this infection was to actually remove his left lung, which they did.
    0:10:19 So this is a 15-year-old boy.
    0:10:22 He is without his left lung.
    0:10:23 He only has a right lung.
    0:10:26 And he starts to decline even after that.
    0:10:31 They do a CT scan, and it shows that now the infection has moved to his remaining right lung.
    0:10:34 They have a family conference.
    0:10:38 And as Amy is telling me this story, I could hear her choking up.
    0:10:39 She’s telling me this on the phone.
    0:10:42 She’s saying that he’s 15.
    0:10:43 He’s completely awake.
    0:10:44 He’s completely alert.
    0:10:46 He knows everything that’s going on around him.
    0:10:50 He’s on a ventilator, like a machine that they use for sleep apnea.
    0:10:52 It’s like a BiPAP machine that’s breathing for him.
    0:10:55 It’s not intubation, but it’s on his mouth.
    0:10:59 And the doctors, you know, have done everything they possibly can.
    0:11:02 And they say, look, he’s getting worse.
    0:11:04 We can’t take – obviously, we can’t take the right lung out.
    0:11:09 We can’t put him on a heart-lung machine because there’s no sort of destination to where he’s going.
    0:11:16 We recommend not intubating him and making what they call DNR, do not resuscitate.
    0:11:21 So they’re like, wow, they were not expecting this coming.
    0:11:22 So they have a big conference.
    0:11:26 They call in help to, like, how do you explain to a 15-year-old boy that you’re dying?
    0:11:28 And how is that going to feel?
    0:11:33 So they ask the doctors, how much time does he have?
    0:11:34 They say two days.
    0:11:42 So in this situation, they ask this boy, okay, you’re going to die.
    0:11:46 What do you want to do with your life in the next two days?
    0:11:46 What do you want to do?
    0:11:51 And surprisingly, he says, I want to go outside.
    0:11:54 I just want to go outside.
    0:11:59 This guy grew up probably on a farm or something, and he spent his time outside.
    0:12:00 So he wants to go outside.
    0:12:15 So you know how – I mean, I don’t know if you know this, but, like, if you’re a nurse or you’re a doctor and you’ve done everything you can and you’re just completely horrified at the fact that this 15-year-old is going to die and he has one request,
    0:12:19 you’re going to move heaven and earth to fulfill that one request.
    0:12:20 And that’s exactly what they do.
    0:12:24 They get this boy, the hospital bed outside.
    0:12:28 He’s on a BiPAP machine the respiratory therapists have put together.
    0:12:33 So this guy is outside, and they’re not putting him outside to get better.
    0:12:35 He’s just – this is his dying wish.
    0:12:38 They also use this thing called a firefly.
    0:12:40 It’s like a light device that they were using.
    0:12:43 I – to be honest, I don’t know which did it.
    0:12:44 The firefly, what’s that?
    0:12:51 It’s a light device that gives off light at different wavelengths, and they would use that for about three times a day for five minutes.
    0:12:56 This guy does not die.
    0:13:00 After the first day, his white count starts to come down.
    0:13:03 That’s like a measure of the infection that’s going on in the lung.
    0:13:12 And by the way, they do a CT scan of his lung before this all starts, and it’s just – the remaining lung on the right is just filled with infection.
    0:13:13 It’s horrible.
    0:13:18 By the second day, the white count comes down even more.
    0:13:20 And by the way, they haven’t changed any of the other treatment.
    0:13:22 He’s been – by this point, he’s been in for six weeks.
    0:13:24 He has not seen the light of day.
    0:13:31 And he’s still getting the powerful antifungal medication, amphotericin B and posaconazole.
    0:13:38 All of these things are really high-powered drugs that just completely fight fungus, but it’s not working.
    0:13:39 He’s getting worse.
    0:13:41 But now he’s out for the second day.
    0:13:44 The white count’s coming down, which is good – that’s a good sign.
    0:13:46 His oxygen requirement is coming down.
    0:13:47 That’s a good sign.
    0:13:48 He’s requiring less and less oxygen.
    0:13:53 By the time he gets to day five – okay, we’re already past two days.
    0:13:55 He’s off the BiPAP.
    0:14:00 He’s on regular just nasal cannula oxygen that you see people wearing on their nose.
    0:14:03 The doctors are scratching their head.
    0:14:06 They’re like, we should get a CT scan to see what’s going on.
    0:14:11 So Amy tells me that they get a CT scan of this guy, and they’re in the room.
    0:14:13 And some even, like, swear under their breath.
    0:14:17 Like, they’re completely amazed.
    0:14:21 Because on the CT scan, obviously, the left lung is still gone.
    0:14:26 But the right lung, the disease is probably 60%, 70% gone.
    0:14:29 And he’s still alive.
    0:14:31 He goes home.
    0:14:34 There’s no sign of the disease after treatment.
    0:14:42 And he – I just – she just communicated with me to tell me that he just got his make-a-wish
    0:14:44 thing for his cancer.
    0:14:46 He’s continuing treatment.
    0:14:53 And she just can’t believe that he was literally two days away from dying.
    0:14:54 They changed nothing.
    0:14:56 They changed none of his treatments.
    0:14:59 The only thing that they did was they took him outside,
    0:15:05 and they were using this Firefly before inside, but they were using it more consistently when
    0:15:06 he got outside.
    0:15:08 Maybe hospitals should be outside.
    0:15:13 This is exactly what – okay, so if you wanted to know what my drive was,
    0:15:17 what it is, my purpose that I’m doing right now, I’m working at three different hospitals.
    0:15:22 And I’m trying to work in each of those three different hospitals to try to get patients
    0:15:23 outside.
    0:15:26 The biggest barrier that we have is staff taking those patients outside.
    0:15:27 That’s the thing that’s the hardest.
    0:15:31 But this is what we used to do, Stephen.
    0:15:36 This is what we used – when we built hospitals at the turn of the century, we had hospital rooms
    0:15:40 where beds could be taken out onto the veranda and people could get sunlight.
    0:15:44 I would love to see a time where we could go back to that type of effect.
    0:15:45 There are studies that have been done.
    0:15:51 People in a two-bed room, if you’re the bed closer to the window, you get discharged from
    0:15:52 the hospital faster on average.
    0:15:54 Really?
    0:15:55 Yes.
    0:15:59 I need to swap sides of the bed with my girlfriend.
    0:16:01 She’s on the sunny side.
    0:16:03 There’s so much evidence for this.
    0:16:07 People who are in hospitals that have bigger windows, they give better surveys.
    0:16:13 And hospitals’ reimbursement is tied to the surveys that they get from patients.
    0:16:15 So it’s literally a win-win-win.
    0:16:21 If hospitals started to, I believe, get patients outside – and they’re already doing this.
    0:16:23 I don’t want to say that this isn’t happening.
    0:16:26 There are hospitals that have programs to get patients outside.
    0:16:29 So I think we just ought to be doing it a lot more.
    0:16:33 Temperance.
    0:16:34 Temperance?
    0:16:35 What does that mean?
    0:16:37 It’s an old term, isn’t it?
    0:16:39 It really means moderation.
    0:16:46 And I would say in this sense, temperance really means to avoid toxins in the body.
    0:16:50 As somebody who is a pulmonologist who is –
    0:16:51 What’s a pulmonologist?
    0:16:53 A pulmonologist is someone who takes care of the lungs.
    0:17:01 And so as a result of that, I see a lot of issues with lung cancer related to smoking.
    0:17:06 I see in the intensive care unit people with liver failure as a result of alcohol abuse.
    0:17:13 I also see people on amphetamines here in Southern California where I reside and where I work.
    0:17:14 We have quite a bit of that.
    0:17:16 And temperance.
    0:17:21 If you want to live a long and wholesome life, there are some toxins that you want to avoid.
    0:17:25 And understanding that is really important.
    0:17:32 So this is something that if you stop some of those things that we’re talking about, all of those links are going to be improved.
    0:17:34 Air.
    0:17:36 Seems kind of obvious.
    0:17:45 Early on, I used to think that what this meant was getting pure air with absolutely nothing in it except for just nitrogen and oxygen.
    0:17:47 That’s not true anymore.
    0:17:55 We now understand that for you to have the best type of air, it actually has to come with some things in it.
    0:18:03 Just like our gut has a microflora that you may have heard about, so too does the air that we breathe also must have that.
    0:18:08 And the best type of air that you can have is actually outside.
    0:18:10 Rest.
    0:18:15 This is really interesting because we just mentioned that exercise was a pillar.
    0:18:16 But rest also is.
    0:18:20 How can rest and exercise at the same time be pillars of health?
    0:18:24 And it really comes down to knowing when to do what.
    0:18:26 Sleep, which is also part of rest.
    0:18:31 So we’re not just talking about a daily rest when you go to sleep.
    0:18:34 And as a sleep physician, I can tell you quite a bit.
    0:18:40 We have lots of information about how long we should sleep, the quality of sleep, some of the diseases that prevent us from sleeping.
    0:18:42 Sleep is so important.
    0:18:45 I couldn’t overexpress it enough.
    0:18:53 Not just a daily rest, but I would also say, and venture out and we can talk more about this, a weekly rest.
    0:18:54 A weekly rest?
    0:18:55 A weekly rest.
    0:18:57 What do you mean?
    0:18:57 A weekend?
    0:18:58 Like?
    0:18:58 Yeah.
    0:18:59 Yeah, absolutely.
    0:19:04 How many times do we, even on the weekend, do we put down our phone?
    0:19:04 Never.
    0:19:06 Or we stop reading emails.
    0:19:10 And we take the time out to do things that we would never be able to do.
    0:19:11 Finally, trust.
    0:19:16 So this is something that really just can’t be ignored.
    0:19:29 And I’ll say this up front, that in the world of research and science, there is a silo of science and there is a silo of faith.
    0:19:52 But what we can’t ignore is the growing body of evidence from the scientific world that’s peeking over and looking at faith, that people who have faith and people who have faith in God, whether that is their God in that particular denomination, are better apt and able to deal with stress and depression and anxiety.
    0:19:56 So this is something scientifically that has been shown.
    0:20:15 Now, if you may have noticed that I did these in a particular order, and if you go through them, you’ve got nutrition, you’ve got exercise, you’ve got water, you’ve got sunlight, you’ve got temperance, you have air, you have rest, and finally, you have trust.
    0:20:18 You put that together and it spells out new start.
    0:20:23 So interestingly, these particular topics are not copyrighted.
    0:20:32 But there is a university in Northern California called Weimar University that has actually put these together in that very pattern as called it new start.
    0:20:33 They actually have a new start program.
    0:20:39 And so this is something that is actually being used internationally.
    0:20:48 So of these subjects that you just went through there for this new start framework, where do you want to start?
    0:20:54 I think actually sunlight is one of those things where I’m excited about all of those.
    0:21:01 But I think sunlight is really where we have, let’s put it this way, it’s the lowest hanging fruit.
    0:21:01 Okay.
    0:21:06 Explain to me why sunlight is the place where your focus is at the moment.
    0:21:10 It’s a long trip that has gotten me to that.
    0:21:13 And I think part of it goes through right through COVID.
    0:21:27 So as a critical care intensivist, when I heard that there was this virus that was coming, they all told us that it was going to be people with respiratory illnesses, which I was certainly comfortable with.
    0:21:29 But that’s not what it turned out to be.
    0:21:31 We certainly saw people with respiratory illnesses.
    0:21:43 But what we saw in the intensive care unit, the people that were dying around me were people with obesity, people with heart disease, people with kidney disease, people with dementia, people with chronic diseases.
    0:21:46 And it made me think, why was that the case?
    0:21:52 All of those things have one thing in common and many other things too.
    0:21:57 But specifically, they’re rooted in something called mitochondrial dysfunction.
    0:21:59 So let me unpack that for you.
    0:22:02 And this has to do with longevity.
    0:22:03 This has to do with aging.
    0:22:06 This is a huge topic that is now just emerging.
    0:22:08 And we’re now finding more about this.
    0:22:19 So when I was in high school biology, when I was in college, we all learned about this little organelle in all of our cells except for red blood cells called the mitochondria.
    0:22:20 And I have to say it.
    0:22:21 What is the mitochondria?
    0:22:23 It’s the powerhouse of the cell, right?
    0:22:25 So it’s the thing that makes energy.
    0:22:33 What we didn’t know at the time is that as we get older, the output from these batteries in our cells drops by about 70%.
    0:22:34 Damn.
    0:22:38 Can you imagine running your house on 70% less energy?
    0:22:41 How fundamentally that would change what happens in your house?
    0:22:44 Like, you could not run the laundry the same way.
    0:22:46 You could not run the microwave and the laundry at the same time.
    0:22:49 And what does that look like in terms of symptoms?
    0:22:50 Excellent question.
    0:22:54 Because what it looks like is depending on the cell type that we’re talking about, that’s going to have the issue.
    0:22:57 So if we’re talking about the liver, the liver is going to get more fatty.
    0:23:01 If we’re talking about the heart, the heart is going to become more congested.
    0:23:03 If we’re talking about the brain, it’s going to have more dementia.
    0:23:12 And so what’s happening here is that as we get older, the batteries in our cells are not working the same way as they used to.
    0:23:13 Metabolism is slowing down.
    0:23:16 And so these are huge issues.
    0:23:25 And all of these diseases that I just talked about, all the ones that we saw in COVID, if you look in a lot of these diseases, they are rooted in mitochondrial dysfunction.
    0:23:29 So the question is, is why is that the case and what can we do about it?
    0:23:36 So there was a paper that came out in 2019 that fundamentally changed the way I saw this.
    0:23:43 It was written by Russell Ryder, who is the executive editor of Melatonin Research.
    0:23:45 He’s out of University of Texas.
    0:23:47 And Scott Zimmerman, who’s a light engineer.
    0:23:58 And what they set forth was to show that basically sunlight is made up of so many different types of wavelengths.
    0:24:01 You’ve got ultraviolet on one end, which of course makes vitamin D.
    0:24:03 And it’s very beneficial.
    0:24:09 It’s the type of light from the sun that is very shortwave but cannot penetrate very deeply.
    0:24:12 Let me back up a little bit and explain.
    0:24:18 You pull up to a stop sign and somebody pulls up next to you and they’re playing the latest hip-hop music.
    0:24:20 How does that sound to you in your car?
    0:24:23 It’s very boom, boom, right?
    0:24:24 Yeah, muffled.
    0:24:24 And muffled.
    0:24:31 And the reason why is because low wave frequency has the ability to travel very far.
    0:24:35 Go to the Grand Canyon and there’s a thunderstorm at the other end of it.
    0:24:36 What do you hear?
    0:24:37 It’s like a rumbling.
    0:24:40 And then as it gets closer, you hear the higher-pitched sounds.
    0:24:43 This is a fundamental physics principle.
    0:24:50 And so when the sun is shining, there’s very short wavelengths, ultraviolet B involving vitamin D.
    0:24:54 But at the other end, there’s this infrared light, which we’ll talk about, or red light.
    0:24:59 It’s a very long wavelength and it can penetrate very, very deeply.
    0:25:02 That’s very important because what we’re talking about is the human body.
    0:25:07 And if the sun is going to have an effect on the human body, it’s got to be more than just the skin.
    0:25:21 So that’s exactly what this paper showed, is that basically infrared light from the sun is able to penetrate probably up to about eight centimeters, according to Scott Zimmerman in this article.
    0:25:26 And it fundamentally interacts with specifically the mitochondria.
    0:25:28 And what does it do to the mitochondria?
    0:25:31 So let’s back up and talk about the mitochondria because this is central.
    0:25:36 The mitochondria to the cell is like the engine in your car.
    0:25:41 The engine produces locomotion that causes the wheels to spin.
    0:25:46 But in the process of doing it, it causes heat to surround the engine.
    0:25:51 And if you don’t deal with that heat, it will shut down the engine.
    0:25:54 It will make it more inefficient and eventually it will shut it down.
    0:25:56 So what do all internal combustion engines have?
    0:25:57 They have a cooling system.
    0:25:58 They have a radiator.
    0:26:00 They have an oil pan.
    0:26:01 They have a water pump.
    0:26:04 And that’s exactly what the cell has to have for the mitochondria.
    0:26:06 It’s not heat in the mitochondria.
    0:26:18 It’s called oxidative stress and it’s specifically oxidative stress that causes destruction and, yeah, destruction of the mitochondria and leads to these types of diseases.
    0:26:22 So oxidative stress causes the mitochondria not to work well.
    0:26:23 This leads to diabetes.
    0:26:26 Oxidative stress makes the mitochondria not work so well.
    0:26:27 This leads to dementia.
    0:26:29 So this has already been laid out.
    0:26:30 This is not that controversial.
    0:26:33 The controversial part is what do we do about it?
    0:26:43 So what these guys in this paper showed was that, and not just them, but reviewing the literature, is that the mitochondria makes its own cooling system.
    0:26:46 And that cooling system is melatonin.
    0:26:50 Now, you might be thinking, wait a minute, melatonin?
    0:26:54 Isn’t that the stuff that we take, that our brain makes right before we go to sleep?
    0:26:57 Yeah, it’s absolutely correct.
    0:26:57 That’s what happens.
    0:27:02 The problem is, is that this is not melatonin that’s made in the brain.
    0:27:07 This is not melatonin that goes through the blood supply and goes through our blood and tells us it’s time to go to sleep.
    0:27:12 This is melatonin that’s made in the cell, in the mitochondria.
    0:27:17 And it’s a powerful antioxidant that basically prevents the oxidative stress from occurring.
    0:27:37 What Scott Zimmerman and Russell Ryder showed and proposed in this was that basically the infrared radiation that’s coming in to the body is able to stimulate and upregulate melatonin and a number of other factors that keep the mitochondria cool and can actually improve the energy output of the mitochondria.
    0:27:48 So this is, this was actually mind blowing to me, and I’ll tell you why I resonated with this as a critical care physician, because there was two things that bothered me the most.
    0:27:52 Number one, SARS-CoV-2 virus.
    0:27:56 When it comes into the body, it interacts with something called the ACE2 receptor.
    0:27:58 You may have heard about the ACE2 receptor.
    0:27:58 Okay.
    0:28:04 This is where the virus actually latches on to the cell and gets internalized.
    0:28:06 So what is this ACE2 receptor?
    0:28:11 Is this, was this there for all of humanity just to be a receptor, or does it actually have a role?
    0:28:13 It turns out it actually has a role.
    0:28:19 And mind blowingly, the ACE2 receptor is involved in mitigating oxidative stress.
    0:28:25 So in other words, it’s another part of the cell’s cooling system for the mitochondria.
    0:28:35 What’s happening is that the, the virus, when it attaches to the cell, is basically eliminating that action.
    0:28:43 And so imagine you have a bunch of people with various different engines running at different temperatures.
    0:28:47 In other words, you’ve got some people with chronic disease, and we know their engines are running hot.
    0:28:51 We have other people who are completely healthy, and they’re doing quite well.
    0:28:52 Their engines are nice and cool.
    0:28:54 They have no problems at all.
    0:28:58 Now imagine COVID comes, and SARS-CoV-2 is infecting everybody.
    0:29:10 What that tendency is to do is, because it’s knocking out everybody’s ACE2 receptor, which has the ability to cool down the engine, in other words, it’s causing everybody’s engine to run hot.
    0:29:11 Right?
    0:29:13 So, but in somebody, so in other words, picture it this way.
    0:29:20 You’re, you’re, you’re driving along in your car, and your thermometer is there, and all of a sudden, there’s this big hill that you have to climb called COVID-19.
    0:29:24 Who’s going to make it over that hill, and who’s not going to make it over that hill?
    0:29:30 The people that make it over the hill are those with great cooling engines whose temperatures are running great.
    0:29:36 The ones that don’t make it over that hill are the ones that have the thermometer on their engine running hot.
    0:29:39 Those are the ones that poop out at the top and can’t make it.
    0:29:44 And they’re the ones pulled over to the side of the road with the hood up and the steam coming out of the engine.
    0:29:45 Do you understand what I’m saying?
    0:29:45 Of course, yeah.
    0:29:51 So this makes perfect sense to me why I wasn’t seeing what they were predicting, which is these respiratory patients coming into the ICU.
    0:29:53 Who was I seeing in the ICU?
    0:29:57 I was seeing people with dementia, as we talked about, diabetes, kidney disease.
    0:29:59 These are the ones that were, that were sick.
    0:30:16 The other thing that really hit me and resonated with this was, and this was not even controversial, we knew early on in the pandemic that people who came into the hospital and had higher levels of vitamin D did really well.
    0:30:18 They didn’t die.
    0:30:22 They didn’t have the same chances of dying.
    0:30:28 People who had low vitamin D levels, they had much higher levels, chances of dying.
    0:30:30 So we would check these vitamin D levels.
    0:30:32 And so think about this.
    0:30:42 You’re there at ground zero, and you’re taking care of these patients, and you see this data over and over and over again that vitamin D is very predictive of who’s going to die.
    0:30:44 Obviously, what are you going to do?
    0:30:51 Even though this is an associative study, that association doesn’t mean causation, you’re going to be giving people vitamin D and try to get those levels up.
    0:30:58 The problem is, is that we gave vitamin D, and it really didn’t have much of an effect.
    0:31:01 You gave it in supplement type of thing?
    0:31:03 Yeah, when people would come into the hospital.
    0:31:03 Like this?
    0:31:04 Exactly.
    0:31:05 Exactly.
    0:31:06 Just like that.
    0:31:07 In fact, I was supplementing myself.
    0:31:09 I mean, what have you got to lose, right?
    0:31:15 I already took my vitamin D tablet this morning.
    0:31:18 I don’t, there’s not, that’s very hard to overdose, but it’s possible.
    0:31:23 So you noticed that it was hard to treat people with vitamin D, but giving them a tablet didn’t really do much.
    0:31:24 That’s correct.
    0:31:25 Why?
    0:31:35 Well, this is what I believe is the fact, is we saw that people with high levels of vitamin D or normal levels of vitamin D did better than those that had low levels.
    0:31:38 I believe that that was a marker of something else.
    0:31:47 In other words, people who had higher levels of vitamin D meant that they were out in the sun more.
    0:31:52 They were outside more than those, the people that had very low vitamin D levels.
    0:31:57 The people with low vitamin D levels were telling me these are people that were not getting outside into the sun.
    0:31:59 And so what’s the real factor here?
    0:32:01 What’s doing the heavy lifting?
    0:32:08 And I would propose, and Scott Zimmerman and Russell Ryder would propose, and I can tell you a number of other scientists that would agree with me on this,
    0:32:18 is that infrared radiation from the sun is causing an effect at the mitochondrial level in terms of oxidative stress.
    0:32:27 And that vitamin D was just the marker of who was getting the infrared light and who was not, who was going outside and who was not going outside.
    0:32:32 So when the sun is shining, for the most part, you’re getting infrared light.
    0:32:36 You’re getting the entire biological spectrum from the sun.
    0:32:46 We can go to the longest wavelength, which is far infrared, all the way to the shortest wavelength, which is ultraviolet B, okay, which makes vitamin D.
    0:32:52 So in other words, when you are outside in a natural environment, you’re getting a very broad spectrum of light.
    0:32:57 And so because of that, if you’re getting infrared light, you’re also going to be making vitamin D.
    0:32:59 You’re getting both.
    0:33:12 Now, that can change because in the wintertime, when the sun is lower in the sky, especially, you know, in England, this is a special issue at that latitude.
    0:33:18 When the sun is low in the sky, it’s got – the light has to penetrate through obliquely through the atmosphere.
    0:33:25 And because of that, shortwave radiation from the sun, like ultraviolet B, does not make it very well.
    0:33:33 So there’s times of the year where you’re not getting enough ultraviolet B or maybe even no ultraviolet B from the sun.
    0:33:34 Which makes the vitamin D.
    0:33:35 Which makes the vitamin D.
    0:33:37 You’re going to be deficient.
    0:33:37 You need to supplement.
    0:33:46 However, during that same period of time, when you’re not getting enough vitamin D because there’s no ultraviolet B radiation, that sun is low.
    0:33:54 But that’s – it’s still enough to allow that long wavelength penetrating infrared light to still come through.
    0:34:01 So is the longwave infrared light the type of thing that we see these gadgets doing?
    0:34:02 Absolutely.
    0:34:11 And I would say just to be specific is because you can see that as red light there, that’s not infrared light because you can see it.
    0:34:14 So infrared light technically is completely invisible.
    0:34:18 But these do give out infrared light, but you just can’t see it.
    0:34:18 Yes, exactly.
    0:34:20 So it’s toward that red end of the spectrum.
    0:34:37 And people like Glenn Jeffrey out of UCL is actually doing research at 670 nanometers of red light and has shown in randomized controlled trials that that type of light right there at 670, the type that you can even see, actually does improve mitochondrial efficiency.
    0:34:39 He’s shown this in a number of randomized controlled trials.
    0:34:41 It improves eyesight.
    0:34:46 And you have to realize that the retina at the back of your eye is very rich in mitochondria.
    0:34:52 He’s shown this in terms of managing glucose and output from mitochondria.
    0:35:07 And the reason why these things work so well is because what’s going on here is as you get older, your skin starts to become more saggy because the fibroblasts or the cells in your skin, they’re designed to make collagen.
    0:35:12 And collagen is the skeleton that makes your skin soft and subtle.
    0:35:12 Yeah.
    0:35:13 Don’t mind me, please.
    0:35:14 No, no.
    0:35:16 So this is exactly it.
    0:35:17 My wife uses the same thing.
    0:35:19 This is a fun charge.
    0:35:25 So what’s going on right now is that red light, which can penetrate very deeply down, is going into the skin.
    0:35:32 And it is activating the mitochondria in your fibroblasts to produce more energy, which those cells need to deposit collagen.
    0:35:43 And so when you deposit collagen, that’s going to give the skin a more tight feel because as you get older, that collagen deposition is going to get less and less and less.
    0:35:44 So this is going to help keep me looking young.
    0:35:46 That’s the whole point of it.
    0:35:50 And you’re saying that the light in these penetrates, what, six or seven centimeters?
    0:35:53 The infrared does about eight centimeters.
    0:35:59 This red light would be a little bit less because this light, obviously you can see it, so it is a little bit shorter wavelength.
    0:36:04 But yes, this light, the red light, can penetrate deeper than, for instance, yellow light or blue light.
    0:36:09 And it’s this light particularly that interacts with the mitochondria to increase that.
    0:36:11 So should we be putting this all over our body?
    0:36:18 Because, okay, it’s good for my skin, but if it’s penetrating deeper, presumably there’s other parts of my body that would benefit from that, another mitochondria.
    0:36:19 It’s interesting you say that.
    0:36:29 The study that I’m referring to with Glenn Jeffrey out of University College London, he took young people in this study.
    0:36:30 He gave them a bunch of glucose.
    0:36:34 And everybody who gets a bunch of glucose should have a spike in their blood sugar.
    0:36:43 And he randomized them on their backs to see what would happen when he shined red lights on their backs.
    0:36:45 And the people that got the red light had lower spikes.
    0:36:54 In other words, it seemed as though the mitochondria were metabolizing faster, which caused less of a spike of the glucose in their blood.
    0:37:00 The way he confirmed that is looking for the byproducts of the mitochondrial metabolism, which is carbon dioxide.
    0:37:08 So when we breathe, when we metabolize, we’re breathing out carbon dioxide, which is the result of a mitochondrial metabolism.
    0:37:17 And in fact, in those people that had the light on, it showed a higher level of carbon dioxide in the exhaled breath.
    0:37:20 The whole point of that is to get back to your question is whether we should be putting this all over your body.
    0:37:26 He was able to get that effect systemically with just putting the light on the back.
    0:37:31 That was a systemic ability.
    0:37:42 We don’t understand everything about the mitochondria, but what we do seem to understand is that they can communicate with each other and that you don’t need to have this all over the body to have systemic effects.
    0:37:52 In this particular case, though, if you want to have the skin here to be more, you know, younger looking, then it makes sense that this is where you need to have it.
    0:37:57 If you want to have a particular other part of your body to look younger, then perhaps that’s where the light needs to go.
    0:37:58 So interesting.
    0:38:03 How long did it take in those studies to see the effect of red light therapy like this?
    0:38:04 Well, that’s a very good question.
    0:38:09 If you talk to Glenn Jeffrey, which I have, he noticed an improvement in 15 minutes.
    0:38:11 15?
    0:38:12 15 minutes.
    0:38:13 What did he notice in 15 minutes?
    0:38:22 He said he has studied the mitochondria in fruit flies and in mosquitoes and bees and in human beings, and it’s the same every time.
    0:38:33 He says after about 15 to 20 minutes of this type of light in that type of setting, there is a switch that turns on, and you don’t need further stimulation.
    0:38:35 Further stimulation doesn’t do anything more.
    0:38:37 It’s a very bizarre thing.
    0:38:41 You would think that the more light that you gave, the more the effect would be.
    0:38:41 It’s not.
    0:38:45 After about 15 minutes, there’s something that changes in the mitochondria.
    0:38:48 There are certain theories about where this might be.
    0:38:52 This might be in the electron transport chain, complex four.
    0:38:54 These are very technical things.
    0:38:57 There’s a lot of studies that are actually, there’s a number of groups that are actually looking at this.
    0:39:01 There’s a whole area of science called photobiomodulation, which is looking at this.
    0:39:05 But 15 minutes is really what it takes.
    0:39:08 So we’re not talking about a long period of time.
    0:39:11 This is really, really interesting.
    0:39:19 So getting back to my experience in the intensive care unit, the vitamin D wasn’t working.
    0:39:27 These patients were dying, and it became clear to me that COVID was a metabolic issue for these patients.
    0:39:35 By the time I had realized this, the pandemic arguably is still going on because people are still becoming infected.
    0:39:43 But the rush to come into the hospital and the number of bodies that we were seeing circulating through the intensive care unit had dropped dramatically.
    0:39:55 And at that point, I was able to see that potentially infrared light may be very, very beneficial in these patients with COVID-19.
    0:39:58 Now, there was a study in Brazil.
    0:40:07 They took COVID patients that were sick enough to be admitted to the hospital, but not too sick to be intubated in an intensive care unit.
    0:40:09 And they did something tremendous.
    0:40:14 They actually manufactured a jacket that they could put on patients.
    0:40:22 And on the inside of this jacket were these LED bulbs that gave off infrared radiation at exactly 940 nanometers.
    0:40:30 They put the jackets on, and they randomly randomized the sign which jacket was turned on and which jacket was turned off.
    0:40:35 It was blinded because the light coming from this jacket could not be seen by the human eye.
    0:40:37 It wasn’t even enough to produce enough heat.
    0:40:40 And so they did this on 30 subjects, and they randomized them.
    0:40:41 15 did it.
    0:40:45 All 30 had the jackets on.
    0:40:47 15 had it turned on.
    0:40:48 15 did not have it turned on.
    0:40:49 And they watched them.
    0:40:50 What happens to these patients?
    0:40:55 Every single endpoint that they looked at was statistically significant.
    0:40:57 What does that mean?
    0:41:01 It means that the differences between these two groups could not have been from chance.
    0:41:03 There was a real difference.
    0:41:10 The group that had the jacket turned on had improvement in their oxygen saturation,
    0:41:15 could take breaths in more deeply and stronger,
    0:41:18 had improvements in their white blood cells.
    0:41:23 And not only that, had improvements in their heart rate, their respiratory rate,
    0:41:24 all of these statistically significant.
    0:41:29 But the most important and mind-blowing statistic was the length of stay in the hospital.
    0:41:38 So they had these jackets on for 15 minutes once a day for seven days.
    0:41:43 In the group that did not have the jacket turned on,
    0:41:45 their average length of stay was 12 days in the hospital.
    0:41:49 For those that had the jacket turned on, it was eight days.
    0:41:52 That was a four-day difference.
    0:41:59 That’s tremendous when you realize that it costs thousands of dollars to hospitalize patients.
    0:42:06 It’s a huge amount when you think about the fact that there are certain drugs that get FDA approved
    0:42:11 for influenza, for instance, by just cutting short the symptoms for 24 hours.
    0:42:13 This is not just 24 hours, 40.
    0:42:17 People were discharged from the hospital four days faster.
    0:42:20 When I saw that study, that was enough for me to convince me.
    0:42:22 I mean, obviously, it was 30 subjects, right?
    0:42:23 We should do a bigger study.
    0:42:25 We should do a couple hundred, right?
    0:42:26 That would be ideal to do.
    0:42:31 But the fact that with just 30 patients, they could show statistical significance.
    0:42:36 That was enough for me to say every patient from now on that I see that comes in with COVID-19
    0:42:42 that’s hospitalized, that they’re asking me to go intubate, to bring to my ICU, these patients
    0:42:43 are going to get outside.
    0:42:45 I don’t have that jacket that they made in Brazil.
    0:42:48 I don’t even know how I would make that jacket.
    0:42:49 They made it for the study.
    0:42:51 And it’s not commercially available.
    0:42:55 There’s no 940 nanometer light, which is what they did in the study.
    0:42:56 But I do know this.
    0:43:00 I do know that sunlight has 940 nanometers in it.
    0:43:05 And if I could just take these patients outside, maybe they could improve.
    0:43:07 So I got my wish.
    0:43:09 I had a patient on the floor.
    0:43:18 He was on 35 liters a minute, 100% oxygen through a high flow.
    0:43:19 Through his nose.
    0:43:19 Through his nose.
    0:43:22 Barely saturating because he had COVID-19.
    0:43:27 And I was asked to go see him because he was potentially needing to be intubated or brought
    0:43:28 to the intensive care unit.
    0:43:31 I could not believe it because I had not seen one of these in months.
    0:43:34 So I went down, walked into the room, opened the door.
    0:43:35 It was in isolation.
    0:43:37 I had a mask on, the whole nine yards.
    0:43:38 The room was completely dark.
    0:43:40 The blind was closed.
    0:43:41 His daughter was there.
    0:43:43 And the first words out of his mouth to me was,
    0:43:46 Doc, how much time have I got?
    0:43:48 I mean, it was a catastrophe.
    0:43:51 Like, there was no light, no circadian rhythm.
    0:43:52 This guy was depressed.
    0:43:56 I immediately called my respiratory therapist, immediately called the charge nurse.
    0:43:58 We got everybody together.
    0:44:00 And I said, we need to get this guy outside.
    0:44:01 It was a bright and sunny day.
    0:44:03 How are we going to get this guy outside?
    0:44:04 35 liters, 100%.
    0:44:09 We, my respiratory therapist, Kim, managed to put a couple of oxygen tanks together.
    0:44:12 And we were able to get this guy into a wheelchair.
    0:44:14 And we wheeled him outside.
    0:44:19 And he told me this weeks later.
    0:44:22 But he says, you know, that first day that you got me outside in the sun,
    0:44:24 because we did this for like seven days in a row.
    0:44:27 He said, that felt so good.
    0:44:32 He, after just one day, dropped down from 35 liters to 15 liters.
    0:44:33 15 liters of?
    0:44:34 Of oxygen.
    0:44:36 And then down to 12.
    0:44:38 And then down to eight the next day.
    0:44:38 And then down to five.
    0:44:40 Five days.
    0:44:42 The amount of oxygen he was inhaling to keep it alive.
    0:44:42 Correct.
    0:44:46 So in other words, we were titrating down the amount of oxygen that we had to give him
    0:44:48 to maintain a saturation in the 90s.
    0:44:51 In five days, he was discharged home without oxygen.
    0:44:55 Now, obviously, that’s an anecdote, right?
    0:44:55 That’s not a study.
    0:45:00 But I’m looking at the risks of getting people out in the sun for 15, 20 minutes.
    0:45:02 There’s not a lot of risk to that.
    0:45:05 And if there’s a benefit, I thought it was worthwhile doing.
    0:45:08 We need to have larger randomized controlled trials.
    0:45:16 But it got me down the road to looking to see what was it about sunlight that was affecting
    0:45:16 this change.
    0:45:17 And you know what?
    0:45:18 There’s ample data.
    0:45:26 There was a study, actually, that was done in Europe where they said, OK, here’s COVID.
    0:45:27 COVID’s going up.
    0:45:29 When does COVID go up?
    0:45:31 Is it because of temperature that changes?
    0:45:32 Is it because of humidity?
    0:45:34 And the answers to both of those were no.
    0:45:38 Do you know what predicted when countries were to have their first surge in the autumn
    0:45:39 of 2020?
    0:45:40 There was a study that was actually done on this.
    0:45:42 It was latitude.
    0:45:47 It started in Finland and then went down the entire continent.
    0:45:52 The last country in the autumn of 2020 to have a COVID surge was Greece.
    0:45:59 So as the sun is literally pulling down into the southern hemisphere, as the shadow starts
    0:46:04 to go over Europe, that’s when we start to see COVID surges, one by one by one.
    0:46:09 Is that because COVID and the sun aren’t friends?
    0:46:13 So it makes it harder to spread because, you know, if I put COVID on this table and then
    0:46:15 I put sunlight on the table, the COVID is going to die.
    0:46:17 Yeah, it’s possible.
    0:46:22 Although we now know that COVID probably doesn’t spread too much through contact.
    0:46:24 It’s more of an airborne thing.
    0:46:27 So there was a study that was done at the University of Edinburgh.
    0:46:32 And they looked at this very question that we had talked about earlier about vitamin D.
    0:46:35 They looked at the United States in the wintertime.
    0:46:39 So and they eliminated the southern part of the United States because in the southern part
    0:46:42 of the United States, you can actually get some vitamin D in the wintertime.
    0:46:45 So they just looked at the sort of the northern portion of the United States.
    0:46:53 And they were able to show that the more sunlight there was in particular areas, the lower the
    0:46:55 mortality from COVID-19.
    0:46:57 So they said, well, this is interesting.
    0:46:59 What about in England?
    0:47:02 So they did the exact same study in England.
    0:47:05 And sure enough, of course, they didn’t have to eliminate any part of England because the
    0:47:08 whole country doesn’t get any vitamin D in the wintertime.
    0:47:12 What they showed was that, again, certain parts of the country in England, as you know,
    0:47:14 get more sunlight than other parts.
    0:47:19 Well, those areas that got more sunlight had lower mortality from COVID-19.
    0:47:24 Then they took the same, they predicated the same study and they looked in Italy.
    0:47:27 Exactly the same finding.
    0:47:27 And they published this.
    0:47:31 And they said in their study, and this is what really amazed me.
    0:47:42 They said, if this is causal, they say, they said that this might actually show a possible
    0:47:43 public health intervention.
    0:47:48 The fact that it is completely independent of vitamin D means that there’s something else
    0:47:49 going on.
    0:47:52 There was a study in 2011 in Sweden.
    0:47:53 Yes.
    0:47:55 Is that linked to this?
    0:47:57 No, this is a completely different study.
    0:47:58 But that’s also a very important study.
    0:48:01 So the Swedish study is groundbreaking.
    0:48:10 This was a study where they asked 20,000, 20 to 30,000 Swedish women about their habits
    0:48:10 in sunlight.
    0:48:14 And they divided these women into three categories.
    0:48:19 Those women that did not get a lot of sun, those that got a moderate amount of sun, and
    0:48:20 those that got a lot of sun.
    0:48:23 And they followed them for 20 years.
    0:48:27 And they kept a track of each one that died and what they died of.
    0:48:29 And when they were done with that, they were astonished.
    0:48:36 Because what they found was that the women who had spent the large amount of their time
    0:48:42 outside or spent the most amount of time outside had the least amount of mortality from cancer,
    0:48:46 from cardiovascular disease, and non-cardiovascular disease.
    0:48:51 And those that spent the least amount of time outside had the highest levels of that.
    0:48:57 The magnitude difference between those two was so much that they were able to show that
    0:49:07 women who, in Sweden, who spent the most amount of time outside and smoked had the same mortality
    0:49:12 as those women that did not spend as much time outside and did not smoke.
    0:49:15 They were equal?
    0:49:16 They were equal.
    0:49:21 In other words, being in that category of not spending much time outside in the sun
    0:49:24 was the same risk factor for death as smoking.
    0:49:27 How do they know it wasn’t linked to exercise?
    0:49:30 How are they able to establish causation?
    0:49:30 Because that’s a…
    0:49:31 Absolutely.
    0:49:32 That’s an excellent question.
    0:49:37 So the difference here, as you go up, is this is an association study, okay?
    0:49:41 So the question is, is how can you get causation from association?
    0:49:42 You can’t.
    0:49:49 But if you look at the Bradford Hill criteria, there is a way that you can potentially make
    0:49:54 a strong argument for causation if there’s something called a dose-response curve.
    0:49:57 In other words, if you can show…
    0:50:00 You’re not just comparing two things, but you’re comparing three or more.
    0:50:08 If you can show that as you increase the variable, that there is a change in the output,
    0:50:11 that is strongly suggestive of potentially causation.
    0:50:14 By the way, this is exactly what we did to show that smoking causes lung cancer.
    0:50:17 Obviously, we can’t do a randomized controlled trial.
    0:50:18 Here, you get to smoke.
    0:50:19 You don’t get to smoke.
    0:50:21 We’ll follow up in 20 years to see who has lung cancer.
    0:50:22 This is exactly what we did.
    0:50:28 We showed that there was such a strong association with cancer risk, with smoking, that we were
    0:50:31 able to say through association that smoking causes lung cancer.
    0:50:39 By the way, Richard Weller, who’s a dermatologist in England, did just last year a very similar
    0:50:45 study as to the Swedish study, except it was 10 times bigger, and he did it with both men
    0:50:45 and women.
    0:50:47 He found the same results.
    0:50:50 It was a UK biobank study.
    0:50:51 What did he discover?
    0:51:02 He discovered that either from solariums or being outside using solar radiation data, he was able
    0:51:09 to show both on their questionnaire and also where they lived that the more light that they
    0:51:15 had, the lower their risk of mortality and cancer mortality.
    0:51:19 So the question was, does it increase melanoma?
    0:51:21 What’s melanoma?
    0:51:22 Melanoma is a skin cancer.
    0:51:24 So that’s the big risk.
    0:51:25 That’s the big risk that everybody’s concerned about.
    0:51:28 You go out into the sun, you’re going to get skin cancer.
    0:51:34 And he was able to show in that study, this was like three, three, 400,000 people in this
    0:51:36 study, UK biobank study, Richard Weller.
    0:51:44 He was able to show that there was no increased, there’s no statistical increased risk of melanoma
    0:51:50 incidence, but there was a reduction in non-skin cancer mortality.
    0:51:53 Okay, so here’s the trade-off.
    0:52:00 If you want to go out into the sun in England, okay, the benefits are you’re going to have a
    0:52:04 reduction in non-skin cancer mortality.
    0:52:05 So everything other than skin cancer.
    0:52:06 Correct.
    0:52:11 On the other hand, there’s no increase in melanoma incidence.
    0:52:15 So that caused him to write an op-ed and publish it.
    0:52:17 And actually, you can look up this op-ed.
    0:52:24 It’s a great op-ed published in the Journal of Investigative Dermatology called Sunlight,
    0:52:27 Time for a Rethink, where he goes through the arguments.
    0:52:32 And he’s actually shown, and there’s been a number of changes that people are making around
    0:52:33 the globe.
    0:52:40 So public health organizations that are saying now, you know, before we have said that, you
    0:52:45 know, the sun is a deadly laser, and you should avoid it at all costs.
    0:52:47 We may need to rethink that.
    0:52:53 So are you telling me that essentially 15 minutes in the sun every day turns on a switch in my
    0:52:59 body that improves my mitochondrial function, which is going to impact a variety of different
    0:53:00 parts of my health?
    0:53:01 Is that essentially what you’re saying?
    0:53:02 Essentially, yes.
    0:53:09 And we’re looking—and this is in an environment where we are spending less and less and less
    0:53:09 time.
    0:53:15 To give you—to put in perspective, if we were on a British ship 300 years ago, and I came
    0:53:18 to you and I said, do you see this little yellow fruit?
    0:53:22 Just by eating a little bit of this yellow fruit, all of this disease that you’re seeing
    0:53:24 around you with your fellow shipmates is going to go away.
    0:53:26 That would seem almost incredulous, right?
    0:53:28 But that’s exactly the case.
    0:53:34 We are—the scurvy of the 21st century is the lack of sunlight.
    0:53:37 Everything is inside.
    0:53:39 We avoid the outside.
    0:53:41 We avoid discomfort.
    0:53:42 We avoid high temperatures.
    0:53:43 We avoid low temperatures.
    0:53:46 We used to go out and play sports.
    0:53:50 We now are playing virtual sports on pads.
    0:53:56 We have windows that are specifically designed, especially here in Southern California, to
    0:53:58 eliminate infrared lights.
    0:53:59 Because why?
    0:54:01 Infrared lights comes in, and it heats up.
    0:54:05 One of the interesting things—we didn’t mention this about infrared light—is the way
    0:54:08 that we interact with infrared light, you can tell this on your own.
    0:54:12 You go outside and close your eyes.
    0:54:15 You can tell which side of your body the sun is on.
    0:54:20 And the reason is, is because that infrared light not only can penetrate through your body,
    0:54:22 it’s also penetrating through clothes very easily.
    0:54:24 And you can feel that.
    0:54:29 That heat that you’re feeling is the infrared light going through the clothes, going through
    0:54:33 the skin, and interacting with your heat receptors that are well below the surface.
    0:54:35 So, all of this.
    0:54:37 All right, guys.
    0:54:38 I’m going to go get Steve.
    0:54:39 The guest is here.
    0:54:40 Ready?
    0:54:41 Come in.
    0:54:42 Oh, my God, Steve!
    0:54:43 What?
    0:54:44 What are you doing?
    0:54:46 This is the Bonchage face mask.
    0:54:48 It’s good for blemishes, wrinkles.
    0:54:50 It clears up the skin.
    0:54:51 It’s red light.
    0:54:52 Have you not used it before?
    0:54:53 No.
    0:54:53 Have you tried this before?
    0:54:55 It’s really, really good.
    0:55:00 It shines red light on your face, which helps increase and boost collagen production.
    0:55:02 I actually found it out because of the missus.
    0:55:03 I’ve seen her wearing it.
    0:55:04 She terrified me a couple of nights in a row.
    0:55:08 I thought it was to scare people with, but actually, it’s really, really good for your skin.
    0:55:14 So, they are a sponsor of the podcast, and I’ve been using it every day for about a year and a half now.
    0:55:14 Wow.
    0:55:15 You’re glowing.
    0:55:15 Wow, Steve.
    0:55:16 You’re glowing, aren’t you?
    0:55:16 I’m glowing, aren’t you?
    0:55:16 Great.
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    0:56:32 How long does the average American spend indoors, or the average Brit spend indoors?
    0:56:33 Good question.
    0:56:34 They’re almost identical.
    0:56:38 I think the Brits spend a little bit more time outside than Americans.
    0:56:44 The last number for Americans was 93%, and Brits was 92%.
    0:56:45 Were we born to be outside?
    0:56:46 I think so.
    0:56:49 You’d think our ancestors probably spent a huge amount of time outside.
    0:56:55 And if you think about when I say outside, that also brings into play a number of other
    0:56:58 of the Newstart letters that we haven’t talked about.
    0:56:59 Exercise.
    0:57:02 You’re much more likely to do good exercise outside.
    0:57:04 You’re much more likely to get air.
    0:57:07 That’s the right type of air outside.
    0:57:15 The other aspect about infrared light, briefly, is that trees are highly reflective of infrared
    0:57:15 light.
    0:57:20 In other words, if you’re in an environment where there are trees are present, you’re going
    0:57:24 to get much more of this beneficial infrared light than if you’re in a concrete jungle.
    0:57:27 So plants like this.
    0:57:34 In fact, the way that we measure the forestation of the Amazon is through satellite imaging that
    0:57:37 looks at infrared light because it reflects infrared light back.
    0:57:46 So the best thing, best situation to be in is to be outside on a green, on a day where there’s
    0:57:47 lots of green trees.
    0:57:54 We’ve known for decades that people who live in green spaces do much better in terms of
    0:57:58 diabetes, do much better in terms of hypertension, mortality, all of these things.
    0:57:59 Depression.
    0:58:00 Depression, all of these things.
    0:58:00 Yeah.
    0:58:07 And when you think about this, you bring up a point in terms of correlation.
    0:58:09 How do we know it’s not depression?
    0:58:12 We used to say, well, people who live in green spaces have more money.
    0:58:15 The people, they have more access to things.
    0:58:16 Maybe that’s what we’re seeing.
    0:58:18 I just have to tell you this study.
    0:58:21 There was something called the Green Heart Study in South Louisville, Kentucky.
    0:58:23 They did an amazing thing.
    0:58:31 They took this four-square-mile area in South Louisville, Kentucky, urbanized area, and they
    0:58:33 measured everybody’s HSCRP.
    0:58:35 What is HSCRP?
    0:58:38 Highly sensitive C-reactive protein.
    0:58:44 It’s a marker of inflammation, and it’s been correlated to bad things like stroke and heart
    0:58:44 attack.
    0:58:47 So if you have high levels of CRP, that’s not good.
    0:58:54 So they measured about 700 people, and then they did something extraordinary.
    0:59:04 They purchased 8,000 mature trees, dug holes, and planted 8,000 trees into four-square-mile
    0:59:04 area.
    0:59:06 And these are trees with leaves on them.
    0:59:12 Two years later, they come back, and they measure all 700 people in their study, repeat
    0:59:19 the HRCRP, dropped by 13% to 20%, which correlated to about a 10% to 15% reduction in strokes.
    0:59:23 These people didn’t change their socioeconomic status.
    0:59:26 They didn’t institute an exercise program.
    0:59:32 And so really, it kind of shoots in the heart the idea that the advantage that we see with
    0:59:35 green spaces has to do with something else that we’re not measuring.
    0:59:43 I actually believe that we’ll talk about fresh air, too, that things like these plants, but
    0:59:44 much bigger.
    0:59:45 This is kind of like a bonsai plant.
    0:59:48 But trees outside, they actually have a benefit.
    0:59:57 And what they represent, again, is these things that don’t leverage the other parts of your
    1:00:02 body in terms of the chains that make all of the chains bigger because they’re having a
    1:00:03 benefit.
    1:00:06 But you can’t get the benefit of this if you’re inside a house.
    1:00:11 So what should we do about this in terms of how, what changes should I make in my life
    1:00:12 to capitalize on this?
    1:00:16 This brand here is called Bond Charge.
    1:00:18 They do these red light devices.
    1:00:21 They do like red light saunas, blankets, masks.
    1:00:25 They’re actually a sponsor of mine because I started wearing this, and I think they found
    1:00:25 out.
    1:00:28 I started wearing it because of my girlfriend.
    1:00:28 Yeah.
    1:00:30 She was wearing it every day, and I got curious.
    1:00:33 And so I, as I always do, I’m always super skeptical.
    1:00:33 Sure.
    1:00:37 So I went online and started looking at some of the research, and I was shocked.
    1:00:37 Yeah.
    1:00:42 It made no intuitive sense to me that a red light mask or any red light device could have
    1:00:45 a profound, like what I see as a profound impact on my health.
    1:00:46 Like I didn’t believe it.
    1:00:46 Yes.
    1:00:47 To start with.
    1:00:47 Yes.
    1:00:49 It was like woo-woo stuff to me.
    1:00:50 But I couldn’t disprove it.
    1:00:51 Right.
    1:00:56 All the studies, many of which you’ve referenced, supported that it was having a profound impact.
    1:00:58 And as I’ve said on this podcast before, my girlfriend’s always right.
    1:01:00 She’s like always ahead of the curve and always right.
    1:01:03 So I started wearing her mask, and now I have my own from Bond Charge.
    1:01:04 Yeah.
    1:01:06 Do you recommend these kinds of things?
    1:01:08 I think it’s reasonable to do.
    1:01:09 I will say this.
    1:01:16 If you are getting enough infrared light from the sun, what we find in studies, not particularly
    1:01:21 with the mask, but we find in other things, is that these other areas don’t have as much
    1:01:21 efficacy.
    1:01:26 It’s almost to say if you’re on a ship with a bunch of people with scurvy, and you already
    1:01:29 have a diet that’s rich in vegetables and fruits, eating an extra lemon is not going to
    1:01:30 be that beneficial.
    1:01:31 So what do you do?
    1:01:35 Like a lot of doctors do, we have shifts that go from 7 a.m. to 7 p.m.
    1:01:36 So you’re in the hospital.
    1:01:37 You’re not going to get outside.
    1:01:43 So at lunch, I try to get outside as much as I possibly can into the sun for my 15 minutes.
    1:01:44 What if you live in a cloudy country?
    1:01:46 So that’s a good point.
    1:01:52 Clouds, because they are water molecules, will absorb a lot of the infrared light.
    1:01:57 And the problem is, is that that’s exactly the type of light that you want to get.
    1:02:02 However, even on a cloudy day, being outside, you’re going to get more infrared light than
    1:02:03 if you were inside.
    1:02:10 Okay, so I still get the light I need when it’s cloudy, but I just don’t get a lot.
    1:02:12 Yes, exactly.
    1:02:16 Is there anything I can do to get, if it’s super cloudy, and I know I’m going to be indoors,
    1:02:18 what do I do then?
    1:02:19 Yeah.
    1:02:22 So the type of lights that we have inside.
    1:02:23 Like these ones?
    1:02:28 Like these, and actually, I think the UK and the United States are very similar in this
    1:02:32 regard, is that we really can’t get the old incandescent bulbs.
    1:02:34 We’re on LED or fluorescent.
    1:02:42 And if you think about what they’ve done in terms of these bulbs, the old incandescent
    1:02:47 bulbs used to give you a very broad spectrum.
    1:02:52 So all the way from, you know, just near blue, all the way down into the infrared.
    1:02:58 The way that they’ve made the bulbs more efficient, they said, hey, let’s stop using energy to give
    1:03:04 off this light that we can’t see and give a very narrow spectrum of light that we can see.
    1:03:06 So think about what they’ve done.
    1:03:11 They have, for the first time in the history of humanity, they are now, we are now being
    1:03:16 exposed to light in a very narrow spectrum without anything else.
    1:03:22 Whatever, in the history of humankind, when we’d light a candle, when we would go outside
    1:03:27 into the sunlight, when we would have a kerosene lamp, we were getting full spectrum.
    1:03:32 In other words, we were never getting blue lights without red lights.
    1:03:34 Now we’re starting to get blue light without red light.
    1:03:37 So do I change my bulbs?
    1:03:43 It’s difficult to do that because you can’t pick up these incandescent bulbs, which brings
    1:03:49 me to, I mean, at least in the United States, we have laws now that outlaw the regular selling
    1:03:52 of incandescent bulbs because of energy efficiency.
    1:03:52 Oh, yeah.
    1:03:55 I’m on Google now and I’ve typed in incandescent bulb.
    1:03:59 So there’s something called a general service lamp, which is what the type of bulbs that
    1:04:00 you can plug in.
    1:04:06 But if you decide that you want to get a bulb that you put into your microwave or a bulb that
    1:04:10 you would do into a type of chandelier that’s a special type of chandelier, those are still
    1:04:10 available.
    1:04:13 You can still get incandescent bulbs for those.
    1:04:14 What about these kinds of bulbs?
    1:04:16 Is that an incandescent bulb?
    1:04:21 That is an incandescent bulb, again, for these special type of lights.
    1:04:26 But I’m talking about the light, like the good old-fashioned A90, I think it’s called,
    1:04:28 or light bulb that you just screw in.
    1:04:31 Those are the 120 watts.
    1:04:32 Those are getting more difficult.
    1:04:33 It’s harder to find.
    1:04:35 You can’t go down to your Home Depot and find them there.
    1:04:46 So Glenn Jeffrey, and this is a preprint that he’s done, he actually took people that were
    1:04:47 working in this environment with LED bulbs.
    1:04:50 He’s actually, it’s not peer-reviewed.
    1:04:51 It’s not published yet, but it’s a preprint.
    1:04:52 It’s available on the internet.
    1:04:54 So I’m not speaking out of class.
    1:05:03 And what he did with 22 people is he switched out these LED bulbs and put in incandescent
    1:05:03 bulbs.
    1:05:09 And there was a 25% improvement in color differentiation in his study.
    1:05:10 What does that mean?
    1:05:17 They were able to distinguish colors 25% better than they were when they were exposed to LED.
    1:05:21 When I say LED bulbs, these are the bulbs that are high on the blue end.
    1:05:24 So why would that be?
    1:05:28 The retina, which is the back of your eye, wherein the light is coming in, there’s these
    1:05:33 cones that are tremendously metabolically active.
    1:05:37 They’re constantly updating, sending signals to the brain.
    1:05:42 And it’s the one tissue in your body with the most amount of mitochondria.
    1:05:44 And it’s because they have to supply a lot of energy.
    1:05:50 As somebody gets older, that mitochondria is not producing the same amount of energy.
    1:05:57 And so the ability of the energy that those cones have to draw on to do their work is less.
    1:05:59 And so they’re not going to do the job as well.
    1:06:06 If you can perhaps increase the amount of output of energy from those mitochondria, you could
    1:06:11 improve the ability to visually perceive.
    1:06:19 And Glenn Jeffrey’s done this study already where he, for just three minutes, 670 nanometer light,
    1:06:27 very similar to that mask, in the eye, only in the morning, improved those people’s ability
    1:06:30 to visualize and actually see.
    1:06:33 And what does that mean for the broader picture of our health?
    1:06:37 They would be able to distinguish colors better and actually improve their vision.
    1:06:40 That’s basically what it means.
    1:06:44 And so the question goes back to the first question that you had at the very beginning of the podcast,
    1:06:49 which is, what is the effect of low energy output from the mitochondria?
    1:06:51 Well, it depends on what tissue the mitochondria is in.
    1:06:57 And so if it’s in the eye, then it’s going to be a better visual perception.
    1:06:59 If it’s in the brain, it’s dementia.
    1:07:01 If it’s, you know, see what I’m saying?
    1:07:09 So what we start to see is we start to see that a myriad of different diseases are affected by the sun.
    1:07:11 I challenge anyone to do this.
    1:07:18 If you look at a publication in the United States, I’ve seen it, where they map out the amount of deaths
    1:07:29 in a calendar day, cardiac disease, respiratory disease, kidney disease, pneumonia, all sorts of diseases,
    1:07:34 infectious diseases, non-infectious diseases, you will see a very clear pattern.
    1:07:41 The maximum amount of deaths every year occurs within a month after the shortest day of the year.
    1:07:44 So we’re talking December, January.
    1:07:49 We see the most amount of influenza deaths at that time.
    1:07:53 We see the most amount of cardiac deaths at that time.
    1:07:56 We see the most amount of kidney deaths at that time.
    1:08:02 So you might ask, well, that’s because people get together at Christmastime,
    1:08:04 and they spread the germs around more.
    1:08:07 And we have Thanksgiving in late November here in the United States.
    1:08:09 And that’s what’s going on.
    1:08:14 The problem is, is if you look at Australia, which is on the other end.
    1:08:16 So when is their longest day of the year?
    1:08:20 Their longest day of the year is in December.
    1:08:24 And that’s when they have the least amount of deaths, despite the fact that they’re all getting
    1:08:26 together for Christmas in December.
    1:08:28 So that doesn’t fly.
    1:08:30 It’s exactly the opposite.
    1:08:36 The most amount of deaths occur in Australia, in the Southern Hemisphere, in June to July.
    1:08:37 That’s their winter.
    1:08:44 And so what you see is deaths are correlated to the length of the day.
    1:08:48 This is the reason why whenever they have to, whenever they show you deaths in the year,
    1:08:50 they always have to seasonally adjust it.
    1:08:53 And the length of the day is a proxy for the amount of sunlight.
    1:08:54 Absolutely.
    1:09:00 You’re much more, you’re much more likely to get sunlight on the longest day of the year than the
    1:09:05 shortest day of the year, especially when, and this is well known, there are some months,
    1:09:10 especially in people who are doing shift work, like 7 a.m. to 7 p.m., there’s literally like
    1:09:15 December and January, you will not see the sun because you are going off to work before the sun
    1:09:15 gets up.
    1:09:18 And you’re coming home after the sun is long set.
    1:09:21 So you’re not able to see the sun.
    1:09:25 And so you could go literally weeks without seeing the sun at all.
    1:09:29 Is there an optimal time of day to get sunlight?
    1:09:30 Yes.
    1:09:36 So optimal time of day to get sunlight would be for those that are concerned about getting
    1:09:38 damage from ultraviolet radiation.
    1:09:45 As we talked about, when the sun is low in the sky, that’s going to be beneficial because
    1:09:50 the ultraviolet cannot penetrate obliquely through the atmosphere as well as long wavelength
    1:09:50 radiation.
    1:09:55 So when the sun is coming up, so in the mornings, in the mornings, and when the sun is going
    1:09:59 down in the evenings, that’s going to be the time where you’re going to get proportionally
    1:10:03 more infrared light and the least amount of ultraviolet light.
    1:10:07 Now, when the sun is directly overhead at noon, you’re going to be getting the most amount
    1:10:11 of infrared light at that time, but you’re also going to be getting a lot of ultraviolet
    1:10:11 radiation.
    1:10:16 And so if you’re not someone that’s gone out into the sun a lot, you may want to avoid this
    1:10:17 period of time.
    1:10:22 Or as we talked about, put on a broad-rimmed hat, put on clothes.
    1:10:24 I mean, more clothes.
    1:10:29 Because as we said, ultraviolet light does not penetrate through clothes very well.
    1:10:30 But infrared light can.
    1:10:33 Does it matter where the sun is hitting on my body?
    1:10:33 Shouldn’t.
    1:10:38 So if I go outside and I’m wearing a big hat, it’s obviously going to cover my eyes, my
    1:10:38 face.
    1:10:38 Yes.
    1:10:39 But I’ll be hitting my legs.
    1:10:43 For the purposes that we’re talking about with the mitochondria, it will not matter.
    1:10:49 However, if we’re talking about circadian rhythm, if we’re talking about getting the circadian
    1:10:51 rhythm, that pathway is through the eyes.
    1:10:53 So you want to maximize light through the eyes.
    1:10:53 Yeah.
    1:10:56 So this type of a light is called the sad light.
    1:11:01 So your question has to do with what part of the body does it need to touch or need to
    1:11:02 be touching.
    1:11:07 So for the effect of the mitochondria and the metabolic effects, it should not matter.
    1:11:08 Okay.
    1:11:13 For this type of a light, though, what we’re looking at is circadian rhythm.
    1:11:17 And that’s a completely different system that we’re talking about.
    1:11:18 That’s not mitochondrial.
    1:11:23 That has to do with the internal clock that’s in your brain that is regulating when all of
    1:11:25 these things in your body happens.
    1:11:28 And this light is about 10,000 lux.
    1:11:30 Lux is a way of measuring the brightness of light.
    1:11:37 And what studies have shown is that when you shine this type of a light into your eyes, it’s
    1:11:40 the way of adjusting your circadian rhythm.
    1:11:43 You know, if you have a clock and it’s not set to the right time, there’s a little thing
    1:11:45 at the back that you can pull out and you can change the time.
    1:11:46 Yeah.
    1:11:50 That pulling out and changing the time about when things happen in your body is affected
    1:11:53 most by light.
    1:11:57 And light can actually shift it one way or the other, depending on when you’re shining that
    1:11:58 light.
    1:12:02 If you’re shining the light in the morning time, and this is what a lot of people do is they’ll
    1:12:04 use these, what they call sad lights.
    1:12:07 Sad stands for seasonal affective disorder.
    1:12:14 These lights, especially in the morning, have a way of not only setting your circadian rhythm
    1:12:18 and making sure it’s on track, but also reducing depression.
    1:12:22 There’s a portion in your brain that receives light information.
    1:12:24 It’s called the perihabenular nucleus.
    1:12:27 It’s a long name, but it’s back there.
    1:12:30 And if it doesn’t get stimulated, it can cause depression.
    1:12:37 And so for people who live at high latitudes, further away, closer to the poles, where the
    1:12:41 sun is getting up very late in the morning and they’re already off at work inside, this
    1:12:42 can actually be very beneficial.
    1:12:47 So what I would recommend doing, you can pick these up pretty cheaply on Amazon for about
    1:12:51 20 bucks, but they should generally be about 11 to 16 inches from your face.
    1:12:56 And what people should be getting is about 3,000 luxe hours.
    1:13:03 And what I mean by luxe hours is you multiply the luxe times the amount of hours that you’re
    1:13:03 wearing it.
    1:13:05 So 3,000 is where you ought to be.
    1:13:10 Because this is 10,000 luxe, you only have to look at it for about a third of an hour or
    1:13:11 20 minutes.
    1:13:12 And that should be enough.
    1:13:14 So is this a replacement for going outside?
    1:13:19 It’s a replacement for going outside because of the fact that you’re living at a very high
    1:13:20 latitude and the sun is not up.
    1:13:25 And because of the job that you have, it’s going to have that effect.
    1:13:30 But realize that this will not replace the effect that the sun has on your mitochondria.
    1:13:34 This is only to affect the effect that lack of sunlight has on depression.
    1:13:35 Okay.
    1:13:38 So what if I’m looking at the sun out of a window?
    1:13:40 It depends on the window.
    1:13:44 So you’re not still, the window is going to be reducing the amount of luxe.
    1:13:48 So I would not recommend, if you can, I would not recommend, I would not say that staying
    1:13:50 inside, looking out the window is the same as going outside.
    1:13:51 That’s number one.
    1:13:55 The other thing that you have to understand is a lot of these windows, especially if they’re
    1:14:00 modern windows, will be specifically designed to reduce infrared light.
    1:14:04 I want you to give me any information you have as it relates to light health.
    1:14:05 Yeah.
    1:14:06 That will improve my life.
    1:14:08 Things that I can actionably do tomorrow.
    1:14:11 Obviously, one of them is that I’m going to go outside and make sure I get some sunlight,
    1:14:12 ideally in the morning.
    1:14:12 Yes.
    1:14:19 We talked about this sad lamp for people, especially that live in certain countries, which have less
    1:14:19 sunlight.
    1:14:19 Correct.
    1:14:23 To set their circadian rhythm and to help with things like mental health.
    1:14:26 Is there anything else I should be thinking about or can do or change?
    1:14:34 So just like we had in our mnemonic of Newstart, rest and exercise, both at the same time, and
    1:14:37 yet they’re sort of like opposite of each other, it’s important to have darkness.
    1:14:39 Okay.
    1:14:40 It’s important to have darkness.
    1:14:41 And this is a real issue.
    1:14:46 This is one of the biggest issues is the fact there was a study that was published recently
    1:14:49 and the title was dark days and bright nights.
    1:14:53 And that correlated with increased mortality.
    1:14:55 I mean, that’s how most of us live.
    1:14:55 That’s the problem.
    1:14:58 We have dark days and we have bright nights.
    1:15:01 And what we really should be having is bright days and dark nights.
    1:15:07 So just as important as it is to have bright sunlight and getting outside in the middle of
    1:15:11 the day, we also need to start working on getting darker nights as well.
    1:15:12 And how do we do that?
    1:15:13 Turning things off.
    1:15:16 Getting these screens away from our eyes.
    1:15:22 These are really important because the screens have a lot of light and the light, what’s going
    1:15:24 on here, this is the reason why it’s important.
    1:15:30 There’s two reasons actually, is the light that’s going into our eyes is doing two things at night.
    1:15:34 Number one, it is shutting down melatonin production from the pineal gland.
    1:15:38 And as we just talked about, melatonin is a very powerful antioxidant that’s very beneficial.
    1:15:43 The second thing that it’s doing is it’s confusing your circadian rhythm.
    1:15:47 You see, your circadian rhythm is designed to see light as day.
    1:15:53 If your eyes are seeing light, your brain thinks it’s the day.
    1:15:58 So if it’s 10 o’clock at night and your eyes are seeing light, your circadian rhythm is saying,
    1:15:59 I must have made a mistake.
    1:16:01 I thought it was 10 o’clock.
    1:16:03 It must not be 10 o’clock because look, there is light.
    1:16:09 And so what it’s going to do is it’s going to adjust itself and delay everything.
    1:16:11 Because it’s saying, well, it can’t be 10 o’clock at night.
    1:16:13 It must be 6 o’clock.
    1:16:19 And so therefore, when you would normally feel tired and sleepy at 10 o’clock at night,
    1:16:25 after a number of days of doing this, you’re not going to feel sleepy until 1 o’clock in the morning.
    1:16:28 These devices we have, they spit out a lot of blue light, right?
    1:16:29 Yes.
    1:16:31 Is there a way to like turn that off?
    1:16:31 Yeah.
    1:16:38 Well, actually, a lot of these come with tied to the clock where after a certain time of night,
    1:16:43 it will shift its spectrum to a more red spectrum.
    1:16:45 So it’s giving you less blue light.
    1:16:52 The problem is, is that while the sensor in your eyes are tuned more to blue light,
    1:16:54 it’s not just blue light.
    1:16:57 So really the solution, the best solution is to turn off the light.
    1:17:04 The next best solution is to have more of a red shift or, you know, put these glasses on at night.
    1:17:06 So these are blue blockers.
    1:17:10 They’re trying to eliminate blue, but I’m still getting light in.
    1:17:13 And that’s enough light to shut down melatonin production.
    1:17:14 Even with those on?
    1:17:15 Yeah, absolutely.
    1:17:17 But you’re telling me these help?
    1:17:19 They’re better than not turning off the light.
    1:17:23 And you’re saying I still get light in because there’s light coming over the top?
    1:17:29 Even that light there is still going to bleed and it’s going to bleed into that part of the spectrum
    1:17:30 and cause melatonin to be shut down.
    1:17:31 Yeah.
    1:17:36 So it’s just the eyes are the sort of the barometer for what time of day it is?
    1:17:36 Correct.
    1:17:41 And the problem is, is that even when you close your lids, light can still get through
    1:17:41 the lids.
    1:17:44 What do you think of these sleep masks?
    1:17:51 I think they’re great in terms of the fact that we now know that closing your eyelids still
    1:17:53 can allow some light to go in.
    1:17:58 So if you’re sleeping in an environment where, you know, light is out of your control, if you’re
    1:18:02 living in the city and you can close your blinds, but there’s still light that’s coming in,
    1:18:05 these things could actually be very beneficial.
    1:18:07 I don’t recommend nightlights in bedrooms.
    1:18:09 You don’t recommend?
    1:18:09 I do not.
    1:18:14 Even clock radios or air conditioners with LED displays on them.
    1:18:17 That’s just like total light pollution to your bedroom.
    1:18:20 Your bedroom should be as dark as possible.
    1:18:23 What if I have those lamps that don’t have blue light in them?
    1:18:25 Because I think my girlfriend’s put some of those by the bed.
    1:18:26 Yeah.
    1:18:28 Do they, are they still not great?
    1:18:30 Again, the best thing is no light.
    1:18:34 The second best thing is light with no blue light in it.
    1:18:37 And then the worst is, you know, blue light.
    1:18:38 What about candle light?
    1:18:40 That’s interesting.
    1:18:48 There was a study that was done where they compared someone reading at night with a book with a light
    1:18:53 bulb shining on it versus the LED, you know, like a Kindle or whatever.
    1:18:58 What they found was that there was a lot more light coming out of the Kindle than there was
    1:19:00 just reading the book with the lamp.
    1:19:03 And it delayed sleep onset.
    1:19:05 So…
    1:19:06 Which delayed sleep onset?
    1:19:07 The Kindle.
    1:19:07 The Kindle.
    1:19:07 Yeah.
    1:19:08 It delayed sleep onset.
    1:19:13 Enough to actually shut down, actually delay the circadian rhythm and shut down melatonin production.
    1:19:15 So the answer to your question is, is candlelight’s great.
    1:19:17 The only thing I’d be concerned about is just the fire risk.
    1:19:20 Yeah, because you fall asleep with that thing.
    1:19:20 Exactly.
    1:19:24 So the adjacent topic there was vitamin D, which we touched on a little bit.
    1:19:26 Do vitamin D supplements work?
    1:19:28 Oh, yeah, certainly.
    1:19:28 They do work.
    1:19:29 And they’ve tested them.
    1:19:29 Yeah.
    1:19:31 There’s a number of studies that have come out.
    1:19:34 Martineau, actually published in the British Medical Journal.
    1:19:37 This was back before 2020.
    1:19:42 It was a meta-analysis of randomized controlled trials showed that people who supplement every day
    1:19:45 with vitamin D had lower risks of acute chest syndrome.
    1:19:50 The other one, there was a recent study that came out that showed that people who supplemented
    1:19:57 with 2,000 international units a daily of vitamin D had a lower risk of all-cause autoimmune conditions.
    1:20:03 We’re talking rheumatoid arthritis, Crohn’s disease, ulcerative colitis, you name it.
    1:20:09 That was a study that came out that we actually reviewed that on our MedCram channel.
    1:20:13 Because I’ve heard before in the past that a lot of vitamin supplements we take don’t even
    1:20:15 get into our bloodstream and into our bodies.
    1:20:16 Yeah.
    1:20:18 So vitamin D is very interesting.
    1:20:23 It is a supplement and it is a vitamin, but it’s also a hormone.
    1:20:29 It actually manipulates DNA production.
    1:20:31 So it is quite interesting.
    1:20:34 But these are well-described randomized controlled trials.
    1:20:38 So if you’re looking at the autoimmune condition, this was actually a study that was designed
    1:20:40 looking at cardiac disease.
    1:20:46 They actually had two arms, one with omega fatty acids and vitamin D.
    1:20:53 And they showed that in the vitamin D group, there was a statistically significant reduction
    1:20:55 in autoimmune conditions.
    1:20:58 I supplement with vitamin D.
    1:21:05 Here’s the concern I have, is if you are going to supplement with vitamin D, make sure that
    1:21:06 you get your levels checked.
    1:21:07 Why?
    1:21:13 The reason is because it is a fat-soluble vitamin and it is possible to take too much.
    1:21:15 What happens if you take too much?
    1:21:22 It can affect calcium metabolism and you can have issues with calcium, too high levels of calcium.
    1:21:26 It’s very rare, but it can happen.
    1:21:31 And I don’t mean to say that in a sense that I would dissuade people from supplementing because
    1:21:33 I think supplementation can be good.
    1:21:36 But at some point, you want to get a level check to see where you are.
    1:21:42 The other reason is because based on your body habitus, based on your skin color, because
    1:21:45 people who have darker skin, it’s harder for them to make their own vitamin D.
    1:21:49 They need to be more time outside, especially if they’re at high latitudes.
    1:21:53 So like me living in the UK, I need to be outside more.
    1:21:58 It’s going to be harder for you to make as much vitamin D as somebody who, for instance,
    1:22:02 if you were living at a lower latitude or if you had lighter skin, yeah.
    1:22:04 What is vitamin D doing in my body?
    1:22:05 Oh, good question.
    1:22:06 Lots of things.
    1:22:12 So vitamin D, if you were to look at the structure of vitamin D, actually, I actually did research
    1:22:13 on this, interestingly, in college.
    1:22:17 I used to make starting material for the graduate students.
    1:22:18 It’s a lipid-soluble molecule.
    1:22:24 And because it’s lipid-soluble, it’s able to go right through into the nucleus and actually
    1:22:31 go onto the DNA and combine with proteins that actually affect the transcription of your DNA.
    1:22:36 So in other words, depending on which cell type we’re talking about, it can cause a lot
    1:22:37 of interesting changes.
    1:22:39 So it affects calcium metabolism.
    1:22:42 There’s vitamin D receptors on your immune system.
    1:22:49 So it affects your immune system, it affects calcium metabolism, a whole host of things.
    1:22:54 My team did some research and found that approximately 1 billion people globally have a vitamin D deficiency.
    1:22:55 Not surprising.
    1:23:01 And about 50% of the global population has insufficient levels of vitamin D.
    1:23:01 Absolutely.
    1:23:03 Yeah.
    1:23:10 Yeah, so the issue is that as the world becomes more industrialized, as the world becomes more
    1:23:16 well-off, they’re able to create dwellings and they’re able to air-condition those dwellings.
    1:23:19 And we as human beings tend to avoid extremes.
    1:23:21 We don’t like things too hot.
    1:23:22 We don’t like things too cold.
    1:23:24 Let’s face it.
    1:23:26 In our cars, we have something called climate control.
    1:23:31 We can set the temperature and that’s what the temperature is going to be.
    1:23:35 There’s other implications which we can talk about in terms of hydrotherapy, perhaps, if
    1:23:35 we get to that.
    1:23:39 But the issue is, is we don’t like those extremes.
    1:23:40 We don’t like going out into the sun.
    1:23:44 And when we don’t do that, we suffer the consequences.
    1:23:48 Is there a way for me to get vitamin D without supplementation and without going into the sun?
    1:23:49 Yes.
    1:23:51 It’s in certain foods as well.
    1:23:57 Mushrooms, for instance, certain types of fish, they have vitamin D in them as well.
    1:24:00 This is a strange question.
    1:24:05 But do you think our body knows which foods we’re deficient in?
    1:24:10 And really what I’m saying there is, if I’m vitamin D deficient, do you think there’s a
    1:24:12 part of my body that knows that I need to eat mushrooms?
    1:24:13 That’s a good question.
    1:24:14 And that makes me hungry for mushrooms?
    1:24:16 I don’t know about that particularly.
    1:24:17 I can say this, though.
    1:24:25 In people who don’t get enough sleep, we tend to have a predilection to eating more carbohydrate-rich
    1:24:26 foods.
    1:24:27 That one we do know.
    1:24:33 And this is the reason why people who, this is the reason why many scientists believe that
    1:24:37 people who don’t get enough sleep tend to have food choices that tend to put weight on.
    1:24:43 Every single one of you watching this right now has something to offer, whether it’s knowledge
    1:24:44 or skills or experience.
    1:24:46 And that means you have value.
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    1:24:53 knowledge into a business through one single click.
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    1:25:39 Of these cards that we have left in front of us from the Newstart framework, which one are
    1:25:41 you compelled to talk about next?
    1:25:41 Water.
    1:25:42 Water?
    1:25:43 Yeah.
    1:25:47 Okay, so tell me what you mean by water, because people will think, yeah, I drink enough water.
    1:25:50 Well, first of all, I don’t think we do drink enough water.
    1:25:55 But everyone talks about, you know, the internal use of water, and it makes sense.
    1:26:01 But as I was talking about before, the external use of water can actually be very impressive.
    1:26:05 And it has to do with body temperature, and it has to do with the immune system.
    1:26:10 So we’ll talk about water, but let’s sort of set the framework for that conversation.
    1:26:14 Your immune system is broken up into two types.
    1:26:16 There’s the innate immune system and the adaptive.
    1:26:21 We’ve become very familiar with the adaptive immune system during COVID, because all of
    1:26:27 the talk was about antibodies and antigens, and the fact that SARS-CoV-2 was mutating, and
    1:26:32 would the vaccines that made antibodies against them be still functional?
    1:26:38 All of that, where we have like, where we literally have a key with a keyhole that it fits into and
    1:26:42 turns the lock, and these antibodies, and they fit, that’s all the adaptive immune system.
    1:26:49 It’s very important, but it completely eliminates or removes from discussion the innate immune
    1:26:50 system.
    1:26:53 The innate immune system is really the body’s first defense.
    1:26:59 And what’s happening there is there’s these cells that are circulating, cells like monocytes
    1:27:06 and natural killer cells and a number of other cells, which scour the body, always looking
    1:27:08 for something that looks foreign to it.
    1:27:16 And it can tell based on the molecular patterns of these invaders that they’re not supposed to
    1:27:18 be there, and they should be eaten up.
    1:27:26 The major effector of this innate immune system is something called interferon.
    1:27:35 Interferon is a very important molecule in the body, and it is effective, it is so effective
    1:27:43 at preventing viral infections that just about every single viral infection that plagues the
    1:27:47 human body today has a defense mechanism against interferon.
    1:27:49 It is a prerequisite.
    1:27:56 There’s no self-respecting virus that can think it’s going to infect the human body without
    1:28:00 dealing with the issue of interferon, period.
    1:28:04 Think about interferon as the security guard at the bank.
    1:28:09 And if you want to rob a bank, you’ve got to have a plan for how you’re going to deal with
    1:28:10 the security guard.
    1:28:11 Otherwise, you’re not getting the money.
    1:28:12 Does that make sense?
    1:28:13 Yeah.
    1:28:17 So there was actually an article that was published a couple of years ago where they
    1:28:23 talked about this battle between interferon and emerging viruses and what viruses are doing
    1:28:25 to try to get around interferon.
    1:28:31 You may recall that back in 2002, we had an outbreak of something called SARS, which especially
    1:28:34 was pretty bad in China, but also in Canada.
    1:28:41 The reason why we were able to secure that outbreak was because that everybody who came down
    1:28:43 with SARS developed a fever.
    1:28:50 And so it was easy to tell who those people were, and we were able to hospitalize and isolate
    1:28:50 them.
    1:28:57 The issue with SARS-CoV-2, and indeed many infections like the common cold, is that you don’t necessarily
    1:28:57 get a fever.
    1:29:02 And fever is really important.
    1:29:03 And you’re like, what does this have to do with water?
    1:29:04 We’re going to talk about this.
    1:29:09 Interferon production goes up with temperature.
    1:29:19 And in fact, the body’s fever mechanism is one of the ways that it tells the body that
    1:29:21 it needs to increase interferon to deal with the viral infection.
    1:29:23 Is that why you feel hot?
    1:29:24 You feel hot.
    1:29:26 You may actually feel cold.
    1:29:31 And the reason why you might feel cold and even have chills is because the way you feel
    1:29:36 is a product of what your temperature is and what your thermostat in your body is set to.
    1:29:44 So if your body’s thermostat is saying, okay, here we are at 98.6, or I guess in terms of
    1:29:51 Celsius, 37 degrees, and you develop an infection, the body’s going to say, whoa, we have an infection
    1:29:53 and we need to increase the body temperature.
    1:29:59 We’re going from 37 degrees or 98.6 up to 38 degrees or 100.4.
    1:30:05 Because your actual body temperature is below where your body wants it to be, you’re going
    1:30:05 to feel cold.
    1:30:08 You’re going to shiver to try to increase that temperature.
    1:30:09 So you go up with that.
    1:30:14 Now, once the fever is done and the infection is done and it comes down, you’re going to have,
    1:30:15 you’re going to break a sweat.
    1:30:19 So that’s why when someone, oh, he’s sweating, that means the fever is breaking.
    1:30:21 That means your temperature is coming down.
    1:30:23 So typically you’ll feel cold.
    1:30:24 You’ll feel like you’re shivering.
    1:30:27 You’ll want to get into bed and put the covers on.
    1:30:29 And that’s when your temperature goes up.
    1:30:31 And that’s for a reason.
    1:30:36 Because what happens when the temperature goes up in your body is that creates an environment
    1:30:38 where the virus can’t replicate very well.
    1:30:44 All viruses really cannot replicate very well at high temperatures, including SARS-CoV-2.
    1:30:50 It’s also a signal to your body to produce more interferon.
    1:30:55 So there was a study that was published last year where they looked in mice, which by the
    1:30:57 way, have the same body temperature as we do.
    1:31:03 And they found that there was like five different regulatory proteins, all of which led to one
    1:31:04 endpoint.
    1:31:06 And that was to produce this thing called interferon.
    1:31:15 All of them jumped in production when your body went from 37 degrees to 38 degrees.
    1:31:19 That’s basically right below a fever, right?
    1:31:25 So the point, the take-home point that I got from all of that was that we should not really
    1:31:30 be treating fevers unless they’re so high that there’s other complications that could occur
    1:31:35 like, you know, racing heart rates or having seizures.
    1:31:37 But we do this all the time.
    1:31:40 We treat fevers because it makes us feel bad.
    1:31:43 And we think that by treating the fever, we’ll feel better.
    1:31:48 But what we’re actually doing is we’re cutting the legs out from our immune system because part
    1:31:53 of the immune system response is to generate a fever and the fever generates interferon.
    1:31:59 Now, I don’t want to overstate this, but let’s compare the innate immune system to the adaptive
    1:31:59 immune system.
    1:32:05 The adaptive immune system is pretty specific for a particular variant of a virus.
    1:32:11 And for a virus that mutates very rapidly, like SARS-CoV-2, the immunization may be very
    1:32:12 good in terms of binding.
    1:32:19 But if that virus mutates, that binding is going to be affected in some way.
    1:32:23 It may not affect hospitalization, but maybe in terms of preventing infection.
    1:32:24 Do you understand what I’m saying?
    1:32:29 So the different variants, we had the alpha variant, then we had the delta variant, then
    1:32:31 we had Omicron, et cetera.
    1:32:35 Those are material changes for the adaptive immune system.
    1:32:40 For the innate immune system, for interferon, it doesn’t matter.
    1:32:46 Interferon is just as effective against alpha as it was for delta as it would be for Omicron.
    1:32:48 So let’s set this up again.
    1:32:49 Water.
    1:32:59 We said that water has a very high specific heat, which means that if I apply hot water onto
    1:33:01 the human body, it’s able to transfer heat.
    1:33:04 This is why people can get burned with boiling water.
    1:33:06 We don’t obviously want to burn anybody.
    1:33:10 But if we’re able to put them into a sauna, if we’re able to put them into a spa, if we’re
    1:33:15 able to use hot towels and apply it to the human body to heat up their body to cause a sweat,
    1:33:21 in other words, if we’re able to induce artificial fevers in patients who have these infections,
    1:33:27 there seems to be evidence that the interferon response will be better.
    1:33:31 There was a study that was done looking at lymphocytes and taking them out of the human body.
    1:33:37 And at different temperatures, once it hit about 38, 39 degrees, there was off the charts
    1:33:43 a tenfold increase in interferon, which is exactly what you would want to have.
    1:33:48 Now, how do I know that interferon levels are so important in things like COVID-19?
    1:33:53 Well, there was a study that was done that showed that high levels of interferon correlated
    1:34:02 with more mild SARS-CoV-2 infections, and that people that had low interferon levels had very
    1:34:04 severe COVID-19 infections.
    1:34:07 So you suggesting that we should be in the sauna more often?
    1:34:08 Yes.
    1:34:18 And it’s based on data that has been well documented in the Finnish sauna realm.
    1:34:28 So people who use sauna four, five, six, seven times a week are more likely to have less death
    1:34:32 from cardiovascular disease than people who use sauna once a week.
    1:34:34 And in Finland, once a week is kind of the standard.
    1:34:37 And why do they say to do hot and cold therapy together?
    1:34:45 So they would, I would argue that the reason why it has been argued to do this, and this
    1:34:50 goes back to a number of papers that have been written back over 100 years ago, is what you’re
    1:34:54 doing when you’re doing hot for a long period of time, let’s say 20 minutes in the sauna.
    1:34:59 And what you’re doing is you’re heating up the body, and the whole purpose of that is to
    1:35:01 increase the body temperature.
    1:35:06 What the cold at the end does is it does two things, they believe.
    1:35:09 The first thing that it does is it causes vasoconstriction.
    1:35:12 So you put a brief amount of cold onto the body.
    1:35:18 It’s going to cause vasoconstriction superficially so that when you’re done, you’re not going
    1:35:21 to lose as much heat through those blood vessels.
    1:35:26 And so you’re going to keep the core body temperature higher for long, which is exactly what you want
    1:35:26 to do.
    1:35:30 The other thing that cold water does, again, is the vasoconstriction.
    1:35:34 It’s well known that when you take a cold shower, your blood vessels constrict.
    1:35:41 And when you look at a blood vessel on end in a person who’s living and circulating, there
    1:35:46 are a number of white blood cells that are latched on to the inside surface of that blood vessel.
    1:35:52 When that blood vessel contracts, a lot of those white blood cells that were stuck get kicked
    1:35:56 off into circulation, and they go off and they do whatever it is that they’re going to do.
    1:35:57 It’s called demargination.
    1:35:59 So two things for cold right at the end.
    1:36:01 It doesn’t have to be very long, maybe just a minute.
    1:36:06 It causes actually to keep your body temperature higher for longer, ironically.
    1:36:08 And number two, demargination.
    1:36:12 So that’s water, which is the W.
    1:36:17 Of these, which one do you want to pick next?
    1:36:18 Which one do you find most compelling?
    1:36:22 Let’s talk about air real briefly.
    1:36:29 So we said that air is not just the lack of toxins, but actually benefits.
    1:36:31 So first of all, we want to have good oxygen.
    1:36:35 We want to get rid of carbon dioxide, especially in buildings when there’s no ventilation.
    1:36:36 That’s not good.
    1:36:42 But there’s been actually a number of studies looking at plants and trees and the fact that
    1:36:44 they can give off things like phytoncides.
    1:36:44 What’s that?
    1:36:49 These are aromatic compounds that the tree actually gives off.
    1:36:55 And when we look to see the effect of these compounds on the human body, they’re actually
    1:36:56 very beneficial.
    1:37:00 They interact with our immune system and elevate our immune system, and it actually can make
    1:37:00 us more relaxed.
    1:37:07 There’s a lot of data in the Japanese literature on this, in what they call the Hanoki cypress
    1:37:10 forests, where they looked at these CEOs.
    1:37:13 There’s a podcast about CEOs.
    1:37:15 There’s these CEOs in Japan.
    1:37:21 And they took them from their jobs and basically took them up into the mountains of the Hanoki
    1:37:23 cypress and had them walk around, took blood tests.
    1:37:28 And they found that the natural killer cells, which are so important in terms of immunity,
    1:37:36 were not only increased in number, but they were also the enzymes within them that break
    1:37:40 down diseases or viruses, were also increased.
    1:37:48 So when they brought them back down to the city in Japan, they put them up in hotels and
    1:37:55 they infused some of these chemicals, these naturally produced phytoncides, they’re called.
    1:38:01 And they had almost exactly the same effects in these subjects.
    1:38:05 So you think plants and being out in nature could actually be giving us much more than just
    1:38:06 clean air.
    1:38:09 It’s giving us chemicals which help us fight disease.
    1:38:09 Absolutely.
    1:38:12 So again, here’s this dichotomy.
    1:38:13 Inside versus outside.
    1:38:14 What do you get when you’re outside?
    1:38:16 We’ve already talked about exercise.
    1:38:19 We’ve already talked about sunlight.
    1:38:26 And now we’re adding to it fresh air, not just the fact that you have low pollutants, which
    1:38:30 is certainly very important, but the fact that when you’re around green plants, when you’re
    1:38:33 around green trees, there could actually be a benefit.
    1:38:37 By the way, the benefit that they found lasted for about seven days.
    1:38:42 So just going out one day a week can actually have that benefit.
    1:38:47 I think a lot about carbon dioxide, obviously because I spend a lot of time sat in the studio
    1:38:54 recording and this is our big LA studio, but in the UK, it started in a really small room
    1:38:55 and there wasn’t air conditioning.
    1:39:00 And obviously I sit here sometimes for several hours with a guest and we’re recycling CO2 at
    1:39:01 that point.
    1:39:01 Yes.
    1:39:05 And then I read a couple of studies that showed the impact that would have on my cognitive performance.
    1:39:06 Yes.
    1:39:07 That’s all true.
    1:39:13 We actually had on our channel with MedCram, we had Dr. Joseph Allen out of the Harvard
    1:39:17 Public School of Health and he showed us.
    1:39:23 I mean, he literally had the CO2 meter and just by cracking the window just a little bit
    1:39:27 allowed carbon dioxide to escape and brought down those carbon dioxide levels.
    1:39:28 So very important.
    1:39:28 Absolutely.
    1:39:34 And for people that work in offices or travel in hotel rooms or are inside a lot, what should
    1:39:38 they be thinking about and how can they go about making sure that the air quality is optimal?
    1:39:42 Well, the surrogate for that is carbon dioxide, as we mentioned.
    1:39:47 So cracking open a window if they’re able to, if there’s a door that they can open up safely
    1:39:49 without compromising security.
    1:39:57 These are all things that would be very beneficial, even rolling down the window in the car and maybe
    1:40:02 making sure that we’re taking that recirculation button off when we’re driving.
    1:40:06 I’ve got friends that won’t stay in certain hotel rooms unless the window opens, because
    1:40:10 you know, in a lot of hotel rooms, especially ones that are high up, you can’t open the windows.
    1:40:16 And there’s also a bunch of devices that we, in our UK studio, which is smaller, we found
    1:40:19 on Amazon for, you know, not super expensive, that we just sometimes put on the floor in the
    1:40:21 studio just to see how we’re doing.
    1:40:25 I’ll link some of that stuff on screen if anyone’s interested in getting, seeing what the
    1:40:27 CO2 levels are in whatever room you’re working in.
    1:40:27 Yeah.
    1:40:30 What is, what’s next on your list then here?
    1:40:33 Well, we’ve talked about, I mean, exercise, nutrition, temperance.
    1:40:35 These are things that a lot of people talk about.
    1:40:36 Not many people talk about trust.
    1:40:39 When you say trust, you really mean religious faith?
    1:40:47 Religious faith, something that would give you a way of dealing with stress and anxiety.
    1:40:49 That’s really where this comes down.
    1:40:52 And there’s been actually a number of studies that have looked at that.
    1:40:54 So, yeah, basically the Bible.
    1:40:57 Or it doesn’t have to be the Bible as well.
    1:41:02 There’s other faith denominations that look into this as well.
    1:41:09 A number of studies that have looked at trust in God and how that relates to anxiety.
    1:41:15 So a number of studies have shown that people who have a good faith and trust in a God that
    1:41:21 is, or in a religion that is supportive and not non-supportive, can they have less anxiety,
    1:41:27 less depression, have a faith community that they can engage with and be supportive.
    1:41:34 And I think that that’s, that the literature is, whereas you have, the science behind that
    1:41:37 is not as strict as it would be for like a randomized placebo-controlled trial.
    1:41:42 There’s a lot of associations that you have to say here that it certainly is one of those
    1:41:45 pillars that I believe helps with all of those links.
    1:41:46 What do you think is going on there?
    1:41:52 So you’re telling me that from what the literature is saying, people who have a faith in a God
    1:41:57 are insulated from depression and anxiety in some interesting way?
    1:42:01 Yeah, that’s a question that a lot of people have tried to answer.
    1:42:07 And they believe that it comes down to if you have a trust in a God that is looking out for
    1:42:10 you and is there on your side.
    1:42:17 Then that type of a relationship does lead, is associated, let’s say, I shouldn’t say does
    1:42:18 lead to, because that implies causation.
    1:42:24 Let’s say it’s associated with a reduction in depression, a reduction in anxiety, particularly.
    1:42:32 There are some studies that have been done, particularly in Christianity, where there
    1:42:33 was a study that was published.
    1:42:40 This is Krauss and out of, I believe, University of Texas, where he did a survey and he asked
    1:42:42 people how they forgive.
    1:42:48 And he basically divided them to two different groups.
    1:42:52 There were people that would forgive conditionally and people that would forgive unconditionally.
    1:42:53 Let me put it into practical terms.
    1:42:58 If someone does something to you and you say, oh, that’s okay, I forgive you, the question
    1:42:59 is, would you forgive that?
    1:43:04 There are some people that would only forgive if that person came back and, you know, did
    1:43:06 some sort of act of contrition.
    1:43:07 Like, okay, I’ll forgive that person.
    1:43:08 They came back and apologized.
    1:43:10 Or I’ll forgive that person.
    1:43:12 They came back and they did, you know, whatever it is.
    1:43:14 That would be considered conditional forgiveness.
    1:43:18 The other type is unconditional forgiveness.
    1:43:21 So in other words, someone does something to you, you don’t see them again.
    1:43:27 Or they’ve never expressed any kind of, you know, being apologetic for what they did.
    1:43:28 They still get forgiven.
    1:43:30 So that’s unconditional forgiveness.
    1:43:37 What they found in the study when they divided that is that the people that forgave unconditionally
    1:43:41 had less depression.
    1:43:44 They had less feelings of inadequacy.
    1:43:47 They had less anxiety regarding end of life.
    1:43:53 They had all of these, they had more, the people that forgave conditionally had more
    1:43:55 somatization of depression.
    1:44:01 So these were real medical, you know, things that they could actually diagnose with surveys
    1:44:03 and tests that are well validated.
    1:44:07 And what would decide between these two was how they forgave.
    1:44:11 So they were puzzled by this.
    1:44:14 They said, well, what, well, then what determines whether or not someone is going to forgive
    1:44:16 conditionally versus unconditionally?
    1:44:19 So they looked at a bunch of factors and none of them stood out except for one.
    1:44:22 And, and the odds ratio on this was like 2.5.
    1:44:25 And, and it boiled down to this one question.
    1:44:30 Do you believe that God has forgiven you?
    1:44:33 That was, that was the major thing.
    1:44:39 If, if somebody believed that the God that they had faith in had forgiven them, they were
    1:44:43 two and a half times more likely to, to forgive somebody unconditionally.
    1:44:45 Which then meant?
    1:44:50 Which then was associated with all of these other things being low, like less depression,
    1:44:51 less anxiety.
    1:45:00 So to me, that, that’s, that’s, that’s fascinating that, that in their minds, this is what’s actually
    1:45:00 happening.
    1:45:05 And so there have been randomized controlled trials where they have, when people are doing
    1:45:09 therapy, like you say, have you have anxiety, there is cognitive behavioral therapy that we
    1:45:10 can do for those people.
    1:45:17 But what has been shown in a randomized placebo controlled fashion is that if somebody is of
    1:45:26 a faith and you inject into that cognitive behavioral therapy aspects of that faith, the cognitive behavioral
    1:45:27 therapy is even more effective.
    1:45:38 So I guess I should preface this by saying, I don’t believe that any of this stuff should
    1:45:40 be placed on people without their permission.
    1:45:43 So I’m working, I work in a healthcare environment.
    1:45:48 So do I go and pray for people who don’t believe?
    1:45:49 No.
    1:45:51 This is something that, that always has to be done.
    1:45:53 It has to be asked permission.
    1:46:00 Do you think people who believe in God are healthier generally?
    1:46:01 All other factors?
    1:46:08 It would seem the data would indicate that people who have a healthy relationship with
    1:46:14 their church, who have a healthy relationship in God are associated with less disease.
    1:46:17 Because from a causation point of view, you could say, well, causation, yeah.
    1:46:20 So this, this is what we don’t, we, they probably have more friends.
    1:46:21 They probably have, yeah.
    1:46:28 So the question is, is whether or not people who are healthier and have more friends are more
    1:46:31 likely to be religious, or is it the other way around?
    1:46:34 And sometimes it’s difficult to tell those things.
    1:46:39 But I imagine there’s a great calming force that comes from believing in a higher power.
    1:46:40 Absolutely.
    1:46:42 And the other thing that, the other thing that’s interesting about all of these like
    1:46:49 new start stuff is when you look at other particular religions, how a lot of these
    1:46:51 things are actually incorporated in this.
    1:46:55 Like for instance, the Hindus are very famous for getting up in the morning and welcoming the
    1:46:55 sun.
    1:46:58 We just talked about the benefits of, of sunlight.
    1:47:02 We didn’t talk too much about nutrition, but fasting is, is an important part of that.
    1:47:07 And, and, and Muslims are, are obviously, um, uh, part of their religion is actually doing
    1:47:08 fasting during Ramadan.
    1:47:12 Lots of religions have hot and cold practice as well, don’t they?
    1:47:12 Yes.
    1:47:12 Yeah.
    1:47:18 And on the flip side of that, I would say that it’s also shown that if you have a unhealthy
    1:47:23 relationship, like if you have, if you believe in a God who is vindictive or who’s out to
    1:47:27 get you or who’s going to do something to you unless you do something else, that has also
    1:47:29 been shown to be negatively impactful.
    1:47:34 So it depends on the relationship that you’ve got.
    1:47:35 What do you see in your practice?
    1:47:38 Because you said something earlier that you, you’re often there at the end of people’s
    1:47:39 lives.
    1:47:39 Yeah.
    1:47:47 Uh, some, unfortunately, sometimes I’m the last person they see and, and it’s, you start
    1:47:53 to realize that you cannot, I mean, that death is inevitable and all we do in medicine is
    1:47:54 delay the inevitable.
    1:48:02 So what we try to do and, and, and I have a colleague who’s very philosophical about this
    1:48:07 is we try to make sure that when these things happen, that they happen with dignity and we
    1:48:12 celebrate the person’s life and, and making sure that it’s done in the way that they would
    1:48:12 want to have it done.
    1:48:16 What do people say as they’re about to die?
    1:48:21 People become very, very, it’s very different, uh, for, for different people, but, uh, they
    1:48:27 can become very circumspect and, and, uh, I’ve seen such, such contrasts.
    1:48:28 People are ready to go.
    1:48:33 People feel like they’ve, they’ve done what they’ve come to do and, uh, they don’t want
    1:48:34 anything further to do.
    1:48:38 Like we’re, we’re there to, to, to, to, to delay death, right?
    1:48:41 We’re there to put them on a ventilator or to give them this medication.
    1:48:47 And you would be surprised people who are, look, you know, relatively healthy, but, and
    1:48:49 something has happened that we could easily correct.
    1:48:51 They’re like, no, I, I, I don’t want that.
    1:48:53 I, I choose not to have that.
    1:48:56 And we have to respect obviously what they, what they choose.
    1:48:59 Obviously we have to educate them to make sure that they’re making the right choice.
    1:49:04 But once, once they’re given all the information, ultimately they’re the one that makes the
    1:49:04 decision.
    1:49:06 So you see people choose death.
    1:49:11 When we can intervene in artificial ways, they would rather not have.
    1:49:12 that and they would choose death.
    1:49:13 Yes.
    1:49:15 Are there any particular cases that changed you?
    1:49:16 Yeah.
    1:49:17 Yeah.
    1:49:21 There’s, there’s, there’s a case that changed me, but not in the way that we’ve just been
    1:49:22 talking about where it was horrible.
    1:49:24 This is, this is actually a miracle.
    1:49:26 I’ve actually seen a miracle happen.
    1:49:29 And for me, it happened early in my training.
    1:49:34 So it, it, it made me think twice about being a prognosticating physician.
    1:49:36 A prognosticating physician.
    1:49:36 Yeah.
    1:49:40 Saying, oh, you’re never going to walk again, or, or you’ve only got two years to live.
    1:49:42 I must’ve missed that day in med school.
    1:49:44 I just didn’t show up that day.
    1:49:45 This was a young guy.
    1:49:52 He was, he had, he had testicular cancer and he went to the operation.
    1:49:54 The testicular cancer surgery was a success.
    1:49:58 Unfortunately, during the operation, something happened.
    1:49:59 He didn’t get enough oxygen to the brain.
    1:50:03 And he came out of the operation with, with anoxic injury of the brain.
    1:50:08 This guy must’ve been in his twenties and he had a young wife.
    1:50:14 And I had come onto the rotation as a, as a, as a, as a resident.
    1:50:20 And we had attendings and you have to realize in medicine, you have attendings above you.
    1:50:23 And what they say is just, you know, that’s, that’s the word.
    1:50:23 That’s what happens.
    1:50:27 And, and the ICU attend, and we were the ones that were sort of taking care of the patient
    1:50:28 because he was on a ventilator.
    1:50:32 But there was the neuro neurologist who looked at everything and says, look, this guy is not
    1:50:33 waking up.
    1:50:35 He has severe anoxic brain injury.
    1:50:37 We’ve looked at the scans.
    1:50:38 This is what’s going to happen.
    1:50:47 And so, um, every day we’d run on this guy and he was just, he was just a shaking mess.
    1:50:47 He was just there.
    1:50:48 He was just kind of shaking.
    1:50:50 His eyes were rolling, no response, nothing.
    1:50:59 And every day his wife would come in and wife, and she, uh, she just didn’t believe that this
    1:51:01 guy was going to be like this for the rest of his life.
    1:51:02 He was going to wake up eventually.
    1:51:07 And so she, he would, she would be at his bedside, like attending to him and making sure
    1:51:11 this, that, and the other, and even asking us to put, you know, some special concoction
    1:51:15 that she made at home into his tube feeding so that this could go and help him make him
    1:51:15 better.
    1:51:19 And we would, we would go along with her, but I was looking into my attendings and they’re
    1:51:22 like, she’s, she does, she doesn’t understand what’s going on.
    1:51:23 She doesn’t understand that he’s never going to wake up.
    1:51:27 So this is, this is what I’m seeing.
    1:51:32 One day she came in and she’s, and she just had this smile on her face.
    1:51:35 She was just so at peace and a smile.
    1:51:37 And, uh, they were Hispanic couples.
    1:51:39 So we had to ask a translator what was going on.
    1:51:44 And she told us, she said, um, I had a dream last night.
    1:51:47 I had a dream that he was going to come home.
    1:51:53 And she was convinced, just absolutely happy, beaming.
    1:51:56 And we’re like, man, this lady is, is crazy.
    1:51:57 She doesn’t understand what’s going on.
    1:52:02 Well, days went on, weeks went on.
    1:52:07 And, uh, one day, uh, and where I was rounding, it was, it’s just in this round nursing, nursing
    1:52:11 stations in the middle and the doors to the rooms are all around in a periphery.
    1:52:14 And we were going around the circle rounding on the patients.
    1:52:18 And I could look in and I saw him and he was kind of shaking, but he was kind of opening his eyes.
    1:52:22 And I said, he seems to be focusing a little bit.
    1:52:25 His eyes seem to be focusing a little bit more than they would be.
    1:52:30 And he kind of, I, I just said, I just kind of put my hand up like this.
    1:52:36 And I just kind of, and sure enough, he put his hand up like this shaking and he put it back
    1:52:36 down again.
    1:52:37 I’m like, what?
    1:52:38 He waved at you.
    1:52:38 Yeah.
    1:52:40 What?
    1:52:43 And I said, let’s go check this out again.
    1:52:47 Long story short, took months.
    1:52:51 But that guy walked out of that hospital.
    1:52:57 Six months later, he and his wife came back, walked onto the unit, like, like there was
    1:52:58 nothing wrong with the guy.
    1:53:05 And he gave us a big basket of flowers to thank that unit for what they had done for him.
    1:53:11 In my mind, I knew that for most of that staff, for most of that time, there were people were
    1:53:15 just going through the motions, keeping him alive, because that’s what she wanted.
    1:53:19 Obviously, when, when there were signs that this guy was recovering, it was, it was complete
    1:53:20 shift.
    1:53:21 People were amazed.
    1:53:30 And so what that did to me in my career was it made me think twice, like, what, why did
    1:53:31 this guy get better?
    1:53:33 Now, he was 22.
    1:53:33 He was young.
    1:53:37 And, and typically, if something like that is going to happen, it’s going to happen in
    1:53:42 someone who’s very young, whose mind is plastic, who can, who can survive that type of a situation.
    1:53:46 But it really, it was a miracle.
    1:53:48 I can’t, I can’t say anything else.
    1:53:51 I mean, it’s not something that we would know, all of the experts said that this wasn’t going
    1:53:52 to happen, but it happened.
    1:53:53 What do you think happened?
    1:53:58 I think he had a loving wife who believed in him.
    1:54:04 And something happened outside of the physical and the mental, maybe the spiritual.
    1:54:05 I don’t know.
    1:54:07 It happens.
    1:54:09 It’s very rare.
    1:54:11 And when it does happen, it happens in young people.
    1:54:13 That would be what the medical part of my brain would say.
    1:54:16 But the other part of my brain says, you know what?
    1:54:20 I only know about 10%, maybe 5% of the world’s knowledge.
    1:54:20 No.
    1:54:23 World’s knowledge, 1% of the world’s knowledge.
    1:54:26 Maybe I have 5% to 10% of all of the medical knowledge in this world.
    1:54:32 And I would say probably the explanation is somewhere in that other 80% to 90% that I
    1:54:33 just don’t know.
    1:54:38 I think what it taught me was, is that we have to be humble about what it is that we know.
    1:54:41 There’s things that we know, we know.
    1:54:44 And there’s things that we don’t know, that we don’t know.
    1:54:48 We talked a little bit about this chemical earlier on melatonin.
    1:54:48 Yeah.
    1:54:51 I just wanted to close off because I had a question on it.
    1:54:55 A lot of people take melatonin supplements at nighttime to help them sleep.
    1:54:56 Yes.
    1:54:58 Good, bad, and different?
    1:55:00 I think it’s good in certain situations.
    1:55:05 So if you’re having difficulty falling asleep, a little tiny dose of melatonin,
    1:55:08 no more than 5 milligrams, can be actually very beneficial.
    1:55:13 If you’re wanting to shift your circadian rhythm back instead of it being pushed back,
    1:55:17 but you want it to be advanced forward, melatonin can be very beneficial.
    1:55:19 That’s very beneficial for jet lag.
    1:55:22 It’s also beneficial for a few sleep diseases,
    1:55:25 but I would not recommend routinely, for no other reason,
    1:55:27 taking large doses of melatonin.
    1:55:27 What’s the trade?
    1:55:31 You said earlier on that everything has side effects, right?
    1:55:32 And it impacts another part of it.
    1:55:36 So taking high doses of melatonin can actually make you more irritable.
    1:55:37 Irritable?
    1:55:38 Irritable, yeah.
    1:55:39 In what regard?
    1:55:40 Just mentally irritable.
    1:55:41 Yeah.
    1:55:42 What does that look like?
    1:55:45 Things set you off more easily.
    1:55:47 So like a mood disorder?
    1:55:48 Yeah, absolutely.
    1:55:50 Anything else with melatonin that you’re aware of?
    1:55:52 Not that we have studies for.
    1:55:59 People have concerns that sometimes taking too much melatonin may actually affect the melatonin
    1:56:01 secretion from the pineal gland itself.
    1:56:04 I don’t have evidence of that as yet to see if that’s actually the case.
    1:56:09 Dr. Roger, is there anything else that we haven’t discussed that we should have discussed?
    1:56:12 We’ve discussed a lot.
    1:56:18 I think putting it all together is, again, the links.
    1:56:24 And if we have those links, medications have their place.
    1:56:30 But the way that they work is by breaking down other parts of the chain to strengthen the
    1:56:31 weak chain.
    1:56:35 That can have an effect, especially at the end of life, if you want to sustain life.
    1:56:40 But if you’re interested in longevity, if you’re interested in making and living the best life,
    1:56:43 then you want to strengthen all of those chains.
    1:56:47 And I believe the key to doing that is something called New Start.
    1:56:51 We have a closing tradition on this podcast where the last guest leaves a question for the next guest,
    1:56:52 not knowing who they’re leaving it for.
    1:56:56 And the question that was left for you is,
    1:57:00 What is the area of your focus that you are most dying to talk about,
    1:57:03 which you are almost never asked about?
    1:57:09 This book, the Bible, which is my tradition.
    1:57:17 Evidence for science in the Bible.
    1:57:19 What do you mean?
    1:57:28 What we’ve been talking about is the body and the health in the body.
    1:57:34 I’d like to put to the test some of the statements in the Bible to see if they work scientifically.
    1:57:37 Like turning water into wine?
    1:57:39 No, well, potentially.
    1:57:40 That’s a miracle.
    1:57:44 What I was referring to is this.
    1:57:46 And this is what I’ve actually done, and it’s actually quite interesting.
    1:57:51 is, you know, Paul, who is one of the New Testament writers in the Bible,
    1:57:53 wrote to the Corinthians,
    1:57:59 Don’t you understand that your body is the temple of the Holy Spirit?
    1:58:03 I said, That’s a really interesting statement.
    1:58:06 How would he come to that conclusion?
    1:58:09 Like, what does that mean, the temple of the Holy Spirit?
    1:58:15 So, the only temple at that time was the temple in Jerusalem where they would have the sacrifices and things.
    1:58:20 So, what I did was, I went back, and this is answering the question is,
    1:58:28 I’m looking for evidence of scientific truth, probably unknowingly, by some of the writers in the Bible,
    1:58:30 to see whether or not there is truth.
    1:58:32 Does that make sense, what I’m saying?
    1:58:46 So, if you look at most of Exodus 25 through 30 is this painstakingly detailed description of the sanctuary that Moses built in the wilderness that he supposedly he got from God.
    1:58:47 This is what he says.
    1:58:51 So, here’s a great way to see whether or not this all fleshes out.
    1:58:55 Moses is saying, Here’s the description of the pattern that I got for the temple.
    1:58:59 And Paul is saying, Your body is a temple.
    1:59:01 So, here’s my hypothesis.
    1:59:11 If we look at the pattern in the temple, should it match the human body that they had no understanding of at the time that Paul wrote this?
    1:59:15 We didn’t know about cells until Van Leeuwenhoek in the 1600s.
    1:59:22 We didn’t know about the circulation of the heart until the 1600s with William Harvey.
    1:59:29 Yet, if you look in the human body, you have the blood system.
    1:59:32 You have blood circulating around in the vascular system.
    1:59:35 And then it goes into the interstitial fluid.
    1:59:43 And then the interstitial fluid then goes to the cell, which is, there’s a plasma membrane on the cell that you can’t penetrate through,
    1:59:45 but unless you actually have the proteins to go.
    1:59:50 And then it goes into the cell, which is a compartment with two compartments within it, right?
    1:59:52 You’ve got the cell and the nucleus, right?
    1:59:57 This is exactly the same structure that Moses was given in the wilderness.
    2:00:02 And by the way, Hindu temples are actually similarly designed.
    2:00:04 There’s sort of this three-part situation.
    2:00:09 So, you have this altar of sacrifice, which is where the blood is.
    2:00:12 That’s the blood in the human body.
    2:00:17 Next, you move to the laver, which is this container full of water.
    2:00:22 And that’s the interstitial space after you go from the blood into the interstitial space.
    2:00:25 Any pharmacologist will know that this is exactly the pattern that you move to.
    2:00:33 The next thing that comes is this structure that has a veil that you can’t penetrate through unless you go through it.
    2:00:39 That’s the cell because this structure is the building and it’s got a room within a room.
    2:00:41 And that’s exactly what the cell is.
    2:00:44 The cell is this nucleus surrounded by the cytoplasm.
    2:00:56 Well, in this room that you go into at first, there’s pieces of furniture in there that are very similar to the types of organelles that you see in the cytoplasm itself.
    2:01:02 For instance, there’s this seven-branch candlestick that’s in there that’s burning olive oil and producing energy.
    2:01:04 That’s like beta-oxidation producing energy.
    2:01:06 That’s exactly what you see in the mitochondria.
    2:01:09 But the final thing is you move into the nucleus.
    2:01:17 And this temple has something called the Most Holy Place where there’s this altar of – where there’s this Ark of the Covenant.
    2:01:18 You’ve seen Indiana Jones, right?
    2:01:18 Yeah.
    2:01:21 And the first – Raiders of the Lost Ark.
    2:01:26 There’s this Ark and you open it up and this is where the two tablets of stone, the Ten Commandments, rested.
    2:01:39 So in that area, you have two tablets of stone written by the hand of God, the code of life.
    2:01:49 And according to Jewish and Christian belief that this is the law, and if you break the law, that’s how sin is and the consequences of sin is disease and death.
    2:01:55 Well, when we get to the nucleus of the human body, you have two strands of DNA.
    2:02:02 And on the strands of DNA is the code, the nucleotides, of which is the code of life.
    2:02:08 If you manipulate that code, that leads to mutations, which leads to disease and death.
    2:02:13 None of this was known until 1950 when they discovered DNA.
    2:02:21 And yet we have Paul who’s making this jump and saying, your body is the temple of the Holy Spirit.
    2:02:24 I just find that fascinating.
    2:02:26 Nobody ever asked me about that.
    2:02:30 But that’s – as soon as you ask that question, that’s the first thing that pops up.
    2:02:35 By the way, there’s so many other places in the scriptures where I see that alluded to.
    2:02:37 It’s fascinating.
    2:02:42 Paul talks about the body of Christ and how it’s one body, but it’s made up of parts.
    2:02:44 There’s the hand, the foot.
    2:02:48 He didn’t know about cells, but that’s exactly what the human body is.
    2:02:50 The human body is one body made up of many parts.
    2:02:53 Van Leeuwenhoek didn’t discover that until the 1600s.
    2:02:56 We didn’t have cell theory until the 1800s.
    2:03:01 So this is – it’s interesting to me how statements are made in ancient texts,
    2:03:05 which have scientific relevance far below the surface.
    2:03:07 I just find that interesting.
    2:03:08 Thank you so much.
    2:03:10 And I hope to speak to you again very, very soon.
    2:03:15 And thank you for all the work you’re doing because you’ve made some of these difficult scientific subjects so unbelievably accessible.
    2:03:19 You have a real art for simplifying.
    2:03:25 And simplifying in a way, that means that millions of people – you’ve got millions of subscribers on your YouTube channel.
    2:03:30 Millions of people can access this information, which is often confined within the walls of some academic study.
    2:03:36 So thank you for the work you’re doing because it’s going to – I’m sure it’s really had a profound impact on many, many millions of people’s lives.
    2:03:38 And I’m sure my audience are deeply appreciative.
    2:03:39 So thank you so much, Roger.
    2:03:39 I appreciate you.
    2:03:40 Thank you, Stephen.
    2:03:42 Thank you for having me on and having this opportunity.
    2:03:46 Make sure you keep what I’m about to say to yourself.
    2:03:50 I’m inviting 10,000 of you to come even deeper into the diary of a CEO.
    2:03:53 Welcome to my inner circle.
    2:03:56 This is a brand new private community that I’m launching to the world.
    2:04:00 We have so many incredible things that happen that you are never shown.
    2:04:03 We have the briefs that are on my iPad when I’m recording the conversation.
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    2:04:30 So if you want to join our private closed community, head to the link in the description below.
    2:04:34 Or go to doaccircle.com.
    2:04:35 I will speak to you there.
    2:04:39 Quick one before we get back to this episode.
    2:04:40 Just give me 30 seconds of your time.
    2:04:42 Two things I wanted to say.
    2:04:46 The first thing is a huge thank you for listening and tuning into the show week after week.
    2:04:48 It means the world to all of us.
    2:04:52 And this really is a dream that we absolutely never had and couldn’t have imagined getting to this place.
    2:04:56 But secondly, it’s a dream where we feel like we’re only just getting started.
    2:05:04 And if you enjoy what we do here, please join the 24% of people that listen to this podcast regularly and follow us on this app.
    2:05:06 Here’s a promise I’m going to make to you.
    2:05:11 I’m going to do everything in my power to make this show as good as I can now and into the future.
    2:05:14 We’re going to deliver the guests that you want me to speak to.
    2:05:17 And we’re going to continue to keep doing all of the things you love about this show.
    2:05:19 Thank you.
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    2:05:43 Thank you.
    Ông ấy chỉ còn hai ngày nữa để sống. Đây là câu chuyện về một cậu bé 15 tuổi bị chẩn đoán mắc bệnh ung thư máu, nhưng cậu đã phát triển một nhiễm trùng ăn mòn trong phổi. Cậu ấy sẽ không qua khỏi. Vì vậy, cậu có một yêu cầu duy nhất. Cậu muốn ra ngoài, và đó chính xác là điều họ đã làm. Điều này thực sự khiến tôi choáng váng. Sau ngày thứ hai, nhiễm trùng có lẽ đã giảm khoảng 60%, 70%. Và tôi nhận ra rằng ánh sáng mặt trời có rất nhiều lợi ích quan trọng. Ví dụ, nếu bạn nằm trên giường gần cửa sổ, bạn sẽ được xuất viện nhanh hơn. Vì vậy, tôi muốn bạn cung cấp cho tôi bất kỳ thông tin nào bạn có liên quan đến sức khỏe ánh sáng. Ví dụ, bạn có khuyến nghị những điều như vậy không? Tiến sĩ Roger Seaholt là một bác sĩ chuyên khoa chăm sóc sức khỏe tích cực có chứng chỉ hội đồng, người khiến khoa học phức tạp trở nên dễ hiểu và cung cấp những lời khuyên cứu sống. Tôi thấy những người ở giai đoạn cuối của cuộc đời, vì vậy tôi biết điều gì ngăn cản họ không bị bệnh nặng như vậy và cách kéo dài sự sống. Vậy hãy tóm tắt thành tám trụ cột. Điều đầu tiên, tập thể dục. Nó giúp giảm nguy cơ đột quỵ. Nó giúp giảm trầm cảm. Tiếp theo, ánh sáng mặt trời. Bạn có biết rằng ánh sáng hồng ngoại từ mặt trời có thể thâm nhập tới khoảng tám milimet và kích thích và tăng cường melatonin, giúp ngăn ngừa nhiều bệnh như chứng mất trí nhớ, bệnh tim mạch, tiểu đường? Thế nếu bạn sống ở một quốc gia nhiều mây thì sao? Có một số điều vô cùng hữu ích mà bạn có thể làm, và chúng ta sẽ nói về điều đó. Điều tiếp theo, nước. Ví dụ, những người sử dụng xông hơi có khả năng ít bị tử vong vì bệnh tim mạch hơn. Tiếp theo, không khí. Có những nghiên cứu cho thấy chỉ cần ra ngoài một ngày trong tuần cũng có thể tăng cường hệ thống miễn dịch và làm chúng ta thư giãn hơn. Và rồi có… Nhưng cuối cùng là niềm tin. Đây là điều không thể bỏ qua vì các nghiên cứu đã chỉ ra rằng những người có đức tin và tin tưởng vào Chúa là… Một điều nhanh chóng, trước khi chúng ta quay lại tập này, chỉ cần cho tôi 30 giây thời gian của bạn. Có hai điều tôi muốn nói. Điều đầu tiên là một lời cảm ơn lớn vì đã lắng nghe và theo dõi chương trình tuần này qua tuần khác. Điều này có ý nghĩa rất lớn với tất cả chúng tôi, và thực sự là một giấc mơ mà chúng tôi chưa bao giờ có và không thể tưởng tượng ra được việc đến được nơi này. Nhưng thứ hai, đó là một giấc mơ mà chúng tôi cảm thấy như chúng tôi chỉ mới bắt đầu. Và nếu bạn thích những gì chúng tôi làm ở đây, xin hãy tham gia vào 24% người thường xuyên lắng nghe podcast này và theo dõi chúng tôi trên ứng dụng này. Đây là một lời hứa mà tôi sẽ làm với bạn. Tôi sẽ làm mọi thứ trong khả năng của mình để làm cho chương trình này tốt nhất có thể ngay bây giờ và trong tương lai. Chúng tôi sẽ mang đến những vị khách mà bạn muốn tôi trò chuyện cùng, và chúng tôi sẽ tiếp tục làm tất cả những điều bạn yêu thích về chương trình này. Cảm ơn bạn. Tiến sĩ Roger Schwelt, với công việc mà bạn làm, bạn đang nhằm đạt được điều gì? Ngoài những nhiệm vụ lâm sàng của tôi, và có thể cả một phần trong đó, tôi muốn giải thích rõ ràng những công cụ dễ hiểu mà có thể áp dụng để giúp mọi người sống tốt nhất có thể. Và điều đó đặc biệt liên quan đến sức khỏe và sự an lành của họ. Khi chúng ta đi sâu vào sức khỏe và sự an lành, vì đó là một khái niệm khá rộng, thì điều gì trong sức khỏe và sự an lành mà bạn đã dành sự nghiệp và cuộc sống của mình để tập trung vào? Tôi là một chuyên gia y khoa nội khoa đã được chứng nhận. Sau đó, tôi đã trải qua ba năm đào tạo bổ sung ở đây tại Hoa Kỳ về bệnh phổi và chăm sóc tích cực. Vì vậy, tôi xử lý tất cả các vấn đề liên quan đến phổi và khía cạnh chăm sóc tích cực. Nếu bạn nhập viện và đang bị ốm nặng, bạn sẽ vào đơn vị chăm sóc đặc biệt, và tôi là bác sĩ mà bạn sẽ gặp. Tôi đặt đường truyền tĩnh mạch, dùng thuốc vận mạch, đặt ống nội khí quản cho họ. Hôm nay tôi đã làm việc ở phòng khám. Và có những điều nào mà hầu hết mọi người không nghĩ đến? Bởi vì chúng ta nghĩ về việc, bạn biết đấy, không ăn thực phẩm chế biến sẵn và tập thể dục. Nhưng có những điều ngoài những điều đó mà bạn cho rằng người bình thường không đánh giá cao đủ không? Có, chắc chắn rồi. Những điều đó là gì? Nếu chúng ta nhìn vào những điều kéo dài tuổi thọ và có lợi, chúng ta có thể phân loại chúng vào những gì tôi gọi là tám trụ cột sức khỏe. Nếu bạn có thể tưởng tượng cuộc sống của bạn như một chuỗi với nhiều mắt xích, được chưa? Tôi đang nói về mặt y tế, mỗi mắt xích đó là một hệ thống cơ quan. Vì vậy, trái tim của bạn là một mắt xích, phổi của bạn là một mắt xích, gan của bạn là một mắt xích, thận của bạn v.v. Khi bạn trải qua cuộc sống, hãy tưởng tượng rằng những mắt xích đó bắt đầu erode đến một thời điểm nào đó trong cuộc đời bạn, bạn sẽ mắc phải một loại bệnh hoặc chẩn đoán nào đó chỉ tập trung vào một hệ thống cơ quan trong cuộc sống của bạn. Đối với nhiều người ở Hoa Kỳ và Vương quốc Anh, đó là trái tim. Và khi mắt xích đó ngày càng bị erode, chúng ta có thể thấy rất rõ ràng rằng đây sẽ là mắt xích bị đứt trước tiên. Do đó, sự chú ý được tập trung vào mắt xích đó. Đối với nhiều người, chẩn đoán đó đi kèm với thuốc men. Vậy đây là một trong những sự thật đầu tiên mà tôi muốn nói tiếp theo. Tất cả thuốc men đều có tác dụng phụ. Và mục tiêu trong y học hiện đại là sử dụng kiến thức về những loại thuốc đó và ảnh hưởng của chúng đối với cơ thể con người để khai thác những mắt xích còn lại nhằm bảo vệ mắt xích yếu nhất. Vì vậy, tôi có thể đưa ra một loạt các loại thuốc mà tôi thường xuyên cho bệnh nhân trong đơn vị chăm sóc đặc biệt, nơi tôi tập trung vào việc cứu sống họ bởi vì tôi có thể thấy rõ ràng mắt xích nào là yếu nhất. Nhưng tôi làm điều đó với sự hiểu biết rằng có tác dụng phụ vì tôi đang cố gắng cứu mắt xích đó để bảo vệ sự sống đó. Và tôi đang sử dụng những điều khác. Ví dụ, có người vào viện do đột quỵ. Họ đã bị yếu một bên cơ thể, bên phải hoặc bên trái, bên nào cũng được. Tôi có thể cho họ một loại thuốc ngay lập tức giúp phá vỡ tất cả các cục máu đông trong cơ thể họ. Nó được gọi là TPA hoặc TNK. Và nó sẽ phục hồi dòng máu đến não. Và nếu họ đến kịp thời, chúng tôi có thể thực hiện điều này.
    Điều đáng kinh ngạc là loại thuốc đó có tác dụng có thể làm được điều này. Nhưng nó cũng có một tác dụng phụ khá nghiêm trọng là nó có thể làm tan cục máu đông ở nơi khác và gây ra chảy máu. Vì vậy, chúng ta phải cẩn thận về những gì chúng ta đang làm. Rõ ràng ở đó, những gì chúng ta đang làm là cứu một liên kết này với cái giá phải trả cho những liên kết khác. Nhưng đó là những gì bạn phải làm trong tình huống khẩn cấp. Nhưng nếu sau đó, tôi chỉ gửi bệnh nhân đó về nhà mà không nói cho họ biết tại sao họ lại bị đột quỵ và họ cần phải làm gì để ngăn ngừa việc bị đột quỵ lần nữa và những yếu tố lối sống nào gây ra điều đó, thì tôi chưa hoàn thành công việc của mình. Vậy những can thiệp nào mà chúng ta có thể thực hiện, hy vọng là từ sớm trong cuộc sống, để không cho những liên kết đó bị suy yếu, để tất cả các liên kết đều mạnh mẽ? Và khi chúng ta lớn tuổi hơn, chúng ta có thể tiếp tục tăng cường tất cả các liên kết. Đây là tám yếu tố. Đầu tiên là dinh dưỡng, đó là dinh dưỡng. Về cơ bản, bạn biết đấy, chúng ta biết có những nghiên cứu đã chỉ ra rằng tùy thuộc vào những gì chúng ta đưa vào cơ thể như thực phẩm có thể có tác động đáng kể đến sức khỏe của chúng ta. Được rồi, đó là dinh dưỡng. Tiếp theo là tập thể dục. Như tôi đã nói, tập thể dục không chỉ có tác dụng phụ mà thuốc và những thứ khác có. Tập thể dục có những lợi ích phụ. Rõ ràng là tập thể dục sẽ làm cho bạn có sức khỏe tốt hơn. Nó sẽ giúp bạn có sức bền tốt hơn. Nhưng bạn có biết rằng nó giảm nguy cơ đột quỵ không? Bạn có biết rằng nó cải thiện sức khỏe tâm thần không? Nó giảm trầm cảm. Có rất nhiều lợi ích. Vậy tất cả những liên kết này thực ra đang được cải thiện. Không có sự khai thác ở đây. Tập thể dục thật tuyệt vời. Nước. Điều này có thể nghe có vẻ hiển nhiên, đúng không? Bạn uống nước vì bạn khát. Nơi tôi muốn đến hôm nay là nói một chút về tác động của nước bên ngoài đối với cơ thể bạn có thể làm gì. Và bạn đang nói về việc sử dụng nước nóng và lạnh. Chính xác. Về các loại vòi sen hay tắm lạnh, sauna, đó kiểu như vậy? Chính xác. Chúng ta sẽ đi vào các bằng chứng thực tế cho điều này. Chúng ta sẽ tìm hiểu sau. Nhưng vấn đề tiềm ẩn là gì? Điều này ảnh hưởng đến hệ thống miễn dịch của bạn. Điều này thay đổi xác suất bạn mắc bệnh và những thứ như vậy? Chính xác. Đặc biệt là trong tình huống cấp tính. Đặc biệt. Vì vậy, không chỉ trong tình huống cấp tính, mà chúng tôi cũng có những dữ liệu khá tốt từ Phần Lan, nơi họ có nhiều phòng xông hơi hơn cả người. Ở đó, họ đã thực hiện nghiên cứu và chỉ ra qua các đường cong phản ứng liều rằng điều này thực sự rất có lợi. Chúng ta sẽ không đi vào quá nhiều điều đó. Nhưng điều mà tôi muốn tập trung nhiều hơn do công việc của tôi trong đơn vị chăm sóc đặc biệt và những gì chúng tôi đang thấy ngay bây giờ với virus và sự đột biến trong hệ thống miễn dịch bẩm sinh. Tại sao điều gì như thế này có thể thực sự quan trọng khi chúng ta nhìn về phía trước. Thú vị là, khi chúng ta nhìn về tương lai, những điều như đại dịch, chúng ta có thể nhìn lại và xem những gì chúng ta đã làm trong quá khứ. Và chúng tôi có một số thông tin thực sự tốt về điều đó. Hãy nói về ánh sáng mặt trời. Đây là điều mà tôi thực sự ngày càng tham gia nhiều hơn vì một số lợi ích mà điều này có thể mang lại. Một quan niệm sai lầm rất lớn mà mọi người có là ánh sáng mặt trời bằng vitamin D. Và do đó, nếu bạn uống vitamin D bổ sung, bạn không cần phải ra ngoài nắng. Đây thực sự là điều đang bị bác bỏ. Ánh sáng mặt trời có nhiều lợi ích hơn chỉ là vitamin D. Không nói rằng vitamin D không phải là thứ mà bạn muốn bổ sung. Tôi bổ sung vitamin D. Tôi nghĩ có lợi ích từ việc bổ sung vitamin D, không nghi ngờ gì. Nhưng ánh sáng mặt trời có rất nhiều điều quan trọng. Và tôi thực sự muốn dành phần lớn thời gian để nói về điều này vì điều này thực sự quan trọng. Điều này thật tuyệt. Và nó thực sự khiến tôi suy nghĩ về ánh sáng mặt trời. Đây là một câu chuyện của một người phụ nữ tên là Amy Hahnmeyer. Con trai 15 tuổi của cô đã được chẩn đoán bị bệnh bạch cầu lymphoblastic, đã nhập viện và thực sự bắt đầu hóa trị cho nó. Đây là bệnh ung thư máu. Đúng vậy, đây là bệnh ung thư máu. Và vì vậy, điều trị cho bệnh ung thư máu là hóa trị, mà cậu đã bắt đầu. Tác dụng phụ của hóa trị là ức chế hệ thống miễn dịch. Và không may, cậu đã không nhận ra điều đó, nhưng cậu đã phát triển – cậu không nhận ra ngay lập tức, nhưng cậu đã phát triển một nhiễm trùng nấm ăn thịt trong phổi của mình. Và đã nhập viện vào tháng 6 năm 2024. Đây là ở Minnesota, một bệnh viện điều trị thứ cấp. Và cậu trở nên xấu đi và xấu đi cho đến mức cách duy nhất họ có thể kiểm soát nhiễm trùng này là thực sự loại bỏ phổi bên trái của cậu, điều mà họ đã thực hiện. Vì vậy, đây là một cậu bé 15 tuổi. Cậu không còn phổi bên trái. Cậu chỉ còn phổi bên phải. Và cậu bắt đầu suy giảm thậm chí sau đó. Họ thực hiện CT scan, và cho thấy giờ đây nhiễm trùng đã di chuyển đến phổi bên phải còn lại của cậu. Họ đã có một cuộc họp gia đình. Và khi Amy kể cho tôi câu chuyện này, tôi có thể nghe thấy cô ấy nghẹn ngào. Cô đang nói cho tôi điều này qua điện thoại. Cô ấy nói rằng cậu ấy 15 tuổi. Cậu hoàn toàn tỉnh táo. Cậu hoàn toàn tỉnh táo. Cậu biết mọi thứ diễn ra xung quanh cậu. Cậu đang dùng máy thở, như một loại máy mà họ sử dụng cho chứng ngưng thở khi ngủ. Giống như một máy BiPAP đang thở cho cậu. Không phải là nội khí quản, nhưng nó ở trong miệng cậu. Và các bác sĩ, bạn biết đấy, đã làm mọi thứ họ có thể. Và họ nói, nhìn này, cậu ấy đang trở nên xấu hơn. Chúng tôi không thể lấy – rõ ràng, chúng tôi không thể lấy phổi bên phải ra. Chúng tôi không thể đặt cậu ấy lên máy tim-phổi vì không có điểm đến nào cho cậu ấy. Chúng tôi khuyên không nên nội khí quản cho cậu ấy và thực hiện những gì họ gọi là DNR, không hồi sức. Vì vậy, họ như kiểu, wow, họ đã không mong đợi điều này. Họ đã có một cuộc hội thảo lớn. Họ gọi thêm sự trợ giúp để, như, làm thế nào để giải thích cho một cậu bé 15 tuổi rằng bạn đang chết? Và cảm giác như thế nào? Vì vậy, họ hỏi các bác sĩ, cậu ấy còn thời gian bao lâu? Họ nói hai ngày. Vì vậy, trong tình huống này, họ nói với cậu bé này, được rồi, bạn sẽ chết.
    Bạn muốn làm gì với cuộc sống của mình trong hai ngày tới?
    Bạn muốn làm gì?
    Và thật ngạc nhiên, anh ấy nói: tôi chỉ muốn ra ngoài.
    Anh chàng này có lẽ lớn lên ở nông trại hoặc gì đó tương tự, và anh ấy đã dành thời gian ngoài trời.
    Vì vậy, anh ấy muốn ra ngoài.
    Bạn biết đấy – tôi không chắc bạn biết điều này, nhưng nếu bạn là một y tá hoặc bác sĩ và bạn đã làm mọi thứ có thể, và bạn hoàn toàn hoảng sợ trước thực tế rằng một cậu bé 15 tuổi sắp chết và cậu ấy chỉ có một yêu cầu, bạn sẽ di chuyển tất cả mọi thứ để đáp ứng yêu cầu đó.
    Và đó chính xác là những gì họ đã làm.
    Họ đưa cậu bé này ra ngoài giường bệnh của bệnh viện.
    Cậu ấy đang sử dụng máy BiPAP mà các kỹ thuật viên hô hấp đã lắp ráp.
    Vì vậy, anh ấy ở ngoài trời, và họ không đưa cậu ấy ra ngoài để cải thiện sức khỏe.
    Đây chỉ là ước nguyện trước khi chết của cậu ấy.
    Họ cũng sử dụng một thiết bị gọi là đom đóm.
    Đó là một thiết bị phát sáng mà họ đã sử dụng.
    Tôi – nói thật, tôi không biết cái nào có tác dụng.
    Đom đóm, cái đó là gì?
    Nó là một thiết bị phát sáng ở các bước sóng khác nhau, và họ sử dụng nó khoảng ba lần một ngày trong năm phút.
    Cậu bé này không chết.
    Sau ngày đầu tiên, số lượng bạch cầu của cậu ấy bắt đầu giảm xuống.
    Điều đó giống như một cách đo lường tình trạng nhiễm trùng trong phổi.
    Và nhân tiện, họ đã thực hiện một cuộc CT scan phổi của cậu ấy trước khi tất cả những điều này bắt đầu, và chỉ còn lại phổi bên phải thì bị nhiễm trùng hoàn toàn.
    Thật khủng khiếp.
    Đến ngày thứ hai, số lượng bạch cầu giảm xuống thậm chí nhiều hơn.
    Và nhân tiện, họ không thay đổi bất kỳ phương pháp điều trị nào khác.
    Đến thời điểm này, cậu ấy đã nằm viện được sáu tuần.
    Cậu ấy chưa hề thấy ánh sáng mặt trời.
    Và cậu ấy vẫn đang được dùng thuốc chống nấm mạnh, amphotericin B và posaconazole.
    Tất cả những thứ này đều là thuốc rất mạnh chỉ có tác dụng chống lại nấm, nhưng chúng không hiệu quả.
    Cậu ấy đang trở nên tồi tệ hơn.
    Nhưng bây giờ cậu ấy đã ra ngoài ngày thứ hai.
    Số lượng bạch cầu đang giảm xuống, điều này tốt – đó là một dấu hiệu tốt.
    Yêu cầu oxy của cậu ấy đang giảm xuống.
    Đó là một dấu hiệu tốt.
    Cậu ấy cần ít oxy hơn.
    Đến ngày thứ năm – được rồi, chúng ta đã qua hai ngày.
    Cậu ấy đã không sử dụng BiPAP.
    Cậu ấy đang sử dụng chỉ là ống thở mũi bình thường mà bạn thấy mọi người đeo trên mũi.
    Các bác sĩ thì gãi đầu.
    Họ như kiểu, chúng ta nên làm xét nghiệm CT để xem có chuyện gì đang xảy ra.
    Vì vậy, Amy nói với tôi rằng họ đã làm xét nghiệm CT cho cậu ấy, và họ ở trong phòng.
    Và một số người thậm chí còn thề thốt dưới hơi thở.
    Họ hoàn toàn ngạc nhiên.
    Bởi vì trên phim CT, rõ ràng phổi bên trái vẫn bị tổn thương.
    Nhưng phổi bên phải, bệnh tật có lẽ đã giảm khoảng 60%, 70%.
    Và cậu ấy vẫn sống.
    Cậu ấy được về nhà.
    Không có dấu hiệu bệnh sau điều trị.
    Và tôi – cô ấy chỉ vừa thông báo cho tôi rằng cậu ấy vừa nhận được điều ước của mình về bệnh ung thư.
    Cậu ấy đang tiếp tục điều trị.
    Và cô ấy không thể tin rằng cậu ấy chỉ còn hai ngày nữa là chết.
    Họ không thay đổi gì cả.
    Họ không thay đổi bất kỳ phương pháp điều trị nào của cậu ấy.
    Điều duy nhất họ đã làm là đưa cậu ấy ra ngoài,
    và họ đã sử dụng Firefly bên trong trước đó, nhưng họ đã sử dụng nó nhiều hơn khi cậu ấy ra ngoài.
    Có lẽ các bệnh viện nên nằm ngoài trời.
    Đó chính xác là những gì – được rồi, nếu bạn muốn biết động lực của tôi là gì,
    mục đích mà tôi đang làm bây giờ, tôi đang làm việc tại ba bệnh viện khác nhau.
    Và tôi đang cố gắng làm việc tại từng bệnh viện ấy để cố gắng đưa bệnh nhân ra ngoài.
    Rào cản lớn nhất mà chúng tôi gặp phải là nhân viên đưa những bệnh nhân đó ra ngoài.
    Đó là điều khó khăn nhất.
    Nhưng đây là những gì chúng tôi đã làm, Stephen.
    Đây chính là những gì chúng tôi đã làm – khi chúng tôi xây dựng bệnh viện vào đầu thế kỷ, chúng tôi có những phòng bệnh mà giường có thể được đưa ra ban công và mọi người có thể nhận ánh sáng mặt trời.
    Tôi rất muốn thấy một thời điểm mà chúng tôi có thể quay trở lại loại hiệu ứng đó.
    Có những nghiên cứu đã được thực hiện.
    Người trong phòng hai giường, nếu bạn nằm gần cửa sổ, bạn sẽ được xuất viện nhanh hơn trung bình.
    Thật không?
    Đúng vậy.
    Tôi cần đổi chỗ nằm với bạn gái của mình.
    Cô ấy ở bên nắng.
    Có rất nhiều bằng chứng cho điều này.
    Những người ở trong bệnh viện có cửa sổ lớn hơn, họ nhận được phản hồi tốt hơn.
    Và viện phí của các bệnh viện liên quan đến phản hồi mà họ nhận được từ bệnh nhân.
    Vì vậy, đó thực sự là một tình huống có lợi cho tất cả các bên.
    Nếu các bệnh viện bắt đầu, tôi tin rằng, đưa bệnh nhân ra ngoài – và họ đã bắt đầu làm điều này.
    Tôi không muốn nói rằng điều này không xảy ra.
    Có những bệnh viện có chương trình để đưa bệnh nhân ra ngoài.
    Vì vậy, tôi nghĩ chúng ta chỉ nên thực hiện điều này nhiều hơn.
    Điều độ.
    Điều độ?
    Điều đó có nghĩa là gì?
    Đó là một thuật ngữ cổ, phải không?
    Nó thực sự có nghĩa là sự điều độ.
    Và tôi sẽ nói trong ý nghĩa này, điều độ thực sự có nghĩa là tránh các chất độc trong cơ thể.
    Là một bác sĩ hô hấp –
    Bác sĩ hô hấp là gì?
    Bác sĩ hô hấp là người chăm sóc phổi.
    Và do đó, tôi thấy rất nhiều vấn đề liên quan đến ung thư phổi do hút thuốc.
    Tôi thấy trong phòng hồi sức những người bị suy gan do lạm dụng rượu.
    Tôi cũng thấy những người sử dụng amphetamines ở đây tại Nam California, nơi tôi cư trú và làm việc.
    Chúng tôi có khá nhiều trường hợp như vậy.
    Và điều độ.
    Nếu bạn muốn sống một cuộc sống lâu dài và lành mạnh, có một số chất độc mà bạn muốn tránh.
    Và hiểu điều đó là rất quan trọng.
    Vì vậy, đây là điều mà nếu bạn ngừng một số thứ mà chúng tôi đã nói, tất cả những liên kết đó sẽ được cải thiện.
    Không khí.
    Có vẻ khá rõ ràng.
    Ban đầu, tôi từng nghĩ điều này có nghĩa là có không khí tinh khiết mà không có bất cứ thứ gì trong đó ngoài nitơ và oxy.
    Điều đó không đúng nữa.
    Chúng tôi hiện nay hiểu rằng để có không khí tốt nhất, thực sự nó phải có một số yếu tố bên trong.
    Giống như ruột của chúng ta có một hệ vi sinh vật mà bạn có thể đã nghe nói đến, thì không khí mà chúng ta hít thở cũng phải có điều tương tự. Và loại không khí tốt nhất mà bạn có thể có là thực sự ở ngoài trời.
    Nghỉ ngơi.
    Điều này thật sự thú vị vì chúng ta vừa nói rằng tập thể dục là một trụ cột. Nhưng nghỉ ngơi cũng vậy. Làm thế nào mà nghỉ ngơi và tập thể dục cùng lúc có thể là những trụ cột của sức khỏe? Và điều đó thực sự phụ thuộc vào việc biết khi nào làm gì. Ngủ, cũng là một phần của nghỉ ngơi. Vì vậy, chúng ta không chỉ nói về việc nghỉ ngơi hàng ngày khi bạn đi ngủ. Là một bác sĩ chuyên về giấc ngủ, tôi có thể nói với bạn khá nhiều. Chúng ta có rất nhiều thông tin về thời gian mà chúng ta nên ngủ, chất lượng giấc ngủ, một số bệnh lý ngăn cản chúng ta ngủ. Giấc ngủ rất quan trọng. Tôi không thể nhấn mạnh điều này đủ. Không chỉ là nghỉ ngơi hàng ngày, mà tôi cũng sẽ nói, và dám nói ra và chúng ta có thể nói thêm về điều này, là nghỉ ngơi hàng tuần. Nghỉ ngơi hàng tuần? Nghỉ ngơi hàng tuần. Bạn có ý nghĩa gì? Cuối tuần? Giống như vậy? Đúng. Đúng, hoàn toàn đúng. Bao nhiêu lần, thậm chí vào cuối tuần, chúng ta đặt điện thoại xuống? Không bao giờ. Hoặc chúng ta dừng đọc email. Và chúng ta dành thời gian để làm những điều mà chúng ta sẽ không bao giờ có thể làm. Cuối cùng, niềm tin. Đây thực sự là điều mà không thể bị bỏ qua. Tôi sẽ nói điều này ngay từ đầu, rằng trong thế giới nghiên cứu và khoa học, có một sự phân cách giữa khoa học và đức tin. Nhưng điều mà chúng ta không thể bỏ qua là cơ sở dữ liệu ngày càng lớn từ thế giới khoa học đang nhìn vào đức tin, rằng những người có đức tin và những người có đức tin vào Chúa, cho dù đó là Chúa của họ trong tín ngưỡng cụ thể nào, có khả năng đối phó với căng thẳng, trầm cảm và lo âu tốt hơn. Điều này là điều đã được chứng minh bởi khoa học.
    Bây giờ, nếu bạn để ý, tôi đã trình bày những điều này theo một thứ tự cụ thể, và nếu bạn xem qua chúng, bạn có dinh dưỡng, bạn có tập thể dục, bạn có nước, bạn có ánh sáng mặt trời, bạn có tiết chế, bạn có không khí, bạn có nghỉ ngơi, và cuối cùng là niềm tin. Nếu bạn kết hợp tất cả lại và nó tạo thành từ “new start” (bắt đầu mới). Thú vị là, những chủ đề cụ thể này không bị bản quyền. Nhưng có một trường đại học ở Bắc California gọi là Đại học Weimar đã thực sự kết hợp chúng lại trong mẫu hình như vậy và gọi nó là “new start”. Họ thực sự có một chương trình new start. Và đây là điều đang được sử dụng rộng rãi trên toàn thế giới.
    Vậy trong số những vấn đề mà bạn vừa đề cập đến cho khung “new start” này, bạn muốn bắt đầu từ đâu? Tôi nghĩ thực sự ánh sáng mặt trời là một trong những điều mà tôi rất hào hứng với tất cả. Nhưng tôi nghĩ ánh sáng mặt trời thực sự là nơi mà chúng ta nên tập trung, hãy nói theo cách khác, đó là thứ trái cây dễ hái nhất. Được rồi. Giải thích cho tôi lý do tại sao ánh sáng mặt trời là nơi bạn tập trung vào lúc này. Đó là một hành trình dài đã đưa tôi đến đây. Và tôi nghĩ một phần trong số đó đi qua COVID. Là một bác sĩ chăm sóc đặc biệt, khi tôi nghe rằng có một virus đang đến, mọi người đều nói rằng đó sẽ là những người mắc bệnh hô hấp, điều mà tôi cảm thấy khá thoải mái. Nhưng đó không phải là những gì đã xảy ra. Chúng ta chắc chắn đã thấy những người có bệnh hô hấp. Nhưng những gì tôi thấy ở đơn vị chăm sóc đặc biệt, những người đang chết xung quanh tôi là những người béo phì, những người mắc bệnh tim, những người mắc bệnh thận, những người bị sa sút trí tuệ, những người có bệnh mãn tính. Và nó làm tôi suy nghĩ, tại sao lại như vậy? Tất cả những điều đó có một điểm chung và nhiều điều khác nữa. Nhưng cụ thể, chúng gắn liền với điều được gọi là rối loạn chức năng ty thể. Hãy để tôi giải thích rõ hơn cho bạn. Và điều này liên quan đến tuổi thọ. Điều này liên quan đến lão hóa. Đây là một chủ đề khổng lồ đang nổi lên. Và chúng ta ngày càng tìm hiểu nhiều hơn về điều này. Khi tôi còn học môn sinh học ở trường trung học, khi tôi đang học đại học, tất cả chúng ta đều học về một tổ chức nhỏ trong tất cả các tế bào của chúng ta ngoại trừ tế bào hồng cầu được gọi là ty thể. Và tôi phải nói điều này. Ty thể là gì? Nó là nhà máy năng lượng của tế bào, đúng không? Vì vậy, đó là thứ tạo ra năng lượng. Những gì chúng ta không biết vào thời điểm đó là khi chúng ta già đi, đầu ra từ những pin trong tế bào của chúng ta giảm khoảng 70%. Thật không thể tin được. Bạn có thể tưởng tượng việc vận hành ngôi nhà của bạn với 70% ít năng lượng hơn không? Thật căn bản sẽ thay đổi những gì xảy ra trong ngôi nhà của bạn? Bạn không thể vận hành máy giặt theo cách giống như trước. Bạn không thể vận hành lò vi sóng và máy giặt cùng một lúc. Và điều đó trông như thế nào về triệu chứng? Câu hỏi tuyệt vời. Bởi vì điều đó trông như thế nào sẽ phụ thuộc vào loại tế bào mà chúng ta đang nói đến, và điều đó sẽ gặp vấn đề. Nếu chúng ta đang nói về gan, gan sẽ trở nên mỡ nhiều hơn. Nếu chúng ta đang nói về tim, tim sẽ trở nên bị sung huyết nhiều hơn. Nếu chúng ta đang nói về não, nó sẽ có nhiều bệnh sa sút trí tuệ hơn. Và điều đang xảy ra ở đây là khi chúng ta già đi, những pin trong tế bào của chúng ta không hoạt động giống như trước đây nữa. Chuyển hóa đang chậm lại. Và vì vậy, đây là những vấn đề lớn. Và tất cả những bệnh mà tôi chỉ nói đến, tất cả những bệnh mà chúng ta đã thấy trong COVID, nếu bạn nhìn vào nhiều bệnh này, chúng đều gắn liền với rối loạn chức năng ty thể. Vậy câu hỏi là, tại sao lại như vậy và chúng ta có thể làm gì về điều đó? Có một bài báo được công bố vào năm 2019 đã thay đổi cách nhìn của tôi về điều này. Nó được viết bởi Russell Ryder, là tổng biên tập của Nghiên cứu Melatonin. Ông ấy đến từ Đại học Texas. Và Scott Zimmerman, là một kỹ sư ánh sáng. Và những gì họ đưa ra là để chứng minh rằng về cơ bản ánh sáng mặt trời gồm rất nhiều loại bước sóng khác nhau. Bạn có tia cực tím ở một đầu, mà tất nhiên tạo ra vitamin D. Và nó rất có lợi. Đó là loại ánh sáng từ mặt trời có bước sóng rất ngắn nhưng không thể xâm nhập quá sâu. Hãy để tôi lùi lại một chút và giải thích.
    Bạn lái xe đến một biển báo dừng và có ai đó lái xe bên cạnh bạn với nhạc hip-hop mới nhất. Âm thanh từ đó nghe như thế nào trong xe của bạn? Rất to, đúng không? Vâng, bị dồn nén. Và việc bị dồn nén là do tần số sóng thấp có khả năng truyền rất xa. Hãy đến Grand Canyon, nơi có một cơn bão sấm sét ở đầu bên kia. Bạn nghe thấy gì? Nó giống như một tiếng ầm ầm. Và khi nó đến gần, bạn nghe thấy những âm thanh có âm cao hơn. Đây là một nguyên tắc vật lý cơ bản. Khi mặt trời chiếu sáng, có những bước sóng rất ngắn, tia cực tím B liên quan đến vitamin D. Nhưng ở đầu bên kia, có ánh sáng hồng ngoại, mà chúng ta sẽ nói đến, hoặc ánh sáng đỏ. Đây là một bước sóng rất dài và nó có thể thâm nhập rất sâu. Điều này rất quan trọng vì những gì chúng ta đang nói đến là cơ thể con người. Và nếu ánh nắng mặt trời có ảnh hưởng đến cơ thể con người, thì nó phải hơn chỉ là trên da. Vậy đây là điều mà tài liệu này đã chỉ ra, là ánh sáng hồng ngoại từ mặt trời có khả năng thâm nhập khoảng tám centimet, theo Scott Zimmerman trong bài viết này. Nó tương tác một cách cơ bản với đặc biệt là ti thể. Và nó làm gì với ti thể? Hãy để tôi quay lại và nói về ti thể vì điều này là rất trung tâm. Ti thể đối với tế bào giống như động cơ trong xe của bạn. Động cơ sản sinh ra chuyển động khiến bánh xe quay. Nhưng trong quá trình làm việc, nó tạo ra nhiệt bao quanh động cơ. Và nếu bạn không xử lý nhiệt đó, nó sẽ làm tắt động cơ. Nó sẽ làm cho nó hoạt động kém hiệu quả hơn và cuối cùng sẽ làm tắt nó. Vậy tất cả các động cơ đốt trong đều có gì? Chúng có một hệ thống làm mát. Chúng có một bộ tản nhiệt. Chúng có một bể dầu. Chúng có một bơm nước. Và đó chính xác là những gì tế bào cần có cho ti thể. Không phải là nhiệt trong ti thể. Đó gọi là stress oxy hóa và chính stress oxy hóa gây ra sự hủy hoại và, đúng, sự hủy hoại của ti thể và dẫn đến những loại bệnh này. Vậy stress oxy hóa làm cho ti thể không hoạt động tốt. Điều này dẫn đến bệnh tiểu đường. Stress oxy hóa khiến ti thể hoạt động kém. Điều này dẫn đến chứng mất trí. Điều này đã được phác thảo trước đây. Điều này không phải là gây tranh cãi. Phần gây tranh cãi là chúng ta sẽ làm gì về nó? Vậy những người này trong tài liệu này đã chỉ ra rằng, và không chỉ họ, mà khi xem xét tài liệu, thì ti thể tự làm hệ thống làm mát của riêng mình. Và hệ thống làm mát đó là melatonin. Bây giờ, bạn có thể nghĩ, khoan đã, melatonin? Đó không phải là thứ mà chúng ta uống, mà não của chúng ta sản xuất ngay trước khi chúng ta đi ngủ sao? Vâng, đúng vậy. Đó là những gì xảy ra. Vấn đề là, đây không phải là melatonin được sản xuất trong não. Đây không phải là melatonin đi qua mạch máu và thông báo cho chúng ta rằng đã đến lúc đi ngủ. Đây là melatonin được sản xuất trong tế bào, trong ti thể. Và nó là một chất chống oxy hóa mạnh mẽ ngăn chặn stress oxy hóa xảy ra. Những gì Scott Zimmerman và Russell Ryder đã chỉ ra và đề xuất trong này là, về cơ bản, bức xạ hồng ngoại đi vào cơ thể có khả năng kích thích và tăng cường melatonin và một số yếu tố khác giữ cho ti thể mát mẻ và thực sự có thể cải thiện đầu ra năng lượng của ti thể. Điều này làm tôi thực sự ngạc nhiên, và tôi sẽ nói cho bạn biết tại sao tôi lại cảm nhận điều này như một bác sĩ chăm sóc đặc biệt, vì có hai điều khiến tôi lo lắng nhất. Thứ nhất, virus SARS-CoV-2. Khi nó vào cơ thể, nó tương tác với một thứ gọi là thụ thể ACE2. Bạn có thể đã nghe nói về thụ thể ACE2. Được rồi. Đây là nơi mà virus thực sự bám vào tế bào và được nội hóa. Vậy thụ thể ACE2 là gì? Đây có phải chỉ là thứ tồn tại cho toàn nhân loại để làm một thụ thể, hay nó thực sự có một vai trò? Hóa ra nó thật sự có vai trò. Và một cách gây bất ngờ, thụ thể ACE2 liên quan đến việc giảm thiểu stress oxy hóa. Nói cách khác, nó là một phần khác của hệ thống làm mát của tế bào cho ti thể. Điều đang xảy ra là, khi virus gắn vào tế bào, nó thực chất đang vô hiệu hóa hành động đó. Và vì vậy hãy tưởng tượng rằng bạn có một nhóm người với các động cơ khác nhau đang hoạt động ở các nhiệt độ khác nhau. Nói cách khác, bạn có một số người có bệnh mãn tính, và chúng ta biết rằng động cơ của họ đang hoạt động nóng. Chúng ta có những người khác hoàn toàn khỏe mạnh, và họ đang hoạt động khá tốt. Động cơ của họ thì mát mẻ. Họ không gặp vấn đề gì cả. Bây giờ hãy tưởng tượng COVID đến, và SARS-CoV-2 đang lây nhiễm mọi người. Xu hướng mà điều đó dẫn đến là, vì nó đang làm mất đi thụ thể ACE2 của mọi người, mà có khả năng làm mát động cơ, nói cách khác, nó làm cho động cơ của mọi người hoạt động nóng. Đúng không? Vậy, trong trường hợp của một người nào đó, hãy hình dung nó theo cách này. Bạn đang lái xe trong chiếc xe của mình, và nhiệt kế của bạn ở đó, và đột nhiên, có một cái đồi lớn mà bạn phải leo lên gọi là COVID-19. Ai sẽ vượt qua cái đồi đó, và ai sẽ không vượt qua được? Những người vượt qua cái đồi là những người có động cơ được làm mát tốt mà nhiệt độ đang hoạt động tốt. Những người không vượt qua được cái đồi là những người có nhiệt kế trên động cơ của họ đang hoạt động nóng. Đó là những người sẽ ngất xỉu ở đỉnh và không thể vượt qua. Và họ là những người bị dừng lại bên lề đường với nắp ca pô mở và hơi nước bay ra từ động cơ. Bạn có hiểu những gì tôi đang nói không? Tất nhiên rồi. Vậy điều này làm cho tôi hoàn toàn hiểu tại sao tôi không thấy điều mà họ đang dự đoán, đó là những bệnh nhân hô hấp đến ICU. Ai là người tôi thấy trong ICU? Tôi thấy những người bị mất trí, như chúng ta đã nói, bệnh tiểu đường, bệnh thận.
    Đây là những người đã mắc bệnh, đã bị ốm.
    Một điều khác mà thực sự khiến tôi suy nghĩ và hòa nhập với điều này là, và điều này thậm chí không gây tranh cãi, chúng tôi đã biết ngay từ đầu trong đại dịch rằng những người vào bệnh viện có mức vitamin D cao hơn thì làm rất tốt. Họ không chết. Họ không có khả năng chết như những người khác. Những người có mức vitamin D thấp thì có khả năng tử vong cao hơn rất nhiều. Vì vậy, chúng tôi đã kiểm tra các mức vitamin D này. Và hãy nghĩ về điều này. Bạn có mặt ở điểm nóng, và bạn đang chăm sóc cho những bệnh nhân này, và bạn thấy dữ liệu này lặp đi lặp lại rằng vitamin D là rất dự đoán ai sẽ chết. Hiển nhiên, bạn sẽ làm gì? Mặc dù đây là một nghiên cứu tương quan, nhưng mối liên hệ đó không có nghĩa là nguyên nhân, bạn sẽ cho mọi người vitamin D và cố gắng nâng cao các mức này. Vấn đề là, là chúng tôi đã cho vitamin D, và thực sự không có tác dụng nhiều. Bạn đã cho nó dưới dạng bổ sung? Đúng vậy, khi mọi người vào bệnh viện. Như vậy sao? Chính xác. Chính xác. Cứ như vậy. Thực tế, tôi cũng đã tự bổ sung. Ý tôi là, bạn có gì để mất, đúng không? Tôi đã uống viên vitamin D của mình sáng nay. Tôi không, rất khó để quá liều, nhưng vẫn có thể.
    Vì vậy, bạn nhận thấy rằng rất khó để điều trị mọi người bằng vitamin D, nhưng cho họ một viên thuốc không thực sự làm được gì nhiều. Đúng vậy. Tại sao? Vâng, đây là điều tôi tin, chúng tôi đã thấy rằng những người có mức vitamin D cao hoặc bình thường thì làm tốt hơn những người có mức thấp. Tôi tin rằng đó là một dấu hiệu của một điều gì đó khác. Nói cách khác, những người có mức vitamin D cao hơn có nghĩa là họ ra ngoài nắng nhiều hơn. Họ ở bên ngoài nhiều hơn so với những người có mức vitamin D rất thấp. Những người có mức vitamin D thấp đang nói với tôi rằng đây là những người không ra ngoài dưới ánh nắng mặt trời. Vậy yếu tố thực sự ở đây là gì? Cái gì đang làm việc nặng? Và tôi đề xuất, cùng với Scott Zimmerman và Russell Ryder, và tôi có thể nói với bạn một số các nhà khoa học khác đồng ý với tôi về điều này, là bức xạ hồng ngoại từ mặt trời đang gây ra một tác động ở mức độ ty thể về sự stress oxy hóa. Và vitamin D chỉ là dấu hiệu của việc ai đang nhận được ánh sáng hồng ngoại và ai không, ai đang ra ngoài và ai không ra ngoài. Vì vậy, khi mặt trời chiếu sáng, phần lớn thời gian, bạn đang nhận được ánh sáng hồng ngoại. Bạn đang nhận được toàn bộ quang phổ sinh học từ mặt trời. Chúng ta có thể đi tới bước sóng dài nhất, là hồng ngoại xa, cho đến bước sóng ngắn nhất, là cực tím B, được coi là tạo ra vitamin D.
    Vì vậy, nói cách khác, khi bạn ở bên ngoài trong môi trường tự nhiên, bạn đang nhận được một quang phổ ánh sáng rất rộng. Và vì lý do đó, nếu bạn đang nhận được ánh sáng hồng ngoại, bạn cũng sẽ tạo ra vitamin D. Bạn nhận được cả hai. Bây giờ, điều đó có thể thay đổi bởi vì vào mùa đông, khi mặt trời thấp hơn trên bầu trời, đặc biệt là, bạn biết đấy, ở Anh, đây là một vấn đề đặc biệt ở vĩ độ đó. Khi mặt trời thấp trên bầu trời, ánh sáng phải xuyên qua không khí theo chiều chéo. Và vì lý do đó, bức xạ sóng ngắn từ mặt trời, chẳng hạn như cực tím B, không dễ dàng đi qua. Vì vậy, có những thời điểm trong năm mà bạn không nhận được đủ cực tím B hoặc thậm chí có thể không nhận được cực tím B nào từ mặt trời.
    Điều này tạo ra vitamin D. Điều này tạo ra vitamin D. Bạn sẽ bị thiếu hụt. Bạn cần phải bổ sung. Tuy nhiên, trong khoảng thời gian đó, khi bạn không nhận được đủ vitamin D vì không có bức xạ cực tím B, mặt trời vẫn thấp. Nhưng ánh sáng hồng ngoại bước sóng dài vẫn đủ để cho phép ánh sáng xuyên qua. Vậy ánh sáng hồng ngoại bước sóng dài có phải là loại mà chúng ta thấy những thiết bị này đang làm không? Chắc chắn rồi.
    Và tôi muốn nói rõ rằng bạn có thể thấy điều đó dưới dạng ánh sáng đỏ, đó không phải là ánh sáng hồng ngoại vì bạn có thể thấy nó. Vì vậy, ánh sáng hồng ngoại về kỹ thuật hoàn toàn vô hình. Nhưng những thứ này quả thực phát ra ánh sáng hồng ngoại, nhưng bạn chỉ không thể thấy được. Đúng, chính xác.
    Vì vậy, nó hướng về phía đầu đỏ của quang phổ. Và những người như Glenn Jeffrey từ UCL thực sự đang nghiên cứu ở mức 670 nanomet của ánh sáng đỏ và đã chỉ ra trong các thử nghiệm có kiểm soát ngẫu nhiên rằng loại ánh sáng này ngay tại 670, loại mà bạn thậm chí có thể thấy, thực sự cải thiện hiệu suất của ty thể. Anh ấy đã chứng minh điều này trong một số thử nghiệm có kiểm soát ngẫu nhiên. Nó cải thiện thị lực. Và bạn phải nhận ra rằng võng mạc ở phía sau mắt của bạn rất giàu ty thể. Anh ấy đã chứng minh điều này về việc quản lý glucose và sản lượng từ ty thể. Và lý do tại sao những thứ này hoạt động rất tốt là vì khi bạn già đi, làn da của bạn bắt đầu trở nên nhão hơn vì các tế bào fibroblast hoặc tế bào trong làn da của bạn, chúng được thiết kế để tạo ra collagen. Và collagen là bộ khung làm cho làn da của bạn mềm mại và linh hoạt.
    Đúng vậy. Đừng để ý đến tôi, làm ơn. Không, không. Vậy đây chính xác là điều đó. Vợ tôi cũng sử dụng cùng một thứ. Đây là một điều lý thú.
    Vì vậy, điều đang diễn ra ngay bây giờ là ánh sáng đỏ, có thể xuyên rất sâu vào trong da, đang đi vào da. Và nó đang kích hoạt ty thể trong các tế bào fibroblast của bạn để sản xuất nhiều năng lượng hơn, mà các tế bào đó cần để deposit collagen. Và vì vậy khi bạn deposit collagen, điều đó sẽ làm cho làn da có cảm giác chặt chẽ hơn vì khi bạn lớn tuổi, việc deposit collagen sẽ ngày càng ít đi. Vì vậy điều này sẽ giúp tôi trông trẻ hơn. Đó là toàn bộ điểm của điều này.
    Và bạn đang nói rằng ánh sáng trong những thiết bị này xuyên vào, cái gì, sáu hoặc bảy cm? Ánh sáng hồng ngoại khoảng tám cm. Ánh sáng đỏ này sẽ ít hơn một chút vì ánh sáng này, hiển nhiên bạn có thể thấy nó, vì vậy nó có bước sóng ngắn hơn một chút.
    Nhưng đúng vậy, ánh sáng này, ánh sáng đỏ, có thể xuyên sâu hơn, chẳng hạn như ánh sáng vàng hoặc ánh sáng xanh. Và chính ánh sáng này tương tác với ti thể để tăng cường điều đó. Vậy chúng ta có nên sử dụng ánh sáng này lên toàn bộ cơ thể không? Bởi vì, được rồi, nó tốt cho làn da của tôi, nhưng nếu nó xuyên sâu hơn, có lẽ còn nhiều bộ phận khác của cơ thể tôi sẽ được hưởng lợi từ điều đó, từ các ti thể khác. Thật thú vị khi bạn nói như vậy. Nghiên cứu mà tôi đang nói đến với Glenn Jeffrey tại University College London, ông ấy đã tiến hành nghiên cứu với những người trẻ. Ông đã cho họ một lượng glucose. Và bất cứ ai nhận được một lượng glucose đều nên có sự gia tăng lượng đường trong máu. Ông đã ngẫu nhiên cho họ nằm sấp để xem điều gì sẽ xảy ra khi ông chiếu ánh sáng đỏ lên lưng họ. Và những người nhận được ánh sáng đỏ có sự gia tăng đường trong máu thấp hơn. Nói cách khác, dường như ti thể đang chuyển hóa nhanh hơn, điều đó dẫn đến việc có ít sự gia tăng glucose trong máu hơn. Cách mà ông xác nhận điều đó là tìm kiếm các sản phẩm phụ của quá trình chuyển hóa ti thể, đó là carbon dioxide. Khi chúng ta hít thở, khi chúng ta chuyển hóa, chúng ta thải ra carbon dioxide, đó là kết quả của quá trình chuyển hóa ti thể. Thực tế là, ở những người có ánh sáng chiếu vào, nó cho thấy mức carbon dioxide cao hơn trong hơi thở thở ra. Điểm quan trọng của điều đó là để trở lại câu hỏi của bạn về việc liệu chúng ta có nên sử dụng ánh sáng này trên toàn bộ cơ thể hay không. Ông ấy đã có thể đạt được hiệu ứng toàn thân chỉ bằng cách chiếu ánh sáng vào lưng. Đó là một khả năng toàn thân. Chúng ta không hiểu tất cả về ti thể, nhưng điều mà chúng ta có vẻ hiểu là chúng có thể giao tiếp với nhau và bạn không cần phải sử dụng ánh sáng này trên toàn bộ cơ thể để có hiệu ứng toàn thân. Trong trường hợp cụ thể này, tuy nhiên, nếu bạn muốn làn da ở đây trông trẻ trung hơn, thì có vẻ hợp lý rằng đây là nơi bạn cần sử dụng nó. Nếu bạn muốn một phần khác của cơ thể trông trẻ hơn, thì có lẽ đó là nơi ánh sáng cần chiếu. Thật thú vị. Những nghiên cứu này mất bao lâu để thấy được hiệu ứng của liệu pháp ánh sáng đỏ như vậy? Đó là một câu hỏi rất hay. Nếu bạn nói chuyện với Glenn Jeffrey, như tôi đã làm, ông ấy đã nhận thấy có sự cải thiện trong 15 phút. 15 phút? 15 phút. Ông ấy nhận thấy điều gì trong 15 phút? Ông nói rằng ông đã nghiên cứu ti thể ở ruồi khiên và trong muỗi và ong và ở con người, và mọi lần đều giống nhau. Ông ấy nói sau khoảng 15 đến 20 phút ánh sáng kiểu này trong môi trường đó, có một công tắc bật lên, và bạn không cần thêm kích thích nào nữa. Kích thích thêm không làm gì hơn. Đó là một điều rất kỳ lạ. Bạn sẽ nghĩ rằng càng nhiều ánh sáng bạn cung cấp, hiệu ứng sẽ càng mạnh mẽ hơn. Nhưng không phải vậy. Sau khoảng 15 phút, có điều gì đó thay đổi trong ti thể. Có một số lý thuyết về nơi điều này có thể xảy ra. Điều này có thể xảy ra trong chuỗi vận chuyển electron, phức hợp bốn. Đây là những điều rất kỹ thuật. Có rất nhiều nghiên cứu đang thực sự, có một số nhóm đang xem xét điều này. Có một lĩnh vực khoa học gọi là photobiomodulation, đang nghiên cứu điều này. Nhưng 15 phút thực sự là thời gian cần thiết. Vậy nên chúng ta không đang nói về một khoảng thời gian dài. Điều này thực sự, thực sự thú vị. Quay lại với trải nghiệm của tôi trong phòng chăm sóc đặc biệt, vitamin D không có tác dụng. Những bệnh nhân này đang chết, và tôi nhận ra rõ ràng rằng COVID là một vấn đề chuyển hóa cho những bệnh nhân này. Vào thời điểm tôi nhận ra điều này, đại dịch có thể nói là vẫn đang tiếp diễn vì mọi người vẫn đang bị nhiễm bệnh. Nhưng sự vội vàng vào bệnh viện và số lượng cơ thể mà chúng tôi thấy lưu thông qua phòng chăm sóc đặc biệt đã giảm đáng kể. Và vào thời điểm đó, tôi có thể thấy rằng ánh sáng hồng ngoại có thể rất, rất có lợi cho những bệnh nhân mắc COVID-19. Giờ đây, có một nghiên cứu ở Brazil. Họ đã lấy những bệnh nhân COVID bị ốm đủ để được nhập viện, nhưng không đủ nặng để phải thở máy trong phòng chăm sóc đặc biệt. Và họ đã làm một điều tuyệt vời. Họ thực sự chế tạo một chiếc áo cho bệnh nhân. Và bên trong chiếc áo này có những bóng đèn LED phát ra bức xạ hồng ngoại ở mức 940 nanomet. Họ đã cho bệnh nhân mặc những chiếc áo này, và họ ngẫu nhiên phân phối áo nào được bật và áo nào được tắt. Nó được làm mờ vì ánh sáng phát ra từ chiếc áo này không thể nhìn thấy bằng mắt thường. Nó thậm chí không đủ để tạo ra nhiệt. Và vì vậy, họ đã làm điều này trên 30 đối tượng, và họ đã ngẫu nhiên phân phối. 15 người có ánh sáng được bật. Tất cả 30 đều mặc áo. 15 người có ánh sáng bật. 15 người không có ánh sáng bật. Và họ theo dõi họ. Điều gì xảy ra với những bệnh nhân này? Mọi điểm cuối mà họ xem xét đều có ý nghĩa thống kê. Điều đó có nghĩa là sự khác biệt giữa hai nhóm này không thể chỉ do ngẫu nhiên. Có sự khác biệt thực sự. Nhóm có ánh sáng bật có sự cải thiện trong độ bão hòa oxy, có thể hít vào sâu hơn và mạnh mẽ hơn, có sự cải thiện trong tế bào bạch cầu. Và không chỉ vậy, còn có sự cải thiện trong nhịp tim, nhịp thở, tất cả đều có ý nghĩa thống kê. Nhưng thống kê quan trọng và gây sốc nhất là thời gian lưu trú tại bệnh viện. Họ đã đeo những chiếc áo này trong 15 phút mỗi ngày trong bảy ngày. Ở nhóm không có ánh sáng bật, thời gian lưu trú trung bình của họ là 12 ngày trong bệnh viện. Còn những người có ánh sáng bật, thời gian chỉ là tám ngày. Đó là sự khác biệt bốn ngày. Thật đáng kinh ngạc khi bạn nhận ra rằng việc nhập viện bệnh nhân tốn hàng nghìn đô la.
    Đó là một số lượng lớn khi bạn nghĩ đến việc có những loại thuốc nhất định được FDA phê duyệt cho bệnh cúm, chẳng hạn, chỉ bằng cách rút ngắn triệu chứng trong 24 giờ. Điều này không chỉ là 24 giờ, mà là 40. Người bệnh được xuất viện nhanh hơn bốn ngày. Khi tôi thấy nghiên cứu đó, điều đó đủ để thuyết phục tôi. Ý tôi là, rõ ràng, chỉ có 30 đối tượng, đúng không? Chúng ta nên thực hiện một nghiên cứu lớn hơn. Chúng ta nên thực hiện một vài trăm, đúng không? Đó sẽ là lý tưởng để làm. Nhưng thực tế là với chỉ 30 bệnh nhân, họ có thể cho thấy sự khác biệt thống kê. Điều đó đủ để tôi nói rằng từ giờ trở đi, mọi bệnh nhân nào tôi thấy mắt thị lực COVID-19 và cần nhập viện, mà họ yêu cầu tôi đi đặt ống thở, đưa vào phòng chăm sóc đặc biệt, những bệnh nhân này sẽ được đưa ra ngoài. Tôi không có cái áo khoác mà họ làm ở Brazil. Tôi thậm chí không biết làm cái áo khoác đó như thế nào. Họ đã làm nó cho nghiên cứu. Và nó không có sẵn để bán. Không có ánh sáng 940 nanomet, cái mà họ đã sử dụng trong nghiên cứu. Nhưng tôi biết rằng ánh sáng mặt trời có 940 nanomet trong đó. Và nếu tôi có thể đưa những bệnh nhân này ra ngoài, có thể họ sẽ cải thiện. Vì vậy, tôi đã có được điều tôi mong muốn. Tôi có một bệnh nhân trên giường. Anh ấy đang sử dụng 35 lít một phút, 100% oxy qua một dòng chảy cao. Qua mũi anh ấy. Qua mũi anh ấy. Hầu như không bão hòa vì anh ấy bị COVID-19. Và tôi được yêu cầu đi xem anh ấy vì anh ấy có thể cần được đặt ống thở hoặc đưa vào phòng chăm sóc đặc biệt. Tôi không thể tin được bởi vì tôi đã không thấy một ca như vậy trong nhiều tháng. Vì vậy, tôi đã xuống, bước vào phòng, mở cửa. Nó ở trong khu cách ly. Tôi đã đeo khẩu trang, hết sức cẩn thận. Căn phòng hoàn toàn tối. Rèm đã đóng. Con gái anh ấy ở đó. Và những lời đầu tiên từ miệng anh ấy với tôi là, “Bác sĩ, tôi còn bao nhiêu thời gian?” Ý tôi là, đó là một thảm họa. Như thể không có ánh sáng, không có nhịp sinh học. Người này đang bị trầm cảm. Tôi ngay lập tức gọi cho kỹ thuật viên hô hấp của tôi, ngay lập tức gọi cho y tá trưởng. Chúng tôi tập hợp mọi người lại. Và tôi nói, chúng ta cần đưa anh chàng này ra ngoài. Đó là một ngày sáng và nắng. Làm thế nào để chúng ta đưa anh chàng này ra ngoài? 35 lít, 100%. Chúng tôi, kỹ thuật viên hô hấp của tôi, Kim, đã quản lý để kết hợp một vài bình oxy. Và chúng tôi đã có thể đưa anh chàng này vào xe lăn. Và chúng tôi đã đẩy anh ấy ra ngoài. Và anh ấy đã nói với tôi điều này vài tuần sau đó. Nhưng anh ấy nói, bạn biết không, ngày đầu tiên mà bạn đưa tôi ra ngoài dưới ánh nắng, vì chúng tôi đã làm điều này liên tục trong khoảng bảy ngày. Anh ấy nói, cảm giác đó thật tuyệt. Sau chỉ một ngày, anh ấy đã giảm từ 35 lít xuống còn 15 lít. 15 lít oxy. Rồi xuống 12. Rồi xuống 8 vào ngày hôm sau. Và rồi xuống 5. Năm ngày. Khối lượng oxy mà anh ấy hít vào để giữ sự sống. Đúng vậy. Nói cách khác, chúng tôi đã điều chỉnh lượng oxy mà chúng tôi phải đưa cho anh ấy để duy trì mức bão hòa trong những năm 90. Chỉ trong năm ngày, anh ấy đã được xuất viện về nhà mà không cần oxy. Bây giờ, rõ ràng, đó là một câu chuyện cá nhân, đúng không? Đó không phải là một nghiên cứu. Nhưng tôi đang nhìn vào những rủi ro khi đưa mọi người ra ngoài ánh nắng trong 15, 20 phút. Không có nhiều rủi ro cho điều đó. Và nếu có lợi ích, tôi nghĩ rằng điều đó là xứng đáng để làm. Chúng ta cần có các thử nghiệm ngẫu nhiên lớn hơn. Nhưng điều đó đã dẫn tôi đến việc tìm hiểu xem điều gì về ánh sáng mặt trời đang ảnh hưởng đến sự thay đổi này. Và bạn biết không? Có rất nhiều dữ liệu. Thực tế có một nghiên cứu đã được thực hiện ở châu Âu mà họ đã nói, OK, có COVID. COVID đang tăng lên. Khi nào thì COVID tăng lên? Có phải vì nhiệt độ thay đổi? Có phải vì độ ẩm? Và câu trả lời cho cả hai điều đó là không. Bạn có biết điều gì dự đoán khi các quốc gia có đợt bùng phát đầu tiên vào mùa thu năm 2020 không? Có một nghiên cứu thực sự đã được thực hiện về điều này. Đó là vĩ độ. Nó bắt đầu ở Phần Lan và sau đó xuống toàn bộ lục địa. Quốc gia cuối cùng có đợt bùng phát COVID vào mùa thu năm 2020 là Hy Lạp. Vì vậy, khi mặt trời thực sự chìm xuống nửa cầu nam, khi bóng bắt đầu phủ lên châu Âu, đó là lúc chúng ta bắt đầu thấy các đợt bùng phát COVID, từng cái một. Điều đó có phải là vì COVID và mặt trời không phải là bạn bè? Vì vậy, điều đó làm cho việc lây lan khó khăn hơn vì, bạn biết không, nếu tôi đặt COVID lên bàn này và sau đó tôi đặt ánh sáng mặt trời lên bàn, COVID sẽ chết. Đúng vậy, điều đó có thể. Mặc dù bây giờ chúng ta đã biết rằng COVID có lẽ không lây lan quá nhiều qua tiếp xúc. Nó chủ yếu là vấn đề không khí. Có một nghiên cứu đã được thực hiện tại Đại học Edinburgh. Và họ đã xem xét câu hỏi này mà chúng tôi đã bàn đến trước đây về vitamin D. Họ đã xem xét Hoa Kỳ vào mùa đông. Vì vậy và họ đã loại bỏ phần phía nam của Hoa Kỳ vì ở phần phía nam của Hoa Kỳ, bạn thực sự có thể nhận được một số vitamin D vào mùa đông. Vì vậy, họ chỉ xem xét phần phía bắc của Hoa Kỳ. Và họ đã có thể cho thấy rằng càng có nhiều ánh sáng mặt trời ở những khu vực cụ thể, thì tỷ lệ tử vong từ COVID-19 càng thấp. Vì vậy, họ đã nói, điều này thật thú vị. Còn ở Anh thì sao? Vì vậy, họ đã thực hiện nghiên cứu chính xác tương tự ở Anh. Và tất nhiên, họ không cần phải loại bỏ bất kỳ phần nào của Anh vì toàn bộ quốc gia đều không nhận được vitamin D vào mùa đông. Những gì họ đã chỉ ra là, một lần nữa, một số khu vực của đất nước ở Anh, như bạn biết, nhận được nhiều ánh sáng mặt trời hơn những khu vực khác. Vâng, những khu vực mà nhận được nhiều ánh sáng mặt trời có tỷ lệ tử vong thấp hơn từ COVID-19. Sau đó, họ đã lấy cùng một nghiên cứu và xem xét ở Italy. Kết quả giống hệt. Và họ đã công bố điều này. Và họ nói trong nghiên cứu của họ, và đây là điều thực sự khiến tôi ngạc nhiên. Họ đã nói, nếu điều này là nguyên nhân, họ nói, điều này có thể cho thấy một can thiệp sức khỏe cộng đồng có thể xảy ra. Thực tế là nó hoàn toàn độc lập với vitamin D có nghĩa là có điều gì khác đang xảy ra.
    Có một nghiên cứu vào năm 2011 tại Thụy Điển.
    Có.
    Điều đó có liên quan đến nghiên cứu này không?
    Không, đây là một nghiên cứu hoàn toàn khác.
    Nhưng đó cũng là một nghiên cứu rất quan trọng.
    Vậy nghiên cứu Thụy Điển là có tính đột phá.
    Đây là một nghiên cứu mà họ đã hỏi 20.000, từ 20 đến 30.000 phụ nữ Thụy Điển về thói quen
    tắm nắng của họ.
    Và họ đã chia những phụ nữ này thành ba loại.
    Những phụ nữ không nhận được nhiều ánh sáng mặt trời, những người nhận được một lượng ánh sáng mặt trời vừa phải, và
    những người nhận được nhiều ánh sáng mặt trời.
    Và họ đã theo dõi họ trong 20 năm.
    Và họ đã theo dõi từng người đã qua đời và nguyên nhân cái chết của họ.
    Và khi họ hoàn thành việc đó, họ rất kinh ngạc.
    Bởi vì điều họ phát hiện ra là những phụ nữ đã dành phần lớn thời gian của họ
    ngoài trời hoặc dành nhiều thời gian nhất ngoài trời có tỷ lệ tử vong do ung thư,
    bệnh tim mạch và bệnh không phải tim mạch thấp nhất.
    Còn những người dành ít thời gian nhất ngoài trời lại có tỷ lệ cao nhất.
    Sự khác biệt lớn giữa hai nhóm đó đến nỗi họ có thể chỉ ra rằng
    những phụ nữ, ở Thụy Điển, những người dành nhiều thời gian nhất ngoài trời và hút thuốc có tỷ lệ tử vong
    giống như những người phụ nữ không dành nhiều thời gian ngoài trời và không hút thuốc.
    Họ bằng nhau?
    Họ bằng nhau.
    Nói cách khác, ở trong nhóm không dành nhiều thời gian ngoài trời dưới ánh nắng mặt trời
    có nguy cơ tử vong giống như hút thuốc.
    Làm thế nào họ biết điều đó không liên quan đến việc tập thể dục?
    Họ đã có thể xác định nguyên nhân ra sao?
    Bởi vì đó là một…
    Chắc chắn rồi.
    Đó là một câu hỏi tuyệt vời.
    Vì vậy, sự khác biệt ở đây, khi bạn tăng lên, là đây là một nghiên cứu liên quan, được chưa?
    Vì vậy, câu hỏi là, làm thế nào bạn có thể nhận ra nguyên nhân từ liên quan?
    Bạn không thể.
    Nhưng nếu bạn xem xét các tiêu chí Bradford Hill, có một cách mà bạn có thể đưa ra
    một lập luận mạnh mẽ cho nguyên nhân nếu có một cái gọi là đường cong liều-đáp ứng.
    Nói cách khác, nếu bạn có thể cho thấy…
    Bạn không chỉ so sánh hai điều, mà bạn đang so sánh ba hoặc nhiều hơn.
    Nếu bạn có thể cho thấy rằng khi bạn tăng biến, thì có một sự thay đổi trong kết quả,
    điều đó rất có thể cho thấy nguyên nhân.
    Nhân tiện, đây chính xác là những gì chúng tôi đã làm để chỉ ra rằng hút thuốc gây ra ung thư phổi.
    Rõ ràng, chúng tôi không thể tiến hành một thử nghiệm đối chứng ngẫu nhiên.
    Ở đây, bạn được hút thuốc.
    Bạn không được hút thuốc.
    Chúng tôi sẽ theo dõi trong 20 năm để xem ai mắc ung thư phổi.
    Đây chính xác là những gì chúng tôi đã làm.
    Chúng tôi đã chỉ ra rằng có một sự liên kết mạnh mẽ với rủi ro ung thư, với việc hút thuốc, đến mức chúng tôi
    có thể nói qua sự liên quan rằng hút thuốc gây ra ung thư phổi.
    Nhân tiện, Richard Weller, một bác sĩ da liễu ở Anh, cũng đã thực hiện một nghiên cứu rất tương tự với nghiên cứu Thụy Điển năm ngoái, ngoại trừ nó lớn gấp 10 lần, và ông đã thực hiện với cả nam và nữ.
    Ông đã tìm ra những kết quả tương tự.
    Đó là một nghiên cứu ngân hàng sinh học của Vương quốc Anh.
    Ông ấy đã phát hiện ra điều gì?
    Ông ấy đã phát hiện rằng từ việc sử dụng giường tắm nắng hay ra ngoài, sử dụng dữ liệu bức xạ mặt trời, ông đã có thể
    cho thấy cả trên bảng câu hỏi của họ và cả nơi họ sống rằng càng nhiều ánh sáng mà họ có,
    thì nguy cơ tử vong và tử vong do ung thư của họ càng thấp.
    Vậy câu hỏi đưa ra là, điều đó có làm tăng nguy cơ mắc u hắc tố (melanoma) không?
    U hắc tố là gì?
    U hắc tố là một loại ung thư da.
    Vì vậy đó là rủi ro lớn.
    Đó là rủi ro lớn mà mọi người đều lo ngại.
    Bạn ra ngoài dưới ánh nắng mặt trời, bạn sẽ mắc ung thư da.
    Và ông ấy đã có thể chứng minh trong nghiên cứu đó, đây là khoảng ba, ba, 400.000 người trong
    nghiên cứu này, nghiên cứu ngân hàng sinh học của Vương quốc Anh, Richard Weller.
    Ông ấy đã có thể cho thấy rằng không có sự gia tăng, không có rủi ro thống kê nào về tỷ lệ mắc u hắc tố,
    nhưng có sự giảm thiểu trong tỷ lệ tử vong do ung thư không phải da.
    Được rồi, vậy đây là sự đánh đổi.
    Nếu bạn muốn ra ngoài dưới ánh nắng mặt trời ở Anh, được rồi, lợi ích là bạn sẽ có một
    sự giảm thiểu trong tỷ lệ tử vong do ung thư không phải da.
    Vậy là mọi thứ ngoại trừ ung thư da.
    Đúng.
    Mặt khác, không có sự gia tăng trong tỷ lệ mắc u hắc tố.
    Vì vậy điều đó khiến ông ấy viết một bài bình luận và xuất bản nó.
    Và thực sự, bạn có thể tìm kiếm bài bình luận này.
    Đó là một bài bình luận tuyệt vời được xuất bản trong Tạp chí Da Liễu Nghiên Cứu mang tên Ánh Sáng Mặt Trời,
    Đã Đến Lúc Suy Nghĩ Lại, nơi ông ấy trình bày các lập luận.
    Và ông ấy thực sự đã chỉ ra, và đã có một số thay đổi mà mọi người đang thực hiện trên toàn cầu.
    Vì vậy, các tổ chức y tế công cộng hiện đang nói rằng, bạn biết đấy, trước đây chúng tôi đã nói rằng, bạn biết đấy, ánh nắng mặt trời là một thứ laser chết chóc, và bạn nên tránh nó bằng mọi giá.
    Có thể chúng ta cần suy nghĩ lại về điều đó.
    Vậy bạn đang nói với tôi rằng cơ bản là 15 phút dưới ánh nắng mặt trời mỗi ngày kích hoạt một công tắc trong cơ thể tôi, giúp cải thiện chức năng ty thể của tôi, điều này sẽ ảnh hưởng đến nhiều khía cạnh khác nhau về sức khỏe của tôi?
    Đó có phải là những gì bạn đang nói không?
    Cơ bản là đúng.
    Và chúng tôi đang nhìn vào—và đây là trong một môi trường mà chúng tôi đang dành ít thời gian hơn và ít thời gian hơn.
    Để đưa ra một góc nhìn, nếu chúng ta trên một con tàu của Anh 300 năm trước, và tôi đến
    bạn và tôi nói, bạn có thấy trái cây màu vàng nhỏ này không?
    Chỉ cần ăn một chút trái cây màu vàng này, tất cả những căn bệnh mà bạn đang thấy
    xung quanh bạn với những người đồng đội trên tàu sẽ biến mất.
    Điều đó có vẻ gần như không thể tin nổi, phải không?
    Nhưng đó chính xác là trường hợp.
    Chúng tôi—scurvy (bệnh thiếu vitamin C) của thế kỷ 21 là sự thiếu ánh sáng mặt trời.
    Mọi thứ đều ở bên trong.
    Chúng tôi tránh xa bên ngoài.
    Chúng tôi tránh sự khó chịu.
    Chúng tôi tránh nhiệt độ cao.
    Chúng tôi tránh nhiệt độ thấp.
    Chúng tôi từng ra ngoài và chơi thể thao.
    Bây giờ chúng tôi đang chơi thể thao ảo trên các thiết bị.
    Chúng tôi có những chiếc cửa sổ được thiết kế đặc biệt, đặc biệt ở miền Nam California,
    để loại bỏ ánh sáng hồng ngoại.
    Bởi vì sao?
    Ánh sáng hồng ngoại vào trong, và nó làm nóng lên.
    Một trong những điều thú vị—chúng tôi không đề cập đến ánh sáng hồng ngoại là cách mà chúng ta tương tác với ánh sáng hồng ngoại, bạn có thể tự cảm nhận điều này.
    Bạn ra ngoài và nhắm mắt lại.
    Bạn có thể cảm nhận được bên nào của cơ thể bạn có ánh nắng.
    Và lý do là, vì ánh sáng hồng ngoại không chỉ có thể xuyên qua cơ thể của bạn, nó còn dễ dàng xuyên qua quần áo. Bạn có thể cảm nhận điều đó. Cái nóng mà bạn cảm nhận là ánh sáng hồng ngoại đi qua quần áo, đi qua da, và tương tác với các thụ thể nhiệt của bạn nằm sâu dưới bề mặt. Tất cả những điều này. Được rồi, các bạn. Tôi sẽ đi đón Steve. Khách đã đến. Sẵn sàng chưa? Vào đi. Ôi, trời ơi, Steve! Gì vậy? Bạn đang làm gì? Đây là mặt nạ Bonchage. Nó tốt cho các vết blemishes, nếp nhăn. Nó làm sạch da. Nó phát ra ánh sáng đỏ. Bạn chưa từng sử dụng nó trước đây sao? Không. Bạn đã thử cái này trước đây chưa? Nó rất, rất tốt. Nó chiếu ánh sáng đỏ lên mặt bạn, giúp tăng cường và kích thích sản xuất collagen. Tôi thực sự biết đến nó nhờ vợ tôi. Tôi đã thấy cô ấy đeo nó. Cô ấy đã làm tôi sợ hãi vài đêm liên tiếp. Tôi nghĩ nó để doạ mọi người, nhưng thực sự, nó rất, rất tốt cho làn da của bạn. Họ là nhà tài trợ của podcast, và tôi đã sử dụng nó mỗi ngày khoảng một năm rưỡi nay. Wow. Bạn đang phát sáng. Wow, Steve. Bạn đang phát sáng, phải không? Tôi đang phát sáng, phải không bạn? Tuyệt vời. Vâng. Và Bonchage giao hàng toàn cầu với việc trả hàng đơn giản và bảo hành một năm cho tất cả các sản phẩm của họ. Hãy truy cập bonchage.com/slash/diary để nhận 25% giảm giá cho bất kỳ sản phẩm nào trên toàn trang. Nhưng bạn phải đặt hàng qua liên kết đó. Đó là bonchage.com/slash/diary với mã code diary. Cho dù bạn là người mới hay đã làm việc trong ngành thuế và kế toán trong nhiều năm, nếu bạn muốn làm việc với một đội ngũ chuyên gia có kinh nghiệm và đầu tư vào việc học tập và phát triển của bạn, có cơ hội nghề nghiệp thực sự với nhà tài trợ của chúng tôi, Intuit, nhà sản xuất TurboTax và QuickBooks. Đào tạo tự quản của họ, Intuit Academy, cung cấp cho bạn một con đường để có được những kỹ năng cần thiết mà bạn sẽ cần để cảm thấy tự tin mở rộng sự nghiệp trong lĩnh vực thuế và kế toán. Và đội ngũ của họ cũng rất hỗ trợ, với một mạng lưới lớn các chuyên gia có kinh nghiệm và chứng chỉ sát cánh bên bạn khi bạn học hỏi và tích lũy kinh nghiệm. Ngoài việc nâng cao kỹ năng này, họ còn cung cấp lịch làm việc linh hoạt, cho dù đó là toàn thời gian, bán thời gian, trực tuyến, tại chỗ, hoặc thậm chí cho phép bạn chọn giờ làm để phát triển theo tốc độ bạn muốn. Intuit đang mở rộng mạng lưới các chuyên gia thuế và kế toán. Vì vậy, nếu bạn muốn xây dựng sự nghiệp với họ theo cách của riêng bạn, hãy truy cập vào Intuit.com/slash/expert. Tôi sẽ hiện nó trên màn hình. Đó là Intuit.com/slash/expert. Trung bình một người Mỹ chi bao nhiêu thời gian trong nhà, hoặc một người Anh? Câu hỏi hay. Chúng gần như giống hệt nhau. Tôi nghĩ người Anh dành thời gian ngoài trời nhiều hơn một chút so với người Mỹ. Con số cuối cùng cho người Mỹ là 93%, và người Anh là 92%. Chúng ta có được sinh ra để ở ngoài không? Tôi nghĩ vậy. Bạn sẽ nghĩ rằng tổ tiên chúng ta có lẽ đã dành rất nhiều thời gian ở ngoài trời. Và nếu bạn nghĩ khi tôi nói về ngoài trời, điều đó cũng liên quan đến một số chữ cái Newstart khác mà chúng ta chưa đề cập. Tập thể dục. Bạn có khả năng thực hiện các bài tập tốt hơn rất nhiều khi ở ngoài trời. Bạn có khả năng nhận được không khí. Đó là loại không khí đúng ở bên ngoài. Một khía cạnh khác về ánh sáng hồng ngoại, tóm tắt lại, là cây cối rất phản chiếu ánh sáng hồng ngoại. Nói cách khác, nếu bạn ở trong môi trường có cây cối, bạn sẽ nhận được nhiều ánh sáng hồng ngoại có lợi này hơn so với ở một khu rừng bê tông. Vì vậy, thực vật như thế này. Thực tế, cách mà chúng ta đo lường việc trồng rừng Amazon là thông qua hình ảnh vệ tinh nhìn vào ánh sáng hồng ngoại vì nó phản chiếu ánh sáng hồng ngoại trở lại. Vì vậy, điều tốt nhất, tình huống tốt nhất để bạn ở là ở bên ngoài trên một vùng đất xanh, vào một ngày có nhiều cây xanh. Chúng ta đã biết trong nhiều thập kỷ rằng những người sống trong không gian xanh làm tốt hơn rất nhiều về tiểu đường, làm tốt hơn về tăng huyết áp, tỷ lệ tử vong, tất cả những thứ này. Trầm cảm. Trầm cảm, tất cả những điều đó. Vâng. Và khi bạn nghĩ về điều này, bạn gợi ý một điểm về mối tương quan. Làm thế nào chúng ta biết rằng đó không phải là trầm cảm? Chúng ta đã từng nói rằng những người sống trong không gian xanh có nhiều tiền hơn. Những người đó có nhiều quyền truy cập hơn vào những thứ. Có thể đó là những gì chúng ta thấy. Tôi chỉ cần nói với bạn về nghiên cứu này. Có một cái gọi là Nghiên Cứu Trái Tim Xanh ở Nam Louisville, Kentucky. Họ đã làm một điều tuyệt vời. Họ đã lấy một khu vực bốn dặm vuông ở Nam Louisville, Kentucky, một khu vực đô thị hóa, và họ đã đo lường HSCRP của tất cả mọi người. HSCRP là gì? Protein C-reactive nhạy cảm cao. Đây là một dấu hiệu của viêm nhiễm, và nó đã được liên kết với những điều xấu như đột quỵ và cơn đau tim. Vì vậy, nếu bạn có mức CRP cao, điều đó không tốt. Họ đã đo lường khoảng 700 người, và sau đó họ đã làm một điều tuyệt vời. Họ đã mua 8.000 cây trưởng thành, đào hố và trồng 8.000 cây trong khu vực bốn dặm vuông. Và đây là những cây có lá. Hai năm sau, họ trở lại và đo tất cả 700 người trong nghiên cứu của họ, lặp lại HRCRP, giảm từ 13% đến 20%, điều này tương ứng với việc giảm khoảng 10% đến 15% số ca đột quỵ. Những người này không thay đổi tình trạng kinh tế xã hội của họ. Họ không triển khai một chương trình tập thể dục. Và vì vậy thực sự, điều này thể hiện rõ mô hình rằng lợi ích mà chúng ta thấy từ không gian xanh liên quan đến điều gì khác mà chúng ta không đang đo lường. Tôi thực sự tin rằng chúng ta sẽ nói về không khí trong lành, cũng như những thứ như những thực vật này, nhưng lớn hơn nhiều. Đây giống như một chậu cây bonsai. Nhưng những cây bên ngoài, chúng thực sự mang lại lợi ích. Và những gì chúng đại diện, một lần nữa, là những thứ mà không tác động đến các bộ phận khác của cơ thể bạn như các chuỗi tạo ra tất cả các chuỗi lớn hơn vì chúng đã mang lại lợi ích. Nhưng bạn sẽ không thể nhận được lợi ích này nếu bạn ở trong một ngôi nhà.
    Vậy chúng ta nên làm gì về điều này, về việc thay đổi và những thay đổi nào tôi nên thực hiện trong cuộc sống của mình để tận dụng điều này?
    Thương hiệu này tên là Bond Charge. Họ sản xuất các thiết bị ánh sáng đỏ. Họ có các phòng xông hơi ánh sáng đỏ, chăn, mặt nạ. Họ thực sự là một nhà tài trợ của tôi vì tôi đã bắt đầu sử dụng sản phẩm này và tôi nghĩ họ đã phát hiện ra. Tôi bắt đầu sử dụng nó vì bạn gái của tôi. Đúng rồi. Cô ấy đã sử dụng nó mỗi ngày và tôi cảm thấy tò mò. Và như tôi thường làm, tôi luôn rất hoài nghi. Chắc chắn rồi. Vì vậy, tôi đã lên mạng và bắt đầu tìm hiểu một số nghiên cứu, và tôi rất sốc. Đúng vậy. Nó không có lý do trực giác đối với tôi rằng một chiếc mặt nạ ánh sáng đỏ hoặc bất kỳ thiết bị ánh sáng đỏ nào có thể có tác động sâu sắc, như tôi thấy là một tác động sâu sắc đến sức khỏe của tôi. Tôi đã không tin. Vâng. Để bắt đầu. Vâng. Đó giống như những thứ viển vông đối với tôi. Nhưng tôi không thể bác bỏ nó. Đúng. Tất cả các nghiên cứu, nhiều nghiên cứu trong số đó bạn đã đề cập, đã ủng hộ rằng nó có tác động sâu sắc. Và như tôi đã nói trong podcast này trước đây, bạn gái tôi luôn đúng. Cô ấy luôn đi trước thời đại và luôn đúng. Vì vậy, tôi đã bắt đầu đeo mặt nạ của cô ấy, và bây giờ tôi có mặt nạ của riêng mình từ Bond Charge. Đúng rồi. Bạn có推荐 những thứ như thế này không? Tôi nghĩ đó là điều hợp lý để làm. Tôi sẽ nói điều này. Nếu bạn nhận được đủ ánh sáng hồng ngoại từ mặt trời, những gì chúng tôi tìm thấy trong các nghiên cứu, không đặc biệt với mặt nạ, nhưng chúng tôi tìm thấy ở những thứ khác, là những khu vực khác không có hiệu quả cao như vậy. Nó gần như giống như bạn đang ở trên một con tàu với một đám người bị bệnh scorbut, và bạn đã có một chế độ ăn uống giàu rau củ và trái cây, việc ăn thêm một quả chanh cũng không có lợi nhiều cho bạn. Vậy bạn nên làm gì? Như nhiều bác sĩ khác, chúng tôi có ca làm việc từ 7 giờ sáng đến 7 giờ tối. Vì vậy, bạn ở trong bệnh viện. Bạn sẽ không ra ngoài. Vì vậy, vào giờ ăn trưa, tôi cố gắng ra ngoài càng nhiều càng tốt để đón ánh nắng trong 15 phút. Còn nếu bạn sống ở một đất nước nhiều mây thì sao? Đó là một điểm hay. Mây, vì chúng là phân tử nước, sẽ hấp thụ rất nhiều ánh sáng hồng ngoại. Và vấn đề là, đó chính xác là loại ánh sáng mà bạn muốn nhận. Tuy nhiên, ngay cả trong một ngày nhiều mây, khi ở bên ngoài, bạn vẫn sẽ nhận được nhiều ánh sáng hồng ngoại hơn nếu bạn ở trong nhà. Được rồi, tôi vẫn nhận được ánh sáng cần thiết khi trời nhiều mây, nhưng chỉ không nhiều. Đúng, chính xác. Có điều gì tôi có thể làm để có được ánh sáng đó không, nếu trời cực kỳ nhiều mây và tôi biết mình sẽ ở trong nhà, tôi nên làm gì? Vâng. Vậy loại đèn mà chúng tôi có bên trong. Như những cái này? Như những cái này, và thực sự, tôi nghĩ Vương quốc Anh và Hoa Kỳ rất giống nhau về vấn đề này, đó là chúng tôi thực sự không thể lấy được bóng đèn sợi đốt cũ. Chúng tôi sử dụng đèn LED hoặc đèn huỳnh quang. Và nếu bạn nghĩ về những gì họ đã làm với những bóng đèn này, bóng đèn sợi đốt cũ từng cung cấp cho bạn một phổ rất rộng. Vì vậy, từ gần như màu xanh, tất cả cách xuống ánh sáng hồng ngoại. Cách mà họ đã làm cho bóng đèn hiệu quả hơn, họ đã nói, hãy ngừng sử dụng năng lượng để phát ra ánh sáng mà chúng ta không thể thấy và cho một phổ ánh sáng rất hẹp mà chúng ta có thể thấy. Vậy bạn hãy suy nghĩ về những gì họ đã làm. Họ đã, lần đầu tiên trong lịch sử nhân loại, giờ đây chúng ta đang tiếp xúc với ánh sáng trong một phổ rất hẹp mà không có gì khác. Bất kỳ điều gì, trong lịch sử nhân loại, khi chúng ta thắp nến, khi chúng ta ra ngoài ánh sáng mặt trời, khi chúng ta có đèn dầu, chúng ta đã nhận được phổ hoàn chỉnh. Nói cách khác, chúng ta chưa bao giờ nhận được ánh sáng xanh mà không có ánh sáng đỏ. Bây giờ chúng ta bắt đầu nhận được ánh sáng xanh mà không có ánh sáng đỏ. Vậy tôi có nên thay bóng đèn không? Thật khó để làm điều đó vì bạn không thể tìm thấy bóng đèn sợi đốt, điều này dẫn tôi đến, ít nhất ở Hoa Kỳ, bây giờ chúng tôi có luật cấm việc bán bóng đèn sợi đốt thông thường vì lý do tiết kiệm năng lượng. Ồ, đúng vậy. Tôi đã vào Google và gõ từ “bóng đèn sợi đốt”. Có một cái gọi là bóng đèn dịch vụ chung, đó là loại bóng đèn mà bạn có thể cắm vào. Nhưng nếu bạn quyết định rằng bạn muốn có một bóng đèn để bỏ vào lò vi sóng hoặc một bóng đèn mà bạn sẽ dùng cho một loại đèn chùm đặc biệt, những bóng đèn đó vẫn còn có sẵn. Bạn vẫn có thể tìm thấy bóng đèn sợi đốt cho những thứ đó. Còn những loại bóng đèn này thì sao? Đó có phải là bóng đèn sợi đốt không? Đó là bóng đèn sợi đốt, một lần nữa, cho những loại đèn đặc biệt này. Nhưng tôi đang nói về ánh sáng, như loại bóng đèn A90 tốt cổ điển, tôi nghĩ nó gọi là vậy, hoặc bóng đèn mà bạn chỉ cần xoáy vào. Đó là 120 watt. Những cái đó đang ngày càng khó tìm. Khó hơn để tìm thấy. Bạn không thể xuống Home Depot và tìm thấy chúng ở đó. Vì vậy, Glenn Jeffrey, và đây là một bản in trước mà anh ấy đã thực hiện, anh ấy thực sự đã lấy những người làm việc ở môi trường ánh sáng LED này. Thực sự, nó chưa được bình duyệt. Nó chưa được xuất bản nhưng là một bản in trước. Nó có sẵn trên internet. Vì vậy, tôi không nói ra ngoài phạm vi. Và những gì anh ấy đã làm với 22 người là anh ấy đã thay thế những bóng đèn LED này và đặt vào bóng đèn sợi đốt. Và có sự cải thiện 25% trong việc phân biệt màu sắc trong nghiên cứu của anh ấy. Điều đó có nghĩa là gì? Họ đã có thể phân biệt màu sắc tốt hơn 25% so với khi họ tiếp xúc với đèn LED. Khi tôi nói về bóng đèn LED, đây là những bóng đèn có cường độ ánh sáng xanh cao. Vậy tại sao lại như vậy? Võng mạc, nơi ở phía sau mắt của bạn, mà ánh sáng đi vào, có những tế bào hình nón rất hoạt động chuyển hóa. Chúng luôn cập nhật, gửi tín hiệu đến não. Và đó là mô trong cơ thể bạn có nhiều ti thể nhất. Và đó là vì chúng cần cung cấp rất nhiều năng lượng. Khi ai đó lớn tuổi, ti thể đó không sản xuất ra cùng một lượng năng lượng. Và vì vậy khả năng của năng lượng mà những tế bào hình nón đó có thể sử dụng để thực hiện công việc của chúng ít hơn. Và vì vậy họ sẽ không thực hiện công việc đó tốt hơn.
    Nếu bạn có thể tăng lượng năng lượng đầu ra từ những ti thể đó, bạn có thể cải thiện khả năng nhận thức thị giác. Và Glenn Jeffrey đã thực hiện nghiên cứu này, trong đó ông sử dụng ánh sáng 670 nanometer, rất giống với mặt nạ đó, chiếu vào mắt trong chỉ ba phút, chỉ vào buổi sáng, đã cải thiện khả năng hình dung và thật sự nhìn thấy của những người đó. Vậy điều đó có ý nghĩa gì cho bức tranh rộng hơn về sức khỏe của chúng ta? Họ sẽ có thể phân biệt màu sắc tốt hơn và thực sự cải thiện thị lực của họ. Đó cơ bản là điều đó có nghĩa.
    Và câu hỏi lại trở về với câu hỏi đầu tiên mà bạn đã có ở rất đầu của podcast, đó là, hiệu ứng của năng lượng đầu ra thấp từ ti thể là gì? Chà, điều đó phụ thuộc vào mô hình nào mà ti thể đang ở trong. Nếu nó ở trong mắt, thì sẽ có cảm nhận thị giác tốt hơn. Nếu ở trong não, thì đó là chứng mất trí nhớ. Nếu bạn thấy điều tôi đang nói? Vậy điều chúng ta bắt đầu thấy là một loạt các bệnh tật khác nhau bị ảnh hưởng bởi ánh sáng mặt trời. Tôi thách thức bất kỳ ai làm điều này. Nếu bạn nhìn vào một ấn phẩm ở Hoa Kỳ, tôi đã thấy nó, nơi họ lập bản đồ số lượng tử vong trong một ngày lịch, bệnh tim mạch, bệnh hô hấp, bệnh thận, viêm phổi, đủ loại bệnh tật, bệnh truyền nhiễm, bệnh không truyền nhiễm, bạn sẽ thấy một mẫu rất rõ ràng. Số lượng tử vong tối đa mỗi năm xảy ra trong vòng một tháng sau ngày ngắn nhất của năm. Vì vậy, chúng ta đang nói về tháng Mười Hai và tháng Giêng. Chúng ta thấy số lượng tử vong do cúm nhiều nhất vào thời điểm đó. Chúng ta thấy số lượng tử vong do tim nhiều nhất vào thời điểm đó. Chúng ta thấy số lượng tử vong do thận nhiều nhất vào thời điểm đó.
    Vì vậy, bạn có thể hỏi, tóm lại, đó là vì mọi người tụ tập vào lễ Giáng sinh, và họ lây lan vi khuẩn nhiều hơn. Và chúng ta có Lễ Tạ Ơn vào cuối tháng Mười Một ở Hoa Kỳ. Và đó là những gì đang xảy ra. Vấn đề là, nếu bạn nhìn vào Úc, ở bên kia địa cầu. Vậy khi nào là ngày dài nhất trong năm của họ? Ngày dài nhất trong năm của họ là vào tháng Mười Hai. Và đó là khi họ có ít số lượng tử vong nhất, bất chấp việc họ vẫn tụ tập cho Giáng sinh vào tháng Mười Hai. Vậy điều đó không hợp lý. Đúng hơn là điều ngược lại. Số lượng tử vong nhiều nhất xảy ra ở Úc, ở Bán cầu Nam, từ tháng Sáu đến tháng Bảy. Đó là mùa đông của họ. Và vì vậy, cái mà bạn thấy là số lượng tử vong liên quan đến độ dài của ngày. Đây là lý do tại sao bất cứ khi nào họ phải, bất cứ khi nào họ trình bày số lượng tử vong trong năm, họ luôn phải điều chỉnh theo mùa. Và độ dài của ngày là một thông số cho lượng ánh sáng mặt trời. Chắc chắn rồi. Bạn có khả năng nhận được ánh sáng mặt trời nhiều hơn vào ngày dài nhất trong năm so với ngày ngắn nhất trong năm, đặc biệt là khi, và điều này rất nổi tiếng, có một số tháng, đặc biệt là cho những người làm việc ca, như từ 7 giờ sáng đến 7 giờ tối, bạn sẽ không thấy mặt trời, vì bạn ra khỏi nhà trước khi mặt trời mọc. Và bạn trở về nhà sau khi mặt trời đã lặn. Vì vậy, bạn không thể thấy mặt trời. Và bạn có thể trải qua hàng tuần mà không thấy mặt trời chút nào.
    Có thời điểm tối ưu trong ngày để nhận được ánh sáng mặt trời không? Có. Thời điểm tối ưu trong ngày để nhận ánh sáng mặt trời sẽ dành cho những người quan tâm đến việc nhận tổn thương từ bức xạ cực tím. Như chúng ta đã nói, khi mặt trời ở thấp trên bầu trời, đó sẽ là điều có lợi vì bức xạ cực tím không thể xuyên qua bầu khí quyển một cách chéo như bức xạ sóng dài. Vì vậy, khi mặt trời mọc, vào buổi sáng, và khi mặt trời lặn vào buổi tối, đó sẽ là thời gian mà bạn nhận được nhiều ánh sáng hồng ngoại hơn và ít ánh sáng cực tím nhất. Bây giờ, khi mặt trời trực tiếp chiếu xuống vào buổi trưa, bạn sẽ nhận được nhiều ánh sáng hồng ngoại nhất vào thời điểm đó, nhưng bạn cũng sẽ nhận được nhiều bức xạ cực tím. Và vì vậy, nếu bạn không phải là người thường xuyên ra ngoài ánh nắng, bạn có thể muốn tránh thời gian này. Hoặc, như chúng ta đã nói, hãy đội một chiếc mũ rộng vành, mặc quần áo. Ý tôi là, nhiều quần áo hơn. Bởi vì như chúng ta đã nói, ánh sáng cực tím không xuyên qua quần áo rất tốt. Nhưng ánh sáng hồng ngoại thì có.
    Liệu việc mặt trời chiếu vào đâu trên cơ thể tôi có quan trọng không? Không nên. Vì vậy, nếu tôi ra ngoài và tôi đội một chiếc mũ lớn, thì rõ ràng nó sẽ che mắt, mặt của tôi. Vâng. Nhưng tôi sẽ bị chiếu vào chân. Đối với những mục đích mà chúng ta đang nói đến với ti thể, điều đó sẽ không quan trọng. Tuy nhiên, nếu chúng ta đang nói về nhịp sinh học, nếu chúng ta đang nói về việc đạt được nhịp sinh học, thì con đường đó là qua đôi mắt. Vì vậy, bạn muốn tối đa hóa ánh sáng qua mắt. Vâng. Vì vậy, loại ánh sáng này được gọi là ánh sáng buồn. Vì vậy, câu hỏi của bạn liên quan đến phần nào của cơ thể cần phải chạm vào hoặc cần phải chạm vào. Vì vậy, đối với tác động của ti thể và các hiệu ứng chuyển hóa, điều đó không nên quan trọng. Được rồi. Đối với loại ánh sáng này, tuy nhiên, điều mà chúng ta đang xem xét là nhịp sinh học. Và đó là một hệ thống hoàn toàn khác mà chúng ta đang nói đến. Điều đó không liên quan đến ti thể. Nó liên quan đến đồng hồ bên trong trong não của bạn, mà đang điều chỉnh khi tất cả những điều này trong cơ thể bạn xảy ra. Và ánh sáng này khoảng 10.000 lux. Lux là một cách đo độ sáng của ánh sáng. Và các nghiên cứu đã chỉ ra rằng khi bạn chiếu loại ánh sáng này vào mắt của bạn, đó là cách để điều chỉnh nhịp sinh học của bạn. Bạn biết đấy, nếu bạn có một chiếc đồng hồ và nó không được cài đặt đúng giờ, có một cái nhỏ ở phía sau mà bạn có thể kéo ra và bạn có thể thay đổi thời gian. Vâng. Việc kéo ra và thay đổi thời gian về khi mọi thứ xảy ra trong cơ thể bạn bị ảnh hưởng nhiều nhất bởi ánh sáng. Và ánh sáng có thể thực sự dịch chuyển nó theo hướng này hay hướng kia, tùy thuộc vào khi bạn chiếu ánh sáng đó.
    Nếu bạn đang chiếu ánh sáng vào buổi sáng, và đây là điều mà rất nhiều người làm, đó là họ sẽ sử dụng những thứ mà họ gọi là đèn SAD. SAD là viết tắt của rối loạn cảm xúc theo mùa. Những chiếc đèn này, đặc biệt vào buổi sáng, không chỉ giúp điều chỉnh nhịp sinh học của bạn và đảm bảo nó đang đi đúng hướng mà còn giảm bớt trầm cảm. Có một phần trong não của bạn tiếp nhận thông tin ánh sáng. Nó được gọi là nhân perihabenular. Đó là một cái tên dài, nhưng nó nằm ở phía sau. Và nếu nó không được kích thích, nó có thể gây ra trầm cảm. Vì vậy, đối với những người sống ở vĩ độ cao, xa hơn, gần với các cực, nơi mà mặt trời dậy rất muộn vào buổi sáng và họ đã rời khỏi nhà đi làm, điều này thực sự có thể rất hữu ích. Vậy nên, tôi khuyên bạn nên mua những chiếc đèn này, bạn có thể tìm chúng trên Amazon với giá khoảng 20 đô la, nhưng chúng nên được đặt cách mặt bạn khoảng 11 đến 16 inch. Và điều mà mọi người nên nhận được là khoảng 3.000 giờ lux. Ý tôi là giờ lux là bạn nhân số lux với số giờ mà bạn sử dụng chúng. Vậy thì 3.000 là mức mà bạn nên đạt được. Bởi vì đây là 10.000 lux, bạn chỉ cần nhìn vào nó khoảng một phần ba giờ hoặc 20 phút. Và điều đó nên đủ. Vậy thì đây có phải là sự thay thế cho việc ra ngoài không? Đây là sự thay thế cho việc ra ngoài vì thực tế là bạn sống ở một vĩ độ rất cao và mặt trời không lên. Và vì công việc của bạn, điều này sẽ có hiệu ứng đó. Nhưng hãy nhận ra rằng điều này sẽ không thay thế hiệu ứng mà mặt trời có trên ty thể của bạn. Điều này chỉ ảnh hưởng đến tác động của việc thiếu ánh sáng mặt trời lên trầm cảm. Được rồi. Vậy thì nếu tôi nhìn mặt trời qua cửa sổ thì sao? Điều đó phụ thuộc vào cửa sổ. Vì vậy, cửa sổ sẽ làm giảm lượng lux. Vậy nên tôi không khuyên bạn nên ở trong nhà, nhìn ra ngoài cửa sổ giống như việc ra ngoài. Đó là điều đầu tiên. Điều khác mà bạn cần hiểu là rất nhiều cửa sổ, đặc biệt nếu đó là cửa sổ hiện đại, sẽ được thiết kế đặc biệt để giảm ánh sáng hồng ngoại. Tôi muốn bạn cung cấp cho tôi bất kỳ thông tin nào mà bạn có liên quan đến sức khỏe ánh sáng. Vâng. Điều đó sẽ cải thiện cuộc sống của tôi. Những thứ mà tôi có thể thực hiện ngay ngày mai. Rõ ràng, một trong số đó là tôi sẽ ra ngoài và đảm bảo rằng tôi nhận được một chút ánh sáng mặt trời, lý tưởng là vào buổi sáng. Vâng. Chúng ta đã nói về chiếc đèn SAD dành cho những người, đặc biệt là những người sống ở một số quốc gia có ít ánh sáng mặt trời hơn. Đúng. Để thiết lập nhịp sinh học và giúp với những vấn đề như sức khỏe tâm thần. Có điều gì khác tôi nên nghĩ đến hoặc có thể làm hoặc thay đổi không? Giống như chúng tôi đã có trong cách ghi nhớ Newstart của chúng tôi, nghỉ ngơi và tập thể dục, cả hai cùng một lúc, nhưng lại giống như đối lập nhau, rất quan trọng để có bóng tối. Được rồi. Rất quan trọng để có bóng tối. Và đây là một vấn đề thực sự. Đây là một trong những vấn đề lớn nhất là thực tế có một nghiên cứu được công bố gần đây có tiêu đề là “Ngày tối và đêm sáng”. Và điều đó liên quan đến việc tăng tỷ lệ tử vong. Ý tôi là, đó là cách mà hầu hết chúng ta sống. Đó là vấn đề. Chúng ta có những ngày tối và những đêm sáng. Và những gì chúng ta thực sự nên có là những ngày sáng và những đêm tối. Vì vậy, cũng quan trọng như việc có ánh sáng mặt trời sáng và ra ngoài vào giữa ngày, chúng ta cũng cần bắt đầu làm việc để có những đêm tối hơn. Và làm thế nào để chúng ta làm điều đó? Tắt đèn đi. Lấy những màn hình này ra khỏi mắt chúng ta. Những điều này rất quan trọng vì các màn hình phát ra rất nhiều ánh sáng và ánh sáng, điều đang diễn ra ở đây, đây là lý do tại sao nó quan trọng. Thật ra có hai lý do, ánh sáng đi vào mắt chúng ta đang làm hai điều vào ban đêm. Điều đầu tiên, nó ngăn chặn sản xuất melatonin từ tuyến tùng. Và như chúng ta vừa nói, melatonin là một chất chống oxy hóa rất mạnh mẽ và rất có lợi. Điều thứ hai mà nó đang làm là nó đang gây nhầm lẫn cho nhịp sinh học của bạn. Bạn thấy đấy, nhịp sinh học của bạn được thiết kế để nhìn thấy ánh sáng như vào ban ngày. Nếu mắt bạn nhìn thấy ánh sáng, não bạn nghĩ đó là ban ngày. Vì vậy, nếu là 10 giờ tối và mắt bạn đang nhìn thấy ánh sáng, nhịp sinh học của bạn đang nói, tôi phải đã nhầm. Tôi nghĩ là 10 giờ. Chắc chắn không thể là 10 giờ vì nhìn kìa, có ánh sáng. Và vì vậy, điều nó sẽ làm là điều chỉnh nó và trì hoãn mọi thứ. Bởi vì nó nói, không thể là 10 giờ tối. Nó phải là 6 giờ. Do đó, khi bạn thường cảm thấy mệt và buồn ngủ vào lúc 10 giờ tối, sau một thời gian làm như vậy, bạn sẽ không cảm thấy buồn ngủ cho đến 1 giờ sáng. Những thiết bị này chúng ta có, chúng phát ra rất nhiều ánh sáng xanh, đúng không? Vâng. Có cách nào để tắt nó đi không? Vâng. Thực ra, nhiều cái trong số này được liên kết với đồng hồ, nơi sau một thời gian nhất định vào ban đêm, nó sẽ chuyển quang phổ của nó sang một quang phổ đỏ hơn. Vậy nên nó cung cấp ít ánh sáng xanh hơn. Vấn đề là, trong khi cảm biến trong mắt bạn được điều chỉnh nhiều hơn với ánh sáng xanh, thì đó không chỉ là ánh sáng xanh. Vì vậy, thực sự giải pháp tốt nhất là tắt đèn. Giải pháp tốt thứ hai là có nhiều ánh sáng đỏ hơn hoặc, bạn biết đấy, đeo những chiếc kính này vào ban đêm. Vì vậy, chúng là những chiếc kính chặn ánh sáng xanh. Chúng đang cố gắng loại bỏ ánh sáng xanh, nhưng tôi vẫn nhận được ánh sáng vào. Và đó là đủ ánh sáng để ngăn chặn sản xuất melatonin. Ngay cả khi sử dụng chúng? Vâng, tuyệt đối. Nhưng bạn đang nói rằng chúng giúp được? Chúng tốt hơn là không tắt đèn. Và bạn đang nói rằng tôi vẫn nhận được ánh sáng vào vì có ánh sáng chiếu từ phía trên? Ngay cả ánh sáng đó cũng sẽ rò rỉ và nó sẽ rò rỉ vào phần quang phổ đó và khiến melatonin bị ngăn chặn. Vâng. Vậy nên chỉ có đôi mắt là kiểu như là thước đo cho thời gian trong ngày? Đúng.
    Và vấn đề là, ngay cả khi bạn nhắm mắt, ánh sáng vẫn có thể xuyên qua mí mắt của bạn.
    Bạn nghĩ sao về những chiếc mặt nạ ngủ này?
    Tôi nghĩ chúng rất tuyệt, đặc biệt là vì giờ đây chúng ta biết rằng việc nhắm mắt vẫn có thể cho phép một chút ánh sáng đi vào.
    Vì vậy, nếu bạn đang ngủ trong một môi trường mà, bạn biết đấy, ánh sáng nằm ngoài tầm kiểm soát của bạn, nếu bạn sống ở thành phố và bạn có thể kéo rèm cửa, nhưng vẫn có ánh sáng chiếu vào, những thứ này thực sự có thể rất hữu ích.
    Tôi không khuyên dùng đèn ngủ trong phòng ngủ.
    Bạn không khuyên dùng?
    Tôi không.
    Ngay cả đồng hồ radio hay máy điều hòa không khí có màn hình LED trên chúng.
    Điều đó giống như ô nhiễm ánh sáng hoàn toàn trong phòng ngủ của bạn.
    Phòng ngủ của bạn nên tối nhất có thể.
    Còn nếu tôi có những chiếc đèn không phát ra ánh sáng xanh thì sao?
    Bởi vì tôi nghĩ bạn gái của tôi đã đặt một vài chiếc bên giường.
    Vâng.
    Chúng có vẫn không tốt không?
    Một lần nữa, điều tốt nhất là không có ánh sáng.
    Điều thứ hai tốt nhất là ánh sáng không có ánh sáng xanh.
    Và điều tồi tệ nhất là, bạn biết đấy, ánh sáng xanh.
    Còn ánh sáng nến thì sao?
    Thật thú vị.
    Có một nghiên cứu đã được thực hiện, trong đó họ so sánh một người đọc sách vào ban đêm với một bóng đèn chiếu sáng lên nó với một chiếc Kindle hay bất cứ thứ gì mà có đèn LED.
    Điều họ phát hiện ra là có nhiều ánh sáng hơn từ chiếc Kindle so với việc chỉ đọc sách với đèn bàn.
    Và điều này đã làm chậm lại sự bắt đầu giấc ngủ.
    Vậy…
    Cái nào đã làm chậm sự bắt đầu giấc ngủ?
    Chiếc Kindle.
    Chiếc Kindle.
    Vâng.
    Nó đã làm chậm sự bắt đầu giấc ngủ.
    Đủ để thực sự làm chậm nhịp sinh học và ngăn chặn sản xuất melatonin.
    Vì vậy, câu trả lời cho câu hỏi của bạn là ánh sáng nến thì tốt.
    Điều duy nhất tôi sẽ lo lắng là nguy cơ cháy.
    Vâng, vì bạn có thể ngủ quên với thứ đó.
    Chính xác.
    Vì vậy, chủ đề liên quan là vitamin D, mà chúng ta đã đề cập một chút.
    Các thực phẩm bổ sung vitamin D có hiệu quả không?
    Ồ, có, chắc chắn.
    Chúng có hiệu quả.
    Và họ đã kiểm tra chúng.
    Có một số nghiên cứu đã được công bố.
    Martineau, thực tế đã công bố trên Tạp chí Y học Anh.
    Điều này xảy ra trước năm 2020.
    Đó là một phân tích tổng hợp của các thử nghiệm lâm sàng ngẫu nhiên cho thấy những người bổ sung vitamin D hàng ngày có nguy cơ thấp hơn về hội chứng ngực cấp tính.
    Một nghiên cứu gần đây đã cho thấy rằng những người bổ sung 2.000 đơn vị quốc tế vitamin D mỗi ngày có nguy cơ thấp hơn về các tình trạng tự miễn dịch.
    Chúng ta đang nói đến viêm khớp dạng thấp, bệnh Crohn, viêm loét đại tràng, bạn đặt tên nó đi.
    Đó là một nghiên cứu mà chúng tôi thực sự đã xem xét trên kênh MedCram của chúng tôi.
    Bởi vì tôi đã nghe trước đây rằng rất nhiều thực phẩm bổ sung vitamin chúng ta dùng không thậm chí đi vào máu và cơ thể chúng ta.
    Vâng.
    Vì vậy, vitamin D rất thú vị.
    Nó là một loại thực phẩm bổ sung và nó là một vitamin, nhưng nó cũng là một hormone.
    Nó thực sự điều chỉnh sản xuất DNA.
    Vì vậy, nó khá thú vị.
    Nhưng đây là những thử nghiệm ngẫu nhiên được mô tả tốt.
    Nếu bạn đang xem xét các tình trạng tự miễn dịch, đây thực sự là một nghiên cứu được thiết kế để xem xét bệnh tim mạch.
    Họ thực sự có hai nhóm, một nhóm sử dụng axit béo omega và vitamin D.
    Và họ đã chỉ ra rằng trong nhóm vitamin D, có sự giảm đáng kể về các tình trạng tự miễn dịch.
    Tôi bổ sung vitamin D.
    Đây là mối quan tâm của tôi, nếu bạn quyết định bổ sung vitamin D, hãy đảm bảo rằng bạn kiểm tra mức độ của mình.
    Tại sao?
    Lý do là vì đó là một loại vitamin hòa tan trong chất béo và có khả năng là bạn có thể uống quá nhiều.
    Chuyện gì xảy ra nếu bạn uống quá nhiều?
    Nó có thể ảnh hưởng đến chuyển hóa canxi và bạn có thể gặp vấn đề với canxi, quá nhiều canxi.
    Điều này rất hiếm, nhưng nó có thể xảy ra.
    Và tôi không có ý nói rằng để làm mọi người chùn bước trong việc bổ sung, vì tôi nghĩ bổ sung có thể tốt.
    Nhưng vào một thời điểm nào đó, bạn muốn kiểm tra mức độ để xem bạn ở đâu.
    Lý do khác là dựa trên thể hình của bạn, dựa trên màu da của bạn, vì những người có làn da tối màu, rất khó để họ tự tạo ra vitamin D.
    Họ cần phải dành nhiều thời gian hơn bên ngoài, đặc biệt là nếu họ ở vĩ độ cao.
    Vì vậy, giống như tôi sống ở Vương quốc Anh, tôi cần phải ra ngoài nhiều hơn.
    Sẽ khó hơn cho bạn để tạo ra nhiều vitamin D như ai đó, chẳng hạn như nếu bạn sống ở vĩ độ thấp hơn hoặc nếu bạn có làn da sáng hơn, đúng không?
    Vitamin D có tác dụng gì trong cơ thể tôi?
    Ồ, câu hỏi hay.
    Có nhiều tác dụng.
    Vì vậy, nếu bạn nhìn vào cấu trúc của vitamin D, thực sự, tôi thực sự đã nghiên cứu về điều này, thú vị thay, ở đại học.
    Tôi đã từng làm nguyên liệu cho sinh viên cao học.
    Nó là một phân tử hòa tan trong lipid.
    Và vì nó hòa tan trong lipid, nó có thể đi thẳng vào nhân tế bào và thực sự tương tác với DNA và kết hợp với các protein ảnh hưởng đến quá trình phiên mã của DNA của bạn.
    Vì vậy, nói cách khác, tùy thuộc vào loại tế bào mà chúng ta đang nói đến, nó có thể gây ra nhiều thay đổi thú vị.
    Nó ảnh hưởng đến chuyển hóa canxi.
    Có thụ thể vitamin D trên hệ thống miễn dịch của bạn.
    Vì vậy, nó ảnh hưởng đến hệ thống miễn dịch của bạn, nó ảnh hưởng đến chuyển hóa canxi và rất nhiều thứ khác.
    Nhóm của tôi đã thực hiện một nghiên cứu và phát hiện rằng khoảng 1 tỷ người trên toàn cầu có sự thiếu hụt vitamin D.
    Không có gì ngạc nhiên.
    Và khoảng 50% dân số toàn cầu có mức vitamin D không đủ.
    Chắc chắn rồi.
    Vâng.
    Vì vậy, vấn đề là khi thế giới trở nên công nghiệp hóa hơn, khi thế giới trở nên thịnh vượng hơn, họ có thể tạo ra các cư trú và họ có khả năng lắp đặt điều hòa không khí cho những cư trú đó.
    Và chúng ta, với tư cách là con người, có xu hướng tránh những cực đoan.
    Chúng ta không thích những thứ quá nóng.
    Chúng ta không thích những thứ quá lạnh.
    Hãy đối mặt với điều đó.
    Trong xe của chúng ta, chúng ta có cái gọi là kiểm soát khí hậu.
    Chúng ta có thể thiết lập nhiệt độ và đó sẽ là nhiệt độ mà chúng ta sẽ có.
    Có những tác động khác mà chúng ta có thể bàn luận về liệu pháp thủy sinh, có thể, nếu chúng ta đến đó. Nhưng vấn đề là, chúng ta không thích những cực đoan đó. Chúng ta không thích ra ngoài dưới nắng. Và khi chúng ta không làm điều đó, chúng ta sẽ chịu hậu quả. Có cách nào để tôi nhận được vitamin D mà không cần bổ sung và không cần ra nắng không? Có. Nó có trong một số loại thực phẩm. Nấm, chẳng hạn, một số loại cá cũng có vitamin D. Đây là một câu hỏi lạ. Nhưng bạn có nghĩ rằng cơ thể chúng ta biết chúng ta thiếu hụt loại thực phẩm nào không? Và thực sự điều tôi đang nói ở đây là, nếu tôi bị thiếu vitamin D, bạn có nghĩ rằng có một phần nào đó trong cơ thể tôi biết rằng tôi cần ăn nấm không? Đó là một câu hỏi tốt. Và điều đó khiến tôi thèm nấm? Tôi không biết về điều đó đặc biệt. Nhưng tôi có thể nói rằng, trong những người không ngủ đủ giấc, chúng ta có xu hướng ăn nhiều thực phẩm giàu carbohydrate hơn. Điều đó thì chúng tôi biết. Và đây là lý do tại sao nhiều nhà khoa học tin rằng những người không ngủ đủ giấc có xu hướng chọn thực phẩm có thể gây tăng cân. Mỗi người trong các bạn đang xem điều này ngay bây giờ đều có điều gì đó để cung cấp, cho dù đó là kiến thức, kỹ năng hay kinh nghiệm. Và điều đó có nghĩa là bạn có giá trị. Stand Store, nền tảng mà tôi đồng sở hữu, là một trong những nhà tài trợ của podcast này, biến kiến thức của bạn thành một doanh nghiệp chỉ bằng một cú nhấp chuột duy nhất. Bạn có thể bán sản phẩm kỹ thuật số, coaching, cộng đồng, và bạn cũng không cần bất kỳ kinh nghiệm lập trình nào. Chỉ cần có động lực để bắt đầu. Đây là một doanh nghiệp mà tôi thực sự tin tưởng. Và đã có 300 triệu đô la được các nhà sáng tạo, huấn luyện viên và doanh nhân kiếm được, chính xác giống như bạn có khả năng trở thành trên Stand Store. Đây là những người không chờ đợi, đã nghe tôi nói những điều như thế này, và thay vì trì hoãn, họ đã bắt đầu xây dựng, sau đó ra mắt một điều gì đó, và bây giờ họ đang nhận tiền để làm điều đó. Stand cực kỳ đơn giản và vô cùng dễ dàng. Và bạn có thể liên kết nó với một cửa hàng Shopify mà bạn đã sử dụng nếu bạn muốn. Tôi đang sử dụng nó, và bạn gái tôi cũng như nhiều thành viên trong nhóm của tôi. Vì vậy, nếu bạn muốn tham gia, hãy bắt đầu bằng cách ra mắt doanh nghiệp riêng của bạn với bản dùng thử miễn phí 30 ngày. Hãy truy cập stephenbartlett.stand.store và thiết lập của bạn trong vài phút. Trong những thẻ mà chúng ta còn lại trước mặt từ khung Newstart, bạn bị hút vào việc nói về cái gì tiếp theo? Nước. Nước? Vâng. Được rồi, hãy cho tôi biết bạn nghĩ gì về nước, vì mọi người sẽ nghĩ, vâng, tôi uống đủ nước. Thực ra, tôi không nghĩ chúng ta uống đủ nước. Nhưng mọi người thường nói về việc sử dụng nước bên trong, và cũng có lý. Nhưng như tôi đã nói trước đó, việc sử dụng nước bên ngoài thực sự có thể rất ấn tượng. Và nó liên quan đến nhiệt độ cơ thể, và liên quan đến hệ miễn dịch. Vì vậy, chúng ta sẽ nói về nước, nhưng hãy thiết lập một khung cho cuộc trò chuyện đó. Hệ miễn dịch của bạn được chia thành hai loại. Có hệ thống miễn dịch bẩm sinh và hệ thống miễn dịch thích nghi. Chúng ta đã trở nên quen thuộc với hệ thống miễn dịch thích nghi trong thời kỳ COVID, vì tất cả cuộc bàn luận đều xoay quanh kháng thể và kháng nguyên, và thực tế rằng SARS-CoV-2 đang biến đổi, và liệu các vắc-xin tạo ra kháng thể chống lại chúng còn có hiệu lực hay không? Tất cả những điều đó, nơi mà chúng ta thực sự có một chiếc chìa khóa với một lỗ khóa mà nó vừa vặn và xoay ổ khóa, và những kháng thể này, và chúng vừa vặn, đó là tất cả hệ thống miễn dịch thích nghi. Nó rất quan trọng, nhưng hoàn toàn loại bỏ hoặc không thảo luận về hệ miễn dịch bẩm sinh. Hệ miễn dịch bẩm sinh thực sự là hàng phòng thủ đầu tiên của cơ thể. Và điều đang xảy ra ở đó là có những tế bào đang lưu thông, những tế bào như đại thực bào và tế bào tiêu diệt tự nhiên và một số tế bào khác, mà quét cơ thể, luôn luôn tìm kiếm thứ gì đó có vẻ ngoại lai với nó. Và nó có thể nhận thấy dựa trên các mẫu phân tử của những kẻ xâm nhập này rằng chúng không nên ở đó, và chúng cần bị tiêu diệt. Yếu tố chính của hệ miễn dịch bẩm sinh này là một cái gì đó được gọi là interferon. Interferon là một phân tử rất quan trọng trong cơ thể, và nó hiệu quả, nó cực kỳ hiệu quả trong việc ngăn ngừa nhiễm virus đến mức gần như mọi nhiễm virus mà hiện nay đang hoành hành trong cơ thể con người đều có cơ chế phòng thủ chống lại interferon. Nó là một điều kiện tiên quyết. Không có virus nào tự trọng nào có thể nghĩ rằng nó sẽ lây nhiễm vào cơ thể con người mà không giải quyết vấn đề interferon, chấm dứt. Hãy nghĩ về interferon như là một người bảo vệ an ninh tại ngân hàng. Và nếu bạn muốn cướp một ngân hàng, bạn phải có một kế hoạch cho cách bạn sẽ đối phó với người bảo vệ an ninh. Nếu không, bạn sẽ không lấy được tiền. Điều đó có hợp lý không? Vâng. Thực sự thì đã có một bài báo được công bố cách đây một vài năm, nơi họ đã bàn về cuộc chiến này giữa interferon và các virus mới nổi, và những gì virus đang làm để cố gắng vượt qua interferon. Bạn có thể nhớ rằng vào năm 2002, chúng ta đã có một đợt bùng phát của một cái gì đó gọi là SARS, đặc biệt là khá tồi tệ ở Trung Quốc, nhưng cũng ở Canada. Lý do tại sao chúng ta có thể kiểm soát được đợt bùng phát đó là bởi vì tất cả những ai mắc SARS đều phát sốt. Và vì vậy, thật dễ dàng để xác định những người đó, và chúng ta đã có thể nhập viện và cách ly họ. Vấn đề với SARS-CoV-2, và thực sự nhiều nhiễm trùng như cảm lạnh thông thường, là bạn không nhất thiết phải bị sốt. Và sốt thực sự là rất quan trọng. Và bạn sẽ hỏi, điều này có liên quan gì đến nước? Chúng ta sẽ bàn về điều này. Sản xuất interferon tăng lên với nhiệt độ. Và thực tế, cơ chế của cơ thể để gây sốt là một trong những cách mà nó cho cơ thể biết rằng nó cần tăng cường interferon để đối phó với nhiễm virus. Có phải vì thế mà bạn cảm thấy nóng? Bạn cảm thấy nóng. Bạn có thể thực sự cảm thấy lạnh.
    Và lý do tại sao bạn có thể cảm thấy lạnh và thậm chí còn bị ớn lạnh là vì cảm giác của bạn là sản phẩm của nhiệt độ cơ thể bạn và nhiệt độ mà bộ điều chỉnh nhiệt trong cơ thể bạn được cài đặt. Vì vậy, nếu bộ điều chỉnh nhiệt của cơ thể bạn đang chỉ ra rằng, được rồi, chúng ta đang ở mức 37 độ C (98,6 độ F), và bạn phát triển một nhiễm trùng, cơ thể sẽ nói, ôi, chúng ta có một nhiễm trùng và chúng ta cần phải tăng nhiệt độ cơ thể. Chúng ta sẽ chuyển từ 37 độ C lên 38 độ C (100,4 độ F). Bởi vì nhiệt độ cơ thể thực tế của bạn thấp hơn mức cơ thể muốn, bạn sẽ cảm thấy lạnh. Bạn sẽ run để cố gắng tăng nhiệt độ đó. Vì vậy, bạn sẽ tăng nhiệt độ lên từ đó. Bây giờ, khi cơn sốt qua đi và nhiễm trùng kết thúc và nhiệt độ giảm xuống, bạn sẽ ra mồ hôi. Đó là lý do tại sao khi ai đó nói, ôi, anh ấy đang ra mồ hôi, điều đó có nghĩa là cơn sốt đang giảm. Điều đó có nghĩa là nhiệt độ của bạn đang giảm xuống. Vì vậy, thông thường bạn sẽ cảm thấy lạnh. Bạn sẽ cảm thấy như mình đang run rẩy. Bạn sẽ muốn nằm lên giường và đắp chăn vào. Và đó là khi nhiệt độ cơ thể bạn tăng lên. Và điều đó có lý do. Bởi vì những gì xảy ra khi nhiệt độ trong cơ thể bạn tăng lên là tạo ra một môi trường mà virus không thể sao chép tốt. Tất cả các virus thực sự không thể sao chép tốt ở nhiệt độ cao, bao gồm cả SARS-CoV-2. Đó cũng là tín hiệu cho cơ thể bạn sản xuất nhiều interferon hơn. Có một nghiên cứu được công bố vào năm ngoái mà họ đã nghiên cứu trên chuột, mà btw, có nhiệt độ cơ thể giống chúng ta. Và họ phát hiện rằng có năm protein điều chỉnh khác nhau, tất cả đều dẫn đến một điểm cuối cùng. Và đó là sản xuất một cái gọi là interferon. Tất cả chúng đều tăng sản xuất khi nhiệt độ cơ thể bạn từ 37 độ C lên 38 độ C. Đó cơ bản là ngay dưới mức cơn sốt, đúng không? Vậy điểm chính mà tôi rút ra từ tất cả những điều đó là chúng ta không nên thực sự điều trị sốt trừ khi chúng cao đến mức có những biến chứng khác có thể xảy ra như, bạn biết đấy, nhịp tim đập nhanh hay có cơn co giật. Nhưng chúng ta vẫn làm điều này mọi lúc. Chúng ta điều trị sốt bởi vì nó khiến chúng ta cảm thấy tồi tệ. Và chúng ta nghĩ rằng việc điều trị sốt sẽ khiến chúng ta cảm thấy tốt hơn. Nhưng điều chúng ta thực sự làm là chúng ta cắt đứt sức mạnh của hệ thống miễn dịch của chúng ta vì một phần của phản ứng hệ thống miễn dịch là tạo ra một cơn sốt và cơn sốt tạo ra interferon. Bây giờ, tôi không muốn nói quá lên, nhưng hãy so sánh hệ thống miễn dịch bẩm sinh với hệ thống miễn dịch thích ứng. Hệ thống miễn dịch thích ứng khá cụ thể cho một biến thể virus nhất định. Và đối với một virus biến đổi rất nhanh, như SARS-CoV-2, sự miễn dịch có thể rất tốt về mặt liên kết. Nhưng nếu virus đó đột biến, sự liên kết đó sẽ bị ảnh hưởng theo cách nào đó. Nó có thể không ảnh hưởng đến việc nhập viện, nhưng có thể ảnh hưởng đến việc ngăn ngừa nhiễm trùng. Bạn có hiểu những gì tôi đang nói không? Vì vậy, các biến thể khác nhau, chúng ta đã có biến thể alpha, sau đó là biến thể delta, sau đó là Omicron, v.v. Đó là những thay đổi quan trọng đối với hệ thống miễn dịch thích ứng. Đối với hệ thống miễn dịch bẩm sinh, đối với interferon, nó không quan trọng. Interferon hiệu quả như nhau đối với alpha như nó đã cho delta và sẽ là cho Omicron. Vậy hãy thiết lập lại điều này. Nước. Chúng ta đã nói rằng nước có nhiệt độ cụ thể rất cao, có nghĩa là nếu tôi áp dụng nước nóng lên cơ thể con người, nó có khả năng truyền nhiệt. Đây là lý do tại sao mọi người có thể bị bỏng với nước sôi. Chúng ta rõ ràng không muốn bỏng ai cả. Nhưng nếu chúng ta có thể đưa họ vào xông hơi, nếu chúng ta có thể đưa họ vào một spa, nếu chúng ta có thể dùng khăn ấm và áp dụng lên cơ thể con người để làm nóng cơ thể của họ nhằm tạo ra mồ hôi, nói cách khác, nếu chúng ta có thể kích thích cơn sốt nhân tạo cho những bệnh nhân có những nhiễm trùng này, dường như có bằng chứng rằng phản ứng interferon sẽ tốt hơn. Có một nghiên cứu đã được thực hiện xem xét các tế bào lympho và lấy chúng ra khỏi cơ thể con người. Và ở các nhiệt độ khác nhau, khi đạt khoảng 38, 39 độ C, đã có sự gia tăng mười lần nồng độ interferon, mà đây chính xác là điều bạn muốn. Bây giờ, làm thế nào tôi biết rằng nồng độ interferon là rất quan trọng trong các bệnh như COVID-19? Chà, có một nghiên cứu đã được thực hiện cho thấy rằng nồng độ interferon cao tương quan với các nhiễm trùng SARS-CoV-2 nhẹ hơn, và rằng những người có nồng độ interferon thấp có các nhiễm trùng COVID-19 rất nặng. Vậy bạn gợi ý chúng ta nên ở trong xông hơi thường xuyên hơn? Có. Và điều đó dựa trên dữ liệu đã được ghi chép tốt trong lĩnh vực xông hơi của Phần Lan. Vì vậy, những người sử dụng xông hơi bốn, năm, sáu, bảy lần một tuần có khả năng tử vong do các bệnh tim mạch ít hơn so với những người sử dụng xông hơi một lần một tuần. Và ở Phần Lan, một lần một tuần là tiêu chuẩn. Và tại sao họ nói nên kết hợp liệu pháp nóng và lạnh? Vì vậy, tôi sẽ tranh luận rằng lý do tại sao việc này đã được tranh luận thực hiện, và điều này trở về một số bài báo đã được viết hơn 100 năm trước, là những gì bạn đang làm khi bạn thực hiện nóng trong một khoảng thời gian dài, giả sử 20 phút trong xông hơi. Và những gì bạn đang làm là bạn đang làm nóng cơ thể, và toàn bộ mục đích của điều đó là để tăng nhiệt độ cơ thể. Những gì sự lạnh ở cuối làm là nó làm hai điều mà họ cho là. Điều đầu tiên mà nó làm là gây ra sự co mạch. Vì vậy, bạn đặt một lượng lạnh ngắn lên cơ thể. Nó sẽ gây ra sự co mạch bề mặt, vì vậy khi bạn xong, bạn sẽ không mất nhiều nhiệt qua các mạch máu đó. Và vì vậy bạn sẽ giữ nhiệt độ cơ thể lõi cao hơn lâu hơn, điều đó chính xác là những gì bạn muốn thực hiện. Điều khác mà nước lạnh làm, một lần nữa, là sự co mạch. Nó được biết đến rằng khi bạn tắm nước lạnh, các mạch máu của bạn sẽ co lại.
    Và khi bạn nhìn vào một mạch máu ngang ở một người sống và đang tuần hoàn, có một số tế bào bạch cầu đang bám vào bề mặt bên trong của mạch máu đó. Khi mạch máu co lại, rất nhiều tế bào bạch cầu đã bị mắc kẹt kia sẽ được đẩy vào tuần hoàn, và chúng sẽ đi nơi khác để làm những gì mà chúng sẽ làm. Điều này được gọi là sự tách rời.
    Vì vậy, hai điều đối với việc lạnh ngay ở cuối. Nó không cần phải dài, có thể chỉ một phút. Thực tế nó khiến nhiệt độ cơ thể của bạn duy trì ở mức cao hơn lâu hơn, một cách mỉa mai. Và thứ hai, sự tách rời.
    Đó là nước, cái mà được viết tắt là W. Trong số những điều này, bạn muốn chọn cái nào tiếp theo? Cái nào khiến bạn thấy hấp dẫn nhất? Hãy nói về không khí một cách ngắn gọn.
    Chúng tôi đã nói rằng không khí không chỉ là sự thiếu vắng độc tố, mà thực sự có lợi. Đầu tiên, chúng tôi muốn có oxy tốt. Chúng tôi muốn loại bỏ carbon dioxide, đặc biệt là trong các tòa nhà khi không có thông gió. Điều đó không tốt. Nhưng thực tế đã có một số nghiên cứu nhìn vào cây cối và cây xanh, và sự thật là chúng có thể thải ra những thứ như phytoncides. Nhưng đó là gì?
    Đây là các hợp chất thơm mà cây thải ra. Và khi chúng ta xem xét tác động của các hợp chất này đối với cơ thể con người, chúng thực sự rất có lợi. Chúng tương tác với hệ thống miễn dịch của chúng ta và nâng cao hệ thống miễn dịch, và thực sự có thể giúp chúng ta thư giãn hơn. Có rất nhiều dữ liệu trong tài liệu Nhật Bản về điều này, trong những gì họ gọi là rừng cây tuyết tùng Hanoki, nơi họ đã xem xét những giám đốc điều hành. Có một podcast nói về giám đốc điều hành.
    Có những giám đốc điều hành này ở Nhật Bản. Họ đã đưa họ từ công việc về cơ bản lên núi của cây tuyết tùng Hanoki và để họ đi xung quanh, làm xét nghiệm máu. Họ phát hiện ra rằng các tế bào diệt tự nhiên, rất quan trọng về mặt miễn dịch, không chỉ tăng số lượng mà các enzyme bên trong chúng phân hủy bệnh tật hoặc virus cũng tăng.
    Vì vậy, khi họ đưa họ trở lại thành phố ở Nhật Bản, họ đã cho họ ở khách sạn và truyền một số hóa chất này, những phytoncides tự nhiên này. Và họ đã có gần như chính xác những tác động tương tự ở những đối tượng này. Vì vậy, bạn nghĩ rằng cây cối và việc ở trong thiên nhiên thực sự có thể đem lại cho chúng ta nhiều hơn chỉ là không khí sạch. Nó cung cấp cho chúng ta các hóa chất giúp chúng ta chống lại bệnh tật. Hoàn toàn.
    Vì vậy, một lần nữa, đây là sự phân chia. Bên trong so với bên ngoài. Bạn nhận được gì khi bạn ở bên ngoài? Chúng tôi đã nói về tập thể dục. Chúng tôi đã nói về ánh sáng mặt trời. Và bây giờ chúng tôi đang thêm vào đó không khí trong lành, không chỉ là thực tế rằng bạn có ít ô nhiễm, điều này chắc chắn rất quan trọng, mà thực tế là khi bạn ở gần cây xanh, khi bạn ở quanh những cây xanh, có thể thực sự có một lợi ích.
    Nhân tiện, lợi ích mà họ tìm thấy kéo dài khoảng bảy ngày. Vì vậy, chỉ cần ra ngoài một ngày mỗi tuần có thể thực sự mang lại lợi ích đó. Tôi nghĩ nhiều đến carbon dioxide, tất nhiên vì tôi dành nhiều thời gian ngồi trong studio ghi âm và đây là studio lớn của chúng tôi ở LA, nhưng ở Vương quốc Anh, nó bắt đầu trong một căn phòng rất nhỏ và không có điều hòa không khí. Và rõ ràng tôi ngồi đây đôi khi trong nhiều giờ với một khách mời và chúng tôi đang tái chế CO2 vào thời điểm đó.
    Vâng. Sau đó, tôi đọc một vài nghiên cứu cho thấy tác động mà điều đó sẽ có đối với hiệu suất nhận thức của tôi. Vâng. Điều đó hoàn toàn đúng. Chúng tôi thực sự đã có trên kênh của chúng tôi với MedCram, chúng tôi đã mời Tiến sĩ Joseph Allen từ Trường Y tế Công cộng Harvard và ông ấy đã chỉ cho chúng tôi. Ý tôi là, ông ấy thực sự đã có máy đo CO2 và chỉ bằng cách mở cửa sổ một chút cho phép carbon dioxide thoát ra và hạ thấp các mức carbon dioxide đó.
    Vì vậy, rất quan trọng. Hoàn toàn đúng. Và đối với những người làm việc trong văn phòng hoặc đi lại trong các phòng khách sạn hoặc ở trong nhà nhiều, họ nên suy nghĩ về điều gì và làm thế nào để đảm bảo rằng chất lượng không khí là tối ưu?
    Vâng, chỉ số thay thế cho điều đó là carbon dioxide, như chúng tôi đã đề cập. Vì vậy, mở cửa sổ nếu họ có thể, nếu có một cánh cửa mà họ có thể mở một cách an toàn mà không làm mất an toàn. Đây đều là những điều sẽ rất có lợi, thậm chí là kéo kính xuống trong xe ô tô và có thể đảm bảo rằng chúng ta tắt nút tái chế khi đang lái xe.
    Tôi có những người bạn không ở trong một số phòng khách sạn nhất định trừ khi cửa sổ mở, bởi vì bạn biết đấy, trong nhiều phòng khách sạn, đặc biệt là những phòng nằm trên cao, bạn không thể mở cửa sổ. Và cũng có một số thiết bị mà chúng tôi, trong studio nhỏ của chúng tôi ở Vương quốc Anh, đã tìm thấy trên Amazon, không quá đắt, mà chúng tôi đôi khi chỉ đặt trên sàn trong studio chỉ để xem chúng tôi đang làm như thế nào.
    Tôi sẽ liên kết một số thứ đó trên màn hình nếu ai đó quan tâm đến việc biết, xem mức CO2 trong bất kỳ phòng nào mà bạn đang làm việc. Vâng. Vậy, điều gì tiếp theo trong danh sách của bạn ở đây?
    Vâng, chúng tôi đã nói về, ý tôi là, tập thể dục, dinh dưỡng, sự tiết chế. Đây là những điều mà nhiều người nói đến. Không nhiều người nói về niềm tin. Khi bạn nói về niềm tin, bạn thực sự có ý định nói về đức tin tôn giáo?
    Đức tin tôn giáo, điều gì đó sẽ giúp bạn đối phó với căng thẳng và lo âu. Đó thực sự là điều mà vấn đề này hướng đến. Và thực tế đã có một số nghiên cứu đã nhìn vào điều đó. Vậy thì, vâng, chủ yếu là Kinh thánh. Hoặc nó không nhất thiết phải là Kinh thánh. Cũng có những giáo phái khác cũng nhìn vào điều này. Một số nghiên cứu đã xem xét niềm tin vào Chúa và cách mà điều đó liên quan đến lo âu.
    Vì vậy, một số nghiên cứu đã chỉ ra rằng những người có đức tin tốt và niềm tin vào một vị thần hoặc một tôn giáo hỗ trợ và không hỗ trợ, có thể họ có ít lo âu hơn, ít trầm cảm hơn, có một cộng đồng tín ngưỡng mà họ có thể tham gia và được hỗ trợ.
    Và tôi nghĩ rằng văn học là như vậy, trong khi khoa học đằng sau điều đó không nghiêm ngặt như nó sẽ có đối với một cuộc thử nghiệm có đối chứng giả dược ngẫu nhiên. Có rất nhiều mối liên hệ mà bạn phải bàn đến ở đây, chắc chắn đó là một trong những nền tảng mà tôi tin là giúp ích cho tất cả các mối liên kết đó. Bạn nghĩ điều gì đang diễn ra ở đó?
    Vậy bạn đang nói với tôi rằng từ những gì văn học đã nói, những người có niềm tin vào một vị thần nào đó được bảo vệ khỏi trầm cảm và lo âu theo một cách thú vị nào đó?
    Đúng, đó là một câu hỏi mà nhiều người đã cố gắng trả lời. Và họ tin rằng tất cả đều liên quan đến việc nếu bạn có niềm tin vào một vị thần luôn chăm lo cho bạn và bênh vực bạn. Thì loại mối quan hệ đó thực sự dẫn đến, hay nói cách khác, có mối liên hệ, tôi không nên nói là dẫn đến, vì điều đó hàm ý về nguyên nhân. Hãy nói rằng nó có liên quan đến việc giảm trầm cảm, giảm lo âu, đặc biệt.
    Có một số nghiên cứu đã được thực hiện, đặc biệt trong Cơ đốc giáo, nơi có một nghiên cứu đã được công bố. Đây là nghiên cứu của Krauss từ, tôi tin là, Đại học Texas, nơi ông đã thực hiện một cuộc khảo sát và hỏi mọi người cách họ tha thứ. Và ông đã chia họ thành hai nhóm khác nhau. Có những người sẽ tha thứ có điều kiện và những người sẽ tha thứ vô điều kiện.
    Hãy để tôi nói theo cách thực tế. Nếu ai đó làm điều gì đó với bạn và bạn nói, ôi, không sao, tôi tha thứ cho bạn, câu hỏi là, bạn có tha thứ điều đó không? Có một số người chỉ tha thứ nếu người đó quay lại và, bạn biết đấy, thực hiện một hành động hối lỗi nào đó. Giống như, được rồi, tôi sẽ tha thứ cho người đó. Họ quay lại và xin lỗi. Hoặc tôi sẽ tha thứ cho người đó. Họ quay lại và họ đã làm, bạn biết đấy, bất cứ điều gì. Điều đó sẽ được coi là tha thứ có điều kiện. Loại khác là tha thứ vô điều kiện.
    Nói cách khác, nếu ai đó làm điều gì đó với bạn, bạn không gặp lại họ nữa. Hoặc họ không bao giờ bộc lộ bất kỳ loại gì, bạn biết đấy, để tỏ ra hối lỗi về những gì họ đã làm. Họ vẫn được tha thứ. Thế đó là tha thứ vô điều kiện.
    Những gì họ tìm thấy trong nghiên cứu khi chia nhỏ là những người tha thứ vô điều kiện có ít bị trầm cảm hơn. Họ có ít cảm giác không đầy đủ hơn. Họ có ít lo âu hơn liên quan đến cái chết. Họ có tất cả những điều này, những người tha thứ có điều kiện có nhiều triệu chứng trầm cảm hơn. Vì vậy, đây là những điều thực sự, bạn biết đấy, mà họ có thể chẩn đoán được qua khảo sát và các bài kiểm tra đã được xác thực tốt.
    Và yếu tố quyết định giữa hai nhóm này là cách họ tha thứ. Vì vậy, họ đã cảm thấy bối rối về điều này. Họ nói, vậy thì điều gì xác định liệu một người nào đó có tha thứ có điều kiện hay vô điều kiện? Vì vậy, họ đã xem xét nhiều yếu tố và không có yếu tố nào nổi bật ngoại trừ một điều. Và, và tỷ số odds về điều này là khoảng 2.5. Và, và nó chỉ trở về một câu hỏi này. Bạn có tin rằng Chúa đã tha thứ cho bạn không? Đó là, đó là điều quan trọng nhất. Nếu ai đó tin rằng vị thần mà họ có niềm tin đã tha thứ cho họ, thì họ có khả năng cao gấp hai lần rưỡi để tha thứ cho ai đó vô điều kiện.
    Điều đó có nghĩa là gì? Điều đó có nghĩa là có liên quan đến tất cả những điều khác thấp hơn, như ít trầm cảm hơn, ít lo âu hơn. Vì vậy, đối với tôi, điều đó thật kỳ diệu rằng, trong suy nghĩ của họ, đây chính là những gì đang diễn ra. Và vì vậy đã có những cuộc thử nghiệm có đối chứng ngẫu nhiên nơi mà họ đã, khi mọi người đang tham gia trị liệu, như bạn nói, có lo âu, có liệu pháp nhận thức hành vi mà chúng ta có thể thực hiện cho những người đó. Nhưng điều đã được chứng minh theo cách có đối chứng với giả dược là nếu ai đó có niềm tin và bạn đưa vào đó các yếu tố của niềm tin vào liệu pháp nhận thức hành vi, thì liệu pháp nhận thức hành vi đó thậm chí còn hiệu quả hơn.
    Vì vậy, tôi nghĩ tôi nên mở đầu điều này bằng cách nói rằng tôi không tin rằng bất kỳ điều gì trong số này nên được đặt lên người khác mà không có sự đồng ý của họ. Vì vậy, tôi làm việc trong một môi trường chăm sóc sức khỏe. Vậy tôi có đi cầu nguyện cho những người không tin không? Không. Đây là điều mà luôn phải được thực hiện. Nó phải được xin phép. Bạn có nghĩ rằng những người tin vào Chúa thì thường khỏe mạnh hơn không? Tất cả các yếu tố khác? Dường như dữ liệu cho thấy rằng những người có mối quan hệ lành mạnh với nhà thờ của họ, những người có mối quan hệ lành mạnh với Chúa có liên quan đến ít bệnh tật hơn.
    Bởi vì từ quan điểm nguyên nhân, bạn có thể nói rằng, nguyên nhân, vâng. Vậy, điều này, điều mà chúng tôi không, chúng tôi có thể nói họ có nhiều bạn hơn. Họ có thể có, vâng. Vậy câu hỏi là, là liệu những người khỏe mạnh hơn và có nhiều bạn bè hơn có khả năng tôn giáo cao hơn, hay là ngược lại? Đôi khi rất khó để xác định những điều đó. Nhưng tôi tưởng tượng có một sức mạnh bình yên lớn đến từ việc tin vào một sức mạnh tối cao.
    Chắc chắn rồi. Và điều khác mà, điều khác thú vị về tất cả những thứ như chương trình khởi đầu mới này là khi bạn nhìn vào những tôn giáo cụ thể khác, cách mà nhiều điều này thực sự được tích hợp vào đây. Như ví dụ, người Hindu rất nổi tiếng với việc dậy sớm vào buổi sáng và chào đón mặt trời. Chúng ta chỉ mới nói về những lợi ích của ánh nắng mặt trời. Chúng ta không nói nhiều về dinh dưỡng, nhưng nhịn ăn là một phần quan trọng trong đó. Và, và, người Hồi giáo, rõ ràng, một phần của tôn giáo của họ là thực hiện việc nhịn ăn trong tháng Ramadan. Nhiều tôn giáo cũng có những thực hành nóng và lạnh, phải không? Vâng.
    Và ngược lại của điều đó, tôi sẽ nói rằng cũng có bằng chứng cho thấy nếu bạn có một mối quan hệ không lành mạnh, như nếu bạn tin vào một vị thần trả thù hoặc người mà đang chờ đợi để làm điều gì đó với bạn trừ khi bạn làm điều gì khác, thì điều đó cũng đã được chứng minh là có ảnh hưởng tiêu cực. Vì vậy, nó phụ thuộc vào mối quan hệ mà bạn có.
    Bạn thấy gì trong công việc của mình?
    Bởi vì bạn đã nói trước đó rằng bạn thường có mặt vào những thời điểm cuối đời của mọi người.
    Đúng vậy.
    À, thật không may, đôi khi tôi là người cuối cùng họ nhìn thấy và, và bạn bắt đầu nhận ra rằng cái chết là điều không thể tránh khỏi và tất cả những gì chúng ta làm trong y học chỉ là trì hoãn điều không thể tránh khỏi.
    Vì vậy, điều mà chúng tôi cố gắng làm, và tôi có một đồng nghiệp rất triết lý về điều này, là chúng tôi cố gắng đảm bảo rằng khi những điều này xảy ra, chúng xảy ra với sự tôn trọng và chúng tôi kỷ niệm cuộc sống của người đó và đảm bảo rằng nó diễn ra theo cách mà họ muốn.
    Mọi người nói gì khi họ sắp chết?
    Mọi người trở nên rất, rất khác nhau, đối với từng người khác nhau, nhưng họ có thể trở nên rất thận trọng và, và tôi đã thấy những sự tương phản như vậy.
    Mọi người đã sẵn sàng ra đi.
    Mọi người cảm thấy như họ đã làm tất cả những gì họ cần làm và, và họ không muốn làm gì thêm nữa.
    Chúng tôi ở đó để trì hoãn cái chết, đúng không?
    Chúng tôi ở đó để cho họ thở máy hoặc cho họ thuốc này thuốc nọ.
    Và bạn sẽ ngạc nhiên khi thấy người ta, những người mà nhìn có vẻ, bạn biết đấy, khá khỏe mạnh, nhưng, và có điều gì đó đã xảy ra mà chúng tôi có thể dễ dàng sửa chữa.
    Họ nói, không, tôi, tôi không muốn điều đó.
    Tôi chọn không muốn điều đó.
    Và chúng tôi phải tôn trọng rõ ràng những gì họ chọn.
    Rõ ràng chúng tôi phải giáo dục họ để đảm bảo rằng họ đang đưa ra quyết định đúng đắn.
    Nhưng một khi, một khi họ có đủ thông tin, thì cuối cùng họ là người đưa ra quyết định.
    Vì vậy, bạn thấy mọi người chọn cái chết.
    Khi chúng tôi có thể can thiệp theo cách nhân tạo, họ muốn không có điều đó và họ sẽ chọn cái chết.
    Đúng.
    Có những trường hợp đặc biệt nào đã thay đổi bạn không?
    Có.
    Có.
    Có một trường hợp đã thay đổi tôi, nhưng không theo cách mà chúng ta vừa nói đến, nơi mà nó thật khủng khiếp.
    Điều này, thực sự là một phép màu.
    Tôi đã thực sự thấy một phép màu xảy ra.
    Và đối với tôi, nó xảy ra sớm trong quá trình đào tạo của tôi.
    Vì vậy, nó đã khiến tôi suy nghĩ lại về việc trở thành một bác sĩ dự đoán.
    Một bác sĩ dự đoán.
    Đúng.
    Nói rằng, ôi, bạn sẽ không bao giờ đi lại được nữa, hoặc, hoặc bạn chỉ còn hai năm nữa để sống.
    Tôi nhất định đã bỏ lỡ ngày đó ở trường y.
    Tôi đã không xuất hiện vào ngày đó.
    Đây là một người trẻ.
    Anh ấy, anh ấy bị ung thư tinh hoàn và anh ấy đã đi phẫu thuật.
    Ca phẫu thuật ung thư tinh hoàn thành công.
    Thật không may, trong khi phẫu thuật, điều gì đó đã xảy ra.
    Anh ấy không được cung cấp đủ oxy cho não.
    Và anh ấy ra khỏi ca phẫu thuật với chấn thương não do thiếu oxy.
    Chàng trai này chắc hẳn mới ngoài hai mươi, và anh có một người vợ trẻ.
    Và tôi đã tham gia vào vòng quay như một, như một cư dân.
    Và chúng tôi có các bác sĩ phụ trách và bạn phải hiểu rằng trong y học, bạn có bác sĩ phụ trách ở trên bạn.
    Và những gì họ nói là chỉ cần, bạn biết đấy, đó là lời nói.
    Đó là điều sẽ xảy ra.
    Và bác sĩ phụ trách ICU, và chúng tôi là những người đang chăm sóc bệnh nhân vì anh ấy đang thở máy.
    Nhưng có bác sĩ thần kinh xem xét mọi thứ và nói, nhìn, người này không tỉnh lại.
    Anh ấy bị chấn thương não do thiếu oxy nặng.
    Chúng tôi đã xem các hình ảnh chụp.
    Đây là điều sẽ xảy ra.
    Và vì vậy, mỗi ngày chúng tôi khám cho người này và anh ấy chỉ là một đống hoảng loạn.
    Anh ấy chỉ ở đó.
    Anh ấy chỉ hơi rung rẩy.
    Mắt anh ấy lăn lộn, không có phản ứng, không gì cả.
    Và mỗi ngày vợ anh ấy đều vào thăm, và bà ấy không tin rằng người này sẽ như vậy suốt phần đời còn lại.
    Anh ấy sẽ tỉnh lại vào một ngày nào đó.
    Và vì vậy, bà ấy, bà ấy sẽ ở bên giường anh, chăm sóc anh, và đảm bảo rằng điều này, điều nọ, và thậm chí hỏi chúng tôi cho vào ống ăn của anh một số công thức đặc biệt mà bà đã làm ở nhà để điều này có thể giúp anh hồi phục.
    Và chúng tôi sẽ đồng ý với bà, nhưng tôi đang nhìn các bác sĩ phụ trách và họ nói, bà ấy, bà ấy không hiểu đang xảy ra điều gì.
    Bà ấy không hiểu rằng anh ấy sẽ không bao giờ tỉnh lại.
    Vì vậy, đây là những gì tôi đang chứng kiến.
    Một ngày nào đó bà ấy vào và bà ấy, và bà ấy chỉ có một nụ cười trên khuôn mặt.
    Bà ấy chỉ bình an đến mức, và cười tươi.
    Và, và họ là một cặp vợ chồng người Tây Ban Nha.
    Vì vậy, chúng tôi đã phải hỏi một dịch giả về điều gì đang xảy ra.
    Và bà ấy đã nói với chúng tôi, bà ấy nói, um, tôi đã có một giấc mơ tối qua.
    Tôi đã có một giấc mơ rằng anh ấy sẽ về nhà.
    Và bà ấy rất tin tưởng, hoàn toàn hạnh phúc, rạng rỡ.
    Và chúng tôi nghĩ, ôi, bà này thật điên rồ.
    Bà ấy không hiểu điều gì đang xảy ra.
    Vâng, những ngày trôi qua, tuần trôi qua.
    Và, và một ngày nọ, và nơi tôi đang vòng qua, chỉ là ở trong các trạm điều dưỡng, ở giữa và các cửa vào các phòng đều xung quanh theo chu vi.
    Và chúng tôi đang đi quanh vòng tròn khám bệnh cho bệnh nhân.
    Và tôi có thể nhìn vào và thấy anh ấy và anh ấy đang hơi rung rẩy, nhưng anh ấy đang mở mắt.
    Và tôi nói, có vẻ như anh ấy đang tập trung một chút.
    Mắt anh ấy có vẻ đang tập trung hơn bình thường.
    Và anh ấy đã, tôi đã giơ tay lên như thế này.
    Và thật vậy, anh ấy đã giơ tay lên như thế này rung rẩy và rồi anh ấy lại đặt xuống.
    Tôi nghĩ, cái gì vậy?
    Anh ấy đã vẫy tay với bạn.
    Đúng.
    Cái gì vậy?
    Và tôi nói, cho chúng ta đi kiểm tra lại điều này.
    Nói dài ngắn lại, mất hàng tháng.
    Nhưng người đó đã ra khỏi bệnh viện.
    Sáu tháng sau, anh ấy và vợ anh ấy trở lại, đi vào đơn vị, như thể không có điều gì sai với người đó.
    Và anh ấy đã tặng cho chúng tôi một giỏ hoa lớn để cảm ơn đơn vị vì những gì họ đã làm cho anh ấy.
    Trong tâm trí tôi, tôi biết rằng đối với hầu hết nhân viên trong thời gian đó, mọi người chỉ đi qua các động tác, giữ cho anh ấy sống, vì đó là những gì mà bà ấy muốn.
    Rõ ràng, khi có những dấu hiệu cho thấy người này đang phục hồi, mọi thứ đã thay đổi hoàn toàn.
    Mọi người rất ngạc nhiên.
    Và điều đó đã ảnh hưởng đến sự nghiệp của tôi như thế nào là đã làm tôi suy nghĩ kỹ hơn, như là, tại sao người này lại trở nên tốt hơn? Anh ta mới 22 tuổi. Anh ta còn trẻ. Và thường thì, nếu có một điều gì đó như vậy xảy ra, thì nó sẽ xảy ra với một người rất trẻ, có tư duy linh hoạt, có thể chịu đựng được loại tình huống đó. Nhưng thực sự, đó là một phép màu. Tôi không thể nói gì khác. Ý tôi là, đó không phải là điều mà chúng ta sẽ biết, tất cả các chuyên gia đều nói rằng điều này sẽ không xảy ra, nhưng nó đã xảy ra. Bạn nghĩ điều gì đã xảy ra? Tôi nghĩ anh ta có một người vợ yêu thương, người tin tưởng vào anh. Và có điều gì đó xảy ra bên ngoài thể chất và tinh thần, có thể là tâm linh. Tôi không biết. Nó xảy ra. Điều đó rất hiếm. Và khi nó xảy ra, nó xảy ra với những người trẻ tuổi. Đó sẽ là những gì mà phần y học trong tâm trí tôi sẽ nói. Nhưng phần còn lại trong tâm trí tôi nói, bạn biết không? Tôi chỉ biết khoảng 10%, có thể 5% kiến thức của thế giới. Không. Kiến thức của thế giới, 1% kiến thức của thế giới. Có thể tôi có 5% đến 10% tổng kiến thức y học trong thế giới này. Và tôi sẽ nói rằng có lẽ lời giải thích nằm trong phần còn lại 80% đến 90% mà tôi chỉ không biết. Tôi nghĩ điều mà nó dạy tôi là chúng ta phải khiêm tốn về những gì mà chúng ta biết. Có những thứ mà chúng ta biết, chúng ta biết. Và có những thứ mà chúng ta không biết, mà chúng ta không biết. Chúng ta đã nói một chút về hóa chất này trước đây về melatonin. Vâng. Tôi chỉ muốn kết thúc vì tôi có một câu hỏi về nó. Nhiều người uống bổ sung melatonin vào ban đêm để giúp họ ngủ. Vâng. Tốt, xấu, hay không liên quan? Tôi nghĩ nó tốt trong một số tình huống. Nếu bạn gặp khó khăn trong việc đi vào giấc ngủ, một liều melatonin nhỏ, không quá 5 mili-gram, có thể thực sự rất có ích. Nếu bạn muốn điều chỉnh nhịp sinh học của mình quay trở lại thay vì bị đẩy lùi, nhưng bạn muốn nó tiến về phía trước, melatonin có thể rất có ích. Điều này rất có ích cho chứng jet lag. Nó cũng có lợi cho một số bệnh liên quan đến giấc ngủ, nhưng tôi sẽ không khuyến cáo dùng thường xuyên, không vì lý do nào khác, dùng liều cao melatonin. Có sự đánh đổi nào không? Bạn đã nói trước đó rằng mọi thứ đều có tác dụng phụ, đúng không? Và nó ảnh hưởng đến một phần khác. Vì vậy, việc uống liều cao melatonin thực sự có thể làm cho bạn dễ cáu gắt hơn. Cáu gắt? Cáu gắt, vâng. Theo cách nào? Chỉ là dễ cáu gắt về mặt tinh thần. Vâng. Nó trông như thế nào? Những điều khiến bạn dễ nổi cáu hơn. Vậy có phải liên quan đến rối loạn tâm trạng không? Vâng, hoàn toàn. Còn gì khác với melatonin mà bạn biết không? Không có gì mà chúng tôi có nghiên cứu cho điều đó. Người ta có mối quan tâm rằng đôi khi việc uống quá nhiều melatonin có thể ảnh hưởng đến sự tiết melatonin từ tuyến tùng. Tôi vẫn chưa có bằng chứng về điều đó để xem liệu đó có thực sự là trường hợp hay không. Tiến sĩ Roger, còn điều gì khác mà chúng ta chưa thảo luận mà chúng ta nên thảo luận không? Chúng tôi đã thảo luận rất nhiều. Tôi nghĩ kết nối tất cả lại là, một lần nữa, các liên kết. Và nếu chúng ta có những liên kết đó, thuốc sẽ có vị trí của nó. Nhưng cách mà chúng hoạt động là bằng cách phá vỡ các phần khác của chuỗi để củng cố chuỗi yếu. Điều đó có thể có ảnh hưởng, đặc biệt vào giai đoạn cuối của đời sống, nếu bạn muốn duy trì sự sống. Nhưng nếu bạn quan tâm đến sự trường thọ, nếu bạn quan tâm đến việc tạo ra và sống một cuộc sống tốt nhất, thì bạn muốn củng cố tất cả những chuỗi đó. Và tôi tin rằng chìa khóa để làm điều đó là một cái gì đó gọi là New Start. Chúng tôi có một truyền thống kết thúc trong podcast này, nơi khách mời cuối cùng để lại một câu hỏi cho khách mời tiếp theo, không biết họ để lại cho ai. Và câu hỏi được để lại cho bạn là, Khu vực nào trong sự chú ý của bạn mà bạn rất muốn nói về, mà bạn gần như không bao giờ được hỏi đến? Cuốn sách này, Kinh thánh, thứ mà tôi truyền lại. Bằng chứng cho khoa học trong Kinh thánh. Bạn có ý gì? Những gì mà chúng ta đã nói là cơ thể và sức khỏe trong cơ thể. Tôi muốn thử nghiệm một số tuyên bố trong Kinh thánh để xem liệu chúng có hoạt động một cách khoa học hay không. Như là biến nước thành rượu? Không, có thể. Đó là một phép màu. Điều mà tôi đang nói đến là thế này. Và đây là điều mà tôi thực sự đã làm, và nó thực sự khá thú vị. Bạn biết, Paul, người là một trong những nhà viết Kinh thánh Tân ước, đã viết cho người Corintho, Bạn không hiểu rằng cơ thể của bạn là đền thờ của Thánh Linh sao? Tôi đã nói, Đó là một tuyên bố thực sự thú vị. Làm thế nào anh ta lại đến được kết luận đó? Như thế nào đó có nghĩa là gì, đền thờ của Thánh Linh? Đền thờ duy nhất vào thời điểm đó là đền thờ ở Jerusalem, nơi mà họ sẽ có các cuộc hy tế và những thứ khác. Vậy, điều mà tôi đã làm là, tôi đã quay lại, và đây là câu trả lời cho câu hỏi, tôi đang tìm kiếm bằng chứng về sự thật khoa học, có thể là không biết, qua một số nhà viết Kinh thánh trong Kinh thánh, để xem có sự thật hay không. Có hợp lý không, những gì tôi đang nói? Vì vậy, nếu bạn nhìn vào hầu hết các chương 25 đến 30 của Xuất Hành, là mô tả tỉ mỉ về nơi thờ phượng mà Moses đã xây dựng trong hoang mạc mà ông ấy cho rằng ông đã nhận được từ Chúa. Đây là những gì ông ấy nói. Vì vậy, đây là một cách tuyệt vời để xem liệu tất cả điều này có thật hay không. Moses đang nói, Đây là mô tả về mẫu mã mà tôi đã nhận được cho đền thờ. Và Paul đang nói, Cơ thể của bạn là một đền thờ. Vậy, đây là giả thuyết của tôi. Nếu chúng ta nhìn vào mẫu mã trong đền thờ, liệu nó có tương ứng với cơ thể con người mà họ chưa hiểu biết vào thời điểm Paul viết điều này không? Chúng ta không biết về tế bào cho đến Van Leeuwenhoek vào thế kỷ 1600. Chúng ta không biết về sự tuần hoàn của tim cho đến thế kỷ 1600 với William Harvey. Tuy nhiên, nếu bạn nhìn vào cơ thể con người, bạn sẽ thấy hệ thống máu. Bạn có máu đang lưu thông trong hệ thống mạch. Và sau đó nó đi vào dịch kẽ. Và sau đó dịch kẽ sẽ đến tế bào, mà có một màng plasma trên tế bào mà bạn không thể xuyên thấu qua, nhưng trừ khi bạn thực sự có các protein để đi vào.
    Và sau đó nó vào tế bào, là một khoang có hai phần bên trong, đúng không? Bạn có tế bào và nhân tế bào, đúng không? Đây chính xác là cấu trúc mà Mô-se đã nhận được trong sa mạc. Và nhân tiện, các đền thờ Hindu cũng được thiết kế tương tự. Có một kiểu ba phần. Vì vậy, bạn có bàn thờ hy sinh, nơi có máu. Đó là máu trong cơ thể con người. Tiếp theo, bạn chuyển đến cái chậu, là một cái thùng đầy nước. Đó là không gian kẽ sau khi bạn đi từ máu vào không gian kẽ. Bất kỳ nhà dược lý học nào cũng sẽ biết rằng đây chính xác là mô hình mà bạn chuyển đến. Điều tiếp theo là cấu trúc có một bức màn mà bạn không thể xâm nhập qua trừ khi bạn đi qua nó. Đó là tế bào vì cấu trúc này là tòa nhà và nó có một phòng trong một phòng. Và đó chính xác là những gì tế bào là. Tế bào này là nhân tế bào được bao quanh bởi tế bào chất. Ở trong phòng này mà bạn vào lúc đầu, có những món đồ nội thất rất giống với các loại bào quan mà bạn thấy trong chính tế bào chất. Ví dụ, có một giá nến bảy nhánh đang cháy dầu ô liu và sản xuất năng lượng. Điều đó giống như beta-oxy hóa sản xuất năng lượng. Đó chính xác là những gì bạn thấy trong ty thể. Nhưng điều cuối cùng là bạn chuyển vào nhân tế bào. Và ngôi đền này có một cái gọi là nơi cực thánh, nơi có bàn thờ – nơi có chiếc Hòm Giao ước. Bạn đã xem Indiana Jones, phải không? Vâng. Và Raiders of the Lost Ark. Có chiếc Hòm này và bạn mở nó ra, đây là nơi hai tấm bia đá, Mười Điều Răn, được đặt. Vậy trong khu vực đó, bạn có hai tấm bia đá được viết bằng tay của Chúa, mã sống. Và theo niềm tin của người Do Thái và Kitô giáo, đây là luật, và nếu bạn vi phạm luật, đó là tội lỗi và hậu quả của tội lỗi là bệnh tật và cái chết. Vâng, khi chúng ta đến nhân tế bào của cơ thể con người, bạn có hai chuỗi DNA. Và trên các chuỗi DNA là mã, các nucleotide, chính là mã sống. Nếu bạn thao tác mã đó, điều đó dẫn đến đột biến, dẫn đến bệnh tật và cái chết. Tất cả những điều này không được biết đến cho đến năm 1950 khi họ phát hiện ra DNA. Và vẫn có Phaolô đang thực hiện bước nhảy này và nói, cơ thể của bạn là đền thờ của Chúa Thánh Thần. Tôi chỉ thấy điều đó thật hấp dẫn. Không ai từng hỏi tôi về điều đó. Nhưng đó – ngay khi bạn hỏi câu hỏi đó, đó là điều đầu tiên xuất hiện. Nhân tiện, có rất nhiều nơi khác trong kinh thánh mà tôi thấy điều đó được nhắc đến. Thật thú vị. Phaolô nói về cơ thể của Đấng Christ và cách nó là một cơ thể, nhưng được cấu thành từ các phần. Có bàn tay, bàn chân. Ông ấy không biết về tế bào, nhưng đó chính xác là những gì cơ thể con người là. Cơ thể con người là một cơ thể được tạo thành từ nhiều phần. Van Leeuwenhoek đã không phát hiện ra điều đó cho đến thế kỷ 17. Chúng ta không có lý thuyết tế bào cho đến thế kỷ 19. Vì vậy, điều này – thật thú vị với tôi khi các tuyên bố được thực hiện trong các văn bản cổ xưa, có liên quan khoa học sâu sắc bên dưới bề mặt. Tôi chỉ thấy điều đó thật thú vị. Cảm ơn bạn rất nhiều. Và tôi hy vọng sẽ nói chuyện với bạn rất, rất sớm. Và cảm ơn bạn vì tất cả công việc bạn đang làm vì bạn đã làm cho một số chủ đề khoa học khó khăn trở nên dễ tiếp cận không tưởng. Bạn có một nghệ thuật thực sự trong việc đơn giản hóa. Và đơn giản hóa theo cách đó có nghĩa là hàng triệu người – bạn có hàng triệu người đăng ký trên kênh YouTube của bạn. Hàng triệu người có thể tiếp cận thông tin này, thường bị giam cầm trong những bức tường của một số nghiên cứu học thuật. Vì vậy, cảm ơn bạn vì công việc bạn đang làm vì nó sẽ – tôi chắc chắn nó thực sự đã có ảnh hưởng sâu sắc đến cuộc sống của nhiều, nhiều triệu người. Và tôi chắc chắn rằng khán giả của tôi rất trân trọng điều đó. Vì vậy, cảm ơn bạn rất nhiều, Roger. Tôi đánh giá cao bạn. Cảm ơn bạn, Stephen. Cảm ơn bạn đã mời tôi tham gia và có cơ hội này. Hãy chắc chắn rằng bạn giữ những gì tôi sắp nói cho riêng mình. Tôi mời 10.000 bạn tham gia sâu hơn vào nhật ký của một CEO. Chào mừng đến với vòng tròn nội bộ của tôi. Đây là một cộng đồng riêng mới mà tôi đang ra mắt với thế giới. Chúng tôi có rất nhiều điều tuyệt vời diễn ra mà bạn không bao giờ được thấy. Chúng tôi có những ghi chép trên iPad của tôi khi tôi đang ghi âm cuộc trò chuyện. Chúng tôi có những đoạn clip mà chúng tôi chưa bao giờ phát hành. Chúng tôi có những cuộc trò chuyện bên trong với các khách mời. Và cũng có những tập mà chúng tôi chưa bao giờ phát hành. Và còn nhiều hơn nữa. Trong vòng tròn này, bạn sẽ có quyền truy cập trực tiếp vào tôi. Bạn có thể cho chúng tôi biết bạn muốn chương trình này như thế nào, bạn muốn chúng tôi phỏng vấn ai, và các loại cuộc trò chuyện mà bạn muốn chúng tôi có. Nhưng hãy nhớ, bây giờ, chúng tôi chỉ mời 10.000 người đầu tiên tham gia trước khi nó đóng lại. Vì vậy, nếu bạn muốn tham gia cộng đồng riêng của chúng tôi, hãy truy cập vào liên kết trong mô tả bên dưới. Hoặc vào doaccircle.com. Tôi sẽ nói chuyện với bạn ở đó. Một điều nhanh chóng trước khi quay trở lại tập này. Hãy cho tôi 30 giây thời gian của bạn. Hai điều tôi muốn nói. Điều đầu tiên là một lời cảm ơn lớn vì đã lắng nghe và theo dõi chương trình tuần này qua tuần khác. Điều đó có ý nghĩa rất lớn đối với tất cả chúng tôi. Và đây thực sự là một giấc mơ mà chúng tôi chưa bao giờ có và không thể tưởng tượng được sẽ đến được nơi này. Nhưng thứ hai, đó là một giấc mơ nơi chúng tôi cảm thấy như chỉ mới bắt đầu. Và nếu bạn thích những gì chúng tôi làm ở đây, hãy tham gia cùng 24% người nghe podcast này thường xuyên và theo dõi chúng tôi trên ứng dụng này. Đây là một lời hứa mà tôi sẽ dành cho bạn. Tôi sẽ làm mọi điều trong khả năng của mình để làm cho chương trình này tốt nhất có thể bây giờ và trong tương lai. Chúng tôi sẽ mang đến những khách mời mà bạn muốn tôi nói chuyện. Và chúng tôi sẽ tiếp tục thực hiện tất cả những điều mà bạn yêu thích về chương trình này. Cảm ơn bạn. Cảm ơn bạn. Cảm ơn bạn.
    他在字面上距離死亡只有兩天的時間。
    所以這是一個故事,講述一位15歲的男孩被診斷出得了血癌,但他在肺部發展出了一種吃肉的感染。他不會活下去了。
    所以他有一個請求。他想要出去,而這正是他們所做的。而這對我來說實際上是令人難以置信的。
    第二天之後,感染大約有60%到70%消失了。
    我明白了,陽光有著如此多重要的好處。
    例如,如果你的病床靠近窗戶,你出院的速度會更快。
    所以我想讓你提供任何與光線健康相關的信息。例如,你會推薦這些類似的東西嗎?
    羅傑·席霍特醫生是一位經過認證的重症護理醫生,他能將複雜的科學轉化為清晰的救命建議。
    我見過人們生命的最後時刻,因此我知道什麼防止他們變得如此病重,以及如何延長生命。
    所以讓我們將其提煉成八大支柱。
    第一個是運動。
    它可以減少中風。
    它減少抑鬱症。
    接下來,陽光。
    你知道陽光中的紅外線能穿透大約八毫米,並刺激和上調褪黑激素,這可以預防許多疾病,如癡呆症、心血管疾病和糖尿病嗎?
    如果你生活在多雲的國家怎麼辦?有一些非常可行的措施可以採取,我們會談到這些。
    接下來是水。
    例如,使用桑拿的人心血管疾病死亡率更低。
    接下來,空氣。
    有研究顯示,每週出去一天可以提升我們的免疫系統,使我們更加放鬆。
    然後還有……
    但最後,信任。
    這是不能被忽視的,因為研究顯示,對上帝有信心和信任的人是……
    在我們回到這一集之前,給我30秒鐘的時間。
    我想說兩件事。
    第一件事是對於每週收聽和關注這個節目的感謝。
    這對我們所有人來說意義重大,這實際上是一個我們從未想過的夢想,根本無法想像會到達這個地方。
    但第二件事是,這是一個我們感覺才剛剛開始的夢想。
    如果你喜歡我們在這裡所做的事情,請加入24%定期收聽這個播客的人,並在這個應用程序上關注我們。
    我向你們保證一件事。
    我將全力以赴把這個節目做得盡可能好,現在和未來都如此。
    我們會邀請你希望我訪談的嘉賓,並會繼續做你喜歡的所有節目內容。
    謝謝你。
    羅傑·施維特博士,在你所從事的工作中,你的目標是什麼?
    除了我的臨床職責,也許還包括其中的一部分,我想以清晰易懂的方式解釋可以實施的工具,以幫助人們活出最好的生活。
    這特別是關於他們的健康和福祉。
    隨著我們深入探討健康和福祉,因為那是一個相當廣泛的範疇,在哪些方面你專注於健康和福祉,你花了你的職業生涯和生命來研究?
    所以我是一名經認證的內科醫生。
    然後我在美國進行了額外三年的培訓,專注於肺部和重症護理。
    所以我處理所有與肺部和重症護理相關的問題。
    因此,如果你被送進醫院且病情危急,你會去重症監護病房,我就是你見到的醫生。
    我會插管、使用加壓藥物、進行插管等。
    我今天早上在診所工作。
    那麼有什麼是大多數人未意識到的事情?
    因為我們認為你知道,不要吃加工食品和運動。
    但還有其他你認為普通人未能充分理解的事情嗎?
    是的,絕對是。
    那些事情是什麼呢?
    所以如果我們查看那些延長生命並有益的事物,我們可以將其劃分成我所稱的八大健康支柱。
    如果你能想象你的生命是一條鏈子,有很多鏈節,好的,我在這裡談論醫學,每一個鏈節都是一個器官系統。
    所以你的心臟是一個鏈節,你的肺是一個鏈節,你的肝臟是一個鏈節,你的腎臟,等等等等。
    當你經歷生命的過程時,想象那些鏈節開始侵蝕,以至於在你生命的某個時候,你將會患上某種針對某一個器官系統的疾病或診斷。
    對於許多人來說,在美國和英國,這是心臟。
    隨著這個鏈節越來越被侵蝕,我們可以非常清楚地看到,這將是第一個斷裂的鏈節。
    因此,會將注意力集中在這個鏈節上。
    對於許多人來說,這個診斷會伴隨著藥物。
    因此,這是我想要提出的第一個真理。
    所有藥物都有副作用。
    而現代醫學的目的是利用這些藥物及其對人體的影響,充分發揮其他鏈節的作用,以保護那個最弱的鏈節。
    因此,我可以描述一系列我經常給重症監護病房病人的藥物,因為我專注於拯救他們的生命,因為我能清楚地看到哪個鏈節是最弱的。
    但我這麼做是知道有副作用的,因為我試圖拯救那個鏈節,以拯救生命。
    而且我在運用那些其他的方法。
    例如,某人因中風入院。
    他們的右側或左側身體出現無力,不管是哪一側。
    我可以立即給他們一種藥物來打破他們體內的所有血塊。
    這種藥物叫做TPA或TNK。
    它可以恢復血流到大腦,逆轉他們的許多症狀。
    如果他們來得夠快,我們可以這樣做。
    令人驚訝的是,這種藥物竟然有能夠這樣做的效果。但它也有相當顯著的副作用,可能會在其他地方破壞血塊並引起出血。因此,我們必須小心我們正在做什麼。顯然,在這裡,我們所做的是以犧牲其他連結的代價來拯救一個連結。但在緊急情況下,這就是你必須要做的。但是如果在那之後,我只是將這位患者送回家,而不告訴他們為什麼會中風,以及他們需要做什麼來防止再次中風,以及造成這種情況的生活方式因素,那我就沒有履行我的職責。
    那麼,我們能做些什麼干預,期望在生命早期就進行,以防止這些連結劣化,確保所有連結都能保持牢固?隨著我們年齡的增長,我們可以繼續增強所有的連結。這裡有八個。
    首先是營養。我們知道有研究顯示,我們攝入的食物會對我們的健康和幸福感產生深遠的影響。因此,這是營養。接下來是運動。正如我所說,運動不僅僅是藥物和其他東西有副作用,運動還有附帶的好處。顯然,運動會讓你更健康,增強耐力。但是你知道運動還能降低中風的風險嗎?你知道它還能改善幸福感嗎?它可以減少抑鬱情緒。這些好處多得數不勝數。因此,所有這些連結其實都是在改善的,這裡沒有任何杠桿效應。運動真的是非常棒。
    水。這可能聽起來很明顯,對吧?你因為口渴才喝水。今天我想談談水對你身體的外部影響,像是熱水浴和冷水浸泡,桑拿這類的使用,正是如此。我們稍後會深入探討這方面的實證。但可能存在的問題是什麼?這影響你的免疫系統,改變你患病的概率,等等?絕對如此。尤其是在急性情況下。尤其如此。不僅在急性情況下,我們還有來自芬蘭的相當好的數據,因為那裡的桑拿數量幾乎超過人口。他們實際上進行了研究,並且顯示出劑量反應曲線,證明這樣做其實是非常有益的。我們不會深入討論太多這方面的內容。但我想因我在重症監護病房的工作,以及我們看到的來自病毒和先天免疫系統突變的情況,多花一些時間來關注這個問題,因為這可能在未來顯得非常重要。有趣的是,當我們展望未來的疫情時,我們其實可以回顧一下過去的做法。我們對這方面有一些實際上非常好的信息。
    現在我們來講講陽光。這是我最近越來越感興趣的主題,因為它帶來的一些好處。人們有一個很大的誤解,就是陽光等於維生素D,因此如果你補充維生素D,就不需要曬太陽。這一點現在真的被推翻了。陽光的好處遠遠超過維生素D。我不是說維生素D不是你應該補充的。我自己也補充維生素D,毫無疑問,補充維生素D是有好處的。但陽光還有很多重要的作用。我真的希望能花大部分的時間來談論這個問題,因為這非常重要。這是令人驚嘆的,它真的讓我重新思考陽光。
    這是一個名叫艾米·哈赫梅耶的女士的故事。她的15歲兒子被診斷為淋巴母細胞白血病,進入了醫院,開始了化療。這是一種血癌。化療的副作用就是抑制免疫系統。不幸的是,他並沒有立即意識到,但他最終在肺部發展出了一種真菌性食肉性感染。然後他於2024年6月入院,地點是在明尼蘇達的一家三級醫療機構。他的病情不斷惡化,最終唯一能控制這種感染的方法就是實際上移除他的左肺,這一手術也的確進行了。因此,這是一位15歲的男孩,現在沒有了左肺,只剩下右肺。即便如此,他的狀況仍然在惡化。他們做了CT掃描,顯示感染已經轉移到他剩下的右肺。他們開了一次家庭會議。當艾米告訴我這個故事時,我能聽到她的聲音顯得有些哽咽。她通過電話告訴我,她說他只有15歲,完全清醒,完全警覺,知道周圍發生的一切。他正在使用呼吸機,類似於他治療睡眠呼吸暫停所使用的機器。這不是插管,而是掛在他嘴上的。醫生們已經盡其所能,並表示,他的情況正在惡化,他們無法移除右肺,也不能將他接入心肺機,因為已經沒有任何目的地可去。他們建議不要給他插管,並做出所謂的DNR(不施行心肺復甦術)的決定。這讓所有人都感到震驚,根本不預期會發生這樣的事情。因此,他們召集了大會,並尋求幫助,如何向一個15歲的男孩解釋他正在死去,而這種感受會是什麼。然後他們問醫生,他還能活多久?醫生說兩天。在這種情況下,他們告訴這個男孩,好吧,你將要死去。
    在未來的兩天裡,你想要怎麼樣度過你的生活?
    你想要做什麼?
    令人驚訝的是,他說,我想要出去。
    我只想出去。
    這個人大概是在農場長大的,他的時間都花在外面。
    所以他想要出去。
    所以你知道——我不確定你是否知道,但如果你是一名護士或醫生,你已經盡了全力,卻對這名15歲的孩子即將死亡感到非常恐懼,而他的唯一要求是,
    你會不惜一切去滿足那個要求。
    這正是他們所做的。
    他們把這個男孩的醫院病床搬到外面。
    他在一台呼吸機上,呼吸治療師已經安裝好了。
    所以這個人是在外面,他們不是要讓他好起來。
    他只是——這是他臨終的願望。
    他們還使用了一種叫做“螢火蟲”的東西。
    那是一種光設備他們正在使用。
    老實說,我不知道是什麼造成的效果。
    螢火蟲,那是什麼?
    那是一種發出不同波長光的設備,他們每天大約使用三次,每次五分鐘。
    這個人沒有死。
    在第一天結束後,他的白血球計數開始下降。
    那是肺部感染的一個指標。
    此外,在這一切開始之前,他們對他的肺部進行了CT掃描,結果是——右側的剩餘肺部充滿了感染。
    那是可怕的。
    到了第二天,白血球計數進一步下降。
    順便說一句,他的其他治療方法沒有更改。
    到目前為止,他已經住院六週了。
    他還沒見過陽光。
    而且他還在服用強效的抗真菌藥物兩性霉素B和泊沙康唑。
    所有這些都是高效藥物,可以徹底對抗真菌,但效果不佳。
    他的情況在惡化。
    但現在他在外面度過第二天。
    白血球計數下降,這是好消息——這是一個好兆頭。
    他的氧氣需求正在下降。
    這是一個好兆頭。
    他需要的氧氣越來越少。
    等到第五天——好吧,我們已經過了兩天。
    他已經不再需要BiPAP了。
    他使用的是普通的鼻導管氧氣,也就是你們看到人們在鼻子上佩戴的那種氧氣。
    醫生們都摸不著頭腦。
    他們覺得,我們應該做一個CT掃描,看看發生了什麼。
    所以艾米告訴我,他們給這個人做了CT掃描,然後他們在那個房間裡。
    有些人甚至低聲咒罵。
    因為在CT掃描中,明顯左肺已經消失。
    但右肺,疾病大概減少了60%到70%。
    而他仍然活著。
    他回家了。
    在治療後沒有顯示出任何疾病的跡象。
    而他——我只是——她剛剛告訴我,他剛得到了他的癌症願望。
    他在持續治療。
    她簡直不敢相信他真的只有兩天的生命。
    他們沒有改變任何事情。
    他們沒有改變他的治療。
    他們唯一做的就是帶他出去,
    在他出去之前使用了這個螢火蟲,但在他出去後他們使用得更頻繁。
    也許醫院應該設在戶外。
    這正是——好的,如果你想知道我現在的動力是什麼,我的目的是我正在三家不同的醫院工作。
    我正試圖在這三家不同的醫院中工作,讓病人能夠出去。
    我們面臨的最大障礙是工作人員把病人帶到外面的問題。
    這是最困難的事情。
    但這是我們曾經做過的,史蒂芬。
    在世紀之交建立醫院時,我們有病房,床可以被搬到陽台上,讓人們曬到陽光。
    我希望能看到有一天我們能回到那樣的情況。
    有研究顯示。
    在兩人病房中,如果你是靠近窗戶的床,平均更快出院。
    真的嗎?
    是的。
    我需要跟女朋友調換床的側面。
    她在陽光明媚的一側。
    這方面有太多證據了。
    住在有更大窗戶的醫院的患者會給出更好的評估。
    而醫院的報銷與他們從患者那裡得到的評估息息相關。
    所以這實際上是一個三贏的局面。
    如果醫院開始,依我所見,讓病人到戶外——而且他們已經在這樣做。
    我不想說這並不是在發生。
    有些醫院有將病人帶到戶外的計劃。
    所以我認為我們應該做得更多。
    節制。
    節制?
    那是什麼意思?
    那是一個古老的術語,不是嗎?
    它其實意味著適度。
    我會說在這個意義上,節制真的意味著避免體內的毒素。
    作為一名肺科醫生——
    肺科醫生是什麼?
    肺科醫生是專門照顧肺部的人。
    因此,因為這樣,我看到很多與吸煙有關的肺癌問題。
    我在重症監護病房看到因酗酒導致肝衰竭的人。
    我還在南加州看到使用安非他命的人。
    這裡相當多這樣的情況。
    而節制。
    如果你想過一個長久而健康的生活,有些毒素你需要避免。
    理解這一點是非常重要的。
    因此,如果你停止討論的那些事情,所有這些鏈接將會改善。
    空氣。
    聽起來有點明顯。
    一開始,我認為這意味著獲得純淨的空氣,裡面什麼都沒有,只有氮和氧。
    現在我已經不這麼認為了。
    我們現在明白,要擁有最佳的空氣,其實需要帶有一些其他成分。
    就像我們的腸道有微生物群,您可能聽說過的那樣,我們呼吸的空氣也必須擁有微生物群。 而您能擁有的最佳空氣類型其實就是戶外的空氣。 休息。 這真的很有趣,因為我們剛才提到運動是健康的支柱之一。 但休息也是。 如何能夠同時將休息和運動視為健康的支柱呢? 這最終還是取決於知道什麼時候做什麼。 睡眠,這也是休息的一部分。 因此,我們不僅僅是在談論一天中睡覺時的休息。 作為一名睡眠醫生,我可以告訴您很多。 我們有許多有關睡眠應該持續多久、睡眠質量以及一些妨礙我們入睡的疾病的資訊。 睡眠是如此重要。 我無法過分強調它。 我們不僅在談論每日的休息,我還想說,並且敢於嘗試,我們可以更多地談論每週的休息。 每週休息? 每週休息。 您的意思是什麼? 假期? 像這樣? 是的。 是的,絕對如此。 我們周末有多少次放下手機? 從不。 或者我們停止閱讀電子郵件。 我們花時間去做一些我們永遠無法做到的事情。 最後,信任。 這確實是不能被忽視的事情。 我會坦率地說,在研究和科學的世界中,有一個科學的範疇和一個信仰的範疇。 但我們不能忽視的是,來自科學界的越來越多的證據正在關注信仰,那些懷有信仰以及信仰上帝的人,無論那是某個特定教派的上帝,都更能應對壓力、抑鬱和焦慮。 這在科學上已經得到了證明。 如果您注意到我以特定的順序進行了這些活動,經過這些,您就會發現它們的順序是營養、運動、水、陽光、適度、空氣、休息,最後是信任。 把這些結合起來,拼寫出新的開始。 有趣的是,這些特定的主題並沒有版權。 但是加州北部有一所名為維馬大學的學校,實際上將這些整合在一起,並稱之為新的開始。他們的確有一個新的開始項目。 這是目前正在國際上使用的東西。 那麼,在您剛剛經歷的新的開始框架的這些主題中,您想從哪裡開始? 我認為陽光實際上是我對所有這些感到興奮的地方之一。 但我認為陽光真的可以這樣說,這是最容易獲得的資源。 好吧。 請解釋一下為什麼陽光目前是您的重點。 這是一段漫長的旅程讓我意識到這一點。我認為其中一部分與COVID有關。因此,作為一名重症監護醫生,當我聽說有一種病毒正在蔓延時,大家都告訴我們這將影響呼吸系統疾病的人,我當時對此很有把握。但實際上情況並非如此。 我們確實看到了一些患有呼吸系統疾病的人。 但在重症監護病房中,周圍去世的人都是肥胖症患者、心臟病患者、腎病患者、癡呆症患者和慢性病患者。 這讓我思考,為什麼會這樣? 所有這些問題有一個共同點,還有許多其他的。但是具體來說,它們根源於一種名為線粒體功能障礙的現象。 所以讓我來幫您拆解一下。 這與長壽有關。 這與老化有關。 這是一個如今正逐漸浮出水面的巨大議題。 我們現在對此有了更多的了解。 當我在高中生物課上、在大學的時候,我們都學過在我們所有細胞中,除了紅血球外,這種小細胞器,稱為線粒體。 我必須說,什麼是線粒體? 它是細胞的動力來源,對吧? 所以它是產生能量的東西。 我們當時不知道的是,隨著年齡的增長,這些細胞中電池的產出大約下降了70%。 哇。 您能想像用70%更少的能量來運行您的房子嗎? 這將從根本上改變您家裡發生的事情? 您無法以相同的方式運行洗衣機。 您無法同時運行微波爐和洗衣機。 然後這在症狀上會呈現什麼樣的情況? 非常好的問題。 因為這取決於我們所談論的細胞類型,會有不同的問題。 如果我們談論的是肝臟,肝臟會變得更脂肪化。 如果我們談論的是心臟,心臟會變得更加充血。 如果我們談論的是大腦,則會出現更多的癡呆症。因此,發生的事情是,隨著年齡的增長,我們的細胞中的電池運作方式與以往不同。 新陳代謝正在減緩。 這是非常巨大的問題。 而我剛才談到的所有這些疾病,除了在COVID中出現的那些,如果您查看這些疾病的許多情況,它們都根植於線粒體功能障礙。 所以問題是,這為什麼會如此,我們能做些什麼呢? 2019年出了篇論文,從根本上改變了我對此的看法。 這篇論文的作者是Russell Ryder,他是《褪黑激素研究》的執行編輯,來自德克薩斯大學;還有Scott Zimmerman,一位光能工程師。他們提出的證據表明,陽光由多種不同類型的波長組成。 您在一端有紫外線,當然可以產生維生素D,這是非常有益的。 它來自太陽的光線是短波的,無法深入穿透。 讓我稍微回顧一下並解釋一下。
    你在停車標誌前停下來,旁邊有人開著車,裡面播放著最新的嘻哈音樂。這樣的聲音在你的車內聽起來怎麼樣?很有沉重感,是吧?對,聲音有點被壓抑。這種壓抑的原因是因為低波頻率能夠傳播得很遠。去大峽谷時,如果在另一端有雷陣雨,你會聽到什麼?就像是隆隆的聲音。而隨著雷聲靠近,你會聽到更高頻率的聲音。這是一個基本的物理原則。因此,當陽光照射時,有非常短的波長,紫外線B涉及維他命D。但在另一端,則是紅外光,我們將要談論的,或者說是紅光。那是一種非常長的波長,能夠深入穿透。這一點非常重要,因為我們正在談論的是人體。如果陽光會對人體產生影響,那一定不僅僅是皮膚的問題。因此,這篇文章所指出的正是,根據斯科特·齊默曼的說法,來自陽光的紅外光能夠穿透大約八公分。它與細胞中的粒線體特別地相互作用。那麼,這對粒線體做了什麼呢?讓我們先談談粒線體,因為這是關鍵。對細胞來說,粒線體就像你車子的引擎。引擎產生運動,使得車輪轉動。但在此過程中,會產生熱量包圍著引擎。如果不處理這些熱量,引擎將會關閉,運行效率會降低,最終會停機。那麼,所有內燃機都有什麼?它們有冷卻系統。他們有散熱器,油盤,水泵。而細胞也必須具備相同的東西來保護粒線體。粒線體不是過熱,而叫做氧化壓力,正是這種氧化壓力會導致破壞,對的,導致粒線體的破壞,並引發這類疾病。因此,氧化壓力使得粒線體運作不良,這會導致糖尿病。氧化壓力使粒線體的運作變差,這會導致癡呆症。這一點早已清楚,這並不具爭議性。真有爭議的是我們該怎麼做?這篇文章的研究者們表明,不僅僅是他們,回顧文獻也表明,粒線體會自行製造冷卻系統。而那個冷卻系統就是褪黑激素。你可能會想,等一下,褪黑激素?那不是我們在快要入睡時,大腦會製造的東西嗎?對,這完全正確。就是這樣。問題在於,這不是大腦產生的褪黑激素。這不是透過血液循環到達我們的血液中的褪黑激素,告訴我們該入睡了。這是在細胞內,由粒線體產生的褪黑激素。它是一種強大的抗氧化劑,基本上防止了氧化壓力的發生。斯科特·齊默曼和拉塞爾·萊德所展示和提出的是,基本上進入身體的紅外輻射能激活和促進褪黑激素以及其他一些使粒線體保持冷卻的因子,並能實際提高粒線體的能量輸出。所以,這真的是讓我驚訝,我會告訴你作為一名重症護理醫生,為什麼這對我來說很有共鳴,因為有兩件事讓我最困擾。第一,SARS-CoV-2病毒。當它進入體內時,會與一種叫做ACE2受體的東西互動。你可能聽說過ACE2受體。這正是病毒實際附著在細胞上並被內化的地方。那麼,這個ACE2受體是什麼?它存在於整個人類歷史中只是作為受體,還是實際上有其功能?結果發現,它實際上是有其功用的。令人震驚的是,ACE2受體參與減少氧化壓力。換句話說,它是細胞粒線體冷卻系統的另一部分。發生的事情是,當病毒附著在細胞上時,實際上就在消除這一作用。因此,想像一下你有一群人的引擎以不同的溫度運行。換句話說,你有一些慢性病患者,我們知道他們的引擎在高溫運行。我們還有其他人,他們完全健康,運行得很好。他們的引擎涼爽,沒有任何問題。現在想像一下COVID來了,SARS-CoV-2感染了每一個人。這樣的傾向是什麼?因為它摧毀了每個人的ACE2受體,而ACE2本來有能力讓引擎冷卻,也就是說,它使每個人的引擎都在高溫運行。對吧?所以,換句話說,這樣想像一下。你正在開車,車上的溫度計就在那裡,突然間,你必須爬上一個高峰,叫做COVID-19。誰能克服這個高峰,誰又克服不了?那些能夠越過高峰的人是那些冷卻系統良好、溫度運行正常的人。而那些過不了高峰的人則是引擎溫度高的那一群。他們是在頂部暈倒,無法再繼續前行的那些。這些人就在路邊停著,車引擎蓋打開,蒸汽冒出。你明白我在說什麼嗎?當然,明白。所以,這讓我對為什麼我沒有看到他們所預測的事情,感到很有道理,就是呼吸系統的患者進入重症監護室。誰在重症監護室?我看到的是那些有癡呆症、糖尿病、腎病的人。
    這些就是那些曾經生病的人。
    另一件真正讓我深受感觸並產生共鳴的事情,是在疫情早期我們就知道,進入醫院並且具有較高維他命D水平的患者表現得很好。
    他們沒有死亡。
    他們的死亡幾率不如那些維他命D水平低的患者那麼高。
    維他命D水平低的人死亡的可能性要高得多。
    因此,我們會檢查這些維他命D的水平。
    想想看,
    你在這裡就是在第一線,你在照顧這些病人,你一次又一次地看到該數據,即維他命D對死亡預測有很高的相關性。
    顯然,你會怎麼做?
    即使這是一項關聯性研究,這種關聯並不意味著因果關係,你仍然會給病人補充維他命D,試圖提高這些水平。
    問題是,我們給了維他命D,結果影響並不大。
    你是以補充劑的形式給予的?
    是的,當病人進入醫院時,
    就像這樣?
    完全正確。
    真的就這樣。
    事實上,我自己也有在補充。
    我的意思是,你還能失去什麼,對吧?
    我今天早上已經吃了我的維他命D藥丸。
    我覺得過量的可能性很小,但也是有可能的。
    所以你注意到用維他命D治療病人很難,但給他們一顆藥丸並沒有帶來太大效果。
    沒錯。
    為什麼呢?
    我相信的事實是,我們看到維他命D水平高或正常的人,比那些維他命D水平低的人表現得更好。
    我相信這是另一種情況的指標。
    換句話說,維他命D水平較高的人,意味著他們在陽光下待的時間更多。
    他們比那些維他命D水平很低的人更常待在戶外。
    維他命D水平低的人告訴我這些人並未外出接受陽光照射。
    那麼,真正的因素是什麼呢?
    是什麼在發揮主要作用?
    我會提議,Scott Zimmerman和Russell Ryder也會這麼提議,還有許多其他科學家和我意見一致,
    就是來自陽光的紅外輻射在粒線體層面上造成氧化壓力的影響。
    而維他命D只是指示誰得到了紅外光,誰沒有,誰在外面,誰沒有在外面。
    所以當陽光照射時,大部分時間你會得到紅外光。
    你會得到來自太陽的整個生物光譜。
    我們可以從最長的波長,即遠紅外輻射,到最短的波長,即紫外線B,好的,這會生成維他命D。
    換句話說,當你在自然環境中外出時,你會得到非常廣泛的光譜。
    因此,由於這樣,如果你接受了紅外光,你也在合成維他命D。
    你在得到兩者。
    現在,這可能會改變,因為在冬季,當陽光在天空中的高度較低時,特別是在英國,這在那個緯度是一個特殊的問題。
    當陽光在天空中較低時,光需要斜著穿透大氣層。
    因此,來自太陽的短波輻射,比如紫外線B,並沒有很好地透過。
    所以在某些時候,你並未獲得足夠的紫外線B,甚至可能完全沒有紫外線B。
    這會導致維他命D的不足。
    這會使得維他命D不足。
    你需要補充。
    然而,在同一時期,當你未獲得足夠的維他命D,因為沒有紫外線B輻射,陽光仍然在低處。
    但是,這仍然足夠讓長波紅外光穿透進來。
    那長波紅外光是我們看到這些裝置的類型嗎?
    絕對如此。
    我會具體指出,因為你可以看到那是紅光,但那不是紅外光,因為你可以看到它。
    因此,技術上來說,紅外光是完全不可見的。
    但這些確實發出紅外光,只是你看不見。
    是的,正確。
    那是光譜中接近紅色的部分。
    像Glenn Jeffrey這樣的UCL研究者,實際上在670納米的紅光上進行研究,在隨機對照試驗中顯示,這種光(在670處,即使你能看到的那種類型)確實改善了粒線體的效率。
    他在多項隨機對照試驗中顯示這一點。
    改善視力。
    你需要意識到,眼睛後面的視網膜富含粒線體。
    他展示了這與糖的管理和粒線體的輸出有關。
    這些東西運作如此良好的原因是,隨著年齡增長,你的皮膚開始變得更鬆垮,因為在你皮膚中的纖維母細胞或細胞,旨在製造膠原蛋白。
    膠原蛋白是促使你的皮膚柔軟和有彈性的骨架。
    是的。
    請不要介意我。
    不,不。
    所以這正是如此。
    我妻子也在用同樣的東西。
    這真是一個有趣的充電裝置。
    所以目前的情況是,這些紅光能非常深地穿透皮膚。
    它正在激活你纖維母細胞中的粒線體以產生更多的能量,這些細胞需要來沉積膠原蛋白。
    因此,當你沉積膠原蛋白時,這會使皮膚感覺更緊實,因為隨著年齡增長,膠原蛋白的沉積會越來越少。
    所以這將幫助我保持年輕。
    這就是它的全部意圖。
    你在說這些光的穿透深度,大約是六到七釐米?
    紅外線大約是八釐米。
    這個紅光會稍微少一點,因為這光顯然是可見的,因此它是稍微短一些的波長。
    但的確,這種光,尤其是紅光,能夠比例如黃色光或藍色光穿透得更深。而就是這種光特別與線粒體互動,以增加其活性。那我們是否應該將這種光遍佈於全身呢?因為,好的,它對我的皮膚有益,但如果它能更深層穿透,顯然我身體的其他部分也會從中受益,像是其他的線粒體。你這麼說是有趣的。我提到的研究是由倫敦大學學院的格倫·傑弗里(Glenn Jeffrey)進行的,他在這項研究中選取了年輕人。他給了他們一大堆葡萄糖。所有接受葡萄糖的人都會有血糖上升的情況。而他隨機將這些人背著紅光,觀察發生了什麼。接受紅光的人血糖的上升幅度較低。換句話說,這似乎表明線粒體的代謝速度更快,導致血糖的上升幅度較小。他確認這一點的方法是觀察線粒體代謝的副產物,即二氧化碳。因此,當我們呼吸、當我們代謝時,我們呼出的就是二氧化碳,這是線粒體代謝的產物。事實上,接受光照的那些人的呼氣中顯示出較高的二氧化碳水平。回到你的問題上,我們應該將這些光遍及全身嗎?他能在僅僅背部放光的情況下,達到全身的效果。那是一種系統性的效能。我們並不完全了解線粒體的所有機制,但我們似乎了解它們能夠彼此交流,而你不需要在全身都照射光才能獲得系統性效果。不過在這種特殊的情況下,如果你想讓這裡的皮膚看起來更年輕,那麼在這裡使用這種光是有道理的。如果你希望你身體的其他某個部分也看起來年輕,那也許光就需要照射在那裡。非常有趣。在這些研究中,看到這種紅光療法的效果需要多長時間?這是一個非常好的問題。如果你與格倫·傑弗里交談,正如我所做的,他注意到在15分鐘後就有改善。15分鐘?15分鐘。他在15分鐘內注意到了什麼?他說他研究過水果蒼蠅、蚊子、蜜蜂和人類的線粒體,每一次都是一樣的。他說在這種類型的光照下,大約15到20分鐘後,會有一個開關被打開,之後就不需要進一步的刺激。進一步的刺激不會有更多的效果。這是一個非常奇特的現象。你可能會認為,給予更多的光,效果會更大。事實上並非如此。在大約15分鐘後,線粒體內部會發生某種改變。對於這可能出現的變化有一些理論,這可能發生在電子傳輸鏈的第四個複合物上。這些都是非常技術化的內容。實際上,有很多研究團體正在關注這個問題。有一整個科學領域叫做光生物調節,正是研究這方面的。然而15分鐘就是所需要的。所以我們討論的並不是很長的一段時間。這真的非常有趣。
    回到我在重症監護病房的經歷時,維他命D並沒有起作用。那些病人正在死亡,我很清楚COVID對於這些病人來說是一個代謝問題。在我意識到這一點時,疫情在某種程度上仍然在進行中,因為人們仍然在感染。然而急診室的來患者以及在重症監護病房中出現的躯體數量大幅減少。此時,我開始看到紅外線光對這些COVID-19患者可能非常有益。現在,在巴西有一項研究。他們招募了那些足夠生病以住院,但還不足以插管進入重症監護病房的COVID患者。他們做了一件了不起的事情。他們實際上製造了一件外套,能夠套在病人身上。這件外套的內部裝有LED燈泡,發出940納米的紅外輻射。他們將外套穿上,隨機決定哪一件外套開啟和關閉。這是一項盲測,因為來自這件外套的光無法被人眼看到,甚至不夠產生足夠的熱量。他們在30名受試者身上進行了這個實驗,並對他們進行了隨機分配。15名受試者穿上了開啟的外套,所有30名受試者都穿上了外套,其中15件開啟,15件未開啟。他們觀察這些病人的情況。這些病人發生了什麼?他們所查看的每一個終點指標都是統計上顯著的。這意味著什麼?這意味著這兩組之間的差異不可能是偶然造成的。真的存在明顯的差異。開啟外套的組別在氧飽和度方面有改善,可以更深且更有力地呼吸,白血球也有所改善。不僅如此,他們的心率、呼吸率等也都有統計上的顯著改善。但最重要且驚人的統計數據是住院時間。這些病人每天穿上這些外套15分鐘,連續七天。在沒有開啟外套的組別中,他們的平均住院時間是12天。而那些開啟外套的人則為8天。這是四天的差異。當你意識到住院的費用高達數千美元時,這是非常驚人的。
    當你考慮到某些藥物僅僅透過縮短流感症狀24小時而獲得FDA批准時,這是一個巨大的數字。這不僅僅是24小時,而是40小時。患者出院的速度比預期快了四天。當我看到那項研究時,這夠我說服自己了。我的意思是,顯然,參與者只有30位,對吧?我們應該做一項更大的研究。我們應該做幾百個樣本,對吧?那將是理想的。但是,僅僅用30位患者,他們就能顯示出統計意義。這對我來說已經足夠了,從現在開始,我看到每一位住院的COVID-19患者,他們讓我去插管或帶到我的ICU,這些患者都會被帶到戶外。我沒有那件在巴西製作的夾克。我甚至不知道我會如何製作那件夾克。他們是為了這項研究製作的,並且不銷售。我們沒有940納米的光,這就是他們在研究中使用的。但我知道這一點。我知道陽光裡有940納米的光。如果我能把這些患者帶到戶外,也許他們會改善。
    所以我得到了我想要的。我有一位患者在病房裡。他用35升每分鐘的流量,100%氧氣,通過高流量鼻導管吸氧。因為他感染了COVID-19,他的血氧飽和度幾乎無法達標。我被要求去看他,因為他可能需要插管或被帶到重症監護室。我無法相信,因為我已經幾個月沒見過這種情況了。於是我走下去,走進房間,打開了門。那是隔離病房。我戴著口罩,做足了一切防護措施。房間裡完全暗淡,窗簾緊閉。他的女兒在那裡。他對我說的第一句話是,「醫生,我還能活多久?」我意思是,這真是一場災難。沒有光線,沒有晝夜節律。這個人很沮喪。我立即叫了我的呼吸治療師,馬上叫來了負責護士。我們把所有人都集合在一起。我說,我們需要把這個人帶出去。那是一個明亮而陽光明媚的日子。我們要怎麼把這個人帶出去?35升,100%。我的呼吸治療師金,成功地把幾個氧氣瓶擺在一起,我們能把這個人推到輪椅上。我們把他推出去了。他幾週後告訴我,但他說,知道你那天把我帶到外面陽光下,因為我們接下來連續做了七天。他說,感覺真好。在僅僅一天後,他的氧氣需求從35升降到15升。15升的氧氣。然後降到12升。第二天降到8升。然後降到5升。五天。為了活下來,他每分鐘吸入的氧氣量。正確。所以換句話說,我們在調整給他的氧氣量,以保持他的血氧飽和度在90年代。五天後,他出院回家,沒有需要攜帶氧氣。現在,顯然,這是一個個案報告,對吧?這不是一項研究。但我在考慮讓人們在陽光下待15至20分鐘的風險時,並沒有太大的風險。如果有益處,我認為值得一試。我們需要進行更大規模的隨機對照試驗。但這讓我開始思考陽光對於這一變化的影響。而且你知道嗎?有大量數據。其實在歐洲有一項研究,他們說,好吧,這裡有COVID。COVID在上升。那麼COVID何時上升?是因為氣溫變化?還是因為濕度?對這兩個問題的答案都是不。
    你知道什麼預測國家在2020年秋季首次疫情暴發的嗎?其實有一項研究就是針對這個問題進行的,答案是緯度。它從芬蘭開始,然後向下遍及整個大陸。2020年秋季最後一個出現COVID疫情的國家是希臘。當陽光真正向南半球移動時,陰影開始覆蓋歐洲,我們開始看到COVID一個接一個地暴增。這是因為COVID和陽光不是朋友嗎?所以這讓傳播變得更困難,因為如果我把COVID放在這個桌子上,然後把陽光放在桌子上,COVID將會死亡。是的,這是有可能的。儘管我們現在知道COVID可能不大通過接觸傳播。這更多的是一個空氣傳播的問題。
    在愛丁堡大學做了一項研究。他們針對我們之前討論過的維他命D這個問題進行了調查。他們考察了美國冬季的情況,排除了美國南部,因為在那裡你在冬季仍然可以獲得一些維他命D。於是他們只考察美國的北部地區,並且展示出陽光更豐富的地方COVID-19的死亡率較低。然後他們想,這很有趣。英國呢?於是他們在英國進行了完全相同的研究。果然,他們不需要排除英國的任何部分,因為整個國家在冬季都無法獲得維他命D。他們顯示,英國某些地區的陽光比其他區域多。而那些獲得更多陽光的地方,COVID-19的死亡率較低。然後他們在意大利進行了相同的研究,結果完全一樣。他們發表了這項研究,並且在研究中說,這如果是因果關係,可能顯示出一種潛在的公共衛生干預。這完全獨立於維他命D,意味著還有其他事情在起作用。
    在2011年,瑞典進行了一項研究。
    是的。
    與這項研究有關嗎?
    不,這是完全不同的研究。
    但那也是一項非常重要的研究。
    所以這項瑞典研究是開創性的。
    這項研究詢問了20,000到30,000名瑞典女性的日照習慣。
    她們被分為三類。
    那些曬太陽不多的女性,那些曬太陽適中的女性,以及那些曬太陽很多的女性。
    他們跟踪了這些女性20年。
    並記錄了每位去世者及其死因。
    當研究結束時,研究人員感到驚訝。
    因為他們發現,那些在戶外時間較長的女性,對癌症、心血管疾病和非心血管疾病的死亡率最低。
    而那些在戶外時間最少的女性,則有最高的死亡率。
    這兩者之間的差異如此之大,以至於他們能夠顯示,在瑞典,花最多時間在户外且吸煙的女性,死亡率與那群沒有花那麼多時間在户外且不吸煙的女性相同。
    她們是相等的?
    她們是相等的。
    換句話說,處於那種戶外時間很少的類別,其死亡風險與吸煙是一樣的。
    他們怎麼知道這與運動無關?
    他們是如何能夠確立因果關係的?
    因為那是一個……
    當然。
    這是一個很好的問題。
    所以,這裡的區別在於,這是一項關聯研究,好的?
    所以問題是,你如何從關聯中獲得因果關係?
    你無法做到。
    但如果你查看布拉德福德·希爾標準,有一種方法可以強有力地論證因果關係,如果存在所謂的劑量反應曲線。
    換句話說,如果你能顯示出…
    你不僅僅是在比較兩樣東西,而是在比較三樣或更多的東西。
    如果你能顯示出隨著變數的增加,輸出有變化,這強烈暗示了潛在的因果關係。
    順便說一句,這正是我們用來證明吸煙導致肺癌的方法。
    顯然,我們無法進行隨機對照試驗。
    這裡,你可以吸煙。
    你不能吸煙。
    我們會在20年後跟進,看看誰有肺癌。
    這正是我們所做的。
    我們顯示出,吸煙與癌症風險之間有如此強的關聯,以至於我們能夠通過關聯說吸煙導致肺癌。
    順便說一下,英國皮膚科醫生理查德·維勒去年做了一項非常類似的研究,與瑞典的研究相比,他的樣本大了十倍,而且同時包括男性和女性。
    他發現了相同的結果。
    這是一項英國生物樣本庫的研究。
    他發現了什麼?
    他發現,無論是透過日光燈還是在戶外,使用太陽輻射數據,他都能展示,根據他們的問卷以及他們的居住地,光照越多,他們的死亡風險和癌症死亡風險就越低。
    所以問題是,這會增加黑色素瘤嗎?
    什麼是黑色素瘤?
    黑色素瘤是一種皮膚癌。
    這是大家最擔心的重大風險。
    你出去曬太陽,就會得皮膚癌。
    他能夠在那項研究中顯示,在這項有30萬到40萬人的英國生物樣本庫研究中,以理查德·維勒的研究顯示,黑色素瘤的發病率並沒有顯著增加,但非皮膚癌的死亡率卻降低了。
    好吧,這是取捨。
    如果你想在英國戶外晒太陽,好的,這樣的好處是你將能減少非皮膚癌的死亡率。
    所以說,除了皮膚癌之外。
    正確。
    另一方面,黑色素瘤的發病率並沒有增加。
    所以這促使他寫了一篇專欄並發表。
    實際上,你可以查找這篇專欄。
    這是一篇很好的專欄,發表在《皮膚科研究期刊》中,題為《陽光,重思的時候》,裡面他探討了這些論點。
    他實際上展示了,世界各地都有一些改變正在發生。
    因此,公共衛生組織現在開始說,以前我們一直說,陽光就像致命的激光,你應該竭盡所能地避免它。
    我們可能需要重新思考這一點。
    所以你是在告訴我,基本上每天在陽光下待15分鐘可以啟動我身體中的一個開關,改善我的線粒體功能,這將影響我健康的多個方面?
    大致上是的。
    而且我們正在看──而這是在一個我們越來越少在戶外的環境中。
    讓我給你一個角度,如果我們是在300年前的英國船上,我來到你面前,說,你看到這個小黃色果實了嗎?
    僅僅是吃一點這個黃色果實,周圍你同伴所看到的所有疾病就會消失。
    聽起來幾乎不可思議吧?
    但這就是事實。
    我們的21世紀的壞血病就是缺乏陽光。
    一切都在室內。
    我們避免外出。
    我們避免不適。
    我們避免高溫。
    我們避免低溫。
    我們曾經外出做運動。
    現在我們在墊子上進行虛擬運動。
    我們的窗戶特別設計,尤其是在南加州,以消除紅外光。
    為什麼?
    因為紅外光進來了,會使空氣變熱。
    我們沒有提到的關於紅外光的一個有趣的事情是,在我們與紅外光互動的方式中,你自己可以證明。
    你走出去,閉上眼睛。
    你可以感覺到太陽在你身體的哪一側。
    原因是,紅外線光不僅能穿透你的身體,它也能非常容易地穿透衣物。你可以感受到這一點。你所感受到的熱是紅外線光穿過衣物、穿透皮膚,並與你表面下的熱受體互動所產生的。因此,所有這些。好吧,夥計們。我去找史蒂夫。客人來了。準備好了嗎?進來吧。哇哦,史蒂夫!怎麼了?你在做什麼?這是Bonchage面膜。對於痘痘和皺紋都很好。它能讓皮膚變得更清透。這是紅光。你之前沒用過嗎?沒有。你試過這個嗎?真的非常好。它在你的臉上發射紅光,有助於增加和促進膠原蛋白的生成。我其實是因為我太太才知道這個的。我看到她戴著它。連續幾晚把我嚇壞了。我以為這是用來嚇人的,但實際上,它對你的皮膚真的非常好。所以他們是我們播客的贊助商,我已經每天使用它大約一年半了。哇,你看起來好亮啊。哇,史蒂夫。你看起來好亮,不是嗎?我看起來亮,不是嗎?太好了。是的。Bonchage全球發貨,所有產品都有簡單的退貨政策和一年的保修。請訪問bonchage.com/diary,享受全站任何產品25%的折扣。但你必須通過該鏈接下單。那是bonchage.com/diary,並使用代碼diary。無論你是新手還是已經在稅務和簿記行業工作多年,如果你想和一支投入於你學習和成長的專業團隊合作,我們的贊助商Intuit,TurboTax和QuickBooks的製造商,提供了一個真正的職業機會。他們的自學培訓,Intuit Academy,為你提供了獲得擴展職業所需技能的途徑,讓你能自信地在稅務和簿記領域成長。他們的團隊也非常支持,擁有一個由經驗豐富且具有專業資格的專業人士組成的龐大網絡,隨時陪伴你學習和獲得經驗。除了這些提升技能的機會之外,他們還提供靈活的工作時間安排,無論是全職、兼職、虛擬、現場,甚至讓你選擇工作時間,以便按照你想要的速度成長。Intuit目前正在擴展他們的稅務和簿記專業人士網絡。所以如果你想在他們那裡建立一個以自己為主的職業,只需前往Intuit.com/expert。我會把這個放在螢幕上。那是Intuit.com/expert。普通美國人或英國人花多少時間在室內?好問題。他們幾乎是一樣的。我認為英國人在外面花的時間比美國人稍多。美國人的最新數據是93%,英國人是92%。我們是天生要在戶外的嗎?我想是的。你會覺得我們的祖先可能花了大量的時間在外面。如果你想到我說的戶外,這也引入了許多我們還沒有談到的Newstart字母。運動。你在外面進行良好運動的可能性更大。你更有可能呼吸到新鮮空氣,這是外面的正確空氣。關於紅外光的另一個方面,簡單來說,樹木對紅外線光的反射能力非常強。換句話說,如果你在有樹木的環境中,你會獲得比在水泥叢林中多得多的有益紅外光。因此植物就是這樣。事實上,我們衡量亞馬遜森林覆蓋率的方式是通過衛星影像來觀察紅外光,因為它會反射紅外光回來。因此,最好的情況就是在樹木茂盛的綠地上,選擇在有很多綠樹的日子裡待在外面。我們已經知道幾十年來,住在綠色空間的人在糖尿病、高血壓、死亡率等方面表現得更好,所有這些問題。抑鬱症,所有這些問題。是的。當你考慮到這些時,你提出了關於相關性的一點。我們怎麼知道這不是抑鬱症?我們曾經說過,住在綠色空間的人錢更多。他們擁有更多的資源。也許這就是我們看到的。我必須告訴你這項研究。肯塔基州南路易斯維爾有一項叫做綠色心臟研究的項目。他們做了一件驚人的事情。他們在肯塔基州南路易斯維爾的一個城市化區域內,佔地四個平方英里,測量了每個人的HSCRP。什麼是HSCRP?高度敏感的C反應蛋白。它是炎症的標誌,已經與中風和心臟病等不良事件相關。所以如果你有高水平的CRP,那就不好了。他們測量了大約700人,然後做了一件非凡的事情。他們購買了8000棵成熟的樹木,挖了洞,並在這四個平方英里的區域種植了8000棵樹。這些樹都是帶葉子的。兩年後,他們回來再次測量他們研究中的所有700人,重覆HRCRP,下降了13到20%,這與中風的減少約10%到15%相關聯。這些人沒有改變他們的社會經濟狀況。他們沒有實施運動計劃。因此,這真的很直接地打擊了我們所見的綠色空間的優勢與我們未測量的其他因素有關的觀念。我實際上相信我們還會談到新鮮空氣,像這些植物,但更大。這有點像一盆盆栽植物。但外面的樹木實際上具有好處。它們代表著的一切,再次是這些不會影響你身體其他部分的事物,它們的運作使所有鏈條變得更大,因為它們具有好處。但如果你在屋子裡,你就無法獲得這些好處。
    所以我們該如何應對呢?在生活中我應該做出什麼改變來利用這一點呢?
    這個品牌叫做Bond Charge。
    他們製造這些紅光設備。
    他們有紅光桑拿、毯子、面罩。
    他們實際上是我的贊助商,因為我開始使用這個,我想他們發現了這一點。
    我是因為我的女朋友開始使用它的。
    是的。
    她每天都在用,所以我開始好奇。
    所以像我一直做的那樣,我總是非常懷疑。
    當然。
    我上網尋找一些研究,結果震驚了我。
    是的。
    對我來說,紅光面罩或任何紅光設備能對我的健康產生深遠的影響,這完全沒有直觀上的意義。
    我一開始不相信。
    是的。
    對我來說這像是迷信的東西。
    但我無法證明它是錯的。
    對。
    所有的研究,許多你提到的,都支持它確實有深遠的影響。
    正如我在這個播客中之前所說的,我的女朋友總是對的。
    她總是走在潮流的前面,總是正確的。
    所以我開始使用她的面罩,現在我有了我自己的Bond Charge面罩。
    是的。
    你推薦這種東西嗎?
    我認為這是合理的做法。
    我會這麼說。
    如果你從陽光中獲得足夠的紅外線光,根據我們的研究,不特別是和面罩有關,但我們在其他方面的發現是這些其他領域的效果不如預期。
    就像說,如果你在一艘有很多壊血病患者的船上,而你的飲食已經富含蔬菜和水果,那麼多吃一個檸檬並不會有太大的益處。
    所以你該怎麼辦?
    像很多醫生一樣,我們的工作班次是從早上七點到晚上七點。
    所以你在醫院裡,不能去外面。
    所以在午餐時,我盡量在陽光下待15分鐘。
    如果你住在一個多雲的國家呢?
    這是個好問題。
    雲,由於它們是水分子,會吸收大量的紅外線光。
    問題是,這正是你想要獲得的光。
    但是,即使在多雲的日子裡,待在外面,你獲得的紅外線光仍然比待在室內多。
    好吧,所以我在多雲時仍然能夠獲得我所需的光,但只是少了一些。
    是的,完全正確。
    如果天氣超級多雲,而我知道我會待在室內,我該怎麼辦呢?
    是的。
    我們室內使用的燈具。
    像這些?
    像這些,其實我認為英國和美國在這方面非常相似,就是我們真的不能再獲得老式白熾燈泡。
    我們使用LED或螢光燈。
    如果你思考這些燈泡的製造方式,舊的白熾燈泡能提供非常寬廣的光譜。
    所以從近紫藍到紅外線都有。
    他們使燈泡更有效率的做法是,嘿,讓我們停止使用能量來發出我們看不見的光,而給出我們能看見的非常窄的光譜。
    所以想想他們所做的。
    在整個人類歷史上,首次,我們現在正暴露於非常狹窄的光譜中,沒有其他光。
    無論在整個人類歷史中,當我們點燃一根蠟燭,或當我們走到陽光下,或有一盞煤油燈,我們都獲得了全光譜。
    換句話說,我們從未單獨得到藍光而沒有紅光。
    現在我們開始獲得只有藍光而沒有紅光。
    那我該換我的燈泡嗎?
    因為你無法獲得這些白熾燈泡,所以這是很難做到的,這讓我想到了,在美國,我們現在有法律禁止正常銷售白熾燈泡,因為能源效率問題。
    哦,是的。
    我現在在Google上查找,輸入了白熾燈泡。
    所以有一種叫做普通服務燈的東西,也就是可以插入的燈泡類型。
    但如果你決定想要獲得一個用於微波爐的燈泡,或者用於特別類型的吊燈的燈泡,那些仍然是可以獲得的。
    你可以仍然為那些獲得白熾燈泡。
    那這類燈泡呢?
    那是一個白熾燈泡,再次是用於這類特殊燈光的。
    但我說的是,像老式的A90燈泡,它只需旋入就可以。
    那些是120瓦的。
    那些變得越來越難找了。
    你無法在你的家得寶找到它們。
    所以格倫·傑弗裡,這是一個他做的前刊,他其實帶著22個在使用LED燈的環境中工作的人。
    他實際上,這不是同儕評審的,還未出版,但這是一個前刊。
    它在互聯網上可用。
    所以我不是在胡說。
    他對這22個人做的事情是,把這些LED燈泡更換為白熾燈泡。
    而在他的研究中,顏色區別的改善達到25%。
    那意味著什麼?
    他們能夠比暴露在LED下時更好地區分顏色,提升了25%。
    當我說LED燈泡時,這些是高藍光曲線的燈泡。
    那是為什麼呢?
    視網膜,即眼睛的後部,當光進入時,這裡有些藍錐,它們的代謝活動非常活躍。
    它們不斷更新,向大腦發送信號。
    這是你身體裡含有最多粒線體的組織。
    因為它們需要提供大量能量。
    隨著年齡增長,這些粒線體不再產生相同量的能量。
    因此,這些錐體能夠利用的能量變少了。
    所以它們無法更好地完成工作。
    如果您可以增加這些線粒體的能量輸出,您就能改善視覺感知的能力。Glenn Jeffrey 已經做過這樣的研究,他在早上用 670 奈米的光,僅僅三分鐘,這與那個面具非常相似,可以改善那群人視覺化和實際觀看的能力。這對於我們健康的更廣泛的影響是什麼?他們能更好地區分顏色,實際上改善他們的視力。基本上這就是它的意思。因此,問題回到播客一開始您提出的第一個問題,即線粒體低能量輸出有什麼影響?這取決於線粒體所在的組織。所以如果它在眼睛中,那麼它將有更好的視覺感知;如果它在大腦中,那就是癡呆症;如果它在其他地方,您明白我的意思了吧?我們開始看到的是,各種不同的疾病受到陽光的影響。我挑戰任何人去做這個。如果您查看美國的一項出版物,我已經看過,它描繪了一天中的死亡數量,包括心臟病、呼吸道疾病、腎病、肺炎,各種疾病,傳染病、非傳染病,您會看到一個非常明顯的模式。每年最大量的死亡發生在一年中最短的那天之後的一個月內。因此,我們在談論的是十二月和一月。我們在那段時間看到最多的流感死亡;我們在那段時間看到最多的心臟死亡;我們在那段時間看到最多的腎臟死亡。您可能會問,這是因為人們在聖誕時會聚在一起,然後傳播病菌。我們在美國的十一月底還有感恩節,這就是正在發生的事。問題是,如果您看看澳大利亞,它在另一端。他們一年中最長的一天是什麼時候?他們的一年中的最長一天是在十二月。儘管他們在十二月聚在一起慶祝聖誕節,但那時候的死亡人數最少。因此,這不成立,事實恰恰相反。在澳大利亞,南半球,最多的死亡發生在六月到七月,那是他們的冬天。所以您看到的是死亡與白天的長度相關聯。這就是為什麼每當他們顯示一年中的死亡人數時,總是需要季節性調整的原因。白天的長度是陽光的代理指標。絕對如此。您在一年中最長的一天獲得陽光的可能性遠高於最短的一天,特別是當有些月份,尤其是從早上 7 點到晚上 7 點的輪班工作者時,像十二月和一月,您根本不會見到陽光,因為您在太陽升起前就出門工作,而在太陽完全落下後才回家。所以您可能會整個星期都看不到陽光。那麼,獲得陽光的最佳時間是什麼時候?是的。因此,獲得陽光的最佳時間是針對那些擔心紫外線輻射會造成損害的人。如我們所提到的,當太陽位於天空的低處時,這將是有益的,因為紫外線無法像長波長輻射那樣斜穿過大氣。所以當太陽在早上升起時,和夕陽西下時,那將是您獲得比率上更多的紅外光和最少的紫外光的時候。現在,當太陽正好在中午正上方時,您將在那時獲得最多的紅外光,但您也將接收到大量的紫外線輻射。因此,如果您不是那種經常在陽光下活動的人,您可能會想避免這段時間。或者,如我們所提到的,戴上寬邊帽、穿上衣服。我的意思是,穿更多的衣服。因為正如我們所說,紫外線穿透衣物的效果並不太好。但紅外線卻可以。陽光照射在我身上的位置重要嗎?應該不是。因此,如果我走出去戴著一頂大帽子,顯然會遮住我的眼睛和臉。沒錯。但我的腿也會受到陽光的照射。就我們討論的線粒體的作用而言,這無所謂。然而,如果我們談論的是晝夜節律,如果我們在談論獲得晝夜節律,這一途徑是通過眼睛。所以您想要最大化通過眼睛獲得的光。對。因此,這種光被稱為“抑鬱光”。因此,您的問題與身體的哪個部分需要接觸或需要接觸有關。就線粒體及其代謝效應而言,這應該無所謂。好的。對於這種光來說,我們關注的是晝夜節律。這是一個完全不同的系統,與線粒體無關。這與您大腦中的內部時鐘有關,該時鐘調節著您身體中所有這些事情的發生時間。這種光的亮度大約是 10,000 勒克斯。勒克斯是一種測量光亮度的單位。研究顯示,當您將這種光照射到眼睛時,它可以調整您的晝夜節律。您知道,如果您有一個時鐘且沒有設置正確的時間,後面有一個小東西可以拉出來,然後您可以更改時間。是的。這樣改變身體內部活動時間的過程受到光的影響最多。光實際上可以根據您照射光的時間向一個或另一個方向移動它。
    如果你在早晨時分照明,而這正是許多人所做的事情,他們會使用這些所謂的「悲傷燈」。悲傷燈是季節性情感障礙(Seasonal Affective Disorder, SAD)的縮寫。這些燈,特別是在早上,能夠不僅調整你的生物鐘,確保它正常運作,還能減少抑鬱。你的腦中有一部分負責接收光線信息,叫做旁帶核(perihabenular nucleus)。這個名字很長,但就在那裡。如果它沒有受到刺激,可能會導致抑鬱。因此,對於居住在高緯度地區的人,特別是那些更靠近極地的地方,早上陽光升起得很晚,而他們已經在室內工作的人來說,這實際上是非常有益的。
    我建議你可以在亞馬遜上以約20美元的價格購買這些燈,但它們通常應距離你的臉約11到16英寸。而人們應該獲得大約3000勒克斯小時的光線。我的意思是,將勒克斯數乘以你使用它的時間。因此,3000是你應該達到的數字。因為這種燈是10000勒克斯,所以你只需要看大約三分之一小時或20分鐘,這應該就足夠了。那麼,這是否可以替代外出呢?這是外出的替代方案,因為你居住在一個緯度很高的地方,陽光還未升起,且因為你的工作,這會產生這種效果。但要知道,這無法替代陽光對你線粒體的影響。這只是為了影響缺乏陽光對抑鬱的影響。
    好的,那如果我從窗戶外看陽光呢?這取決於窗戶。因此,窗口仍然會減少進入你眼中的勒克斯數。因此,我不建議,如果能的話,我不會說從屋內看窗外與外出是一樣的,這是第一點。你還必須理解的是,許多現代窗戶會專門設計來減少紅外光。
    我希望你能給我任何有關光線健康的信息。這將改善我的生活。明天我可以採取具體行動的事情。顯然,其中之一就是我會出去,確保我能曬到陽光,最好是在早上。是的,我們談到了這個悲傷燈,尤其是對於那些生活在某些陽光較少的國家的人的幫助,對於調節他們的生物鐘,並幫助心理健康。還有其他我應該考慮的事情或能做的,或者改變的嗎?
    就像我們在「新創」法則的記憶術中提到的,休息和運動同時進行,而它們實際上有點相反,黑暗也是很重要的。好的,黑暗是重要的。這確實是一個問題。這是最大的問題之一,最近發表了一項研究,標題是「黑暗的日子和明亮的夜晚」,該研究與死亡率上升相關。我是說,這幾乎是我們大多數人的生活方式。這就是問題所在。我們有黑暗的日子和明亮的夜晚。而我們真正應該有的是明亮的白天和黑暗的夜晚。因此,正如在中午時分接觸明亮的陽光是同樣重要的,我們還需要開始努力實現更黑暗的夜晚。那我們該怎麼做呢?關掉電子設備,將這些屏幕遠離我們的眼睛。這些是非常重要的,因為螢幕上的光非常強,而這裡發生的事情,這就是為什麼這很重要。其實有兩個原因:眼睛接收到的光在晚上有兩种作用。第一,它會抑制松果體的褪黑素產生。正如我們剛剛所說,褪黑素是一種非常強大的抗氧化劑,對健康有益。第二,它正在混淆你的生物鐘。你看,你的生物鐘是設計來將光視為白天的。如果你的眼睛看到了光,你的腦子會認為是白天。因此,如果是晚上十點而你的眼睛看到了光,你的生物鐘就會說,我一定搞錯了。我以為是十點鐘。因為看,這裏有光。所以它會調整自己,推遲一切。因為它說,現在不可能是晚上十點,肯定是六點。因此,當你在晚上十點通常會感到疲倦和想睡的時候,經過一定天數後,你將不會在凌晨一點之前感到困倦。
    這些設備發出很多藍光,對吧?是的。有沒有什麼方法可以關掉這些?是的。其實,許多這些設備在到達某個時間後會轉換光譜至更紅的光譜,因此會給你更少的藍光。問題是,雖然你的眼睛中的感應器主要對藍光敏感,但這不僅僅是藍光。因此,實際上的解決方案,最好的方案是關掉光。其次最佳的方案是有更多的紅色轉換,或是在晚上佩戴這些眼鏡。這些是藍光過濾眼鏡,試圖消除藍光,但我仍然會接收到光。而這些光足以抑制褪黑素的生成。即使戴著那些?是的,絕對是。但你在告訴我這些對我有幫助?它們總比不關燈要好。而你還說我仍然會接收到光,因為還有光透過上面進入?即使那裡的光也會滲入那一部分的光譜,並導致褪黑素被抑制。是的。那么眼睛可以視為一天中時間的指標嗎?正確。
    問題在於,即使你閉上眼瞼,光線仍然可以透過眼瞼進入。
    你對這些睡眠面罩有什麼看法?
    我認為它們很好,因為我們現在知道閉上眼睑仍然可以讓一些光線進入。
    如果你在一個光源不受控制的環境中睡覺,例如在城市裡,即使你關上窗簾,仍然有光線進入,這些東西實際上可能非常有益。
    我不建議在臥室裡放置夜燈。
    你不建議?
    我不建議。
    即使是有LED顯示的時鐘收音機或空調。
    那對臥室來說就像全部是光污染一樣。
    你的臥室應該儘可能黑暗。
    如果我有那些不會發出藍光的燈怎麼辦?
    因為我想我女朋友在床邊放了一些這樣的燈。
    是的。它們還是不太好嗎?
    再說一次,最好的情況是沒有光。
    其次是沒有藍光的光。
    最糟糕的就是藍光。
    蠟燭光怎麼樣?
    這很有趣。有一項研究比較了晚上用燈泡照著書閱讀的人與用Kindle或其他設備的情況。
    他們發現,Kindle所散發的光比用燈讀書時出來的光要多得多。
    這會延遲入睡。
    所以……
    哪個延遲了入睡?
    Kindle。
    Kindle。
    是的。它延遲了入睡。
    足以實際上抑制生物鐘和減少褪黑素的產生。
    所以對你問題的答案是,蠟燭光很好。
    我唯一擔心的就是火災風險。
    是啊,因為你可能會在那東西旁邊睡著。
    完全正確。
    那麼相關的話題是維他命D,我們提到了一點。
    維他命D補充劑有效嗎?
    哦,當然。
    它們是有效的。
    而且已經進行了測試。
    是的。已有多項研究發表。
    Martineau其實是在英國醫學期刊上發表的。
    這是在2020年之前。
    這是一項隨機對照試驗的綜合分析,顯示每日服用維他命D的人急性胸腔綜合症的風險較低。
    還有一項最近的研究顯示,每日補充2000國際單位維他命D的人,所有原因的自體免疫狀況風險較低。
    我們談論的是類風濕性關節炎、克隆病、潰瘍性結腸炎等等。
    那是一項我們在MedCram頻道上回顧過的研究。
    因為我以前聽說過,很多維他命補充劑根本進不了我們的血液和身體。
    是的。所以維他命D非常有趣。
    它是一種補充劑,也是一種維他命,但它也是一種激素。
    它實際上會影響DNA的產生。
    所以這很有趣。
    但是這些都是描述良好的隨機對照試驗。如果你在看自體免疫疾病,這項研究的設計其實是針對心臟病的。
    他們實際上有兩個組別,一組是ω-3脂肪酸和維他命D。
    他們顯示維他命D組別的自體免疫病狀況顯著減少。
    我會補充維他命D。
    我有一個擔憂,如果你要補充維他命D,確保你檢查你的水平。
    為什麼?
    原因是因為它是一種脂溶性維他命,攝取過多是有可能的。
    如果攝取過多會怎樣?
    這可能會影響鈣的代謝,並且你可能會有鈣含量過高的問題。
    這非常罕見,但有可能發生。
    我並不是在說這樣會讓人不去補充,因為我認為補充是好的。
    但在某些時候,你要檢查一下你現在的水平。
    另外一個原因則是根據你的體型、膚色,因為膚色較深的人製造自己的維他命D較難。
    他們需要更多的時間待在戶外,尤其是在高緯度地區。
    所以像我住在英國,我需要多待在外面。
    你製造維他命D的難度會比住在低緯度或膚色較淺的人要大。
    維他命D在我體內做什麼?
    哦,好問題。
    很多事。
    如果你看維他命D的結構,實際上,我有進行過相關的研究,這很有趣,在大學時期。
    我曾經為研究生提供原料。
    它是一種脂溶性分子。
    因為它是脂溶性的,它能夠直接進入細胞核,實際上可以結合到DNA上,並與影響DNA轉錄的蛋白質結合。
    換句話說,根據我們談論的細胞類型,它可以引起許多有趣的變化。
    它影響鈣的代謝。
    免疫系統上有維他命D受體,所以它影響你的免疫系統,影響鈣的代謝,還有其他一系列的功能。
    我的團隊進行了一些研究,發現全球大約有10億人缺乏維他命D。
    這並不令人意外。
    大約50%的全球人口維他命D水平不足。
    絕對如此。
    是的。所以問題在於,隨著世界的工業化,隨著世界變得更加富裕,人們能夠建造住房,並為這些住房提供空調。
    而我們作為人類往往會避免極端。我們不喜歡太熱的東西,也不喜歡太冷的東西。
    讓我們面對現實吧。
    在我們的車上,我們有氣候控制系統。我們可以設定溫度,那就是我們的溫度。
    這段文字翻譯成繁體中文如下:
    還有其他的含義,我們或許可以在水療方面談談,如果有機會的話。
    但問題是,我們不喜歡那些極端的情況。
    我們不喜歡暴露在陽光下。
    當我們不這樣做的時候,我們就會承受後果。
    有沒有辦法讓我在不補充維他命 D 和不曬太陽的情況下獲得維他命 D?
    有的。
    某些食物中也有維他命 D。
    例如,蘑菇、某些類型的魚,它們也含有維他命 D。
    這是一個奇怪的問題。
    但你認為我們的身體知道我們缺少哪些食物嗎?
    其實我想表達的是,如果我缺乏維他命 D,你認為我的身體中是否有某個部分知道我需要吃蘑菇?
    這是一個好問題。
    這是否會讓我對蘑菇產生食慾?
    我不太確定這個問題。
    不過,我可以這樣說。
    在那些睡眠不足的人中,我們往往對吃更多碳水化合物的食物有偏好。
    這一點我們是知道的。
    這就是為什麼許多科學家相信,睡眠不足的人往往會選擇那些會增加體重的食物。
    在觀看這段節目的每一位觀眾都有所貢獻,不論是知識、技能還是經驗。
    這意味著你有價值。
    Stand Store,我共同擁有的平台,是本播客的一個贊助商,可以通過一個簡單的點擊將你的知識轉化為商業。
    你可以銷售數字產品、輔導、社群,並且不需要任何編程經驗。
    只需要有創業的動力。
    這是一門我真的相信的生意。
    到目前為止,已有三億美元的收益來自於創作者、教練和企業家,正如你在 Stand Store 上所具備的潛力。
    這些人不願等待,聽到我講這樣的話後,沒有拖延,開始建立,然後推出了某些東西,現在他們獲得了報酬。
    Stand 非常簡單且容易使用。
    如果你願意,可以將它與你已經使用的 Shopify 商店連結。
    我正在使用它,我的女友和我的很多團隊成員也在用。
    所以如果你想加入,先從免費的 30 天試用開始建立自己的業務。
    訪問 stephenbartlett.stand.store,幾分鐘內就可以設定好你的帳號。
    在我們面前這些來自 Newstart 框架的卡片中,你最想接下來談哪一個?
    水。
    水?
    好,那告訴我你所指的水是什麼,因為人們會想,是的,我喝了足夠的水。
    首先,我不認為我們喝了足夠的水。
    但每個人都在談論水的內部使用,這是有道理的。
    但正如我之前所說,水的外部使用實際上可以非常驚人。
    這與體溫有關,與免疫系統也有關。
    所以我們會談談水,但讓我們為這個話題設置一下框架。
    你的免疫系統分為兩種類型。
    一個是先天免疫系統,另一個是適應性免疫系統。
    在 COVID 期間,我們對適應性免疫系統變得非常熟悉,因為所有討論的重點是抗體和抗原,以及 SARS-CoV-2 是否在變異,造成抗體的疫苗是否依然有效。
    所有這些,像是字面上有把鑰匙和鎖孔的關聯,這些抗體就像是那把鑰匙,適應性免疫系統非常重要,但它完全排除了先天免疫系統的討論。
    先天免疫系統實際上是身體的第一道防線。
    在這裡發生的是,這些細胞不斷循環,例如單核細胞、自然殺手細胞和其他許多細胞,這些細胞在全身搜尋,看是否有任何看起來不屬於它的東西。
    它可以根據這些侵入者的分子模式來識別它們不應該存在,並且應被清除。
    這個先天免疫系統的主要效應者叫做干擾素。
    干擾素是身體中一個非常重要的分子,它在預防病毒感染方面非常有效,以至於幾乎所有今天困擾人類的病毒感染都有一種對抗干擾素的防禦機制。
    這是基本前提。
    沒有一種自尊自重的病毒會認為能在不處理干擾素問題的情況下感染人類,結束。
    把干擾素想像成銀行的保安。
    如果你想搶銀行,你必須有計劃去應對保安。
    否則,你就拿不到錢。
    這樣理解了嗎?
    是的。
    其實幾年前有一篇文章發表,談到了干擾素和新興病毒之間的對抗,病毒為了規避干擾素所做的努力。
    你可能還記得,2002年我們曾經有一場名為 SARS 的疫情,特別在中國爆發得非常嚴重,也在加拿大。
    我們之所以能夠控制那次疫情,是因為每一個感染 SARS 的人都出現了發燒的情況。
    因此,很容易確定這些人,我們能夠將他們送入醫院並隔離他們。
    而 SARS-CoV-2 的問題,以及許多感染像普通感冒一樣的疾病,就是你不一定會發燒。
    而發燒是非常重要的。
    那這與水有什麼關係呢?
    我們將會談到這個問題。
    干擾素的產生隨著體溫的上升而增高。
    事實上,身體的發燒機制是它告訴身體需要增加干擾素以應對病毒感染的方式之一。
    這就是為什麼你會感到熱?
    你感到熱,其實你可能也會感到冷。
    而你可能感到寒冷甚至有寒顫的原因是,這種感覺是由你的體溫和你身體的恆溫器設定所產生的。如果你身體的恆溫器顯示,好的,我們在98.6華氏度,或者在攝氏度下是37度,如果你感染了某種病,身體就會說,哇,我們有感染,我們需要提高體溫。我們要將體溫從37度或98.6提高至38度或100.4。因為你的實際體溫低於身體所希望的溫度,所以你會感到寒冷。你會顫抖以試圖提高那個溫度。因此你會隨之而上升。現在,一旦發燒結束,感染解除,體溫下降時,你會開始出汗。所以這就是為什麼當有人說,“哦,他在出汗,”這意味著發燒正在退去。這意味著你的體溫正在下降。因此通常你會感到寒冷。你會覺得自己在顫抖。你會想要上床並蓋上被子。就這樣你的體溫上升了。這是有原因的。因為當你的體溫上升時,會創造一個病毒不容易複製的環境。所有病毒在高溫下都無法很好地複製,包括SARS-CoV-2。這也是身體產生更多干擾素的信號。有一項研究在去年發表,研究者觀察了老鼠,順便提一下,它們的體溫與我們相同。他們發現有五種不同的調節蛋白,所有這些都導向一個最終結果,那就是產生一種叫做干擾素的物質。當你的身體溫度從37度上升到38度時,這些調節蛋白的產量會迅速增加。那基本上就是在發燒的邊緣,對吧?所以我從這一切中得到的重點是,我們不應該真的去治療發燒,除非它們高到會出現其它並發症的程度,例如心跳過快或癲癇。但我們經常這樣做。我們治療發燒因為它讓我們感到不適。我們認為通過治療發燒,我們會感覺好一些。但實際上我們在削弱我們的免疫系統,因為免疫系統反應的一部分就是產生發燒,而發燒又產生干擾素。現在,我不想過度強調這一點,但讓我們將先天免疫系統和適應性免疫系統進行比較。適應性免疫系統對特定變異株的病毒非常具體。而對於像SARS-CoV-2這樣快速突變的病毒,免疫接種在結合方面可能非常有效。但是如果那個病毒發生突變,這種結合就會受到影響。這可能不會影響住院情況,但可能會影響預防感染。你明白我說的意思嗎?因此,各種不同的變異株,我們有α變異株,然後是δ變異株,接著是Omicron等等。這些對於適應性免疫系統是實質性的變化。對於先天免疫系統和干擾素來說,這並不重要。干擾素對於α變異株、δ變異株和Omicron的效果都是一樣的。因此再讓我們設定一下。水。我們說水具有非常高的比熱,這意味著如果我將熱水應用到人體上,它能夠轉移熱量。這就是為什麼人們面對滾水會燒傷。我們顯然不希望燒到任何人。但是如果我們能夠讓他們進入桑拿,如果我們能夠讓他們進入水療,或者如果我們能夠使用熱毛巾並將其應用到人體上來加熱他們的身體以引起出汗,換句話說,如果我們能夠在患有這些感染的病人中誘導人工發燒,似乎有證據表明干擾素反應會更好。曾經有一項研究對淋巴細胞進行了分析,並將它們從人體中取出。在不同的溫度下,當溫度達到大約38或39度時,干擾素的生成是原來的十倍增長,這正是我們希望得到的效果。現在,我如何知道干擾素水平在COVID-19等病症中如此重要呢?好吧,有一項研究表明高水平的干擾素與較輕微的SARS-CoV-2感染相關,而那些低干擾素水平的人則患有非常嚴重的COVID-19感染。所以你是建議我們應該更經常地去桑拿嗎?是的。這是基於芬蘭桑拿領域中有良好紀錄的數據。因此,每周使用桑拿四、五、六、七次的人比每周使用桑拿一次的人更可能死於心血管疾病。在芬蘭,每周一次算是標準。他們為什麼會說一起做熱冷療法呢?所以我會爭辯說,為什麼之所以這樣說,這可以追溯到100多年前寫的若干論文,當你長時間進行熱療,比如在桑拿裡待20分鐘時,實際上你是在加熱身體,而這樣做的整個目的是提高體溫。冷療結束時可以產生兩個效果,他們認為。第一個是它引起血管收縮。所以當你將一陣冷放到身體上時,它會在表面上引起血管收縮,以便在你結束時,不會通過那些血管丟失太多熱量。因此你會保持核心體溫增高的時間更長,這正是你想要的。冷水的另一個功能同樣是引起血管收縮。眾所周知,當你洗冷水澡時,你的血管會收縮。
    當你從一個活著並且血液循環的人的血管端部觀察時,你會看到有許多白血球附著在該血管的內表面。當血管收縮時,這些粘附的白血球會被彈入血液循環中,然後它們會去做它們要做的事情。這種現象被稱為去邊緣化。
    所以關於寒冷,有兩件事,結尾時說明一下。這其實不需要太長,可能不到一分鐘。反其道而行,寒冷實際上會使你的體溫保持更高更久。第二點,就是去邊緣化。
    那麼,水就是W。在這些中,你想要選擇哪一個?哪一個對你來說最有吸引力?
    來簡要談一下空氣。我們說空氣不只是缺乏毒素,還具有實際的益處。首先,我們要有良好的氧氣。我們想要去除二氧化碳,尤其是在通風不良的建築物中,這樣不太好。但其實有很多研究探討了植物和樹木,及其釋放的類似植物生長素的物質。那是什麼呢?這些是樹木實際釋放的芳香化合物。我們觀察這些化合物對人體的影響,發現它們實際上是非常有益的。它們與我們的免疫系統互相作用,提升我們的免疫系統,讓我們更放鬆。日本文獻中有很多關於這方面的數據,尤其是在他們所稱的檜木森林中,研究了這些CEO們的情況。日本有一個關於CEO的播客。他們從工作中帶走這些CEO,帶到檜木山中,讓他們漫步並進行血液檢測。他們發現,那些對免疫非常重要的自然殺手細胞,不僅數量增加,而且它們內部分解疾病或病毒的酶也有所增加。
    所以當他們把這些CEO帶回日本市區,讓他們住進酒店,並注入這些自然產生的植物生長素時,這些受試者幾乎得到了完全相同的效果。因此,你認為植物和置身大自然其實能給我們的,不光是乾淨的空氣。它還給我們提供幫助我們對抗疾病的化學物質。確實如此。
    再說一次,這裡有一個二分法。內部與外部。當你在外面時,你會得到什麼?我們已經談過運動,也談過陽光,現在我們增加了新鮮空氣,不僅僅是你擁有低污染物的事實,這當然非常重要,但事實上在綠色植物和綠樹的環繞中,可能會有額外的益處。順便說一下,他們發現的益處持續了大約七天。因此,每週外出一次其實可以帶來這樣的好處。
    我常常思考二氧化碳,顯然是因為我花了很多時間坐在錄音室中錄製,這是我們大洛杉磯的主要錄音室,但在英國,我起初是在一個非常小的房間裡,並且沒有空調。顯然,我有時在這裡和客人坐幾個小時,那時我們就在循環二氧化碳。是的。而且我讀過幾項研究,顯示這對我的認知表現會有影響。是的,這都是事實。我們的頻道上曾邀請過哈佛公共衛生學院的约瑟夫·艾倫博士,他向我們展示。他字面上就是用二氧化碳計,稍微打開窗戶,就讓二氧化碳逃逸,降低了二氧化碳的濃度。因此,這是非常重要的。
    絕對如此。對於在辦公室工作或經常在酒店房間裡的人,他們應該考慮什麼,如何確保空氣品質最佳?我們提到的替代指標就是二氧化碳。因此,如果可能的話,開窗,或開門而不影響安全。這些都是非常有益的措施。甚至在開車時稍微降下車窗,並確保在駕駛時關閉循環空氣按鈕。我有朋友不會住在某些酒店房間,除非窗戶能打開,因為你知道,在很多酒店房間,尤其是高層的房間,你都不能打開窗戶。我們的英國錄音室面積比較小,我們在亞馬遜上找到了一些不太貴的設備,有時會放在錄音室的地板上,看看我們的狀況。如果有任何人對了解你在工作室的二氧化碳水平感興趣,我會在屏幕上提供一些資訊。
    是的,那麼你接下來的清單中有什麼呢?我們已經談過運動、營養和節制。這些事情很多人都會談論。很少有人談論信任。當你說信任時,你的意思是宗教信仰嗎?宗教信仰,某種能幫你應對壓力和焦慮的方式。事實上,這就是問題的關鍵。有許多研究探討了這一點。是的,基本上就是《聖經》。或者它也不必是《聖經》。還有其他的信仰流派也在研究這一問題。許多研究探討了對上帝的信任以及這與焦慮的關係。因此,許多研究顯示擁有良好信仰並信任一位支持性的上帝或宗教的人,往往會有較少的焦慮和抑鬱,並且擁有一個可以互動並提供支持的信仰社群。
    我認為文獻中指出的情況是,雖然科學背後的證據並不像隨機安慰劑對照試驗那麼嚴謹,但這無疑是我相信能幫助所有這些聯繫的一個支柱。你覺得這裡發生了什麼呢?所以你告訴我,根據文獻的說法,對神有信仰的人在某種有趣的方式下,不會受到抑鬱和焦慮的影響?是的,這是許多人試圖解答的問題。他們認為這與對一個在關心你並支持你的神的信任有關。那種關係確實會導致,或可以說,與抑鬱減少、焦慮減少有關,特別是。有一些研究已經進行,尤其是在基督教中,有一項研究被發表,這是來自德州大學的克勞斯所做的,他進行了一項調查,詢問人們如何原諒。他基本上將參與者分成兩組。有些人會有條件地原諒,而有些人則無條件地原諒。讓我用實際的術語來表達。如果有人對你做了某事,而你說,哦,沒關係,我原諒你,問題是,你會原諒那個人嗎?有些人只有在對方回來並且做了一些懺悔的行為後才會原諒。比如,好吧,我會原諒那個人。他們回來了並道歉。或者我會原諒那個人,他們回來了並做了,不論那是什麼。那被認為是有條件的原諒。另一種就是無條件的原諒。換句話說,有人對你做了某事,你再也見不到他們。或者他們從未表示對他們所做的事情感到抱歉,他們仍然會被原諒。這就是無條件的原諒。當研究中將這兩種情況進行區分時,他們發現,那些無條件原諒的人抑鬱感更少。他們對自己的不足感更少。對於臨終的焦慮更少。他們所有的這些情況比起那些有條件原諒的人來說,抑鬱的具體化程度更高。因此,這些是實際的醫療情況,這些都可以通過調查和確認良好的測試來診斷。決定這兩者之間差異的一個因素,就是他們如何原諒。因此,他們對此感到困惑。他們說,那麼,什麼決定一個人會有條件地原諒還是無條件地原諒呢?他們考察了很多因素,沒有一個特別突出,除了其中的一個,這個比率約為2.5。而且這個問題的核心是:你相信神已經原諒你了嗎?這是關鍵。如果某個人相信他們所信仰的神已經原諒了他們,他們無條件原諒別人的可能性會高達兩倍半。那又意味著什麼呢?這與所有其他低的情況有關,例如更少的抑鬱、更少的焦慮。因此對我來說,這是相當有趣的,因為在他們的心中,這就是實際上發生的情況。因此也有隨機對照試驗,在這些試驗中,當人們接受治療時,像你說的,有焦慮的情況,我們可以對那些人進行認知行為療法。但經隨機安慰劑對照的方式顯示,如果一個人有信仰,並在認知行為療法中融入該信仰的元素,則認知行為療法的效果會更顯著。因此我想我應該先說明,我不認為這些東西應該在未經他們同意的情況下強加於人。我在醫療環境中工作,所以我會為不相信的人祈禱嗎?不會。這必須經過請求許可。你認為相信上帝的人一般來說更健康嗎?考慮所有其他因素?數據似乎表明,與教會有健康關係的人,和跟神有健康關係的人,與較少的疾病有關。因為從因果關係的角度來看,你可以說,因果關係,對。所以,這就是我們不清楚的事情,可能他們有更多的朋友。他們可能有,對。所以問題是,健康的人和有更多朋友的人是否更有可能有宗教信仰,還是情況正好相反?有時這些事情是難以分辨的。但我想,對於相信更高權力的人來說,這會帶來一種巨大的平靜力量。絕對是如此。另外有趣的是,當你查看其他宗教時,許多這些情況實際上被納入其中。例如,印度教徒非常出名的是早上起床迎接陽光。我們剛剛談到了陽光的好處。我們沒有太多討論營養,但禁食是其中的重要部分。穆斯林的宗教也是這樣,進行拉馬丹時要禁食。很多宗教都有寒熱的習俗,是不是?是的。而在此之外,我還想說的是,如果你和神的關係不健康,比如如果你信仰的神是報復性的、對你不滿的,或者除非你做了什麼,否則就會對你有所行動,這也被證明會產生負面的影響。所以這取決於你所擁有的關係。
    你在你的實踐中看到什麼?
    因為你之前說過,你經常在人的生命結束時出現。
    是的。
    不幸的是,有時我成為他們見到的最後一個人,而你開始意識到,你不能改變,死亡是必然的,我們在醫學中所做的只是推遲不可避免的事情。
    所以我們試著做的是,我有一位同事對此非常哲學,我們試著確保當這些事情發生時,能夠以尊嚴進行,我們慶祝這個人的生命,確保一切都是按照他們希望的方式進行。
    人們在臨死前會說什麼?
    人們變得不同,對於不同的人而言,這是非常不同的,但他們可能會變得非常審慎,我見過那種強烈的對比。
    有些人已經準備好離開。
    人們感覺到他們已經完成了來這裡的任務,他們不想再有任何其他的牽涉。
    就像我們在這裡是為了推遲死亡,我們在這裡是為了讓他們使用呼吸機或給予他們這些藥物。
    你會驚訝地發現一些看起來相對健康的人,但卻發生了一些我們可以輕易矯正的事情。
    他們卻說,不,我不想這樣。
    我選擇不這樣做。
    而我們必須尊重他們的選擇。
    顯然,我們必須教育他們以確保他們做出正確的選擇。
    但一旦他們獲得了所有的信息,最終做出決定的是他們自己。
    所以你會看到人們選擇死亡。
    當我們能夠用人工方式介入時,他們更願意不這樣做,而選擇死亡。
    是的。
    有沒有具體的案例改變了你?
    是的。
    有一個案例改變了我,但不是我們之前談到的那種可怕的情況。
    這實際上是一個奇蹟。
    我真的見證了一個奇蹟的發生。
    對我來說,這發生在我的訓練初期。
    所以這讓我對成為一個預測性醫生重新思考了一下。
    預測性醫生。
    是的。
    我說,哦,你再也不能走了,或者你只有兩年的生命了。
    我一定在醫學院那天缺席了。
    我沒有出現。
    這是一位年輕人。
    他有睾丸癌,他接受了手術。
    睾丸癌的手術非常成功。
    不幸的是,在手術過程中發生了一些事情。
    他的腦部沒有獲得足夠的氧氣。
    他在手術後出現了缺氧性腦損傷。
    這個人看起來應該二十多歲,還有一位年輕的妻子。
    而我當時作為住院醫生進入了這個輪班。
    我們有主治醫生,你必須意識到在醫學中,你上面有主治醫生。
    他們所說的就是,這就是定論,這就是會發生的事情。
    而重護病房的主治醫生,我們正在照顧這位病人,因為他在使用呼吸機。
    但有一位神經科醫生檢查了所有情況,說,看,這個人根本不會醒來。
    他的缺氧性腦損傷很嚴重。
    我們看過掃描,這就是將會發生的事。
    因此,我們每天都去看這個病人,他就只是一個顫抖的麻煩。
    他就這樣待著。
    他只是在那裡顫抖。
    他的眼睛翻轉,沒有反應,什麼都沒有。
    每天他的妻子都會進來,她不相信這個人會這樣一輩子。
    她相信他會最終醒過來。
    所以她會在他的床邊,照顧他,確保這個、那個,還甚至要求我們把她在家裡調製的特別混合物放入他的管餵中,以便幫助他恢復。
    我們會,會去依從她的請求,但我看到我的主治醫生,他們在想,她不明白發生了什麼事。
    她不明白他將永遠不會醒過來。
    這就是我所看到的。
    有一天她進來,她的臉上掛著微笑。
    她如此平靜,面帶微笑。
    而且他們是一對西班牙裔夫婦。
    所以我們不得不請翻譯了解情況。
    她告訴我們,她說,我昨晚做了一個夢。
    我做了一個夢,他將要回家。
    她堅信,面帶絕對的快樂,興奮不已。
    我們想,這女士是瘋了。
    她不明白發生了什麼。
    隨著日子的推移,幾周過去。
    有一天,我們在病房圍繞,在這個圓形的護理站中,房間的門都圍在周圍。
    我們正在圍著病人轉圈巡視。
    我望進去,看到他在那裡,有點顫抖,但他在睜開眼睛。
    我說,他似乎在專注。
    他的眼睛似乎比之前稍稍聚焦了一些。
    我舉起手來。
    果然,他也舉起手來,顫抖著,然後又把手放下。
    我想,這是什麼情況?
    他向你揮手。
    是的。
    什麼?
    我說,我們去再檢查一下這件事。
    長話短說,這用了幾個月。
    但那個人走出了醫院。
    六個月後,他和他的妻子一起回到了病房,像是沒有什麼問題一樣地走了進來。
    他給我們送了一大籃花,以感謝這個病房對他的幫助。
    在我心中,我知道對於大多數那段時間的工作人員而言,他們只是在走過場,保持他活著,因為那是她想要的。
    顯然,當出現他恢復的跡象時,情況完全改變了。
    人們驚訝不已。
    所以,這對我的職業生涯造成的影響是讓我思考了兩次:這個人為什麼會變得更好?他才22歲,年輕,通常這種情況會發生在非常年輕、心智可塑性強的人身上,他們能夠適應這種情境。但這真的,其實是一種奇蹟。我無法用其他任何詞來形容。我是說,這不是我們所能預料的,所有專家都說這不會發生,但它發生了。你覺得發生了什麼?我認為他有一位相信他的愛妻。而且在生理和心理之外,可能還有某種靈性上的因素。我不知道,這是可能的。這是非常罕見的。而當它發生時,常常發生在年輕人身上。這是我大腦的醫學部分會說的。但我大腦的另一部分則說,你知道嗎?我只知道世界知識的約10%,也許是5%。不,世界知識,1%的世界知識。也許我擁有5%到10%的所有醫學知識。而我會說,解釋可能存在於那其餘的80%到90%中,我就是不知道。我想這教會我的就是,我們必須對自己所知道的保持謙卑。我們知道一些事情,而有一些事情我們不知道,我們不知道。我們之前稍微提過這種化學物質——褪黑激素。是的。我想最後聊聊這個,因為我有一個問題。很多人晚上服用褪黑激素補充劑來幫助入睡。是的,這樣做好嗎?我覺得在某些情況下這是好的。所以,如果你在入睡時有困難,少量的褪黑激素,最多5毫克,實際上是非常有益的。如果你想把你的生理時鐘往回調,而不是推遲,而是希望提前,褪黑激素也非常有益。這對於時差反應非常有幫助。對於一些睡眠疾病也有益,但我並不建議常規使用,只是因為這樣的原因,不要服用大量的褪黑激素。這樣做有什麼副作用?你之前說過一切都有副作用,對吧?而且會影響到其他部分。所以,服用高劑量的褪黑激素可能會讓你變得更容易煩躁。煩躁?是的。在哪方面?只是精神上會變得煩躁。是的。那看起來是什麼樣的?容易受到影響。所以像情緒失調嗎?是的,絕對是。你知道的,還有關於褪黑激素的其他什麼嗎?目前我們並沒有進行相關研究。人們擔心如果服用過多的褪黑激素,可能會影響松果體本身的褪黑激素分泌。但我目前還沒有證據來證實這是否真的如此。羅傑博士,還有什麼是我們未討論而應該討論的嗎?我們已經討論了很多。我認為把它們總結起來就是,那些聯繫。如果我們擁有這些聯繫,藥物有它們的用處。但它們的作用方式是通過分解其他部分的鏈條來增強薄弱的鏈條。這在生命的最後階段可能會有影響,如果你想維持生命。但如果你對長壽感興趣,或者對過上最好的生活感興趣,那麼你就希望增強所有這些鏈條。我相信做到這一點的關鍵是一個叫做新起點的東西。我們這個播客有一個結尾傳統,就是最後一位嘉賓為下一位嘉賓留下問題,而不知道他們是留給誰的。而留給你的問題是:你最迫切想談論的焦點是什麼,幾乎沒有人問過你?這本書,《聖經》,這是我的傳統。聖經中的科學證據。你是什麼意思?我們所談論的是身體和身體的健康。我想檢驗聖經中的某些陳述,以查看它們是否在科學上成立。比如把水變成酒?不,或許。那是一種奇蹟。我所提到的是這個。而這是我實際上所做的,這其實非常有趣。你知道,保羅是聖經新約的作家之一,他寫給哥林多人的信中說,難道你們不明白你們的身體是聖靈的殿嗎?我說,這是一個非常有趣的陳述。他是怎麼得出這個結論的?那麼,聖靈的殿是什麼意思?所以,當時唯一的殿就是位於耶路撒冷的殿,裡面會有祭品等。所以,我所做的是,我回過頭來,這就是在回答問題:我正在尋找聖經中某些作家可能無意間隱含的科學真理的證據,以查看是否真的存在真理。這樣說來是否有道理?所以,如果你看出埃及記第25到30章,大部分內容都是摩西在曠野中建造的聖所的詳盡描述,他說這是他從上帝那裡獲得的。這就是他所說的。因此,這是一個很好的方法來看看這一切是否能夠具體體現出來。摩西說,這是我獲得的殿的模式描述。而保羅說,你的身體是殿。我的假設是,如果我們看看這座殿的模式,應該與人類的身體相匹配,而當時保羅寫這些話時,他們對人體沒有任何理解。我們直到17世紀范・列雲霍克才能認識到細胞。我們直到17世紀威廉·哈維才能了解心臟的循環。然而,如果你仔細觀察人體,你會發現有血液系統。血液在血管系統中循環。然後它進入間質液,接著間質液再進入細胞,細胞上有一層你無法穿透的質膜,除非你實際上有特定的蛋白質。
    然後它進入細胞,這是一個有兩個區域的隔間,對吧?
    你有細胞和細胞核,對吧?
    這正是摩西在曠野中獲得的結構。
    順便說一下,印度教的寺廟也是這樣設計的。
    這是一種三部分的情況。
    所以,你有這個祭壇,那是獻祭的地方,這裏有血。
    這就是人體中的血。
    接下來,你移到洗滌盆,那是一個裝滿水的容器。
    在你從血液進入間質空間後,那就是間質空間。
    任何藥理學家都會知道,這正是你移動的模式。
    接下來的東西是這個有幕的結構,除非你穿過它,否則你無法穿透。
    這就是細胞,因為這個結構是建築,裡面有一個房間。
    這正是細胞的樣子。
    細胞是由細胞質包圍的細胞核。
    好吧,在你一開始進入的這個房間裡,有一些家具,與你在細胞質中看到的類型的細胞器非常相似。
    例如,裡面有一個七枝燭臺,正在燃燒橄欖油並產生能量。
    這就像β-氧化產生能量。
    這正是你在粒線體中看到的。
    但最後,你要進入細胞核。
    這座寺廟裡有一個稱為至聖所的地方,那裡有一個祭壇–就是這個約櫃。
    你看過《印地安納‧瓊斯》吧?
    對。
    還有第一部–《失落的方舟》。
    裡面有這個約櫃,你打開它,這是兩塊石版,十誡放置的地方。
    所以在那個地方,你有兩塊神所親手刻的石版,即生命法則。
    根據猶太教和基督教的信仰,這就是法律,如果你違反了法律,這就是罪,罪的後果就是疾病和死亡。
    當我們來到人體的細胞核時,你會看到兩條DNA鏈。
    而在這些DNA鏈上有生命的密碼,核苷酸,這就是生命的法則。
    如果你操縱這個密碼,將導致突變,進而引起疾病和死亡。
    這一切在1950年之前都不為人知,當時他們發現了DNA。
    然而,我們有保羅在這裡做出了這個跳躍,說你的身體是聖靈的殿。
    我覺得這非常迷人。
    沒有人曾經問我這個問題。
    但只要你問了這個問題,這就是第一個出現的事情。
    順便說一下,經文中還有許多其他地方暗示著這一點。
    真的太有趣了。
    保羅談到基督的身體,它是一個身體,但由許多部分組成。
    有手、有腳。
    他不知道細胞的存在,但這正是人體的樣子。
    人體是一個由許多部分組成的整體。
    范·李文虎直到1600年代才發現這一點。
    我們直到1800年代才有細胞理論。
    所以這很有趣,古代文本中所作的陳述,
    其科學意義遠在表面之下。
    我覺得這一點很有趣。
    非常感謝。
    我希望能夠很快再次與你交談。
    謝謝你所做的所有工作,因為你讓一些這些困難的科學主題變得難以置信的容易理解。
    你真的有簡化的藝術。
    以一種簡化的方式,這意味著數百萬人–你擁有數百萬的YouTube訂閱者。
    數百萬人可以獲取這些信息,而這些信息通常被限制在某些學術研究之內。
    所以,謝謝你所做的工作,因為我相信這對很多很多數百萬人的生活都產生了深遠的影響。
    我相信我的觀眾會深表感激。
    因此,非常感謝你,羅傑。
    我很感激你。
    謝謝,史蒂芬。
    謝謝你邀請我來參加這個會議並提供這個機會。
    確保你把我接下來要說的保密。
    我邀請你們這10,000人進一步深入CEO的日記。
    歡迎來到我的內圈。
    這是我將向全世界推出的一個全新私人社區。
    我們有很多驚人的事情發生,你從未見過。
    我們在錄製對話時的簡報都在我的iPad上。
    我們有從未透露過的片段。
    我們有嘉賓的幕後對話。
    還有我們從未放出的集數。
    以及更多其他內容。
    在這個圈子裡,你可以直接與我接觸。
    你可以告訴我們你希望這個節目變成什麼樣子,你希望我們採訪誰,以及你希望我們進行哪些類型的對話。
    但請記住,現在我們只邀請前10,000位加入的人,然後就會關閉。
    所以,如果你想加入我們的私密社區,請前往下面描述中的鏈接。
    或者訪問doaccircle.com。
    我會在那裡與你交談。
    在我們回到這一集之前,快速說一下。
    只需要你30秒的時間。
    我想說兩件事。
    第一件事是對你一如既往的支持和收聽表示感謝。
    這對我們所有人來說意味重大。
    這真的是一個我們從未擁有過、也無法想像到的夢想,能夠來到這個地步。
    但其次,這是一個我們感覺只是在剛開始的夢想。
    如果你喜歡我們在這裡所做的事情,請加入24%定期收聽這個播客的人,並在這個應用程式上關注我們。
    這是我對你的承諾。
    我將竭盡所能讓這個節目變得盡可能的好,現在和未來。
    我們將提供你希望我與之對話的嘉賓。
    我們會繼續保持你喜愛這個節目的所有內容。
    謝謝。
    謝謝。
    謝謝。

    Is your daily routine ruining your health? Is THIS habit silently triggering dementia? 

    Vitamin D Expert Dr. Roger Seheult reveals how sunlight exposure, caffeine intake, and sleep can impact cancer risk, accelerate dementia, and fry your dopamine brain! 

    Dr. Roger Seheult is a world-leading doctor in internal medicine, lung health, critical care, and sleep medicine. As co-founder of MedCram, he’s helped millions understand how vitamin D, sunlight, mitochondria, and circadian rhythms impact disease, brain health, and longevity.

    In this powerful interview, he explains: 

    ◻️How just 2 minutes of morning sunlight can boost dopamine by 250%. 

    ◻️The daily habit increasing your cancer risk (and how to fix it).

    ◻️What caffeine does to your sleep, hormones, and mental clarity. 

    ◻️How red and infrared light boost your mitochondria. 

    ◻️How sleep, light, and nutrition create a blueprint for longevity. 

    00:00 Intro

    02:27 What Is Roger Aiming to Accomplish?

    03:28 The 8 Pillars of Health

    09:13 Story of Henry: A Fungal Lung Disease Patient

    20:40 Why Our Mitochondria Need Sunlight

    27:46 Sunlight and Viruses: Impact on COVID-19

    30:00 Vitamin D and Lower Risk in COVID Patients

    33:55 Benefits of Using Infrared Light Devices

    47:50 Could More Sunlight Help You Live Longer?

    51:20 Does the Sun Really Cause Melanoma?

    54:37 Are Humans Meant to Live Outside?

    57:31 Is It Worth Wearing an Infrared Light Mask?

    59:31 How to Get Infrared Light on a Cloudy Day

    01:08:14 Optimal Time of Day to Get Sunlight

    01:09:34 Circadian Rhythm and Light Exposure

    01:11:28 Benefits of SAD Light Therapy

    01:13:02 Can Looking Through a Window Help Circadian Rhythm?

    01:15:11 Why Should We Avoid Bright Screens at Night?

    01:17:31 Should the Bedroom Be Completely Dark at Night?

    01:19:23 Do Vitamin D Supplements Work?

    01:21:14 Possible Consequences of Vitamin D Overdose

    01:22:02 The Role of Vitamin D in the Body

    01:24:00 Do Cravings Signal Nutrient Deficiencies?

    01:25:35 Water’s Role in the Body

    01:27:20 Interferons and the Innate Immune System

    01:32:52 Importance of Hydration for Fighting Infections

    01:34:35 Should We Use Hot and Cold Therapy Together?

    01:36:10 Impact of Tree Aromas on Immunity

    01:38:44 Do Indoor CO₂ Levels Matter?

    01:39:30 How Can We Optimize Indoor Air Quality?

    01:40:37 Faith as a Way to Deal With Stress and Anxiety

    01:42:42 Conditional vs. Unconditional Forgiveness and Stress

    01:45:55 Are People Who Believe in God Generally Healthier?

    01:47:34 Roger’s Experience Witnessing Death

    01:49:14 A Miraculous Story: Anoxic Brain Injury Recovery

    01:59:17 Should Hospital Patients Be Taken Outside?

    01:59:57 Are Melatonin Supplements Good for Sleep?

    02:00:45 Side Effects of Melatonin Supplements

    Follow Dr Roger:

    Youtube – https://bit.ly/452IbrP 

    X – https://bit.ly/3Udq5NA 

    Instagram – https://bit.ly/3UgDLaA 

    💡You can find out more about the light therapy lamp mentioned, here: https://amzn.to/4lXsUyc

    💡You can find out more about the Aranet4 CO₂ meter mentioned, here: https://bit.ly/4lIvRmk 

    The Diary Of A CEO:

    ⬜️Join DOAC circle here – https://doaccircle.com/ 

    ⬜️Buy The Diary Of A CEO book here – https://smarturl.it/DOACbook 

    ⬜️The 1% Diary is back – limited time only: https://bit.ly/3YFbJbt 

    ⬜️The Diary Of A CEO Conversation Cards (Second Edition): https://g2ul0.app.link/f31dsUttKKb 

    ⬜️Get email updates – https://bit.ly/diary-of-a-ceo-yt 

    ⬜️Follow Steven – https://g2ul0.app.link/gnGqL4IsKKb 

    Sponsors:

    Linkedin Jobs – https://www.linkedin.com/doac 

    KetoneIQ – Visit https://ketone.com/STEVEN for 30% off your subscription order

    Stan Store – https://stevenbartlett.stan.store/

    Learn more about your ad choices. Visit megaphone.fm/adchoices

  • The AI Pioneer Developing New Kinds of Medicine

    AI transcript
    0:00:01 This is an iHeart podcast.
    0:00:41 If I were going to pick one paper from the past decade that had the biggest impact on the world, I would choose one called Attention is All You Need, published in 2017.
    0:00:45 That paper basically invented transformer models.
    0:00:53 You’ve almost certainly used a transformer model if you have used ChatGPT or Gemini or Claude or DeepSeek.
    0:00:57 In fact, the T in ChatGPT stands for transformer.
    0:01:08 And transformer models have turned out to be wildly useful, not just at generating language, but also at everything from generating images to predicting what proteins will look like.
    0:01:16 In fact, transformers are so ubiquitous and so powerful that it’s easy to forget that some guy just thought them up.
    0:01:22 But in fact, some guy did just think up transformers, and I’m talking to him today on the show.
    0:01:34 I’m Jacob Goldstein, and this is What’s Your Problem, the show where I talk to people who are trying to make technological progress.
    0:01:36 My guest today is Jakob Uskorej.
    0:01:41 And just to be clear, Jakob was one of several co-authors on that transformer paper.
    0:01:46 And on top of that, lots of other researchers were working on related things at the same time.
    0:01:48 So a lot of people were working on this.
    0:01:52 But the key idea did seem to come from Jakob.
    0:01:55 Today, Jakob is the CEO of Inceptive.
    0:02:00 That’s a company that he co-founded to use AI to develop new kinds of medicine.
    0:02:03 And the company is particularly focused on RNA.
    0:02:08 We talked about his work at Inceptive in the second part of our conversation.
    0:02:12 In the first part, we talked about his work on transformer models.
    0:02:21 At the time he started working on the idea for transformers—this is around a decade ago now—there were a couple of big problems with existing language models.
    0:02:23 For one thing, they were slow.
    0:02:29 They were, in fact, so slow that they could not even keep up with all the new training data that was becoming available.
    0:02:31 A second problem?
    0:02:35 They struggled with what are called long-range dependencies.
    0:02:41 Basically, in language, that’s relationships between words that are far apart from each other in a sentence.
    0:02:50 So to start, I asked Jakob for an example we could use to discuss these problems, and also how he came up with his big idea for how to solve them.
    0:02:54 So pick a sentence that’s going to be a good object lesson for us.
    0:02:59 Okay, so we could have—the frog didn’t cross the road because it was too tired.
    0:03:01 Okay, so we got our sentence.
    0:03:02 Yep.
    0:03:11 How would the sort of big, powerful, but slow-to-train algorithm in 2015 have processed that sentence?
    0:03:16 So basically, it would have walked through that sentence word by word.
    0:03:19 And so it would walk through the sentence left to right.
    0:03:25 The frog did not cross the road because it was too tired.
    0:03:29 Which is logical, which is how I would think a system would work.
    0:03:31 It’s more or less how we read, right?
    0:03:34 It’s how we read, but it’s not necessarily how we understand.
    0:03:35 Uh-huh.
    0:03:43 That is actually one of the integral, I would say, for what we then—how we then went about trying to speed this all up.
    0:03:44 I love that.
    0:03:45 I want you to say more about it.
    0:03:48 When you say it’s not how we understand, what do you mean?
    0:04:00 So, on one hand, right, linearity of time forces us to almost always feel that we’re communicating language in order and just linearly.
    0:04:08 It actually turns out that that’s not really how we read, not even in terms of our saccades, in terms of our eye movements.
    0:04:11 We actually do jump back and forth quite a bit while reading.
    0:04:12 Uh-huh.
    0:04:21 And if you look at conversations, you also have highly nonlinear elements where there’s repetition, there’s reference, there’s basically different flavors of interruption.
    0:04:27 But sure, by and large, right, we would say we certainly write them left to right, right?
    0:04:33 So, if you write a proper text, you don’t write it as you would read it, and you also don’t write it as you would talk about it.
    0:04:36 You do write it in one linear order.
    0:04:47 Now, as we read this and as we understand this, we actually form groups of words that then form meaning, right?
    0:04:51 So, an example of that is, you know, adjective noun, right?
    0:04:54 It’s—or say, in this case, an article noun.
    0:04:56 It’s not a frog, it’s the frog, right?
    0:05:00 We could have also said it’s the green frog or the lazy frog.
    0:05:01 Right.
    0:05:02 Language has a structure, right?
    0:05:07 And there are—things can modify other things, and things can modify the modifiers.
    0:05:08 Exactly, exactly.
    0:05:16 But the interesting thing now is that structure, as a tree-structured, clean hierarchy, only tells you half the story.
    0:05:24 There’s so many exceptions where statistical dependencies, where modification actually happens at a distance.
    0:05:30 So, okay, so just to bring this back to your sample sentence, the frog didn’t cross the road because it was too tired.
    0:05:34 That word it is actually quite far from the word frog.
    0:05:39 And if you’re an AI going from left to right, you may well get confused there, right?
    0:05:43 You may think it refers to road instead of to frog.
    0:05:48 So this is one of the problems you were trying to solve.
    0:05:57 And then the other one you were mentioning before, which is these models were just slow, because after each word, the model just recalculates what everything means.
    0:05:58 And that just takes a long time.
    0:06:00 They can’t go fast enough.
    0:06:00 Exactly.
    0:06:07 It takes a long time, and it doesn’t play to the strengths of the computers, of the accelerators that we’re using there.
    0:06:13 And when you say accelerators, I know Google has their own chips, but basically we mean GPUs now, right?
    0:06:14 We mean GPUs.
    0:06:17 We mean the chips that NVIDIA sells.
    0:06:19 What is the nature of those particular chips?
    0:06:19 Exactly.
    0:06:32 So the nature of those particular chips is that instead of doing a broad variety of complex computations in sequence, they are incredibly good.
    0:06:37 They excel at performing many, many, many simple computations in parallel.
    0:07:06 And so what this hierarchical or semi-hierarchical nature of language enables you to do is instead of having, so to speak, one place where you read the current word, you could now imagine you actually read every, you look at everything at the same time, and you apply many simple operations at the same time to each position in your sentence.
    0:07:08 Uh-huh. So this is the big idea.
    0:07:12 I just want to pause here because this is it, right? This is the breakthrough happening.
    0:07:12 Yes.
    0:07:20 It’s basically, what if instead of reading the sentence one word at a time from left to right, we read the whole thing all at once?
    0:07:28 All at once. And now the problem is, clearly something’s got to give, right? So there’s no free lunch in that sense.
    0:07:33 You have to now simplify what you can do at every position when you do this all in parallel.
    0:07:34 Uh-huh.
    0:07:41 But you can now afford to do this a bunch of times after another and revise it over time or over these steps.
    0:07:57 And so instead of walking through the sentence from beginning to end, rather, an average sentence has like 20 words or so, average sentence in prose, instead of walking those 20 positions, what you’re doing is you’re looking at every word at the same time, but in a simpler way.
    0:08:12 But now you can do that maybe five or six times, revising your understanding. And that turns out is faster, way faster on GPUs. And because of this hierarchical nature of language, it’s also better.
    0:08:34 So you have this idea. And as I read the little note on the paper, it was in fact your idea. I know you were working with a team, but the paper credits you with the idea. So let’s take this idea, this basic idea of look at the whole input sentence all at once a few times and apply it to our frog sentence. Give me that frog sentence again.
    0:08:37 The frog did not cross the road because it was too tired.
    0:08:43 Good. Tired is good because that’s unambiguous. Hot could be either one. It could be the road or the frog, right?
    0:08:48 Hot could be either one, exactly, yes. In fact, hot could actually be either one.
    0:08:52 And non-referential, and non-referential because it was too hot outside.
    0:08:56 Outside, it could be any of three things, the weather or the frog or the road.
    0:08:56 Exactly.
    0:09:08 I love that. Tired solves the problem. So your model, this new way of doing things, how does it parse that sentence? What does it do?
    0:09:19 So basically, let’s look at the word it and look at it in every single step of these, you know, say a handful of times repeated operation.
    0:09:28 Imagine you’re looking at this word it, that’s the one that you are now trying to understand better, and you now compare it to every other word in the sentence.
    0:09:39 So you compare it to the, to frog, to did not cross the road because too and tired, was too and tired.
    0:09:57 And initially, in the first pass already, a very simple insight the model can fairly easily learn is that it could be strongly informed by frog, by road.
    0:10:06 by nothing, but not so, by to or by the, or maybe only to a certain extent by was.
    0:10:15 But if you want to know more about what it denotes, then it could be, you know, it could be informed by all of these.
    0:10:21 And just to be clear, that sort of understanding arises because it has trained in this way on lots of data.
    0:10:30 It’s encountering a new sentence after reading lots of other sentences with lots of pronouns with different possible antecedents, yeah.
    0:10:31 Exactly, exactly.
    0:10:43 So now, the interesting thing is that which of the two it actually refers to doesn’t depend only on what those other two words are.
    0:10:48 And this is why you need these subsequent steps because, so let’s start with the first step.
    0:10:56 So what now happens is that, say the model identifies frog and road could have a lot to do with the word it.
    0:11:03 So now you basically copy some information from both frog and road over to it.
    0:11:12 And you don’t just copy it, you kind of transform it also on the way, but you refine your understanding of it.
    0:11:13 And this is all learned.
    0:11:17 This is not given by rules or, you know, in any way pre-specified.
    0:11:21 Right, just by training on lots of libraries.
    0:11:22 Just by training, this emerges, exactly.
    0:11:28 And so that sort of the meaning of it after this first step is kind of influenced by both frog and road.
    0:11:30 Yes, both frog and road.
    0:11:35 Okay, so now we repeat this operation again.
    0:11:41 And we now know that it is unsure, or the model basically now has this kind of superposition, right?
    0:11:43 It could be road, it could be frog.
    0:11:46 But now, in the next step, it also looks at tired.
    0:11:54 And somehow the model has learned that when it means something inanimate, that tired is not the thing.
    0:12:00 And so maybe in context of tired, it is more likely to refer to frog.
    0:12:10 And now you know, well, it is more likely, or now maybe the model has figured out already, maybe it needs a bit more, a few more iterations,
    0:12:15 that it is most likely to refer to frog because of the presence of tired.
    0:12:17 So it has solved the problem.
    0:12:18 But it has solved the problem.
    0:12:23 So you have this idea, you try it out.
    0:12:26 There’s a detail that you mentioned that’s kind of fun, and we kind of skipped it.
    0:12:31 But you mentioned that another one of the co-authors, who has also gone on to do very big things,
    0:12:35 was about to leave Google when you sort of want to test this idea.
    0:12:40 And that fact that he was about to leave Google was actually important to the history of this idea.
    0:12:41 Tell me about that.
    0:12:42 It was important.
    0:12:51 So this Ilya Abdullah-Sushin, he was, at the time that this started to gain any kind of speed,
    0:12:55 Ilya was managing a good chunk of my organization.
    0:13:04 And the moment he really made the decision to leave the company, he had to wait, ultimately, for his co-founder
    0:13:07 and for them to then actually get going together in earnest.
    0:13:13 And so he had a few months where he knew, and I also knew, that he was about to leave.
    0:13:20 And where, you know, the right thing would, of course, be to transition his team to another manager,
    0:13:26 which we did immediately, but where he then suddenly was in a position of having nothing to lose.
    0:13:33 And yet, quite some time left to play with Google’s resources and do cool stuff with interesting people.
    0:13:41 And so that’s one of those moments where suddenly your appetite for risk as a researcher just spikes, right?
    0:13:46 Because you have, for a few more months, you have these resources at your disposal,
    0:13:49 you’ve transitioned your responsibilities.
    0:13:53 At that stage, you’re just like, okay, let’s try this crazy shit.
    0:14:00 And that’s literally, in so many ways, was one of the integral catalysts.
    0:14:07 Because that also enabled this kind of mindset of, we’re going for this now.
    0:14:11 Whatever the reason, it still, you know, affects other people.
    0:14:16 And so there were others who joined that collaboration really, really early on,
    0:14:21 who I feel were much more excited and, as a result, much more likely to really work on this
    0:14:23 and to really give it their all.
    0:14:30 Because of his, you know, nothing left to lose, I’m going to go for this attitude at this point, right?
    0:14:34 Was there a moment when you realized it worked?
    0:14:35 There were actually a few moments.
    0:14:43 And it’s interesting because, on one hand, right, it’s a very gradual thing, right?
    0:14:50 And initially, actually, it took us many months to get to the point where we saw significant first signs of life,
    0:14:54 of this not just being a curiosity, but really being something that would end up being competitive.
    0:14:57 So there certainly was a moment when that started.
    0:15:05 There was another moment when we, for the first time, had one machine translation challenge,
    0:15:09 one language pair of the W&T task, as it’s called,
    0:15:14 where our score, our model performed better than any other single model.
    0:15:19 The point in time when I think all of us realized this is special
    0:15:25 was when we not only had the best one in one of these tasks, but in multiple.
    0:15:29 And we didn’t just have the best number.
    0:15:32 We also, at that point, were able to establish that we’ve gotten there
    0:15:37 with about 10 times less energy or training compute spend.
    0:15:38 Wow.
    0:15:41 So you do one-tenth the work, and you get a better result.
    0:15:43 One-tenth the work, and you get a better result,
    0:15:47 not just across one specific challenge, but across multiple,
    0:15:50 including the hardest, or one of the harder ones, right?
    0:15:56 And then, at that stage, we were still improving rapidly.
    0:16:00 And then you realize, okay, this is for real.
    0:16:07 Because it wasn’t that we had to squeeze those last little bits and pieces of gain out of it.
    0:16:10 It was still improving fairly rapidly,
    0:16:15 to the point where actually, by the time we actually published the paper,
    0:16:18 we, again, reduced the compute requirements,
    0:16:21 not quite by an entire order of magnitude, but almost, right?
    0:16:26 So it still was getting faster and better at a pretty rapid rate.
    0:16:32 So we had, in the paper, we had some results that were those roughly 10x faster on eight GPUs.
    0:16:35 And what we demonstrated, in terms of quality, on those eight GPUs,
    0:16:40 by the time we actually published the paper properly, we were able to do with one GPU.
    0:16:45 One GPU, meaning one chip of the kind that people buy 100,000 of now?
    0:16:46 To build a data center?
    0:16:47 Exactly.
    0:16:55 So the paper, actually, at the end, mentions other possible uses beyond language for this technology.
    0:17:00 It mentions images, audio, and video, I think, explicitly.
    0:17:03 How much were you thinking about that at the time?
    0:17:07 Was that just like an afterthought, or were you like, hey, wait a minute, it’s not just language?
    0:17:12 By the time it was actually published at a conference, not just the preprint, by December,
    0:17:17 we had initial models on other modalities, on generating images.
    0:17:23 We had the first, at that time, they were not performing that well yet, but they were rapidly
    0:17:24 getting better.
    0:17:30 We had the first prototypes, actually, of models working on genomic data, working on protein
    0:17:30 structure.
    0:17:32 That’s good foreshadowing.
    0:17:33 Good foreshadowing as well, exactly.
    0:17:40 But then we ended up, for a variety of reasons, we ended up, at first, focusing on applications
    0:17:41 in computer vision.
    0:17:46 The paper comes out, you’re working on these other applications, you’re presenting the paper,
    0:17:48 it’s published in various forms.
    0:17:50 What’s the response like?
    0:18:00 It was interesting because the response built in deep learning AI circles, basically, between
    0:18:07 the preprint that I think came out in, I want to say, June 2017, and then the actual publication,
    0:18:13 to the extent that by the time the poster session happened at the conference, there was quite
    0:18:20 a crowd at the poster, so we had to be shoved out of the hall in which the poster session
    0:18:25 happened by the security, and had very hoarse voices by the end of the evening.
    0:18:30 You guys were like the Beatles of the AI conference?
    0:18:36 I wouldn’t say that because we weren’t the Beatles, because it was really, it was still
    0:18:37 very specific.
    0:18:39 You were more the cool hipster band.
    0:18:40 You were the it hipster band.
    0:18:42 Certainly more the cool hipster band.
    0:18:46 But it was an interesting experience because there were some folks, including some greats
    0:18:50 in the field, who came by and said, wow, this is cool.
    0:18:55 What has happened since has been wild, it seems.
    0:18:57 Wild, to say the least, yes.
    0:18:59 Is it surprising to you?
    0:19:02 Of course, many aspects are surprising, for sure.
    0:19:12 We definitely saw pretty early on, already back in 2018, 2019, that something really exciting
    0:19:13 was happening here.
    0:19:17 Now, I’m still surprised by it.
    0:19:25 With the advent of ChatGPT, something that didn’t go way beyond those language models that
    0:19:34 we had already seen a few years before was suddenly the world’s fastest growing consumer product.
    0:19:35 Ever, right?
    0:19:36 I think ever.
    0:19:36 Ever.
    0:19:37 Yes.
    0:19:42 And by the way, GBT stands for Generative Pre-Train Transformer, right?
    0:19:44 Transformer is your word.
    0:19:44 That’s right.
    0:19:50 So there’s an interesting, I don’t know, business side to this, right?
    0:19:52 Which is, you were working for Google when you came up with this.
    0:19:55 Google presumably owned the idea.
    0:19:56 Yep.
    0:19:59 Had intellectual property around the idea.
    0:20:00 Has filed many a patent.
    0:20:03 Was it just a choice Google made to let everybody use it?
    0:20:09 Like, when you see the fastest growing consumer product in the history of the world, not only
    0:20:13 built on this idea, but using the name, like, and it’s a different company.
    0:20:14 That was five years later.
    0:20:15 Five years later.
    0:20:17 But a patent’s good for more than five years.
    0:20:18 Is that a choice?
    0:20:20 Is that a strategic choice?
    0:20:21 What’s going on there?
    0:20:29 So the choice to do it in the first place, to publish it in the first place, is really
    0:20:36 based on and rooted in a deep conviction of Google at the time, and I’m actually pretty
    0:20:43 sure it still is the case, that it is actually, these developments are the tide that floats all
    0:20:45 boats, that lifts all boats.
    0:20:45 Uh-huh.
    0:20:47 Like a belief in progress.
    0:20:49 A belief in progress.
    0:20:49 Exactly.
    0:20:50 Like a good old-fashioned belief in…
    0:21:00 Now, it’s also the case that at the time, organizationally, that specific research arm was unusually separated
    0:21:02 from the product organizations.
    0:21:10 And the reason why brain, or in general, the deep learning groups, were more separated was
    0:21:12 in part historical.
    0:21:18 Namely, that when they started out, there were no applications, and the technology was not ready
    0:21:19 for being applied.
    0:21:26 And so it’s completely understandable and just, you know, a consequence of organic developments
    0:21:34 that when this technology suddenly is on the cusp of being incredibly impactful, you’re probably
    0:21:41 still underutilizing it internally and potentially also not yet treating it in the same way as you
    0:21:45 would have maybe otherwise treated previous trade secrets, for example.
    0:21:52 Because it feels like this out there research project, not like what’s going to be this consumer
    0:21:53 product.
    0:22:04 And to be fair, it took OpenAI, in this case, a fair amount of time to then turn this into this
    0:22:04 product.
    0:22:09 And most of that time, it also, from their vantage point, wasn’t a product, right?
    0:22:18 So up until all the way through ChatGPT, OpenAI published all of their GPT developments, maybe
    0:22:22 not all, but, you know, a very large fraction of their work on this.
    0:22:24 Yeah, their early models, the whole models were open.
    0:22:24 Exactly.
    0:22:30 They were more true to their name, really, really also believing in the same thing.
    0:22:37 And it was only really after ChatGPT and after this, to them also surprise, to a certain extent,
    0:22:44 success, that they started to become more closed as well when it comes to scientific developments
    0:22:44 in this space.
    0:22:49 We’ll be back in just a minute.
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    0:23:32 That’s 844-844-iHeart.
    0:23:35 Let’s talk about your company.
    0:23:37 When did you decide to start Inceptive?
    0:23:45 The decision took a while and was influenced by events that happened over the course of
    0:23:52 about three months, two to three months in late 2020, starting with the birth of my first
    0:23:53 child.
    0:23:57 So when Amre was born, two things happened.
    0:24:03 Number one, witnessing a pregnancy and a birth during a pandemic where there’s a pathogen that’s
    0:24:04 rapidly spreading.
    0:24:08 And so all of that was a pretty daunting experience.
    0:24:10 And everything went great.
    0:24:21 But having this new human in my arms also really made me question if I couldn’t more directly
    0:24:24 affect people’s lives positively with my work.
    0:24:31 And so I was at the time quite confident that indirectly it would have effect also on things
    0:24:33 like medicine, biology, et cetera.
    0:24:39 But I was wondering, couldn’t this happen more directly if I focused more on it?
    0:24:45 The next thing that happened was that AlphaFold 2 results at CASP-14 were published.
    0:24:50 CASP-14 is this biannual challenge for protein structure prediction and some other related problems.
    0:24:52 This is the protein folding problem.
    0:24:54 And this is the protein folding problem, exactly.
    0:24:57 So machine learning solving the protein folding problem, which had been a problem for decades,
    0:25:01 given a chain of amino acids to predict the 3D structure of a protein.
    0:25:02 Precisely.
    0:25:05 And humans failed and machine learning succeeded.
    0:25:06 Just amazing.
    0:25:07 Yes.
    0:25:08 It’s a great example.
    0:25:14 Humans failed despite the fact that we actually understand the physics fundamentally, but we
    0:25:19 still couldn’t create models that were good enough using our conceptual understanding
    0:25:20 of the processes involved.
    0:25:23 Yeah, you would think an algorithm would work on that one, right?
    0:25:26 You would just think an old school set of rules.
    0:25:28 Like, we know what the molecules look like.
    0:25:30 We know the laws of physics.
    0:25:33 It’s amazing that we couldn’t predict it that way, right?
    0:25:36 All you want to know is what shape is the protein going to be?
    0:25:37 You know all of the constituent parts.
    0:25:39 You know every atom in it.
    0:25:43 And you still couldn’t predict it with a set of rules, but AI, machine learning, could.
    0:25:45 Amazing.
    0:25:45 Yes.
    0:25:46 And it is amazing.
    0:25:51 Actually, when you put it like this, it’s important to point out that when we say we
    0:25:54 understand it, we make massive oversimplifying assumptions.
    0:25:59 Because we ignore all the other players that are present when the protein folds.
    0:26:04 We ignore a lot of the kinetics of it because we say we know the structure, but the truth
    0:26:08 is we don’t know all the wiggling and all the shenanigans that happen on the way there,
    0:26:08 right?
    0:26:14 And we don’t know about, you know, chaperone proteins that are there to influence the folding.
    0:26:16 We don’t know around all sorts of other aspects.
    0:26:17 I’m doing the physics one.
    0:26:20 I’m doing the assume a frictionless plane version of protein.
    0:26:21 Precisely.
    0:26:22 Which is why it didn’t work.
    0:26:25 And the beauty is that deep learning doesn’t need to make this assumption.
    0:26:27 AI doesn’t need to make this assumption.
    0:26:28 AI just looks at data.
    0:26:35 And it can look at more data than any human or even humanity eventually could look at together.
    0:26:41 It’s such a good example problem to demonstrate that these models are ready for prime time in
    0:26:45 this field and ready for lots of applications, not just one or two, but many.
    0:26:46 And so that happens.
    0:26:48 They’ll be sold, exactly.
    0:26:56 And then the third thing was that these COVID mRNA vaccines came out with astonishing 90 plus
    0:26:57 percent efficacy.
    0:26:57 So fast also.
    0:26:58 Out of the gate.
    0:27:02 How fast and how good they were is still so underrated.
    0:27:03 Underrated.
    0:27:07 At the beginning of the pandemic, people were like, it’ll be two or three years, and if they’re
    0:27:08 60 percent effective, that’ll be great.
    0:27:09 Exactly.
    0:27:10 And so-
    0:27:11 Everybody forgets that.
    0:27:11 Everybody forgets it.
    0:27:16 And when you look at it, this is a molecule family that was for, you know, most of the
    0:27:20 most of the time that we’ve known about it, since the 60s, I suppose, we’ve treated it
    0:27:24 like an addicted stepchild of molecular biology.
    0:27:26 Because we’ve massed-
    0:27:26 You’re talking about RNA in general?
    0:27:27 RNA.
    0:27:28 RNA in general.
    0:27:28 Yeah.
    0:27:30 Everybody loves DNA, right?
    0:27:32 DNA is the movie star.
    0:27:33 Exactly.
    0:27:33 Exactly, exactly.
    0:27:40 Even though now, looking back, DNA is merely, you know, the place where life takes its notes,
    0:27:42 maybe the hard drive and the memory.
    0:27:43 It’s the book, right?
    0:27:43 It’s the book, right?
    0:27:44 It’s the book.
    0:27:50 So, but at the end of the day, it’s this molecule family that was about to save, you know, depending
    0:27:54 on the estimate, tens of millions of lives, and in rapid time.
    0:28:01 So all these things hold, but we have no training data to apply anything like alpha-fold to this
    0:28:02 specific molecule family.
    0:28:03 No training data to speak of.
    0:28:07 We had 200,000 known protein structures at the time.
    0:28:12 I believe, maybe optimistically, we had maybe 1,200 known RNA structures.
    0:28:18 And on top of that, it was also fairly clear that for RNA, going directly to function would
    0:28:22 be much, much more important because it’s, in a certain sense, a weak, less strongly structured
    0:28:25 molecule and other aspects of the molecule might play a bigger role.
    0:28:33 And then, on top of that, the attention that generative AI was receiving overall, also now
    0:28:37 in the field of pharma or of medicine, was building.
    0:28:45 And so I ended up finding myself in a conversation where a very, I’d say, wise, long-time mentor
    0:28:52 of mine pointed out that, you know, maybe 10 years from now or so, somebody could tell my
    0:28:58 daughter that there was this perfect storm where this macromolecule with no training data was
    0:29:02 about to save the world and could do so much more in the direction of positively impacting
    0:29:03 people’s lives.
    0:29:05 We didn’t have training data.
    0:29:07 It would be very expensive to create it.
    0:29:11 But using the technology that I’ve been, or technologies that I’ve been working on for
    0:29:16 the last, I don’t know, 10 plus years, and the ability, because of the attention that
    0:29:22 people were now giving to AI in this field, the ability to raise quite a bit of money,
    0:29:31 I, in that position, chose to stay back at my cushy dream job in big tech and not actually
    0:29:35 take this opportunity to really positively impact people’s lives.
    0:29:39 And that idea was not one I was willing to entertain.
    0:29:44 You couldn’t just coast it out at Google and let somebody else go figure out RNA.
    0:29:44 Yeah.
    0:29:46 And it’s not just RNA.
    0:29:49 I think RNA is a great starting point at the end of the day.
    0:29:57 But building models that learn from, first of all, all the publicly available data that we
    0:30:01 can possibly get our hands on, but also from data that we can reasonably effectively create
    0:30:08 in our own lab, how to design molecules for specific functions, is something that now is
    0:30:15 within reach and that will, in the next years and in the years to come, have completely transformational
    0:30:18 impact on how we even think about what medicines are.
    0:30:26 That any opportunity to speed this up, to make this happen, even just a day sooner than it could
    0:30:29 have otherwise happened, is incredibly valuable, in my opinion.
    0:30:36 As you’re talking about this idea that the absence of training data seems to be at the
    0:30:36 center of it, right?
    0:30:40 It seems to be the core problem, which makes sense, right?
    0:30:44 Like, the reason language works so well is basically because of the internet.
    0:30:48 I know now we’re going beyond it, but it just happened to be that there was this incredibly
    0:30:52 giant set of natural language that became available.
    0:30:54 We don’t have anything like that for RNA.
    0:31:00 So are you, I mean, it’s kind of step one at Inceptive, creating the data?
    0:31:02 Is that kind of what’s happening?
    0:31:08 So step one at Inceptive is learning to use all the data, or was, I think we’ve made a lot
    0:31:12 of progress in that direction, learning to use all the data that is available already, and
    0:31:15 identify what other data we’re missing.
    0:31:20 And then see how far we can get with just the publicly available data, and at the same
    0:31:23 time scale up generating our own data.
    0:31:29 And it turns out that actually, because of the nature of evolution, because of how evolution
    0:31:38 isn’t actually incentivized to really explore the entire space of possibilities, it is almost
    0:31:44 always a given that if you are trying to design exceptional molecules, especially ones that
    0:31:52 are not, say, you know, natural formats, you are basically guaranteed to need novel training
    0:31:52 data.
    0:31:53 Yeah.
    0:31:57 Basically, you’re saying you build RNAs that don’t exist in the world, that have therapeutic
    0:32:01 uses, and there’s no, kind of definitionally, no training data for that, because they don’t
    0:32:01 exist.
    0:32:07 The funny thing is, we have a few of them, and so we have existence proofs of RNA molecules,
    0:32:17 for example, RNA viruses, that actually exhibit incredibly complex, different functions in ourselves
    0:32:23 that do all sorts of things that we don’t usually like, but if we could use those, you know, for
    0:32:30 good, if we could use those, you know, in ways that would actually be aimed at fighting disease
    0:32:36 rather than creating them, those kinds of functions, even just a small subset of them, would really
    0:32:37 transform medicine already.
    0:32:38 And so we know it’s possible.
    0:32:40 What are you dreaming of when you say that?
    0:32:41 What are you thinking of, specifically?
    0:32:41 Okay.
    0:32:49 So, for example, right, one estimate is that in order for COVID to infect you, you would need
    0:32:55 potentially as few as five COVID genomes inside your organism.
    0:32:55 That’s already it.
    0:32:57 Five viral particles?
    0:32:58 Five viral particles.
    0:32:58 Yeah.
    0:33:00 You inhale those.
    0:33:03 You wouldn’t have to inject it.
    0:33:05 You wouldn’t even have to swallow it.
    0:33:06 You inhaled them.
    0:33:10 What if we could have a medicine that worked as well as a disease, is a version of your dream.
    0:33:10 Exactly.
    0:33:11 Exactly.
    0:33:18 So, at the end of the day, right, this medicine is able to spread in your body only into certain
    0:33:20 types of organs and tissues and cells.
    0:33:24 It does certain things there that are really quite complex, right?
    0:33:25 Changing the cells’ behavior.
    0:33:26 Yeah.
    0:33:31 Again, not usually in this case in favorable ways, but still in ways that wouldn’t have
    0:33:36 to be modified that much in order to potentially be exactly what you would need for a complex
    0:33:37 multifactorial medicine.
    0:33:42 And if you could make all of that happen by just inhaling five of those molecules, then,
    0:33:45 again, that would completely change how you think about medicine, right?
    0:33:50 You have viruses that aren’t immediately active, but that are inactive for long periods of time
    0:33:51 in your organism.
    0:33:58 And only under certain conditions, say, under certain immune conditions, really start being
    0:33:59 reactivated.
    0:34:06 Why can’t we have medicines that work in a similar way, where you actually, not only in
    0:34:11 a vaccination sense, but where you take a medicine for a genetic predisposition for a
    0:34:15 certain disease, that you are able to design a medicine that you can take and that waits until
    0:34:17 the disease actually starts to develop.
    0:34:21 And only then, and only where that disease then starts to develop, becomes active and
    0:34:22 actually facts it.
    0:34:25 And potentially also then alarms the doctor through a blood test.
    0:34:28 Like for cancer cells or something.
    0:34:33 So you have some kind of prophylactic medicine in your body, and it is encoded in such a way
    0:34:38 that it just hangs out there like herpes, to take a pathological example.
    0:34:39 For example, yes.
    0:34:42 And only in certain settings does it do anything.
    0:34:46 And those settings are, if you see a cancer cell, destroy it.
    0:34:47 Otherwise, just sit there.
    0:34:48 Precisely.
    0:34:53 And if you can design those also in ways where you can just make them all go away when you
    0:34:58 take a, say, a completely harmless small molecule, and that’s, again, entirely feasible.
    0:34:59 Sure.
    0:35:01 So, I mean, you’re dreaming big.
    0:35:04 These are wonderful big, you know, science fiction-y dreams, and I hope you figure them
    0:35:05 out.
    0:35:09 On a practical level, what’s happening at the company right now?
    0:35:10 How many people work there?
    0:35:10 What are they doing?
    0:35:12 And what have they figured out so far?
    0:35:13 We’re around 40.
    0:35:17 What we’re doing is really exactly what we just talked about.
    0:35:25 We’re basically scaling data generation experiments in our lab that allow us to assess a variety
    0:35:32 of different functions of different, mostly RNA molecules, actually mostly mRNA molecules at the
    0:35:38 moment, that are relevant to a pretty broad variety of different diseases.
    0:35:45 And so, this ranges from things like infectious disease vaccines to cell therapies that can be applied
    0:35:49 in oncology or against autoimmune disease.
    0:35:56 We have mRNAs that we hope will eventually be effective in enzyme replacement as enzyme replacement
    0:36:00 therapies for families of, or a large family of rare diseases.
    0:36:02 And the list goes on.
    0:36:10 And so, we’re creating this, or growing this training data set that eventually, on top of
    0:36:17 foundation and models that we pre-trained on all publicly available data, allow us to tune
    0:36:25 those foundation models towards designing exceptional molecules for exactly those applications and many
    0:36:26 more sharing similar properties.
    0:36:33 So, you basically build new mRNA molecules and test them, and then you give that data to
    0:36:38 your model, and presumably it tells you what to build next, or it helps you figure out what to
    0:36:39 build next.
    0:36:40 It’s sort of a loop in that way?
    0:36:46 The models are definitely one interesting source for proposals, if you wish, for what to synthesize
    0:36:48 and test next.
    0:36:49 They’re not the only such source.
    0:36:55 So, we basically also explore kind of in maybe less guided or heuristically guided ways.
    0:36:57 But, exactly.
    0:37:00 So, in some of the cases, it’s really quite iterative.
    0:37:06 For some of those functions and for some of those modalities and diseases or disease targets,
    0:37:12 we’re actually already at a point where our models can spit out entirely novel molecules that
    0:37:18 really are unlike anything they’ve ever seen or we’ve ever seen in nature, that very consistently
    0:37:24 perform quite favorably compared to pretty strong baselines by incumbents in the field.
    0:37:31 When you say perform quite favorably compared to baselines by incumbents in the field, I mean,
    0:37:35 does that on some level mean better than what experts would think up?
    0:37:40 Better than what experts can think of and also better than more traditional machine learning
    0:37:41 tools can easily produce.
    0:37:48 It’s like that famous moment in the Go match when AlphaGo made some move that, like, no human
    0:37:49 being ever would have thought of.
    0:37:50 Move 37.
    0:37:51 Yes.
    0:37:59 So, I would say we’ve long passed the Move 37 in the sense that our understanding of the
    0:38:06 underlying biological phenomena is so incomplete that for most of the things that we’re able
    0:38:09 to design for, we don’t really understand why they happen.
    0:38:10 Huh.
    0:38:13 When you say we, do you mean at Inceptive or do you mean just medicine in general?
    0:38:15 I would say just medicine in general.
    0:38:16 Okay.
    0:38:21 So, Inceptive is doing this very kind of high-level work, right?
    0:38:24 I mean, building what will hopefully be the foundation.
    0:38:28 What’s the right amount of time in the future to ask about?
    0:38:29 When will we know if it works?
    0:38:31 Do you think five years?
    0:38:40 So, the general idea of using generative AI and similar techniques to generate therapeutics,
    0:38:46 there are some things in clinical trials that were largely designed with AI.
    0:38:55 As far as I know, we’re still, maybe now we have the first trials just now starting for
    0:38:58 molecules that were truly entirely designed by AI.
    0:39:01 As opposed to sort of selected from a library?
    0:39:03 Selected, influenced, exactly.
    0:39:06 Selected, adjusted, tuned, tweaked, et cetera, right?
    0:39:10 So, that’s really still only happening just now.
    0:39:10 Okay.
    0:39:17 But we will see, I believe, the first success or a first success of such molecules, certainly
    0:39:18 within the next five years.
    0:39:21 What about more narrowly the project at Inceptive?
    0:39:23 It’s a similar timeframe.
    0:39:30 We should be able to get molecules into the clinic in the next few years, certainly in the
    0:39:31 next handful of years.
    0:39:40 Now, these will not be molecules with, where the objective that we used in their design is,
    0:39:45 you know, even remotely as complex or the, you know, kind of the different functions that
    0:39:52 we’re designing for are not going to be even remotely as diverse as, say, what you would find in,
    0:39:55 because we used this example earlier in RNA virus.
    0:39:58 These will really be more, you know, simpler.
    0:40:04 Those will be molecules that don’t do things that we couldn’t possibly have done before,
    0:40:11 but that do them much better in ways that are more accessible, in ways that come with less side
    0:40:11 effects.
    0:40:15 What biotech largely is, is they make protein drugs.
    0:40:21 And so if you could make an mRNA drug where you put the mRNA into the body and the body makes the protein,
    0:40:25 it wouldn’t be some crazy sleeper cell that sits in your body for 20 years or whatever.
    0:40:29 But it might be a more practical alternative to today’s biotech drugs.
    0:40:30 Absolutely.
    0:40:35 So you’ve had a kind of crash course in biology in the last few years.
    0:40:35 Yes.
    0:40:41 And I’m curious, like, what is, what is something that has been particularly compelling or surprising
    0:40:44 or interesting to you that you have learned about biology?
    0:40:46 There are countless things.
    0:40:57 The biggest one or the red thread across many of them is really just how effective life is
    0:41:07 at finding solutions to problems that, on one hand, are incredibly robust, surprisingly robust,
    0:41:16 and on the other hand, are so different from how we would design solutions to similar problems.
    0:41:17 Aha.
    0:41:23 That really, this comes back to this idea that we might just not be particularly well-equipped
    0:41:30 in terms of cognitive capabilities to understand biology, that basically, you know, we are,
    0:41:34 we would never think to do it this way.
    0:41:38 And how we think to do it is oftentimes much more brittle.
    0:41:40 Aha.
    0:41:41 Brittle is an interesting world.
    0:41:45 Less resilient, less able to persist under different conditions.
    0:41:46 Exactly.
    0:41:46 Exactly.
    0:41:49 I mean, you know, we still haven’t built machines that can fix themselves, for one.
    0:41:53 Which is fundamentally the miracle of being a human being.
    0:41:54 Which is fundamentally the miracle of life.
    0:41:56 I’m still here after going through all this.
    0:41:56 Exactly.
    0:41:57 Exactly.
    0:41:57 Exactly.
    0:42:00 And so, and of course, this is true across the scales, right?
    0:42:05 From, you know, single cells all the way to complex organisms like ourselves.
    0:42:18 And really just how many also very different kinds of solutions life has found and or constantly
    0:42:19 is finding.
    0:42:22 And you see this all over the place.
    0:42:30 And it’s both daunting, humbling, but also incredibly inspiring when it comes to applying
    0:42:31 AI in this area.
    0:42:37 Because again, I think that at least so far, it’s the best tool and maybe actually the only
    0:42:47 tool we have so far in face of this kind of complexity, really design interventions that go way beyond
    0:42:51 what we were able to do or are able to do just based on our own conceptual understanding.
    0:42:57 We’ll be back in a minute with the lightning round.
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    0:43:40 That’s 844-844-IHEART.
    0:43:43 Let’s finish with the lightning round.
    0:43:50 As an inventor of the Transformer model, are there particular possible uses of it that
    0:43:53 worry you slash make you sad?
    0:44:03 I am quite concerned about the P-Doom, Doomerism, whatever you want to call it, existential fear
    0:44:11 instilling rhetoric that is in some cases actually also promoted by people, by entities in the space.
    0:44:14 So just to be clear, you’re not worried about the existential risk.
    0:44:17 You’re worried about people talking about the existential risk.
    0:44:27 I’m worried about the existential risk being inflated, or the perception being inflated to the extent
    0:44:34 that we actually don’t look enough at some of the much more concrete and much more immediate risks.
    0:44:39 I’m not going to say that the existential risk is zero, but that would be silly.
    0:44:44 What is a concrete and immediate risk that is, you think, under-discussed?
    0:44:52 These large-scale models are such effective tools in manipulating people in large numbers already
    0:44:59 today, and it’s happening everywhere for many, many different purposes by, in some cases, benevolent,
    0:45:06 and in many cases, malevolent actors that I really firmly believe we need to look much more
    0:45:14 at things like enabling cryptographic certification of human-generated content, because doing that
    0:45:19 with the machine-generated content is not going to work, but we definitely can cryptographically
    0:45:21 certify human-generated content as such.
    0:45:25 Basically, watermarking or something, some way to say, a human made this.
    0:45:26 Exactly.
    0:45:31 What would you be working on if you were not working in biology, on drug development?
    0:45:32 Education.
    0:45:37 Using artificial intelligence to democratize access to education.
    0:45:43 What have you seen that has been impressive or compelling to you in that regard?
    0:45:46 There are lots of little examples so far, and really countless.
    0:45:53 It’s what’s happening at the Khan Academy, there are many examples of AI applied to education
    0:45:56 problems in places like China, for example.
    0:46:02 You have a bunch of very compelling examples in fiction, a book I really like by a guy named
    0:46:08 Neil Stevenson, The Diamond Age, or Young Lady’s Illustrated Primer, that I recommend if
    0:46:08 you just want to…
    0:46:10 Everybody in AI talks about that.
    0:46:11 Well, now they do, yeah.
    0:46:13 Yeah, well, now they do.
    0:46:15 You liked it before it was cool, I’m sure.
    0:46:20 At one point, I thought it was really, really important to ensure that Neil Stevenson knows
    0:46:27 that we are about to be able to build the primer, and so I ended up having coffee with
    0:46:28 him to tell him.
    0:46:29 Oh, that’s great.
    0:46:36 So, at the end of the day, maybe the biggest inspiration there is my daughter.
    0:46:45 She’s four and a half now, and I think she could, today, read, she can read okay, but she could
    0:46:52 read, you know, grade school level if she had access to, you know, an AI tutor teaching her
    0:46:53 how to read.
    0:46:54 Does your daughter use AI?
    0:46:57 Use, you know, AI chatbots?
    0:47:05 Not directly without me, but we’ve actually used ChatGPT to implement an AI reading tutor
    0:47:08 that works reasonably well.
    0:47:11 I mean, we basically, you know, kind of as they call it now, vibe coding.
    0:47:15 We vibe coded, and Amway wasn’t there for all of it.
    0:47:17 It took some time, but she was there for some of it.
    0:47:19 Oh, you vibe coded it with her?
    0:47:24 Yeah, well, I mean, she was there, she, you know, she witnessed a good chunk of it, yes.
    0:47:26 Although she was more interested in the image generation parts.
    0:47:30 But yeah, we have a sketch of one that she quite enjoys.
    0:47:35 So, that’s kind of like the extent of her at this age using AI directly.
    0:47:48 Jakob Uskoreit is the CEO and co-founder of Inceptive, and the co-author of the paper,
    0:47:49 attention is all you need.
    0:47:55 Just a quick note, this is our last episode before a break of a couple of weeks,
    0:47:57 and then we’ll be back with more episodes.
    0:48:01 Please email us at problematpushkin.fm.
    0:48:04 We are always looking for new guests for the show.
    0:48:08 Today’s show was produced by Trina Menino and Gabriel Hunter-Chang.
    0:48:13 It was edited by Alexandra Gerritsen and engineered by Sarah Brugger.
    0:48:22 This is an iHeart Podcast.

    Jakob Uszkoreit is the CEO and co-founder of Inceptive, a biotech start-up. He’s also a co-author of “Attention is All You Need,” the paper that created transformer models. Today, transformers power chatbots like ChatGPT and Claude. They’ve also led to breakthroughs in everything from generating images to predicting the structure of proteins.

    On today’s show, Jakob talks about the invention of transformer models. And he discusses how he’s using those models to try to invent new kinds of medicine, with a particular focus on RNA.

    See omnystudio.com/listener for privacy information.