New Science of Stress: Why We Need Stress to Thrive and How The Right Stress Improves Health, Increases Life Span & Can Cut Your Cancer Risk in Half
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Right now, 93% of America has poor metabolic health. It is not a coincidence that when people get older, they feel, oh, they've slowed down, their cognitive capacity isn't what it used to be, or, oh, gee, now I'm developing all these health problems. Our body works in a use-it-or-lose-it way. You can almost double your human potential.

by repeat challenging yourself in recovery. So we can use stressors to build resilience against the very stressors that we have been taught to fear. We need these stressors to become more stress resilient. Our goal is not to cure stress or get rid of it out of our lives.

It's to optimize it. And that has implications not just for our mental well-being, but our physical health, for how we age. The stress biology...

is actually different depending on the stressors. And we can choose certain forms of stress that have these healing hormones. And they not just counteract the potential damage, but they strengthen us and enrich us. That's the new stress management. So at the end of the day, health really happens outside the doctor's office.

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Hi, I'm Mayim Bialik. I'm Jonathan Cohen. And welcome to our breakdown. This is the place where we break things down so that you don't have to. Today we're breaking down the fact that we've all gotten stress wrong. You know, just that. We thought we should avoid it. We thought it was harming us. It's not that that statement isn't true, but there is another part of that statement that may be one of the most significant things to understand about our health.

We're going to be talking with Sharon Berquist. She's an award-winning physician. She's an innovative healthcare leader, a visionary researcher. She was trained at Yale and Harvard Medical School. Her book is called The Stress Paradox, Why You Need Stress to Live Longer, Healthier, and Happier, which is actually out today. Highly recommend it. This is a really good one.

What I would most say about this episode is, for those of you who have heard that many people go to functional medicine doctors when kind of classical Western doctors fail or when doctors say, like, you're fine, I can't explain it. Many of us, and yes, many people who can afford these kind of, like, higher level, more complicated doctors who are pulling from all these different disciplines, they're not going to be able to do it.

That's often what a functional medicine visit is like. What we are providing for our listeners today is literally what it feels like to have an intake appointment with someone who's going to explain to you all the things that you can do, all the things that are true about your body, your environment, and what you do have control over in inexpensive,

and sometimes free ways. Often it is about understanding a different framework, a different perspective. Dr. Berquist is going to take the time to speak to each one of you as if she is your doctor about the things that we've gotten wrong about our health and in a loving and gentle and caring way, teach us

What are the five stressors we can introduce to our lives and to our physiology that can transform our cells' ability to generate energy, to fight disease, to change our mental status, and to do that while also not becoming a crazy biohacker who can't take care of your children or eat out with girlfriends? There's so much in this episode that Mayim and I have spoken about

Fought about. Fought about, tried to convey, tried to implement in our own lives. And this guest just...

helps us understand it in a way that is so accessible. I'm going to say this, and I hope it doesn't sound inappropriate. It felt like she was cradling my body while telling me all the things I need to do for my health. It felt gentle. It felt reasonable. I didn't feel like I was being given, and I hope you don't feel like you're being given, impossible tasks. It's not impossible. Understanding some basic things about the body, some basic

things about eating and sleep. This feels like such a great episode to take with you into 2025. It's such a pleasure to welcome the author of The Stress Paradox, Sharon Horesh-Burquist, to The Breakdown. Break it down. Let's first start with...

You are a clinician, you're a researcher, you are a proper scientific grownup, and you've participated in so many important clinical trials, research facility, you know, undertakings to help us best understand kind of the best way to live, to function, to cope. What would you say your particular mission is?

My overarching mission professionally is to help people understand that their bodies have this incredible, marvelous design to heal us, to repair damage that's happening every day in our environment.

And that is how we can protect ourselves against disease, how we can age better, how we can experience daily life in a way that creates happiness for us. So my overarching mission is for people to take control of their health and

If you are struggling with symptoms that you may not have gotten the answers to, if you're struggling with a health condition and have felt that you may have to deal with this condition and treat it with medications, if you're struggling with seeing your parents suffer,

a devastating health condition and you want a different path. My goal is to help people realize that this is very real. This is very possible. And that's what I've dedicated my professional life to.

I mean, you just hit one of the very important nails on the head. Many of us see aging as this inevitable, devastating, you know, set of processes and degeneration. This is a kind of a great place to start. What do we get wrong about aging?

What we get wrong about aging is not realizing that the majority of it is in our control. So we have known for really several decades now that about 25% of how we age is genetic and the other 75% is in our control.

And what we've learned more recently through a lot of molecular technology and cell-based technology are the very processes and pathways that are contributing to the aging process. These have been termed the hallmarks of aging.

And every one of these processes and pathways are ones that through our lifestyle, through our choices, and particularly through good stress, we are able to slow down. So we are entirely capable of changing the path of our aging, not just adding years, but making those years healthy. Jonathan, in my opinion, is the king of the 75%.

because Jonathan eats very differently than his genetics may have determined he should. He exercises differently. He thinks differently. He operates differently. This is sort of one of Jonathan's arenas where he's got a tremendous amount of experience. Is that some of what it's about? Is it doing the opposite of what your parents did? What does it actually look like?

So what it actually looks like is by all these things that Jonathan is doing, he is taking control

over what is happening even down to the level of his cells. So by eating healthful foods, particularly like plant chemicals, but also getting adequate protein, by doing exercise, especially some high intensity, by eating in a pattern that aligns with our circadian biology, by taking on

just good mental challenges, good emotional challenges. What he is doing and what I hope everybody does is to not just prevent damage, but we're actually building health within ourselves. So if you think of yourselves as a bank account,

the environmental things that we're exposed to, for example, just pollutants and all these things that we can't always prevent, but also just our general health environment. We all know that the default in our current environment is that if we don't take control, we're going to eat foods that are harmful. We're going to be more sedentary. We're going to take on chronic stress. So what all

these things are doing is that they are drawing out of this bank account that we can call our cellular health, right? So when we get to the point where our cells are bankrupt, that's what disease is. But when we take on good stress and we are choosing to

actively invest in our health, what we're doing is we're making deposits into our cellular health account, right? We're building our reserves. And we know for sure that if we are doing all these healthful lifestyle things that we're talking about, we can add a good 10 to 15 years to our life expectancy. Dr. Justin Marchegiani

People think about life expectancy and we have a bias of immediate gratification. So a lot of people, even though the conversation has changed drastically and people have a different perspective, like, oh, we can age differently and we can have health span. And the conversation, especially across social media, but on all media really is different than it ever has been before. People still think, wait, that's a long ways away. But it's actually immediate.

You know, I don't actually do these things because I have great confidence in that I will last that long. I do it primarily because like I want to feel as good as possible right now, mostly because I want to avoid pain. It's actually a very selfish and immediate tool. So when I hear you talk about, you know, the cell basically depleted,

Can you talk us through a little bit of the mechanisms of how that's actually going to help people be able to function now? Because it used to be that 40, you're like, oh, I'm pretty, all these pains I'm having now, that's just because I'm 40 or just because I'm 50 or I'm 35, I can no longer do whatever sport I used to be able to do extensively. So can you talk us through some of the benefits?

real, you know, biology of what is happening that prevents us in the near term from being able to live the life that we're that we would otherwise enjoy.

Yeah. And I'm so glad you said that, Jonathan, because when we think of doing all these healthy things for decades for the hope that one day we may reap the rewards, it's not a very attractive proposition. But the fact that what you do within hours makes you feel better is what happens when we take on good stress challenges. So I will give you...

a specific example of what happens when we exercise. So when we undergo a high-intensity interval training workout,

The concern that some people may have is that cortisol goes up, but we are built and designed for transient stress. So what happens with that rise in cortisol, first of all, there's also a spike in anabolic or growth hormones, such as testosterone and growth hormone. And after the stress,

our basal level of where our cortisol is actually gets lowered. So after the workout, so cortisol goes up about 30 minutes post-workout and by about two hours, it's coming back down.

But our basal level, our baseline level of cortisol is lowered, right? So these transient stressors are paradoxically improving our baseline. So post-exercise, we feel a sense of calm. That really...

carries out the rest of the day. So while the stressor is short-term, the benefit lasts for hours and now we know really even a lifetime through epigenetic changes. You could extrapolate to many other forms of stress because they help symptoms, not just disease prevention. So for example,

A lot of my patients come to me with fatigue, right? And a lot have already tried managing their blood sugar by cutting out some sweets and they've made some dietary interventions, but they're still fatigued and they get every test done and they're told, quote, you're normal, right?

But what's happening at the cellular level is mitochondrial dysfunction. So over time, because we are in an environment that is harming our mitochondria, our mitochondria are the powerhouse in our cells. They control our metabolism. So all the food energy we consume gets converted to energy inside our body to do all

all the repair mechanisms that take place in our cells to heal us, to regenerate us. When our energy system falters, right? So our cellular engines are not as capable due to mitochondrial dysfunction, lack of mitochondria, damage to the mitochondria. Our cells can't make energy.

So no matter what fuel you're giving yourself, even if, you know, you are driving, you know, you want a Ferrari, but your engine is, you know, an old clunker engine, you can't feel better. You can't shake that fatigue.

Similarly, with our cognitive capacity, when we can generate more energy at a cellular level through all these interventions that can improve our mitochondria, we are powering our neurons, our brain cells to think better with greater clarity. So it does affect day-to-day and hormesis, which is the science of good stress,

has been tested across many different organisms like plants, microbes, and with thousands of toxicants that create stress. And we know from any one exposure, you can improve your functioning by 20 to 25%. But with repeat exposure over time, so stress and recovery, you can improve your functioning 60 to 90%. You can almost double your human potential by re-experiencing

repeat challenging yourself and recovering. So doing this daily to feel better, every aspect of how you show up every day, how you physically feel, emotionally manage your emotions and cognitively perform gets affected. So yes, definitely today it makes a difference, not just 30 years from now.

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It's a massive, massive point. The idea, because people think it's incremental change. They're like, I'll feel a little better or this is generally how I am and I can make some progress

small tweaks to the system. But the idea that it could be 60 to 90% difference in function, I have a 16-year-old who plays tennis. I'm like, imagine being 60% more focused, different reaction times, different anticipation of where the ball's going to be. That would transform his entire life.

if I think about myself with sitting down to focus. But I just, I think like people don't even understand, like I don't even understand how drastic some of these changes are when we stack them and we do them on a repeated level. And it is the frog in boiling water scenario where we start to feel badly over time in these very subtle ways. And then we normalize. You're like, oh, I just don't,

think the same way I used to, or I sit down to work and I just kind of get a lot less done. And you don't really understand the impact of it because it happens so slowly. I'm fascinated by like, what are the ways that we are damaging our mitochondria? Because if we start there, we can, we can look at what are the list of activities that are harming me before I start to build up the ones that I know are going to offer repair. Yeah.

Yeah. And your point about, I just also want to piggyback on what you just said, we don't even realize what's happening over time because we don't objectively have a way of measuring this in healthcare. What is happening is at this cellular level where it's not even visible, but our

our body works through plasticity. Like we have tremendous ability to change ourselves, to change the communication between ourselves. And basically our body works in a use it or lose it way. When we take on these challenges to create a stronger body at a cellular level on up,

This is bioplasticity. I mean, this is what we're talking about. And when we do it in the brain, it's neuroplasticity. So even though there aren't direct measurable ways, it is not a coincidence that when people get older, they feel, oh, they've slowed down. Their cognitive capacity isn't what it used to be. Or, oh, gee, now I'm developing all these health problems, right? This is a lifetime of change.

And so to answer your question about what is damaging our mitochondria and what can help us strengthen and build it, we'll start by damage.

essentially our Western lifestyle. So the list is long. It's the foods that we eat, the processed foods, the sugars. It's our activity pattern. It's being sedentary. We're not doing anything that helps grow our mitochondria. They're incurring damage. Chronic stress that we're under. Loneliness contributes to our mitochondria getting damaged and the aging process itself.

is causing damage and loss of volume in our mitochondria. So some of this is the default, right? So this is our passive resilience. Can I clarify one thing? The loss of volume in the mitochondria is the result of not moving, having sedentary lifestyle. So it's not just that they're functioning less, we're actually having less of them.

Yes, and that is critically important, right? So when we use the term mitochondrial dysfunction, we're referring both to a decline in the function of the mitochondria, right? They're impaired, they're not as efficient, as well as a loss in the number and volume of our mitochondria.

And we have tremendous mitochondrial plasticity, just as we have plasticity in every part of our body. So by not actively taking on good challenges and going by the default of our Western lifestyle,

are lifestyles contributing to the mitochondrial dysfunction more than the aging process? Okay, so back to we have more control than what happens genetically or the passing of time. So when you go to...

you know, a typical doctor, right? You go to a doctor and you say, I don't have energy. I'm not feeling like I can do the things that I used to do. What they'll do is they'll run a series of blood tests. They'll do like a CBC panel. You know, they'll look and make sure you don't have cancer, essentially. Like they'll say like, oh, do you have an infection?

You know, are we picking up anything that indicates that you're fighting something bacterial or fighting something viral? You know, if you're lucky, they'll look a little bit closer and say like, gosh, do you have a UTI that, you know, just is asymptomatic, something like that. Most doctors are not going to say, what's going on with your mitochondria? I think this might be a mitochondrial issue, right? What can patients do, you know, to try and better advocate for themselves or in

Is this sort of the new phase of medicine where we have to take this into our own hands? Things like the stress paradox, things like your book, things like understanding more about our diet, our nutrition. Are those the answers since standard Western medicine is kind of saying there's nothing wrong with you, you're fine? Yeah. Is there a mitochondrial test? Yeah.

They're not offering it at Kaiser in your 15 minute appointment. I can tell you that. And I love Kaiser. I'd like to know how many mitochondria I have and how many I could get.

So I will start off by saying, so I'm a primary care physician and this is essentially what I do. I focus on disease prevention. So people come to me asking questions like I'm fatigued and 100% agree that within traditional medicine, we often don't go down to the cellular level, but

There are tests that are currently available that can catch impairment at earlier stages than ones that are traditionally offered. So for example, a very inexpensive test is testing your insulin level. And you can use that insulin level combined with your fasting glucose to essentially determine your insulin resistance. That's a very early marker of metabolic disease.

Another, Jonathan, to your point about how do we measure mitochondria? Well, currently, we can in a research setting. In a clinical setting, the most applicable way of doing that is by testing your VO2 max. It is a test of your aerobic capacity. You're nodding because you sound familiar with it. I want one of the masks. Okay.

Well, that's what I was going to say, Jonathan. So the most accurate way is, you know, what people envision with those respirator masks. And it's actually a very miserable test if you've ever had it done. But it's an expensive test as well.

And what I want people to realize is that what I'm talking about is accessible and affordable for everyone. You can do a VO2 max test by doing a Rockport one mile walk test. So essentially you can walk for one mile on a level surface. You can map it out in your neighborhood. You can measure with your stopwatch how long it takes you to walk that mile as fast as you can. You measure your heart rate at the end of the test and

There are formulas that you can just get online where you plug in the results and it tells you your VO2 max with charts that show what is age and gender appropriate and how you rank. There's also a run test for people who prefer running. There's the Cooper...

12-minute run test. You just essentially see how far you can go during that timeframe. Very similarly, you then just measure the distance. There's a formula. These are inaccessible ways. And the reason testing your VO2 max is an indirect measure of your mitochondrial function is for your aerobic fitness to be good.

You need, obviously, a very strong cardiovascular system. You need strong lungs. But ultimately, you need your mitochondria to be very efficient to be able to create energy for you while you're exercising. The more mitochondria you have, the more energy to fuel that workout, the better your VOT max is.

And VO2 max or cardiorespiratory fitness is the single biggest predictor of your longevity. Wow. And by a long shot, and back to Mayim, your question of what do you do? Do you take health into your hands? I'm going to say an absolute yes, because...

When you look at the magnitude of impact on exercise, which is the most potent way we can increase our mitochondria and improve our cardiorespiratory fitness, people who have the highest quintile of cardiorespiratory fitness compared to the lowest, there's a five-fold difference in what we call a hazard ratio, but in the risk towards early death.

When you look at smoking and people who smoke versus not and what it does on life expectancy, the hazard ratio is it creates about a 40% higher risk of mortality. But having a highest level of cardiorespiratory fitness means

improves your longevity fivefold. So many orders more than even smoking and it outperforms chronic diseases like diabetes, heart disease. So getting out there and exercising is going to trump anything your doctor can do for you.

any tests that they can run, any medication that they can put you on. So at the end of the day, health really happens outside the doctor's office. It is by and large up to us. It's the choices that we make. I can't emphasize this enough because I tell my patients all the time, like I love encouraging people to live the types of lifestyle things that I'm talking about.

I think it's really important for people in healthcare to give their patients the right information and to help them implement it, right? It's not just the knowledge, but it's the skills of implementing it and doing it in a sustainable way to creating objective measures like insulin levels, doing VOT max testing. There's a long list of ways we can measure health. But

At the end of the day, I also tell people that they can do more to help themselves than I could ever do for them, right? So it's a partnership. And I do think that health systems 100% need to be doing more to shift the focus to health and prevention. But I also think that we...

as people collectively need to be doing the hard work. And good stress is really about the hard work and why our body loves it.

Just to wrap that section, it's really changing the mentality from I'm going to go to a doctor who's going to fix me to I'm going to go to a doctor who is going to have some advice and maybe a guidepost and have recommendations unless I need a major intervention. This person is just going to maybe give me some advice and some guidance for me to help myself.

Absolutely. Doctors can help you treat, but by and large, building health, what creates health,

is not anything, it's not something anyone can do for you, right? It is, again, it comes down to hard work. And to add more to that, Jonathan, there was a study in 2002, it was with Michael McGinnis, where they had looked at what contributes to premature mortality.

And from their analysis, they found that if we gave every person like the best health care service that could possibly happen in this country, like 100 percent total access to care. OK, this is idyllic, perfect world scenario.

we would prevent premature mortality by 10%. The other 90% is coming from some genetics, but largely habits, behaviors, socioeconomics, environmental factors, right? So 90% of what prevents premature mortality is not something that you are going to be able to get even if you had the

most incredible health insurance on the planet and could go to your doctor every day and have them run test after test for you. A lot of people hear a lot of different health advice. I mean, I consume a good amount and sometimes I binge and sometimes I stop because it can feel overwhelming, right? It's like, I have to do all of these things and I have to be testing. I mean, we're going to be doing the...

VO2 max walk test this afternoon. But it can feel overwhelming and then it can become a spiral of anxious, you know, oh, I'm not doing all the things I need to do. How long does it

take to start seeing some difference? You know, you talked immediately, oh, you feel better after exercise, but how many, like how many days, how many weeks of consistency for the average person does it take to start to be like, oh, I feel a little bit better or I have a little bit more energy or like how, how quickly does the mitochondria on the cellular level respond?

It's days to weeks. It is fairly quick that you can completely change how your body is structured and how it functions. Um,

When I do testing for my patients where we work on reversing insulin resistance, metabolic disease, improving lipids, I usually have people come back in six weeks, sometimes two to three months. In that time span, I see objective improvement in their numbers. So it's on a very short timescale and it is okay to backslide. Like we are humans.

But I think we have to keep in mind that we just have to get it right, say 80% of the time, right? And keep moving in a direction that is health promoting, right? It's not the one thing that you do today or the one dessert that makes a difference, right? It's the larger pattern. It's the lifestyle that ultimately matters.

MindBalance Breakdown is supported by BetterHelp. I've had many support systems in my life that have changed my life without a doubt. Therapy is one of them, different community groups, spiritual community, self-help groups. Think about your favorite leaders and mentors.

People don't always have all the answers, but what they do know is when to ask questions and seek support from their community. Our society really glorifies hyper-independence, but we're all better with a support system. Therapy can be a support for any area of your life. Let's shift our focus from doing it all to knowing that we're better when we ask for help.

Jonathan, sometimes the hardest thing to do is to say, I need help. But as we've heard from so many experts here on this podcast, it's often the thing that can really transform your mental health. I totally agree. It's so vulnerable sometimes to admit that we don't have all the answers, but that's when breakthroughs can really happen is when we reach out.

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That's T-H-R-I-V-E market.com slash break. Thrivemarket.com slash break. I wonder if we can turn to stress. This has become one of, I'd say, the biggest buzzwords of the last, I don't know, at least five years in terms of everybody trying to assess stress

Where their stress is coming from, what the stresses are of Western society and our culture, what stress social media is adding, what stress having these children that I thought was a good idea to have is having on me, right? All these stressors. What...

I don't need to, you know, I don't need to recite you the TED talk that you did, but one of the things that stands out, you know, is this sort of introduction to an understanding of the stress, the physiological stress system. So, you know, we have the adrenal system, we have the HPA axis, which is the hypothalamic pituitary adrenal axis, which is this really beautiful intricate system that is constantly regulating the

And there are connections to the limbic system, which is your body essentially emotionally processing all of these things. So there's a set of physiological processes and there's a set of, you know, kind of emotional processes that are working together. And these impact...

It impacts the way you lay down plaques in your arteries. It impacts the way your gut can process and take in food. Anyone who ever has had a nervous stomach or has been diagnosed with atypical IBS, which basically means you are so stressed, right, that your gut is churning, right, its own kind of toxic system, right?

We know that stress affects our immune system, our ability to fight disease, our ability to, you know, ward off basic viruses is impaired when we are mostly focused on fight or flight, for example, right? So we know kind of chronic stress, stress related to trauma. These things are bad for your body. What is the point of stress?

stress as you present it in the stress paradox. What are we getting wrong about stress? To me, it sounds like I want to avoid it at all costs. There's not a system in my body that stress, this is what I've been taught. There's not a system in my body that is not going to break down, stop working or work poorly if I'm under stress. What am I getting wrong?

So, everything you said, Mayim, is what we have known for a long time that stress can harm. And that is what the bulk of research on stress has been focused on. We've even published on the harms of stress for heart disease.

But it is also equally indisputable that stress can enrich us and benefit us. And that's the focus of the stress paradox, that we can use stressors, some types that we can optimize to build resilience against the very stressors that we have been taught to fear.

And the counterintuitive or paradoxical part is that we need these stressors to become more stress resilient. Okay, that's the new stress management. And that is the message that I want people to take away because our stress systems are adaptive. They're not there for harm.

And our goal is not to cure stress or get rid of it out of our lives. It's to optimize it. And that has implications, not just for our mental wellbeing, but our physical health, for how we age. And that's what the book is about and what the paradox is about, right? So there's a long history and legacy of how did we get here, right? How did we come to fear stress? And it goes back

really now 90 years to how stress as a medical concept began. So it started with the father of stress research, Hans Selyeck,

And he had conducted a series of experiments on rats. And he had tortured these poor creatures. He had exposed them to, you know, spinal shock, extremes of cold, sublethal doses of formaldehyde, morphine. It's kind of what it feels like to work with Jonathan, but I get it. Right. And then

And no matter how he tortured them, they developed a very similar response, which he called general adaptation syndrome. Their immune systems failed. They developed bleeding ulcers and large adrenal glands. They got sick and then they died. And he published the findings in 1936 in the journal Nature. And that's how stress as a medical concept originated.

But Selye extrapolated, never proved, but extrapolated that we respond similarly to all stress. Okay. Whether we're running out of a burning building or walking our daughter down the aisle, right? Good stressors as well as bad ones that our body has, he kind of hypothesized that we have the same patterned response, no matter the type of stress, what you just described with the HPA axis. Yeah. And,

And that doesn't not make sense. Just in defense of old school, you know, neurophysiology, it doesn't not make sense. The human body is redundant. The nervous system is redundant. We only have so many ways to take in information, to process information, and to churn out a response. So it's not illogical to say, oh, I've got one HPA axis, and it's going to respond this way. And anyone who's ever, you know, fallen in love or fallen off a building knows that your heart races, you start sweating, right? It's the same.

Same thing. Exactly. But what we know now, so in the 90 years since stress has been discovered as a medical concept, is that the biochemistry of the stress response is different depending on the stressor. Because our HPA axis and the adrenaline, noradrenaline that you just described,

interacts with different hormone systems and neurotransmitter systems. They interact with the oxytocin system from our hypothalamus when we are pursuing stressors, like say a first date that would be more human connective, right? When we pursue things that are meaningful and rewarding, we are also releasing dopamine, right?

We also activate endorphins, the endocannabinoid system. So the stress biology is actually different depending on the stressors. And we can choose certain forms of stress that have these healing hormones. And they not just counteract the potential damage, but they strengthen us and enrich us.

Okay, so the example that comes to mind, I'm a person who has had children with no drugs and I use self-hypnosis and I don't consider myself a superwoman. I'm not a magician. It's nothing like that. And this is an example of where pain...

is not necessarily, breaking your leg is not the same thing as squeezing a watermelon through a garden hose, right? In theory, those are both things that can produce a tremendous amount of intensity, but this is a place where your mental state, right, which is not just a thing that floats in the ether, that's something that has to do with the hormones you're secreting, the ways that you're regulating and learning to regulate your blood pressure, your heart rate, all these things,

That's an example where there are other factors contributing that can alter the system in such a way that it's not that your heart rate doesn't increase. It's not that you don't feel sensation, but that we're working towards something that has a different set of goals. That's a different kind of stressor than if I break my leg. A hundred percent. And there are two parts to that, Mayim. So one is, like you said, the biochemistry is different depending on the stress factor.

But the second part of that is simply the mindset of the stress. Whether we go into the stressor thinking this is a stress is beneficial type of stress or we go into it as this is a stress is harmful. That mindset alone changes the cortisol reactivity. That's a huge, that is a huge, huge point that I'd like to underline if it's okay.

You know, we've spoken to Bruce Lipton and we've spoken to, you know, Sharon Salzberg and all sorts of people who work in meditative spaces and also in, you know, kind of neurophysiology spaces in terms of understanding stress and our processing of that space.

This is the notion that maybe manifesting is not just something for hippies sitting on mountaintops. The notion of placing yourself in an appropriate mindset has the ability to alter the way you metabolize a stressful situation.

100%. That is such a critical takeaway that if people do nothing from our conversation other than reframe how they see stress, that alone is an intervention that can benefit how their body responds to stress. I feel so different about working with you now because sometimes it's really stressful putting on a podcast. But it's funny because when

When people say, well, what do you enjoy about it? It takes me out of the immediate stressors so that I can say, I really love talking to people like Dr. Berkowitz so that we can bring information to people. It's a way of modulating and shifting that framework. I'll be honest, I hadn't thought of it that way. We know perspective is everything, right? It's like,

at the beginning of a podcast, if it's what you're setting up another camera right now, it's 10 minutes to the podcast versus, oh my gosh, we're capturing another angle. We're going to have the most tools available for us so that we can edit this properly. And we're going to do it right in the nick of time. Like how amazing is that? All of a sudden it becomes this

exciting adventure that we're on and the success is a collective success versus this guy's just always tinkering. All of a sudden she's a victim and this stress is being done to her and her body's in a defensive mode where it's being attacked.

When you think of it as what, again, what you guys just did, right? What is your bigger goal? Like really the mission that you're on with this podcast, if we're using that as an example, is bigger than you, right? It's a part of this larger mission that you want to communicate certain information to people. And

Just by recognizing that you are making that stressor in the pursuit of something that is meaningful. That reward triggers dopamine, right? When we are pursuing things that

This is really a task that you're doing. And when you can master it and there's the possibility of reward, but it's not guaranteed, right? That's really the sweet spot where we have the peak amount of dopamine. Yeah, you just described gambling, right? Like the stress of gambling, right? Has this possibility for payoff that people find exhilarating. Also spicy food. I don't understand that one. Yeah.

Right. But there's a difference that I'll tap into between pursuing things that spike dopamine first versus doing the hard thing and then letting dopamine be a consequence of that. So when you are, let's say, eating a donut, we know that fat, sugar, and salt release high amounts of dopamine, right? Like that's how food is engineered to be addictive. Right.

And when we get that spike, our body works through a feedback mechanism. So what happens internally is we downregulate our basal level of dopamine. So then we want another donut to get that good feeling back, right? But then we keep downregulating our baseline, right? So we are creating this addictive pattern where we want more donut, more donut, more sugar, right?

When you do the hard thing first, okay, so let's say you decide to do a cold plunge for an example, and your body is going to sense discomfort. It's going to sense some pain from being in that utter cold plunge.

And the dopamine, the norepinephrine that are released in response to that or a response to the discomfort, they go up after that exposure to the stressor. And afterwards, they go down closer to a baseline level, right? You don't create this deficit. So they don't have that same addictive, I want more, right? So when you do the hard thing first, your body's rewarding you for it. Oh,

I wonder if you can get into, you have these five key stressors that you talk about that maximize mental, emotional, and physical resilience. So one of them is heat and cold therapy. What are the others? And can you talk a little bit about these five key stressors? Because for me, I feel like, oh, maybe I should just stress less about how much stress I'm in. But you actually, in your book, you talk about specific ways to introduce stress

positive stress, an amount of stress to your body that also purports that the body is resilient and the body is maximized to utilize stress in ways that can ultimately help the whole system. So can you talk about those five key stressors? And I'm happy to list them or you can, and I can have you talk about each of them individually. Yeah.

Of course. So I'll first list them and then talk a little bit about what they're doing in your body. So the stressors are using plant chemicals, phytochemicals, which are perceived by our bodies actually as good toxins. Exercise, particularly at a high intensity. Temperature, whether it's cold or heat.

fasting, but in a way that I'm going to call normal eating, right? It's in alignment with our biology and mental and emotional challenges. So those types of stressors, and they weren't chosen by accident or by just, you know, random collection of things. What they each do is they activate a hormetic response. So hormesis is from the Greek word to excite.

And these stressors, because they're kind of a mild, when we do them in a mild to moderate way, they activate parts of our genes that protect our cells against damage. So these stressors, you know, molecularly, they turn on certain switches like transcription factors, which are factors that tell our gene sequence which ones to express. And the genes that ultimately get expressed are...

are vitagenes, which is short for vitality genes. So we have these adversity gene pathways that we have inherited from our ancestors over 2 million years. Our ancestors faced these stressors, these five that we just talked about. They were a part of our natural environment until 200 years ago.

And we adapted over this timeframe where our physiology has come to depend on these stressors for keeping us healthy. In the last 200 years as we've removed these stressors from our environment, right? We live in air conditioned spots, we have refrigeration, we have artificial light, etc.,

We have removed the natural stimulus for our body to make ourselves healthy. So when we're exposed to these stressors, what the Vita genes control are genes that help repair our cells. So they repair DNA, they repair proteins, they resist damage by ramping up our antioxidant and anti-inflammatory mechanisms. They recycle damaged parts of our cells and

And they take old cells and kind of junk them, right? And the junkyard of our cells that we call the lysosome. And they recharge our cells by increasing the volume and the number and the functioning. Mitochondria. And, you know, mitochondria have such an outsized role in all of this because if we don't have energy, we can't do all these repair functions. Before we go into more detail with each of these five problems,

key stressors, which I want to hear more about all of them. Can you just frame a little bit what these VitaGenes are? Like I'm picturing that there's like one gene wearing a superhero cape, but that's not what it is, right? This is a collection of genes that have particular functions that work throughout your body. And we're looking to activate these with these different stressors so that they can do a variety of jobs. Tell us a little bit more about what those genes are before we get into each of the stressors.

So these genes really code for protective mechanisms like heat shock proteins, antioxidant genes, the sirtuin family. These are how we develop our cellular stress responses. So what's encoded in these genes is the blueprint of how we can make our bodies healthier.

Great. Okay, let's get into each of the stressors. Wherever you want to start, we can start with plant toxins. Absolutely. So plant toxins, I'll first start off by saying, why are they toxins and why do we refer to them this way? So as...

Our ancestors were roaming the earth as hunter-gatherers. They were essentially nomads and their survival really depended on being able to consume the widest variety of food that they possibly could. Okay, so they had to learn to try different plants. Some of them could have been poisonous, some weren't. So we developed a mechanism to rapidly metabolize

components in plants that could be fatal or toxic to us. And we also developed a mechanism to upregulate our antioxidant defenses.

so that we could tolerate a wider variety of different foods. So why do plants even make components that can be toxic to us? Well, think about this from the perspective of a plant. If you're a plant, you can't run away from predators, right? So all you can do is create a deterrent from animals, insects, and even us from wanting to eat you. And the way that plants did that is they built phytochemicals.

And these phytochemicals are natural pesticides, right? A lot of them are bitter, right? Like we can get to like compounds in broccoli or Brussels sprouts, right? And they're there to deter us. We co-evolved with plants. And when we consume these, because we can rapidly detoxify them and consume a higher amount, they ramp up our cellular stress responses, the ones that we're talking about, these phytogenes.

So we've learned to depend on these plants for becoming healthy, for making ourselves healthier. So this is why adding ketchup to broccoli is like not ideal, but if it gets your kid to eat their broccoli, they're eating their broccoli. Well, and ketchup is tomatoes, right? You can make the argument that you're getting more phytochemicals, right?

But right now, only one out of 10 Americans is getting the recommended amount of fruits and vegetables, right? So we're not using our innate ability to become healthy, right? And of the 30,000 edible foods that exist, we only cultivate 150 of them. That's insane. That's insane. Isn't it?

Well, and only about 30 of them make it to our plate in a given year, right? So 50% of calories are coming from rice, corn, and wheat, right? We have removed plants like fruits and vegetables from our diet and we are really not consuming the variety, right? And we're not using this innate gift that we have for defending our body against all these environmental exposures.

Let's cut through a little bit of internet noise. There are experts on the fringes, some of them, but some of them not even on the fringes who say plant chemicals are actually harming you.

And not that you shouldn't eat some fruits and vegetables. They don't go that far. Some do, but most of the mainstream don't. But what they talk about is the oxalates, the lectins, that some of these are super harmful. And mostly you should eat meat. Well, I want to separate those different characters because some of them are extreme meat-oriented people. But even they fall back and say you should eat fruits and vegetables

But some of them are saying like Brussels sprouts, for example, have things in them that you shouldn't be eating. They're turning on kale too. But it rips apart your gut lining. And quinoa, if you sprout it or instapot it so that it's pressurized, it's good. But otherwise, it's not good. And we've basically been fooled into believing that a lot of these foods that for marketing purposes...

are not actually superfoods at all. How do people start to distinguish this by understanding that, of course, fiber is very good. Literature on fiber is very, very compelling. But are there pockets of plants that actually maybe are less beneficial? And are there people who may have less robust immune systems that kind of need to start on the starter plants before going into ones that are potentially harder to digest?

So multiple things in there that I'd love to address. So the first is that we have created this fear against so many foods to the point where I have patients who are on such restrictive diets that they're really developing malnutrition because of this fear of, well, no, I just read I shouldn't eat kale. I shouldn't eat this. Well, what's left, right?

When you look at studies where, like, for example, the Global Burden of Disease study, it was a large study, 195 countries done over 27 years. That study found that the single biggest predictor of mortality is our diet. But most importantly, it

it's what we're not eating enough of rather than what we're eating too much of. Okay. So they found more longevity benefits from getting enough fruits, vegetables, and a lot of these plant foods. And that far, far in magnitude, almost 30 fold more outweighed the harm from or the death from meat processed sugars, right? So

We're so focused on what to avoid and how it can harm us. And good stress is really about what can we add, right? So we're adding to health as opposed to really years of health education around what we should prevent, what's harming us, okay? So I think...

Whether you're an omnivore, a vegan, it really doesn't matter to me. What matters is that you're adding these health beneficial components, these fruits and vegetables.

To answer your questions of the net harm, so many of the studies that have been done like this one, as well as a lot of population-based studies have been done on conventional crops and these contain potential pesticides, et cetera. And even in these studies, we're seeing a benefit. So there are over 250 population-based studies that show if we eat the recommended five servings of fruits and vegetables a day, we can reduce cancer by 50%.

Okay. Now, your point is also well made that, yes, there's a difference if we're buying organic, if something is like out in the wild. So the highest phytochemical amount is in wild, you know,

fruits, vegetables, animals. Well, not animals don't have phytochemicals, but they're still the healthiest if they're wild. Because these are distressed plants, they make more phytochemicals. They have to deal with drought, with sunshine, UV light, predators, et cetera. So they're going to make the highest amount of phytochemicals. And when we are growing plants,

fruits and vegetables, we're really growing them for their carb load, right? That's how we're selling a larger quantity, not for their phytochemical benefit. So wild has a greater benefit over conventional, which has... And then the organic is 10% to 50% higher in the phytochemical load. So

There's some advantage to getting ones that don't have the, quote, toxins in them. But I don't want that to make people lose sight of the fact that even with conventional crops, we are so under the mark of what our bodies need to be healthy. And we can make such a difference in disease outcomes by just incorporating more. Incredible.

Let's talk about the second stressor, uh, exercising with, you call it intermittent bursts of intense movement. Um, this is something that a lot of kind of like super exerciser people do. Like, you know, I mean, like if I have to do 10 burpees, like I feel like I've done the exercise for the year. Um, talk a little bit about what kind of exercise we're talking about. So, um,

I don't want the thought of intensity to scare people from exercise because I realize that a lot of people are more sedentary, right? Only one out of four people in this country is meeting the physical activity guidelines.

And so what I want people to realize is what activates these stress responses is what is creating discomfort for that person, right? Exercising at all is creating discomfort.

Well, and that is so important, right? Because that's where you are at, right? Not you in particular, but for any person, right? Like there's so much variability. And this goes back to Jonathan's question about like which plants, if you haven't been eating, can cause distress, right? All of this is what is your starting point? You

You want to get to the point where you're creating a little bit of discomfort, right? That's the sweet spot, the Goldilocks zone, the hormetic range where you're activating these stress responses. And you want to do it for a short amount of time, which is why these are brief stressors. And then you want to let your body recover, okay? So the recovery is just as important about stress. Like we're talking so much right now just about the stress, right?

The stress is what sets us up to become more efficient to repair, to regenerate. But it's during the recovery that our body's reconfiguring, rewiring itself and making us stronger. Okay.

Can you explain what recovery is? Because it wasn't until I started wearing a tracking device that I had honestly ever heard that. Like, I had heard of it in the colloquial sense of like, your body needs to recover. And, you know, I was trained as a ballerina when I was younger. And so, you know, like there was definitely an awareness of my body, you know, feeling a special kind of fatigue. But can you talk about what recovery means in sort of a physiological sense? Yeah.

Yeah, so recovery for each of these stressors can be a little different, but what they have in common is they're giving your body a chance to downregulate from that stress response and to build the pathways that we do during our growth phase. So in stress, our body is switching from growth, from synthesis to more energy conservation and repair and doing housekeeping work.

So essentially recovery is going back. So if it's from fasting, it's going back to feeding and eating. If it's from exercise, it's getting good rest and giving your body the nutrients that it needs for synthesis, such as proteins and certain carbohydrates that it needs. When it's a mental or emotional challenge,

It is really a form of more deep rest, not just I'm going to zone out and watch TV, but more of a deep rest where I'm

So you, for example, can be out in nature and doing like a nature prescription where you're taking in every bit of nature, but it's the type that actually allows your brain to do a lot of the healing and repair that's similar to what we do in sleep. So it is

really creating the right environment for our body to grow in response to stress. And obviously there's so many aspects to exercise. If you are fatigued, if you're not getting the appropriate amount of sleep, exercise is going to be even more of a challenge. But that's the thing that I started noticing is that when I was struggling with sleep, my recovery index kept getting lower. And that's because you literally don't have the resources. So this is kind of a multi-pronged

thing going on. It's not just about exercising. It's also balancing your life so that you're getting enough restoration, let's say with sleep, which also is contributed like the factor of when you eat, how you eat, which we'll get to in a little bit. Those things are going to contribute to your ability to recover from that.

Right. So what pushes you to that level of discomfort is not just different person to person, but within the same person day to day, it's going to be a little different. And that's so important. And that's where how well you've recovered factors, right? So if you kept on stacking stress, like exercising to the hilt day after day without the recovery, you're essentially creating chronic stress. You're creating the harmful bad stress that we're trying to avoid.

Can you talk about heat and cold therapy for those of us who may not have access, for example, to a cold plunge? Can you talk a little bit about this sort of

In my opinion, you know, this was just like a fad of just like, let's create a really, really expensive thing that like either requires that you have like a $50,000 thing in your house or you go to some expensive spa that most people don't have access to. What is up with heat and cold therapy and how does it impact our body's ability to tackle stress?

Yeah. So I'll start off by saying to get temperature exposure in a way that's beneficial, you don't need fancy equipment. In fact, our ancestors have, again, have done this for 2 million years without a cold plunge. And I have such a mission to make health accessible and affordable for every person. And everything I'm advocating for is a simple lifestyle intervention that we can all access. So exposure,

Exposure to just cold weather is sufficient. Taking a hot bath, like in a hot tub, is sufficient to activate our stress responses. So what we're doing with temperature exposure, just like these other stressors, is that we are reducing our body's core temperature. And our body is designed to have this temperature.

really wisdom called homeostasis, where we want to create an internal balance that keeps us healthy. When our core body temperature changes, whether it's up with heat exposure or down with cold exposure, the wisdom of our body kicks in to bring our core body temperature back to 98.7, roughly, Fahrenheit.

just so our enzymes in every part of our body can function. But in that process of restoring our body temperature, it activates the stress responses that we're talking about. So at a cellular level, we're activating, say, heat shock proteins, which actually get activated not just with heat, but also with the cold exposure.

We're activating so many of the other downstream molecular switches that turn on these adversity genes. So that's the big picture of why they're beneficial and not a fad. So all these things that we're talking about, because they have been a part of how our physiology adapted over 2 million years, they're actually the non-negotiables of our physiology. Okay.

We cannot bypass these steps to be healthy because our genes have come to need these to maintain our ability to clear out damage and do all the functions they need to to preserve health. Now, I do have to say that I hate that it's become this thing that only wealthy people who can afford $30,000 equipment have access to because health

health is affordable. I don't want people to be deterred from pursuing health. It is not for the elite. It is simply for anybody who's willing to take control because good stress is deliberate. It is a decision to add voluntarily some stresses in your life as opposed to passively letting the environment, this whole Western lifestyle, passively set your potential for health.

Well said. Very well said. I love you. I love you too. These are great. It is very well said. And the message that we have tried to hear and tried to share over and over is that without some sort of personal intervention and agency, just looking around and doing what is expected of us will result in unfavorable ends. And, you know, in...

Some places where it's very hot, the cold water doesn't actually go cold enough to take a cold shower. But there are ways, not affiliated with us, but there was like a little product that was like a small rubber basket with holes that you can hang above your shower, put ice in it, and it creates an ice. And it's very inexpensive relative to an ice bath, but actually it was like 20 bucks. So very easy to get.

And Jonathan, there have been studies of just turning down your thermostat. So there was one study where thermostat was turned down to 60 degrees.

And for 10 days, people sat in the 60 degrees with just a t-shirt and shorts. That alone increased brown adipose tissue by 37%. So brown adipose tissue is mitochondria-rich adipocytes, mitochondria-rich fat cells. So we have

Brown fat, that burns energy, which is very different from the white fat that sits around our belly that stores our energy. And by activating the brown fat, we are burning our fat stores. We are burning glucose, right? That's a big part of molecularly, like how the cold exposure is helping our metabolic health.

So absolutely just turning down the thermostat is enough. You know, it just snowed here in Atlanta and just stepping outside. I went for a nice long walk in the cold because it was a very inexpensive way to get the benefits of cold. There are other practitioners, some very natural practitioners that say for women, you

either for women in general or for women at specific times in their cycle that having that cold is not beneficial. Is there a difference for men and women in using cold as an adaptation?

Yeah, so I will say that, you know, there's a lot of interest in the variations between genders and there aren't a lot of studies on all women. In fact, most of the studies are conducted in men because it's quite honestly easier in a lot of clinical studies to take out the variation of the hormonal changes, not to exonerate it because I think we need studies on women. But that's why a lot of that happens. Also, dudes are more likely to be like, sit in a bucket of ice cubes? Okay. Yeah.

Well, and I think that the couple parts here, that there are some differences between men and women. So for example, and I know we're going to talk about this next, but women are more nutrient sensitive, right? So our threshold of what we sense as say fasting, our threshold may be a little different. And some of that, again, goes back evolutionarily. If we are...

feeling a fasted state, it may not be the best time for us to reproduce. And because we're essentially on this planet to procreate and to survive, it may have been a mechanism for our bodies to say, hey, nutrients are scarce right now. This is a time of starvation, not the best time to try and conceive, right? So women are more nutrient sensitive. But

What I don't want people to take as a big takeaway is that the differences between genders is actually fairly small. That the big picture of how our physiology is designed to need to activate these stress responses. I mean, we're not different species, right? Sometimes it feels like it, but we're not. Right.

Right. Like, you know, so, you know, no health habit works for everyone, but some health habits work for most people, right? And because this is such a conserved part of our physiology, right? Like nature doesn't hand things down for 2 million years and conserve it if it doesn't think it's important. And this is such an important part of our physiology. So we're not like Mars and Venus, like we're much more similar in this scenario. Right.

Let's get into stressor number four. I don't like the word fasting, and there's two reasons I don't like it. And I know that there's a lot of ways to talk around this, but when people hear fasting, when I hear fasting, I think of two things. I think of eating disorders and how fasting can be a very dangerous thing for people who struggle with disordered eating. And it can be a very dangerous way for many of us to hide

behind a notion about health when actually what we're doing is sort of feeding a disordered way of eating, which can be very dangerous. It can be very, I think, culturally dangerous. And especially when it's emphasized and overemphasized on social media, I think it can be a really dangerous thing. So I have an issue with that word. And the other thing is I love food and I love eating. And so fasting to me sounds like deprivation. It sounds like punishment. It really doesn't sound...

optimal at all. But can you talk a little bit, can you humanize the way that we think about food restriction in ways that don't tap into some of the fears that many of us have about either depriving ourselves of food or leaning into disordered eating? Yeah. And I think that is hugely important to point out, Mayim.

What I want to advocate though is really, I think really first defining what I'm calling fasting because I'm not advocating that what we need for hormesis or these mild to moderate stressors are these extremes of water fasting for weeks or what people are out there doing. What I want people to do is just eat in the pattern that

really works with our physiology. So what I mean by that is our ancestors, again, kind of ate when the sun came out, like they could go get food. And after it got dark, they would sit around the fire and go to bed. So they kind of ended eating and they would go to sleep.

And because we can now refrigerate food and have artificial light, we can eat round the clock. Some of us like to eat in bed up until 10 or 10.30 p.m. until Jonathan told us that's not healthy. Well, and that's what the average American does, right? So we eat in a 15-hour time span. From the time we wake up, we have coffee or juice and we start consuming calories to that bedtime snack right before we close our eyes.

And when we're eating, we're putting our body in this buildup phase where we synthesize fats, we're storing energy. And when we fast, so when we've gone 12 hours or longer without eating, our body metabolically switches to where we enter breakdown. So instead of having a glucose, which is how we're supporting our processes when we're eating,

We switch over where our body's using fat in the form of ketones. And that molecular switch from consuming glucose to consuming fats or ketones for our energy changes what's happening at a cellular level.

So when we are in this phase of growing and feeding our bodies, our cells are also growing. But when we switch after that 12-hour mark, our cells start the repair and the regeneration. When we're eating around the clock, we, A, aren't giving our bodies enough time for breakdown, right? If we are doing 15 hours of eating, we're

spending a lot of time in buildup phase, right? And 75% of this country is now either moderately or severely obese, right? So this isn't working so well for us. And what is also not happening that we can't see or feel is we are not turning on our repair mechanisms, right?

So our body, when we're sleeping and when we're fasting, is doing all this housekeeping, right? It's doing all the repairs. So on a given day, we can get 10,000 injuries to our DNA. Hey, that's seven every minute. Our body is working in the background so incredibly hard to not let the daily damage lead to disease and poor outcomes and us feeling crummy.

If we're impairing our body's ability by not giving it that 12 hours, we're handicapping ourselves. And we're talking like that's seven to seven. Can you not eat between 7 p.m.?

and 7 a.m. It means planning your day so that you're eating dinner earlier. It means getting rid of this antiquated notion that if you don't eat at 8, 9, or 10 o'clock, you're going to, quote, wake up starving. Like, this is something also that people get really, really fixated on, that, like, some people's bodies need to eat in the middle of the night. It's not a thing. Like, you can stop eating at 7 p.m. and wake up and start your day and then eat.

A hundred percent. So what I'm advocating for, you know, I hate the term fasting just like you do because this is normal eating. You're sleeping during most of it. It's not that hard. Just go to bed. It's not.

You want to end about three hours, two to three hours before you go to bed. And you want to start about an hour after you wake up. And part of that is so you align with your circadian rhythm. So you're optimizing when your body has the highest amount of the ability of insulin to break down the food. And you are minimizing food intake where the same food can lead to a bigger blood sugar spike and poor metabolic health.

Is 12 hours enough? There's evidence or there's conversation that it's 14 where your body goes into that supercharge of cellular repair.

So that's part one. And part two is, you know, is 16 too much where people are in the 8-16 window because there's some conversation that the 16 window starts to stress the adrenals and then we're doing damage. Well, it also depends what you're doing in your morning. Like I would have a hard time saying to my kid, I'm going to send you to school without eating until lunchtime, right? Like people need some fuel. And I'm not a coffee drinker, but people need some

fuel in the morning. I was raised that you eat breakfast every single morning. Like, you don't skip breakfast, right? So what does that look like? I don't want to stop eating at three or four. That feels dumb. A hundred percent. So...

how long you should go without eating. To your point, Jonathan, it's what are your goals, right? So the 12 hours is if we want to not incur the damage that can lead to disease, it's kind of just daily living for healthy people, just a good practice. I want ultimate repair. You want

You want ultimate repair. So when you get to the 10-hour range, you're going to first get the metabolic benefit. So the first thing the cell does is it wants to utilize energy more efficiently. It increases its insulin sensitivity. So you more efficiently uptake sugars into the cell.

And that is really the hallmark of good metabolic health. For people who have prediabetes, insulin resistance, and diabetes, that 10-hour mark is a really good benchmark.

For people who want to get deeper level of, um, like autophagy, really, you do have to go longer amounts. Um, but it depends on the type of autophagy that we want. So macroautophagy, um,

is kind of going on in the background all the time, right? Like I said, our bodies are constantly trying to repair us. So this recycling that happens in the part of our cells called the lysosomes, which is like the junkyard where we do all the recycling, that's happening in the background. When we extend our fast for longer durations, we're getting selective autophagy

and chaperone-assisted autophagy. These are different types that allow ourselves to do specific types of turnover and to do kind of a deeper level of cleaning. So you probably, you know, we're, honestly, we're extrapolating from animal studies to know when we get to that phase. I think people who are on the internet claiming that they have the answers are extrapolating from animal studies, but it's 48 to 72 hours as the best extrapolation.

And ditto with the 16-8, that was based on animal studies, on mice. We don't know that for humans, that is the best timeframe to be doing the fasting. So much of this is, well, what are your goals? The first thing is just try and get to that 12 hours because you at least want to give your body a chance to do what it's designed to do.

Push a little further for metabolic benefit because if you take two people on the same caloric intake, okay, no difference in calories, but you have one person do it in like a shorter time window, but they're not restricting food. We're just saying, hey, just don't eat right before bed and wake up eating, right?

That alone has a benefit of improving insulin sensitivity. So we do want that because right now, 93% of America has poor metabolic health. Like this is such a huge issue. And then beyond that, for the people who want to live 100 years and quote, biohack their bodies, you know, which is really not my goal with hormesis. I'm really much more into getting America healthy.

But for that, yes, longer durations are probably more beneficial. But back to Mayim's point, it's not that the 12 hours is magical. It's if you are, for example, exercising in that window, you are going to go through your glucose stores, your glycogen stores a heck of a lot quicker, right? So you are going to get to the phase where we're using ketones a lot faster than 12 hours, right? Exercise...

can get you to autophagy faster than fasting. The exercise rapidly depletes your energy stores and turns on a fuel sensor in our cells called AMPK, right? And the sensor kind of turns red that we are out of gas.

And the AMPK activates so many of these cellular responses, increases the number of our mitochondria and has a lot of health-promoting benefits. So you can also stack a few things if you really want a biohack. But, you know, again, my interest is in getting people healthy. And I want this to be what is relevant to the majority of people. There's probably a very small subset that is healthy and trying to achieve ultra-healthy health.

I think also, yeah, and this kind of leads to the fifth key stressor in terms of mental and emotional challenge. You know, a lot of people who want to spend time, you know, doing all this biohacking stuff, they either have, you know, lives of a different level of luxury where other people are helping them cook, care for their children, you know, manage their children's

and things like that. And, you know, I'm sure that there are people of all, you know, socioeconomic ranges who are interested in this, but by and large, the people that I see, you know, on social media and stuff, like that's not accessible to me. Like I also need to be able to like help my kid do his homework, like be able to take care of my household, my family, my work, my stress level, and be able to do things that are reasonable, which is why I kind of like how you're presenting this

But if you can talk about this fifth stressor, you know, mental and emotional stress is something that we're told to kind of avoid at all costs. You know, meditate. Like for me, I have an autoimmune condition that I've been dealing with where it's like

anything can agitate the system. Anything can cause histamine release. So like, don't do the things that you love most, which I thought were helping with stress because it's too agitating for the system. Right. And I feel like so many people feel like, and I think women in particular, like we're these delicate flowers, like we can't have too much stress and we can't handle it. I wonder if you can speak a little about that and,

And I wonder if you can frame it with some of your personal life experience and the stress that your family experienced, which sort of led to your interest in this aspect of the stress paradox.

Yeah, absolutely. So I'll say that for any person, you can use stress to build stress resilience, but it's the type of stress. We associate stress with harmful stress, right? So it is the chronic stress of working with someone that you may not want to work with or...

You know, whatever situation that is creating kind of more of a threat-based type of stress. But what I want people to differentiate, whether they have an autoimmune condition like you do, et cetera, is that we can build our defenses against stress. And if we withdraw from stress, not enough stress is just as harmful as too much. You are lowering your resilience to stress through avoidance.

And that is not the goal. I think that makes you more vulnerable to illness. But we do have to differentiate what makes stress good and what makes stress bad, right? So stress that is bad or harmful to us is generally uncontrollable and it's unpredictable, okay? Child getting sick, etc.,

Stress that is good, that is beneficial to us, occurs in a safe environment. Okay, so it's not falling into a deep icy lake. It's 15 seconds of a cold shower, right? It's a safe environment. It's

deliberate and controllable by its very nature, right? We're adding good stress. And you have to be able to tell yourself this is not that, right? So you have to be able to tell yourself when you're doing a cold plunge or experiencing cold, you're not dying, right? Like that's sort of the challenge here.

Right. It is. That's exactly it. It has to be discomfort, but not to the point where you feel unsafe, right? With any of these, it's exercise to the point of discomfort, but not to the point where you think you're injuring yourself. And the same with picking a mental challenge or an emotional challenge.

Ideally, you want for it to be a good stress. You want it to straddle that possibility of reward, but where it's not guaranteed right back to the how do we maximize the dopamine and

And you want, so for that, it's got to be meaningful, right? It has to align with your personal belief system. That's very different than being in a situation where you don't like your boss and you're being told to do things that go against your belief system, okay? That is a deleterious type of stress. So I'm not giving permission for your boss to say, hey, work harder. It's good for you to stress, right? The type of stress matters, right?

And it's generative, right? It is for the greater good of other people because that is how we as humans were designed. The generative stress is what changes the biochemistry of that stress response to bring in the oxytocin and the dopamine. These are how we kind of control the cortisol in our life.

they bring down the cortisol, they negate it, right? So when we engage these good stressors, we are regulating our cortisol. We are regulating the potential damage from the stressors that we cannot control in our lives.

So I will get you asked for a personal scenario. I will give you mine. So I'll talk about writing this book. So when I first got the offer to write this book, you would think I would be thrilled, but it was actually very overwhelming because I have two clinical practices. I take care of patients in two clinics. I...

you know, have done a lot of clinical studies. I've run up to a dozen clinical trials. I have administrative roles and I work for an academic center and I have three kids and a husband. And somewhere in there, I do like to take care of myself and practice what I preach. So, so,

this was actually first more overwhelming, but when I thought about it as what is my goal from this, right? And it's for all the people who have ever suffered from a health condition, from all the people who've been told medication is the only answer, for all the people who have been told that this is your fate, this is your genetics, you can't do anything about it. My career mission has been to change

the understanding of what we are capable of and to trust our bodies and how marvelously we're designed to be healthy, right?

And when I focused on that, it truly became transformational. Like the whole process of writing set off this cascade of how I just felt stronger. And it created for me the ability to not feel burnt out at work. I mean, right now, over 50% of doctors are burnt out. And I'm sure it's very similar across different professions. I mean, I think it's kind of a phenomenon.

Because what I was doing was aligning with my belief system, right? It's moral clarity. And sometimes when we're asked to do things that don't align, we're creating moral injury, right? It's like a deep soul wound. And this is how we're healing our soul.

So no matter where you're at, and even if you're overwhelmed, if you can tap into good stress, it is really the new stress management. It's not all about using meditation to curb stress, right? We're adding stress to use our innate capability to become stronger. And that's how we can handle all the stressors that we can't control in our lives.

I love that framing. But before we kind of wrap up here, you have these 25 simple, small, actionable habits that can add up to big differences in your health. There's so many that I love.

and, and one of them speaks to that reframing your mindset, uh, about stress and balancing potential harm with potential growth. Um, another is acknowledge fear, but do it anyway. Can you talk a little bit about that one? You know, so many of us also are kind of shying away from situations that are scary, um, and, and,

many of us deal with things that are truly fearful and fear-inducing, but a lot of us just kind of live in, you know, what I refer to as false evidence appearing real, you know, is the acronym that many of us use for fear. What is it about fear and how do we sort of do it anyway?

I think the first step is to realize that not all stress is harmful, right? We have to get away from this entire framework of fearing stress that, you know, that is something that we have to avoid. And the first step is really just understanding how it can benefit us and how

The reason I put, you know, just do it anyway and embrace the stress because my goal for any person is that when they get the next challenge in their life that is in the path of them receiving a potential reward, to recognize that that discomfort is inseparable from the reward.

And that by pursuing it, you can live your best life, right? Do not hold yourself back. You were built to do hard things. You were built for stress. Your body was designed to thrive on this and to grow and enrich you because of this. And

I want people to be able to pursue their dreams. And the key here is first figure out what's meaningful to you, what matters to you. Because as long as you are on the path of pursuing those types of things, even if they scare you,

Trust that the biochemistry of what's happening inside your body is going to propel you to develop stronger networks in your brain, to even grow different brain cells, to remember how you handle the stress and each time become better and better. And you can live the life that you envision for yourself by doing that.

It's so helpful. I plan to print up these 25 actionable habits because honestly, I want to see how many I can tackle. You know, certain things, using cold water for the last 15 plus seconds of your shower, like that I can do, that feels manageable.

You recommend 20 to 30 grams of protein per meal, especially breakfast, trying to get natural daylight in the morning, consistent bedtime, say yes to something that scares you. These are all so terrific. I wonder if you can speak a little bit about

What variability looks like? Because some people go so extreme with this stuff that their whole life can sort of shut down around it. And I've noticed this with me. Is it okay to go out with friends and be out late one night? Is that going to ruin the whole thing? You know, what does it sort of look like if I have one later meal because all my friends think I'm crazy and they want to eat at eight one night? What does it look like to sort of have an attitude of like,

I can make changes, but it's not all or nothing. Those are the wrong friends who want to eat at eight. Okay, Jonathan.

I think that, you know, if I put this in the context of clinical trials, so when they've done the clinical trials of putting people on time-restricted eating in a circadian pattern, even in rigorously controlled trials, the compliance, the ability of people to stick with it is about 80%. And even with people getting good about 80% of the time, we're still seeing these incredible outcomes in cellular health, insulin sensitivity, et cetera. So if

In that controlled setting, people are human and they can only do it 80% of the time. Cut yourself some slack, right? Just, again, think of this as I'm just trying to add as much good stress as I possibly can to build the bank in my cells where I'm depositing, making investments in my health.

So that when the harms come from our environment, when we're making those withdrawals from our bank account, that we have a bigger bank account, right? So the more you do, the bigger your bank account, right? And the less you do, the more you are at risk of going bankrupt. So think of it as not an all or nothing. My goodness, this is all progress over perfection and success.

I would be an absolute hypocrite if I led you to believe that I or anyone could do everything right all the time. I think it's very helpful. I definitely know that I can be a little bit all or nothing. And, you know... Just a little. Yeah.

It's because it's like a slippery slope. I think that people have different ways that they can approach this. And for some people, the all or nothing route works. And for some people, it doesn't. Well, it's about momentum for me and about choices. If I know like, hey, do the 90%, 95% this way, then sometimes when I really can't get dinner earlier, okay, that's fine. But then

If I start to do it too much, then I'm like, well, where's... You also can't have crackers in the house because you'll eat them all. I love crackers. How do people build the habits? Are there tools to help people change? Because we are creatures of habit. And so many of us are, oh, we go here after work and then we shop a little bit to try to get the things we need for dinner. And then it ends up being 8.30 and we don't even realize it. How do we start to implement it? What are the tricks to building these better habits?

So a lot of the building comes from how you structure your environment because we default to the path of least resistance. And I think that's the first thing to recognize that we self-identify with our conscious brain, but so many of our health decisions are made subconsciously. So when we set up our environment where we default to healthy decisions, we're not

We're not just relying on willpower, which is somewhat overrated because by the end of the day, you will have none. You are creating an environment where the healthy choice is the easiest choice. Okay, right now in our environment in America and globally, the healthy choice is the hard choice. We've created obstacles to the healthy choice. So one thing you could do is instead of beating yourself up over not doing something is create

Make it easy to do the things you want to do. If you want to drink more water, you fill up a cup of water, you put it on your desk, and that way during the day you can just take sips of it. If you want to have healthy food, well, have some cut up and prepared so when you're starving and the first thing you see when you open the refrigerator is the fruit and not

something that is processed. Take a carrot. That's what my mother used to say. If you're hungry, take a carrot. Right, but just take the effort to set up an environment that supports your goals.

And I think that is so key because we beat ourself up thinking that every health decision is a deliberate conscious choice. And it simply isn't. Most of these are done out of habit and out of default mechanisms. They're done subconsciously. So cut yourself some slack and put that energy into structuring a health promoting environment. When I cook...

I try to make triple what I'm going to eat in that one meal because I know if there's leftovers, I'm going to go to those leftovers before I'm going to search for something else that may not be as healthy. Right. And make it easy, right? Like you can meal plan, you can batch cook, you can use frozen fruits and vegetables. Like I don't, like, again, I work full time. I have a family. Like I realize that it is hard to be healthy and

But I do think that small changes that we can do set off this cascade where each makes your body stronger, your mindset is different, your cognitive ability, your emotional resilience, that makes the next step easier. And you're taking steps towards this positive virtuous cycle.

where you're not only making yourself healthier, but everyone around you starts to benefit in both direct and indirect ways. The book is The Stress Paradox, Why You Need Stress to Live Longer, Healthier, and Happier. It's actually out now.

today. So please go check it out. Dr. Sharon Berkowitz, thank you so much for being here. I really feel like this was such a special treat and really appreciate the way you present information. And it's so accessible. It's really accessible and doesn't feel scary. And I think so many people are going to get so much out of this episode. So thank you.

you guys are the best. This is so much fun. And you guys, I've been listening to your podcast. That's so sweet. Oh my goodness. I love the work that you are doing. And I just think that the contribution you make and the way that you change the narrative and how people think, I mean, this

is really what people need. People are frustrated. The healthcare system is failing people. And this is ultimately what motivated me to do more than my clinical work and my research. I'm often struck by the incredible energy that people like Dr. Berkowitz have. How is she doing all those things? She does a lot of things, but I believe her when she says she really tries to practice what she preaches and she doesn't do it perfectly.

I love the VO2 max walking test because I've seen the Instagram clips of people on bikes and running on the treadmill with the mask on. And I'm like, how do you get that? That seems very inaccessible. Well, and also there's something about, I think, the attitude that we come to this with. And I often say no to things that you suggest. A lot. We should do a super cut of all the things you say no to.

But a lot of it is about the perceived expectation, I think, that you have for our health or for our knowledge. I just want to take small incremental steps. No, but you don't take small incremental steps. And what I like about Dr. Berkowitz is she is about taking small incremental steps. Like,

Committing to not eating between 7 p.m. and 7 a.m., that sounds reasonable. But being like, you have to fast. It's a way of life. Do you want to live forever? Don't eat at all. Like, that doesn't do it for me. I think what I said is your gut needs a break.

Stop overworking your digestive system and you'll feel better. You know what needs a break? My brain from you talking about biohacking. We are a work in progress and we hope that you are too. We're going to take small incremental steps every day. The biggest thing for you out of that episode was the eating time periods. What did you hear today that you were like, wow? The explanation of the five stressors really made a lot of sense to me. Eating a bigger variety of challenging foods and

forcing myself to exercise and that even if I'm just taking a moderate walk, that walking backwards up a hill, you know, doing anything... That's something that you've said. Why are you doing that, Jonathan? But doing anything to just increase my heart rate a little bit so that I don't feel like, oh, I'm not getting 30 minutes of intense activity. It's not okay. The notion that I don't need to go in a cold plunge until it's like triggering trauma and I'm crying...

but that small amounts of cold exposure or small amounts of like taking a hot bath or doing a sauna or a jacuzzi or something like that, that that's also helpful. Not thinking of it like fasting, but thinking of it like your body needs a rest from you shoving food in it.

That was helpful. And the notion of a perspective shift and a perspective framework in terms of mental and emotional challenges and making sure that the challenges I'm taking on don't lose sight of the larger good. Like it's stressful raising kids, but like they're your kids and you get to put them into the world so they can make the world a better place. Like that's what I have to kind of keep reminding myself. So those five key stressors, that was really helpful. And in addition, I really like these 25 simple small things. I'm going to print them up and make them

Before you get to the 25, and I think we could talk a little bit about them. The idea of having the knowledge of why someone should fast and the fact that the body is going into this reparative cycle, the way she explained it was really helpful to me because I think it's...

It helps with the hunger cues. Like, because we're used to eating so frequently... Well, so many times we eat just because we're lonely or sad. And we just... We're bored. We go to the cupboard. And so by having that awareness, you're like, oh, I'm not going to reach for that because I'm actually helping my...

That actually switches the perspective and decreases the stress response. I'd like to end this episode by reading the 25 simple, small, actionable habits that add up to a big difference. So we're going to end with this. Here we go. Walk 8,000 steps a day. Get at least 15 minutes of natural daylight in the morning. Eat 20 to 30 grams of protein per meal, especially breakfast. Consume 30 plus plant foods per week.

Move throughout the day. Try and get at least 250 steps per hour. Consume your calories in less than a 12-hour window, ideally eight hours. That's a little hard if you're a parent, I'm gonna go ahead and say. Strength training two times a week. Say yes to something that scares you. Get seven to nine hours of sleep a night with as consistent a bedtime as possible. Spend at least two and a half hours per week in nature. That's actually not a lot. We can do it. You can walk in your neighborhood, that counts.

150 plus minutes of moderate intensity exercise a week. Divide that by seven, you'll see that that's also kind of doable. Have consistent mealtimes. Do short sprints of high intensity activity, like run up a flight of stairs. Use cold water for the last 15 seconds of your shower. Eat your last meals two to three hours before bedtime. So that means like seven, seven.

six or seven. Eat more cruciferous vegetables like broccoli, cabbage, cauliflower that activates the body's antioxidant and detoxification enzymes. Dim your lights 50%, at least an hour before bedtime. Just like you don't need to have an overhead light on for everything you're doing. Avoid blue light emitting electronic devices. This we know. Limit refined grains and added sugars.

Take a hot bath or sauna in the evening, which can improve sleep and get the benefits of heat-activated repair processes.

Black, white, and green tea and coffee have good phytochemicals for cellular regeneration and renewal. Do a HIIT workout at least one time a week. Okay, I'll try that. 30 plus grams of fiber a day. There's easy links that are free online that can help you figure out how much fiber you're getting. Reframe your mindset about stress, balancing potential harm with potential growth. Acknowledge fear, but do it anyway. Express your beliefs even when it pushes you out of your comfort zone.

from our breakdown to the one we hope you never have. We will see you next time.