So when I had Beau L’Amour — son of the great Western novelist Louis L’Amour — on the podcast a couple of years ago to talk about his dad’s life and habits, my ears perked up when he mentioned that his father worked out every single day for an hour or two in the afternoon, right into old age.

The conversation moved on, so I didn’t circle back to ask exactly what L’Amour did for his workouts, but that question has been rattling around in my head ever since.

So I recently decided to email Beau to see if he remembered what his dad’s daily workout looked like.

To my pleasant surprise, Beau wrote back immediately with something even better than I had expected. Instead of sending me a general description of Louis’ workouts, he sent me scans of his dad’s typed weekly to-do lists with completed items struck through in red pencil. On these weekly agendas, Louis included his workouts for the week.

The ones he sent span from 1968 to 1983, and they cover a lot more than exercise. A single week might include blocking out the first chapter of a novel, answering all his mail, reviewing his Chinese and French, reading to his kids by the fire, and teaching them how to fall and box correctly. It was inspiring to see that the young autodidact in Education of a Wandering Man continued his self-education even into his 80s and intentionally scheduled it with the same rigor he scheduled his workouts. But it’s L’Amour’s training I want to dig into here in this article.

Why Louis L’Amour Trained

Beau gave me the backstory of his father’s exercise habit. Louis was born in 1908, trained as a boxer, and worked physical labor jobs throughout the 1920s. He boxed and trained for the sport, focusing primarily on speed and endurance. By the early ’30s, he was trying to make it as a writer while training young boxers, which kept him in shape.

Then came WWII. His job in the Transportation Corps had him leading convoys of double gasoline tankers through burning towns in Europe, but the food was plentiful, and the trips into nearby cities were frequent, and he came out of it carrying extra weight.

Louis continued to exercise after the war, but he got really serious about it in 1966, when he was 58 years old. Like other writers, he spent a lot of the day sitting, and this exacerbated a niggling back pain he’d had since the war. The pain was getting in the way of his work. It got so bad that he went to a doctor for advice.

In a letter written in 1976, L’Amour recalled what he did next:

When my doctor told me I should not lift anything heavy, not even my own child, that was more than ten years ago. It was only then that I started lifting weights. I never had before, beyond what I had done in working around the country…I started lifting weights carefully, with very light weights, as I’d had a bad back since riding in jeeps during WWII. Now I can lift five to six thousand pounds in a couple of hours, and after my work-outs I feel great…since I began lifting weights I’ve had no more back trouble. I’d simply been sitting too much, and my muscles had softened, and there are some bones that need the strong muscles around them. I’ve never had to go back to that doctor because my back trouble ended with proper exercise.

L’Amour’s doctor told him to lift nothing. Louis responded by lifting thousands of pounds a session and curing the very problem the doctor was worried about. I love that. Sounds like a young Teddy Roosevelt, who, when his doctor told him not to overexert himself, decided to do the opposite and “make his body.”

There was another reason Louis started lifting when he was nearing 60. In 1974, he wrote in his journal:

I’ve not yet done a book that really pleases my taste…One reason I exercise, too. I am just learning to write, just gaining command of my medium, and must work for a long, long while.

Louis kept training because he wasn’t done creating his art yet, and he wanted a body that would hold up long enough to continue honing his craft and putting his work into the world. He trained for what Nietzsche called “Great Health.” Inspiring!

The Louis L’Amour Workout

Beau L’Amour training with his dad, Louie, back in the day. From the Louis L’Amour Facebook Page.

Alright, so what did ol’ Louis do for his fitness routine?

Remember, the man on these sheets is in his sixties and seventies, and the routine stays remarkably consistent across fifteen years of lists. It breaks down into three parts: conditioning, the iron, and discipline at the table.

Conditioning (the Boxer’s Base)

• Jump rope
• Stationary bike
• Heavy bag work 
• Walking
• Boxing rounds with his son, Beau
• Abs and sidebends

The Lifts (BB & DB — Barbell and Dumbbell)

L’Amour performed a circuit 6X a week that worked both his upper and lower body and included these exercises:

• Bench press
• Overhead press
• Flies
• Curls
• Rows
• Triceps
• Grip work
• Shrugs
• Lat pulldowns

Discipline at the Table

• Standing goal to stay under 220 lbs — sometimes he’d try to get down to 210
• Snacking was skipped when he was cutting weight; “No between meals,” as one sheet bluntly puts it

There’s nothing fancy here. L’Amour skipped rope, hit the bag, ran through his lifts, and ate sensibly. He aimed to do a variety of exercises, treated his workouts like a standing appointment, and got in one to two hours of physical activity every afternoon. 

I lift for plenty of reasons, but as a guy moving through middle age, L’Amour’s reason for lifting is the one that increasingly resonates. I want to stay strong enough to keep doing the work I haven’t finished yet.

Thanks to Beau for sharing these snapshots of his dad’s life. He’s got a new novel out — Skyring Water — that he collaborated with his father on, both before and after Louis’ passing.

For more inside details on Louis L’Amour’s life and work, listen to our podcast with Beau:

This article was originally published on The Art of Manliness.

Walking is one of the most powerful health tools we have. It improves cardiovascular fitness, boosts mood, sharpens cognition, and can even be a predictor of how well you’ll age. But all those benefits depend on something we rarely think about until it starts hurting: our feet.

For many of us, walking is so automatic that we never consider the mechanics that make it possible. Yet the way we move, the shoes we wear, and the strength of the muscles in our feet can have a profound impact on how comfortably and efficiently we walk. When something goes wrong at our physical foundation, the effects can ripple upward, leading to pain not just in the feet, but in the knees, hips, and back.

My guest today is Dr. Milica McDowell, a physical therapist and the co-author of the new book Walk. Today on the show, Milica explains why walking speed may be a hidden vital sign, what gives you your signature walking style, and how to spot and address injury-inducing inefficiencies in your gait. We then talk about feet: whether you should worry about pronation, how to rehab plantar fasciitis — and no, it’s not stretching — the best kind of shoes to wear, and much more.

Resources Related to the Podcast

• AoM Article: Solvitur Ambulando — It Is Solved By Walking
• AoM podcast episode with Manoush Zomorodi
• AoM Article: I Started Taking a Walk Every Morning. Here’s What Happened to My Health
• AoM Article: 20 Rules for Walking
• AoM podcast episode with Matt Fitzgerald
• Altra shoes
• Vivobarefoot
• Lems shoes (this is the pair Brett wears)
• Tyr weightlifting shoe
• Injinji toe socks
• Toe spacer
• Study on calf raise standards

Connect With Milica McDowell

• Milica’s website
• Milica on IG

Listen to the Podcast! (And don’t forget to leave us a review!)

Listen to the episode on a separate page.

Download this episode.

Subscribe to the podcast in the media player of your choice.

Transcript 

Brett McKay:

Brett McKay here and welcome to another edition of the AoM podcast. Walking is one of the most powerful health tools we have. It improves cardiovascular fitness, boosts mood, sharpens cognition, and can even be a predictor of how well you’ll age. But all those benefits depend on something we rarely think about until it starts hurting our feet. For many of us, walking is so automatic that we never consider the mechanics that make it possible, yet the way we move, the shoes we wear and the strength of the muscles in our feet can have a profound impact on how comfortably and efficiently we walk.

When something goes wrong at our physical foundation, the effects can ripple upward leading to pain, not just in the feet, but in the knees, hips, and back. My guest today is Dr. Milica McDowell, a physical therapist and the co-author of the new book Walk. Today on the show, Milica explains why walking speed may be a hidden vital sign, what gives you your signature walking style and how to spot and address injury-inducing inefficiencies in your gait. We then talk about feet, whether you should worry about pronation, how to rehab plantar fasciitis, and no, it’s not stretching the best kind of shoes to wear and much more. After the show’s over, check out our show notes at AoM.is/walk. All right, Milica McDowell, welcome to the show.

Dr. Milica McDowell:

Hi Brett, thanks for having me.

Brett McKay:

So you are a physical therapist and you’ve recently co-authored a book all about the benefits of walking. Why is a physical therapist so into walking?

Dr. Milica McDowell:

Well, it’s one of the things that we spend a lot of time in our careers helping people restore. When you’ve had an injury, a surgery, an unexpected accident, walking is one of the things that we push immediately. You have a baby, guess what we do? We take you for a walk right afterwards; you have a total knee replacement, some physical therapist is going to come popping into your hospital room and say, “Hey, let’s get you sorted out. Let’s take you for a walk.” So walking is really one of our fundamental movements that demonstrates balance. It demonstrates coordination, it demonstrates can you follow directions. And so it is really one of those things that is a vital sign for your human existence.

Brett McKay:

It’s something we take for granted until we have those moments in our lives where walking becomes painful and then you become painfully aware that, oh man, I got to think more about this. I can’t take this for granted anymore.

Dr. Milica McDowell:

Absolutely. I mean, you can not get up and make yourself a cup of coffee or use the washroom easily if walking is limited. And for me, that was an experience I had in high school. I had a sports injury that was misdiagnosed. I spent almost a year out of sports, six months not walking, and it was absolutely eye-opening as a 16-year-old who was hoping to play sports in college, that having a foot injury and not being able to walk just completely changed my entire paradigm.

Brett McKay:

So we’re going to talk about some of the things that prevent us from walking effectively, injuries, how to prevent those, how to rehab injuries. But before we do, let’s just talk about the benefits of walking. We had Manoush Zomorodi on the podcast a little while ago who talked about the benefits of walking even in short bouts. But let’s do a little refresher. Why is walking so good for both our bodies and our minds?

Dr. Milica McDowell:

If you don’t walk, it’s kind of similar to sleeping like trash or breathing poorly. So if you aren’t getting enough walking in your daily life, you aren’t accumulating that rhythmic movement. Your health from a physical side and a mental side can just absolutely go down the drain. And so we really want to emphasize and remind everybody that this is just at your fingertips. A little bit goes a long way. So when we think about the physiological health benefits, if you even go for a five minute walk, so we call that a micro walk, usually that’s about 500 steps for most individuals. We’re strengthening your bones, we’re contracting your muscles, we’re reducing your blood pressure. We can help with blood sugar. It helps with mood. And so as we think about our ability to take control of our health, walking is just so readily available. It’s at our fingertips at all times.

And then on the mental health side, when we think about the psychological and cognitive benefits of walking, as soon as you go for a walk, it boosts your cerebral blood flow. So you’re getting all sorts of healthy oxygen and hormones and temperature change to your brain that not only helps reduce your cortisol, it boosts your dopamine and serotonin. So it’s like kicking in those happy hormones that we’re all looking for, and it actually promotes something we call neurogenesis, which is activating neurological growth factor in your brain. So walking strengthens and improves the health of your brain. It improves the function as well.

Brett McKay:

Typically, when we think about walking for health, a lot of people focus on the number of steps we should get in a day. And I think people probably heard it by this time, it’s like it’s not 10,000 steps. That was a marketing thing by some pedometer company. A Japanese company said, oh yeah, you should get 10,000 steps. But it’s like if you get 7,000 to 8,000 steps, you’re probably good. But I thought it was interesting, you guys in this book talk about a walking metric that seems to tell us more about our overall health and robustness more than the number of steps we walk in a day and that’s walking speed. Tell us about this research. I thought that was really interesting.

Dr. Milica McDowell:

Yeah, so walking speed was identified more than 10 years ago as the sixth vital sign. And when we think about vital signs, if you go to the doctor today, they’re going to poke you, and they’re going to take your heart rate, they’re going to take your blood pressure, they’re going to look at your respiration rate, we might take your blood oxygen. So we have a series of vital signs that are predictive. They tell us if you’ve got an elevated heart rate and you’ve got elevated blood pressure as a healthcare provider, I need to dig deeper. And it was almost 15 years ago now actually that walking speed was characterized as another vital sign, meaning it has high predictability for problems down the road. The slower you walk, the higher your risk of dying. And it sounds dramatic, but it is one of those things that then when you start to connect the dots and think, okay, do I have a friend or family member or an elder or someone I know who, gosh, they do walk really slowly, why is that?

Are they afraid of falling? Do they have a balance issue? Are they starting to have a neurocognitive issue where it’s hard for them to coordinate the movement? Do they have musculoskeletal problem? Do they have a systemic disease? What the heck is going on? And so when we think of vital signs, this is one that should be held in high regard. And it is definitely something that when you go to a rehab pro, a PT, a chiropractor, some of the general practice physicians are kind of in on this secret. This is definitely something that we want to pay attention to.

Brett McKay:

Do we know what an optimal walking speed is?

Dr. Milica McDowell:

So we like to say that about a hundred steps a minute is pretty typical, and between 120 and 130 is what we consider to be brisk. So if you and I are in an airport and we are not late for a flight, we’re probably going to be walking around a hundred steps a minute. But if we’re like, oh, I think they’re boarding, let’s go, most people can kick it up to that 120 to 130. And a good way to test that is if you have access to a treadmill is hop on and just do a step count. So you’re counting each strike right, left, right, left, right, left. And you want to just sort of see what feels comfortable to you. Most normal sized adults, so if you’re not like six foot 10 or four foot 10, most of us that are kind of in that normal center of the bell curve are going to be walking at about three and a half to just under four miles per hour if we’re walking at that 120 to 130. So if you’ve ever walked on a treadmill at that pace, you’re kind of cooking a little bit.

Brett McKay:

Gotcha. Alright, so walking speed. I love that. So that’s the sixth vital metric that we should focus on. Correct. This was interesting. You had this whole section. I thought this was really a lot of fun about us having a signature walking style or signature walking pattern. I didn’t think about that, but it’s true. I think everyone has their own unique way of walking. I mean, one of the things that I can do with my family, if we’re at the airport for example, or out in a crowd, I can recognize people or recognize the people in my family by the way they walk. So how do we develop this signature walking style that we have?

Dr. Milica McDowell:

Well, it’s a culmination of our good habits and our bad habits. And so I love a good airport. I travel a ton for work, and I am an absolute creeper. I watch people walk, I judge anyone wearing a stiletto. If you’re wearing a stiletto in an airport, I’ve got my eyes on you and I’m just going to say it here and now. I know this audience is mostly guys, but maybe you can influence your gals in your life. Stilettos are the new smoking. They’re terrible for your health. They are absolutely something that you should not buy the women you love. Stilettos, please, and thank you. 

Brett McKay:

Who’s wearing Stilettos at the airport?

Dr. Milica McDowell:

Oh my gosh. The next time you’re there, you just take a look my friend and you will be as appalled as I am. Wow. Because what happens if you need to go 120 to 130 steps a minute because they’re boarding, you’re going to miss your flight girl. But at any rate, I love being in an airport. I love observing other humans as a physical therapist. That’s just a big part of my curiosity as a human. And so yes, people have signature walking patterns and they are a culmination of all the good things and all the bad things and all the old injuries and everything that kind of brings you to waking up this morning, all that accumulation of your life. Think about this. If I’m your boss and you come into my office and I give you a raise and I give you another 20% bonus, how are you going to walk out of my office head held high confident, probably brisk a little bit of a spring in your step.

Not quite Connor McGregor walking into the octagon, but you’re going to have a pep in your step. But if you come into my office and I say, look Brett, this isn’t going well. I’m really disappointed in your performance and you’re missing your KPIs, and I’ve got really significant concerns about your future at this company. When you walk out of my office, things are going to look very different. Your posture will look different, your speed might look different, pace is going to be different. And so walking tells us a lot about what happened to you in the past and it tells us a lot about how you’re doing today. Another part of walking signature is it kind of tells us a little bit about your health history. So if you’ve had a leg fracture, if you’ve sprained your ankles 77 times, if you’ve got a leg that’s shorter or longer than the other, if you’ve got low back pain or a limitation in how your pelvis moves, I mean a physical therapist can certainly tell that’s what we’re trained in. But if you’re a lay person, an average Joe, and you’re in the airport and you see someone walk by and you’re like, huh, that doesn’t quite look right. You’re not necessarily able to diagnose or pinpoint the problem like I could. But what you are seeing is a lack of efficiency. And when you see somebody that maybe swings an arm a little differently or they’re wobbling side to side, or you can hear one foot scuffing differently, oftentimes what that means is there’s something imbalanced and an imbalance typically belies an inefficient gait.

Brett McKay:

I want to talk more about having an efficient versus inefficient gait, but one more thing about walking style. So I was listening to Pandora the other day and the Frankie Vallie and The Four Seasons song came up, “Walk Like a Man” – this is the Art of Manliness podcast. We got to talk about this. Do men and women walk differently?

Dr. Milica McDowell:

Absolutely. Absolutely. Men and women, if I saw a skeleton, I’d be able to tell you if it was a man or a woman. And we have significant anatomical differences. And those differences then influence our movement patterns, our postures. And so absolutely. I think too, especially in the US, men tend to be taller, men tend to be heavier, men tend to have more muscle. And so you’re moving a different machine than a woman is. And so yes, the gait pattern, an efficient gait. So an ideal gait is going to be similar regardless of gender, age, height, weight, you name it. But overarchingly, you could probably de-identify a person for me and most clinicians, and we’d be able to tell you roughly height, weight, and gender just by watching their walking pattern.

Brett McKay:

Yeah. One thing I’ve read is that men tend to move their shoulders more while walking than women do.

Dr. Milica McDowell:

Yeah. So when you think about what’s sort of acceptable posture wise in America, and if you lined up a group of guys and gals, most people are going to lift up their shoulders and kind of get tall and suck in their belly because of some sort of arbitrary beauty standard. And what you’ll tend to notice is women tend to minimize some of that sway. We tend to really suck in that belly to try to look snatched if you will and the guys are like, I’m just trying to get from point A to point B, and I’m trying to do it with some level of style. And so when you see more shoulder movement in a guy or in a gal, what’s happening is they’re creating more rotation. Rotation makes you more efficient. And so a man typically is going to walk a little faster than a gal. A man’s typically going to have a longer stride length and less, he’s significantly shorter than a comparable woman. And so men are generating more force and more momentum partially because of the anatomy, partially because of muscle and partially because of culture as well.

Brett McKay:

Yeah, that’s interesting. Culture, the way we think about sex and gender and a culture can influence even the way we walk, which is interesting. 

Dr. Milica McDowell:

Absolutely. 

Brett McKay:

I want to talk more about this efficient and inefficient walking. So you mentioned there’s some things you can look at when someone’s walking to figure out whether or not they’re walking efficiently or inefficiently. If you’re seeing arm movement kind of off, maybe they’re not moving one arm, that could be a sign. What are some other signs of inefficient walking?

Dr. Milica McDowell:

The best place to assess this is if you have access to a treadmill. And what’s kind of fun about walking on a treadmill is you can not only hear the walking pattern, you can see the walking pattern and inefficiencies come in about a billion different ways. I had a good friend who I was training for a marathon with and he kept complaining of shoulder pain. And this guy was like an All-American track athlete, total stud. He’s jacked, he’s fit, he’s smart. He’s one of those people that’s like an ideal patient. They do anything you ask him to do. I’ve got this shoulder pain, it’s killing me. It’s killing me. So I was like, all right, you’re this stud athlete. Let’s bring you into the office and see what’s going on. So I put this guy on a treadmill and he’s a marathoner. He is an all American, he’s a total stud when it comes to running.

I get him walking on the treadmill and I’m standing behind him. And if you have a physical therapist in your life, we’re always watching you with love, but we are. And so I put this friend of mine on the treadmill and I’m standing behind him and I whip out my camera. I start videotaping him. All he is doing is walking and I take him up to running speed and then I take him off the treadmill and I’m like, well, how do you feel? Well, my shoulder hurts. I go, all right, well look at this video. Oh, you were taping me? I’m like, yeah, of course. I’m a physical therapist. So I show him the video and I say, what do you see? And he’s like, well, I, I’m not swinging my arm. And this guy was a 400 meter runner in track, right? He’s not a long distance guy.

He is a track runner, runs around in circles, indoor track, 200 meter track, outdoor track, 400 meter track. I was like, bro, you are carrying a purse in your left arm, right arm, super duper, huge arm swing, torso rotation, hip rotation. It’s like unlocking his foot. He’s doing amazing on the right side of his body. And it looked like he was carrying a lady’s handbag on the left. And I was like, whatcha doing? And he’s like, I don’t know. Putting people in an environment where they don’t know they’re being observed, where you can control speed and you can get some video is sort of the ideal place to assess. Efficient walking or running a treadmill is a perfect spot. And if you have somebody that can set up a camera, then you can sort of look at your own pattern. You can sort of be your own detective.

I love that kind of stuff. You don’t have to go to a, like a PT, personal trainer, chiropractor, whomever, to do some assessment. And so the first thing you’re looking for is does anything look off? Do you see a wobble? Are you dipping side to side? Do you see your hip dropping, your shoulder dropping? Does it look like you’re limping? Most of us, even if you don’t have formal training, can identify those sorts of things. And then the other thing I love about putting someone on a treadmill is you can hear the pattern, you can hear if they scuff, you can hear if one foot lands harder than the other, an efficient walking gait should sound like this.

And any efficient walking gait will sound like . . . or you hear like a scuff. And so pattern is huge. And these are the types of things that those of you that are listening to the podcast today, go be your own detective. You can play with this stuff. You’re like, man, I’ve got this nagging Achilles thing and I haven’t been to a pro. Help me. Well go get on a treadmill and have somebody hold a phone and see if you can tell, right? A treadmill is a great place to look for inefficiencies. The other place that you can find inefficiency two today, you don’t even have to go anywhere, is go pick up your walking shoes or your running shoes and flip ’em over. Look at the sole of the shoe. Now if you have brand new shoes, this isn’t as effective. So the dirtier, the older the shoes, the better.

The more mileage you have in the shoes, the better. Because what will happen is the shoes are going to tell you a story of what your pattern looks like. Do you have more wear on the heel? Do you have more wear on the toe? Is the wear different on your right versus your left? If you look at your shoe from the top, does it look twisted? These are the things that clinicians will do if you come into our office. But this is the kind of stuff that anybody can do at home to start thinking about, am I efficient when I’m walking? Or if you’re a runner, when you’re running.

Brett McKay:

Some of the things you recommend to develop a more efficient walking pattern, walk faster. We naturally start walking more efficiently when we have to walk a bit faster instead of just puttering around. Walk taller, have good posture when you walk, that improves your walking efficiency swing your arms. You talked about that. And then you talked about you have this great diagram in the book that shows a foot and how a foot should land on the ground for an efficient walk. What does that look like?

Dr. Milica McDowell:

Yes. So traditional gait mechanics start at lateral heel, so pinky toe side of your foot. And then as you move your body forward, you’re going to load through the middle of the foot, you load the outside of the pinky toe, the ball of the foot, and then your final part of contact is pushing off the big toe. So it essentially goes from the back to the front and from the outside to the inside. And that’s an ideal pattern. There’s all sorts of reasons people have inefficiencies or they can’t achieve that pattern or it’s difficult or what have you. But in a perfect world, if we were trying to get you to an ideal efficient gait pattern, it’s outside of the heel and then you push off with the inside of big toe.

Brett McKay:

And let’s say you have a patient, you’re looking at them like, okay, someone’s off here. We need to focus on improving your foot strike. How do you do that? How do you rehab that? Because someone might’ve been walking inefficiently where they’re maybe walking on the inside of their foot first for their entire life. So how do you train somebody to be like, okay, you’re going to walk, start on the outside of your heel and then kind of rotate on your foot to the big toe,

Dr. Milica McDowell:

Right? Yeah. I listened to when you interviewed Matt Fitzgerald, and I thought it was really interesting in his episode with you how he talked about being a pro runner and having coaches who didn’t try to mess with his gait mechanics, right? So it’s a slippery slope for sure, and it is definitely something where I always have said in my career, 20 plus years as a PT, if you don’t have pain, if you aren’t having problems, I’m not messing with your mechanics. It’s clearly working for you. And if you’re somebody who has some sort of an anatomical difference or you’ve had an injury or surgery, I had an injury in high school, I still have screws in my foot from when I was 16, that changes my loading mechanics for sure. But I’ve done 13 Ironman triathlons, a 50 KI ultra run. I have no mechanical issues, but I’ve got hardware in there.

And there’s a lot of people who do, right? So if you don’t have any problems, don’t mess with it. But if you’re somebody who’s like, I have a chronic plantar fascia problem, I’ve got chronic heel pain, I’ve got a chronic Achilles thing, I’ve got this bite in my hip, I’ve got achiness in my low back, that’s definitely sort of your body trying to tell you, hello, is there something going on down below at your foot? Now, couple that if you are a guy who wears dress shoes, if you have to be kind of fancily dressed for work, if you wear shoes that are perhaps not the right size, over 60% of adults in the US are wearing the wrong sized shoe, wrong length. There’s a lot of factors that can contribute to that. But to answer your question, if somebody has interest in assessing their mechanics and identifying if their pattern is optimal, you can play with it with some very basic drills.

You can play with it with drills. If you’ve got access to a gym that has a mirror, walking toward a mirror, barefoot can tell you a lot. Again, video analysis is priceless. And so even just throwing your iPhone on the ground and videotaping yourself, walking toward and walking away, you can start to get that idea of how do you land if you feel like you aren’t landing lateral and then pushing off big toe medial. You can play with just that strike pattern and standing. So if you go up to standing and almost stand like you’re going to go into a lunge and then you load the lateral foot roll through, push off the big toe and just see how your body feels when you do that, that can sometimes be a good indicator if you don’t have the range of motion to do that or you’ve got a mobility restriction, or like I said, you’ve got old screws in your foot or have had old fracture injury, whatever, it might be a good time to ping a pro, get ahold of your local PT chiropractor foot person and be like, Hey, can you take a look at me?

Because you don’t want to mess with gait mechanics unless you have issues. But if you do have issues, it is a low hanging fruit to try to correct. So

Brett McKay:

We talked about things that can cause issues in your walking gait or gait mechanics. Injuries are a big one, just your life history. What about your anatomy? What if your ankles or your feet naturally cave in or turn in? Can that mess things up for you down the line?

Dr. Milica McDowell:

So this is one of those things we definitely myth bust in the book. You alluded to the 10,000 steps a day. That is definitely a myth. You’re correct. It’s a leftover from a Japanese pedometer company’s marketing campaign in the 1960s. Another thing we myth bust in the foot, people are terrified of pronation. Pronation become this bad word in gait mechanics and shoe advertisements and people who have flat feet often are told, oh, you need an orthotic. Oh, you need this. Oh, you need surgery. And interestingly, there’s a lot of science that says a flat or arch is within normal limits. There’s a lot of data that looks at different populations who have flatter feet compared to those who have higher arches and overarchingly. There isn’t a significant difference in pretty large population studies for stress fracture risk or tendonitis risk and those sorts of things.

And so it is a little bit about dated thinking that pronation is bad or flat feet or bad. Pronation is a normal range of motion. And so if you’ve heard that term before and you don’t know what it means, that’s okay. Most of you listening are probably not clinicians. Pronation is a normal movement. When your load goes from the outside of the foot to the big toe side, your middle of your foot needs to pronate. So it’s just like flexion or extension. It’s a biomechanical term for the movement we’re going through. Pronation is getting the big toe down. And so you have to pronate in order to be able to load the big toe and push off, you’re pushing off your big toes, you’re gas pedaling, gait mechanics. So someone who has a flatter anatomy, it used to be this idea that, oh, you’re going to be really sloppy and you’re not going to be able to generate force and you’re going to end up with itis and fractures and all this other stuff.

And the science has really rebutted that in probably the last almost 20 years. So the good news is as all of us want to learn more and be better stewards of our bodies, pronation isn’t a bad thing. And very small percentage of the population, let’s say I think it’s under 5%, it might be maybe like 3%, actually truly have what we call flatfoot deformity, which is medical condition where you’re super, super, super flat and all your bones are sitting on the ground. I actually took care of a patient a couple years ago who had that problem and ended up having a surgery to reconstruct his arch because he did fit into that tiny little part of the population. But for most individuals, a flat, flat or arch or a more pronated foot isn’t problematic if you back it up with good strength around the area. And so a lot of times people have a flatter arch and then their foot is terribly weak and that can start to cause problems. Alright,

Brett McKay:

Maybe we can talk about ways you can strengthen that. Okay, so we can’t use flat feet to get out of the draft anymore. You’re not going to get that rejection.

Dr. Milica McDowell:

That’s right.

Brett McKay:

Okay. And I think you also highlight they did research they’ve looked at, we’re always looking at hunter gatherers to figure out what does a human body look like without all these industrial trappings around us. A lot of those hunter gatherer people, they have pretty flat feet. They walk around barefoot and their feet. You look at their print like there’s no arch hardly. And they’re fine. They climb trees, they walk miles a day and they’re okay.

Dr. Milica McDowell:

Yeah, a foot that is unobstructed by a shoe gets strong. And there’s this fabulous researcher, her name’s Sarah Ridge, and she is a really smart woman and she researches minimal shoes. So shoes that allow you to behave in a more barefoot manner. So not a shoe with a ton of cushion, not a shoe with a carbon fiber plate, not a shoe with a ton of stack, all that sort of stuff. So a shoe that truly is zero drop, so meaning flat from the heel to the toe, minimal cushion with a wide toe box. And her research has demonstrated that the more time you spend barefoot, the more time you spend in minimal shoes, the larger cross-sectional area you get in the internal muscles in your feet. Now the stronger the muscles in your feet, the bigger the muscles in your feet, guess what happens? Those feet get wider and flatter because just like if my bicep gets bigger, the anatomy is going to change.

And so these itty bitty little muscles that are in between the long bones of your feet, when their cross-sectional area gets bigger, it gives you an appearance of a wider flatter foot. Guess what? Those feet are super duper, duper strong. If you’ve ever seen somebody with a deformed foot, horrible bunion toes are smashed together, hammer toes, it’s all like claw, like it looks terrible. That is a weak, weak, weak foot. That person is going to have absolutely no control of the intrinsic muscles. They’re going to have super weak toe flexors. Those are very problematic for walking and fall risk and balance. When you see somebody with a wide, flat, thick foot, that foot is strong and that foot has a lot of capacity because it has been, as you said, a barefoot hunter gatherer, people who live in beach communities, people that are more often not in a very structured shoe, they have stronger feet.

Brett McKay:

So one thing that can prevent people from walking efficiently or walking comfortably, and I know a lot of maybe runners have experienced this, but this can pop up in anybody. It’s plantar fasciitis. What causes plantar fasciitis?

Dr. Milica McDowell:

It is a bugger. I’ve struggled with it myself. So the plantar fascia is a connective tissue that runs from your heel to the ball of your foot essentially. And its job is just helping to transmit force. It’s an inert tissue. It’s not muscle, it’s not a ligament. It’s similar to tendon from a structural standpoint. It’s kind of in that connective tissue category. So it has a poor blood supply, it has a ton of nerve. It’s one of those structures that when it gets pissed, it’s pissed for a while. So your plantar fascia’s job is supporting the muscular structure of your foot. So guess what? If your foot is weak, who ends up doing more of the work plantar fascia? And there’s a lot of ways to make it angry. You can make it angry by ramping up your volume too quickly. You can make it angry by having weak feet.

You can make it angry by wearing the wrong shoes. You can make it angry by having bad gait mechanics. There’s all sorts of ways to make this thing really cranky. And when it gets upset, it takes a lot of work to calm it down because resolution typically involves some pretty heavy lifting. We have to figure out why is this tissue staying inflamed? Because tissues want to be in homeostasis. Your body’s not happy when something is chronically inflamed. And so when somebody has chronic heal pain or chronic plantar fascia problems, it’s often because another link in that biomechanical chain is not doing its job.

Brett McKay:

So that could be caused by shoes that you’re wearing. It’s just you’re not giving your foot the opportunity to strengthen the muscles to support the foot. And so the plantar facia has to take up the slack.

Dr. Milica McDowell:

Yeah. So we talk about, in the book, we have a thing we call the 24 hour shoe clock. And it’s assessing your day or 24 hours by the type of footwear you’re wearing. So let’s say you’re sleeping and you’re barefoot for eight hours, and then you’re at home for a couple hours. And are you someone who wears slippers? Are you someone who wears inside shoes? Are you someone who pads around the house barefoot? Do you wear socks? And then when you go outside the house, what do you put on your feet? Are you somebody that we interviewed a flight attendant for the book and for men and women, they are required to wear specific uniform shoes. In all the major Delta, United American, they all have a uniform shoe requirement. That uniform shoe does not allow optimal biomechanics of the foot. And that’s a problem.

So if I was a flight attendant and I’m spending eight hours a day sleeping, and then I’m spending two or three hours at home barefoot, but then I’m going into a shift of let’s say 10 or 12 hours in a shoe that has an elevated heel, that has a narrow toe box and is stiff, my foot musculature is being compromised while I’m in that shoe, my biomechanics are compromised, my mobility is compromised. And so when you run into individuals who have chronic inflammatory problems, foot, toe, heel, achilles tendon plantar fascia, we use that 24 hour shoe concept to assess, all right, well how much time of the day are you spending in shoes that are maybe not a healthy choice?

Brett McKay:

Yeah, we’ll get more into shoes here in a minute. And changing your shoe type can help not just plantar fasciitis, but other issues as well. But what else can you do to rehab? Plantar fasciitis? I know there’s a lot of devices out there, training protocols that people use that these involve stretching programs that you can do what actually works for rehabbing plantar fasciitis.

Dr. Milica McDowell:

So similar to a couple of the other myths we busted today, stretching is not typically the solution for plantar fascia problems. Generally speaking, we need to get people strong. And there’s two areas of culprit when you have a plantar fascia problem. A lot of people have weak foot and a lot of people have weak calves. And oftentimes, and this is sort of where the science points us for sure, there’s tons of research right now that’s like in the last probably five years, that’s really trying to drive clinicians away from thinking that plantar fascia problems are a mobility problem and trying to help educate us so we can do a better job taking care of you guys saying it’s not a stretching problem, it’s a strengthening problem. And so if you’re somebody who’s struggling with plantar fascia issues, I would say there’s two things I would immediately tell you to do. The first is assess your shoes because you’re probably wearing the wrong length, and B, something with a narrow toe box. And then the second thing I would suggest you do is assess your foot intrinsic strength and assess your ability to do a single leg calf raise.

Brett McKay:

Okay? And then if your calf raise is not good, maybe add some more calf raises in your strength training program.

Dr. Milica McDowell:

So what’s interesting about single leg calf raise is it is normalized for gender and age, and there are very clear thresholds that you should be able to do. This is something that you can try at home to assess if you have a calf imbalance right side to left, or if you are weaker than your age matched peers. So for guys, if you’re between 30 and 40, you should be able to, and this is real science, we can put in the show notes if we need to. You should be able to do 32 single leg calf raises with just fingertips on the wall. So not holding onto a counter full excursion. And full excursion means going through all the full range of motion. And that’s like with a cadence. That’s not like one, take a rest, two, take a rest three, check your email. It’s 1, 2, 3. So if you’re between 30 and 40, 32, if you’re between 40 and 50, 28, if you’re 50 to 60 23, if you’re 60 to 70, 19, 70 to 80 14, this is demonstrating your single leg propulsion endurance. And so if you aren’t even close to that, or if you have one side where you aren’t close to those metrics, what that’s telling us is you are overloading other tissues. And if plantar fascia is the problem, most likely that’s who because your calf isn’t doing its part of the job.

Brett McKay:

And then another thing I thought was interesting that you can do to rehab is maybe one run a week if you’re a runner or you can do this if you just walk too, make sure you’re doing it barefoot on grass.

Dr. Milica McDowell:

Yeah, the data on that is really fun. And if you don’t have access to safe grass, barefoot on a treadmill is fantastic. But yeah, that’s one that I think a lot of people are very surprised by that because generally when people have plantar fascia pain or they have heel pain, they go, oh, I should get into a huge cushion shoe. All that’s going to do is make things worse. So that’s actually counterproductive. If you have arch pain or heel pain, cushion shoe is not the solution. Less shoe is more a solution. And think about it like this, if I’m in less shoe, am I going to land harder or softer? You’re going to land softer because you don’t want to bang your foot into the surface. If I’m in a super cushioned shoe, it actually makes us strike the ground harder because there’s so much cushion.

We’re not getting that sensory input into the hundreds of thousands of receptors in the bottom of your foot. You have to land harder to get that information to your brain. So it’s counterintuitive, but one of the recommendations you’re exactly right, is barefoot on grass or if you don’t have access to safe grass barefoot on treadmill. And then the other strengthening piece that I would highly recommend if you’re somebody that’s struggling with this type of problem is assessing the intrinsic muscle endurance and muscle performance in your foot. And so in order to do that, and we demonstrate this, this is a drill we call the movement snacks in the book. And this is something we teach in the book. In our book, we have a whole assessment chapter so you can kind of see where you’re at. And my co-author, Courtney Conley of Gait Happens. She’s a chiropractor.

I’m a physical therapist. If you come to see either one of us, the first thing we do is assess you. So in our book we’re saying, Hey, assess yourself here. We’re giving you the tools, do this at home. So if you want to assess the internal strength of your foot after you’ve done that calf assessment, you take off your sock, you put your foot on the floor, and the first thing you do is you try to lift up big toe without lifting up everybody else and without clawing the ground of toes, four or 5, 1, 2, 3, 4, 5, you’re just going to try to lift up big toe. Then you put big toe down and relax it, and you try to lift up toes 2, 3, 4, 5. And this is an assessment of your intrinsic foot strength. Another way you can look at this is called lift, spread and reach. And this is actually one of the exercises we recommend.

Where you are sitting in a chair foot is barefoot, heels on the ground, toes are on the ground. You start by lifting up all your toes and big toe as high as you can get ’em, and your arch, so your ball of your foot is off the ground. So your heels is the only thing contacting. Then you spread out all your toes like little frog. So you have space between every single toe, and then you try to reach ’em out like you’re some sort of a gecko. So you lift the foot up, spread out the toes, reach out like a gecko, and that activates all those little bitty foot muscles, the intrinsic muscles in between your long bones, if that is hard for you, if your foot cramps, if you can’t do that, it’s telling you those guys are weak. And guess what? If they’re weak and your calf is weak, who’s doing all the work? Your planner fascia. So the three of those structures are a team, and if one or two of the team members are not holding up their end of the job, not doing their work, that’s when plantar fascia has to do more work and it gets grumpy.

Brett McKay:

And then I think something to point out, if you’re rehabbing plantar fasciitis, this could take a while. It could take once a long time. It does. That’s the same thing with other foot injuries. I’m sure as a physical therapist, one of the hardest things you have to deal with is managing people’s expectations on recovery. It could take a while, but you just got to keep going on with it and keep doing the protocol, stick with it because the rehab will work eventually. And I think you’d say too, get going on that rehab as soon as possible. If something’s hurting, don’t just ignore it.

Dr. Milica McDowell:

That’s correct. I will speak for the entire community of medical professionals everywhere. It is easier for us to solve your problem more recently to when you were injured then three months, six months, a year down the road. So please, please make it easier on us. And if you tweak something and it doesn’t get better in a week and a half, go grab a professional to help you. It will make us getting you better faster. It will reduce how much compensation you start to create in your life to be gimping and limping around something that’s acute. The longer you wait, the more compensation, the more bad habits, the more that inflammation gets to hang around. And the harder it is for our teams to help support you on that journey, getting back to what you love to do. So yes, don’t let it hang out there because some of these types of problems really do require professional to help you.

And I think that goes back to the shoe conversation. If you’re wearing a shoe that isn’t the correct length or has a narrow toe box or is a pronation control shoe, and you actually don’t need that, it’s helpful to get a professional’s eyeball on there. It’s like, I don’t work for a shoe company. I have no skin in the game to tell you what shoe to go wear, right? But I am a professional who can say, gosh, Brett, that shoe seems like it’s not helping you. Here’s some video analysis. That shoe has a wear pattern. I think it’s a problem. Let’s actually measure your damn foot. 60% of adults are wearing the wrong length of shoe. That’s a big deal. And that contributes to these types of problems.

Brett McKay:

Well, let’s talk about shoes because we’ve been talking about it throughout this conversation because shoes can cause a lot of foot problems that can affect your foot health. I feel like 15 years ago, barefoot running was all the rage. They even had these shoes, the Vibram five fingers. It’s like a thin piece of rubber under your foot and a place for each toe that was big. But then I feel like in the past five years or so, all the running shoes are, they look like these space, age, moon shoes with lots of cushioning. But it sounds like you’re saying those types of shoes might not be good for our feet. So what is the ideal shoe for foot health, not just for running, but for everyday wear, for walking?

Dr. Milica McDowell:

Yes. Unpopular opinion. I was in London recently, and there was a Hoka store, right?

Brett McKay:

Yeah. The Hokas

Dr. Milica McDowell:

Next. It was right next to the Breitling store. And I was like, wow, Hokas got quite a budget for where they’re putting these stores with their real estate, my friends. Yeah, it is interesting. And you’re correct, there was the, Chris McDougall wrote the book, Born to Run. He’s a friend of Courtney and mine and his conversation changed how people looked at footwear. There was this tribe that was able to run at high performance and super long distances, barefoot. And then the five finger shoe came out and everyone said, oh my gosh, let’s all get those and go run long distances. And what happened there was an epidemic of bone stress, injury, stress, fracture, plantar fascia pain, whatever, because people hadn’t earned the right to wear a minimal shoe. So here’s how I like to characterize shoes, and a lot of this is the work from Courtney and her research over the years.

So there’s three categories of shoes, traditional shoe, which is what most of you’re probably wearing. That’s where I would put a Hoka, a Brooks, a Nike, and Adidas, a dress shoe, a high heel shoe, you name it, a wingtip, whatever. Then there’s a functional shoe. And a functional shoe is a shoe that has the following criteria, wide toe box, low heel to toe drop. So that’s the difference between how much foam is under your heel versus ball of the foot and lower cushion. And you’re correct, Brett, in that most shoes nowadays look like a moon shoe. There’s cushion everywhere. The heels are stacked up super high. And that is a big shift in the pendulum of shoe technology. So we’ve got our traditional shoes, which are normal shoes, like your New Balance, that would be a traditional shoe. Then you have a functional shoe, and then you have that five fingers category, minimal shoes, and not all the minimal shoes have the articulating toes like a five Fingers does.

A minimal shoe is going to be classified as a shoe that has a wide toe box, zero heel to toe drop. So that means your heel is not stacked up above ball of foot and then minimal to no cushion. So if I was going to tell you a brand that meets the criteria for functional, a brand I use personally is called Altra running. So they have wide toe box, they do have cushion shoes, but there are a lot of shoes in their spectrum that are in that functional category for us, which is less than six millimeters of heel to toe drop and then lower cushion. So when their company was created, and I think they’re about 2009, maybe 2013, somewhere in there is when they were launched, their first feature was Our shoe is shaped like a foot. And if you look down at your foot, the widest part of your foot should be your toes.

But because most of us wear traditional shoes or we’ve had to wear uniform shoe, we’ve gotten trapped in wearing dress shoes or whatever, a lot of times the ball of the foot is the widest part and the toes are pinched together. But like you mentioned earlier, people that spend more time barefoot, our ancestors, the widest part of the foot was the toes. And so what Ultra did is they said, it’s for us. Our shoes are going to be foot shaped. They’re going to respect the anatomy. Courtney says that all the time. I love when she says that, respect the anatomy with your shoe choices. So if you look at Ultra’s website or kind of check out their shoes, they’ve got things from that more minimal shoe, right? So very low cushion, zero heel to toe drop. And then they have more introductory shoes that do have a little bit of stack height and a little more cushion.

And then a shoe company that does good job in the minimal space is vivo barefoot. And if you’ve ever picked up a vivo barefoot, it’s minimal. There is very little cushion. Your heel and toe are on the exact same plane. It has a wide toe box. But here’s the thing, with minimal shoes, you have to earn the right, if you just go buy a vibrant five fingers, you go buy a vivo barefoot, and you’ve been in a traditional shoe and you haven’t gained the mobility or the strength, it’s like going to the gym and trying to throw a 300 pound snatch above your head. It’s like going to the gym and trying to bench press your body weight. If you haven’t done that, it’s like going to the gym and trying to do a hundred pull-ups. If you’re not conditioned to do it, you haven’t earned the right.

And so the challenge with shoes is this, because there are gigantic marketing budgets and everyone’s got fancy features and they’ve got pro athletes wearing X, Y, Z shoe. As a consumer, it’s super hard to understand where you fit along that spectrum. So here’s my takeaway. Most of you are in traditional shoes. I would encourage you to consider a shoe with functional criteria. And if you want to go even further, you could consider a minimal shoe. But you have to think about that comparison of can you go in and bench press your body weight? Can you go in and snatch 300 pounds? You have to earn the right to get into that minimal shoe, or you can cause problems.

Brett McKay:

For my everyday shoe, which I do all my walks in, I wear Lems. 

Dr. Milica McDowell:

Oh yeah, I think that’s a great brand. 

Brett McKay: 

Yeah, zero drop. But I love them. I wear them out. I mean, I go through two pairs a year. I walk in them all the time. I wear them all the time. And I’ve been a big advocate for looking for more opportunities to make sure I get shoes that respect the anatomy of my foot. I’m a powerlifter weightlifter. A lot of the weightlifting shoes, very narrow toe box. It’s almost like ballerina shoes. They just kind of scrunch your toes together. Whenever I squat, you got 400 pounds on your back and you’re trying to squat and you’re like, man, my feet just feel all scrunched up. But thankfully, there’s a weightlifting shoe brand that came out, Tyr, that has a wide toe box. It’s improved my lifting experience, it’s so much better. 

And then Lems does make a wide tow box, zero drop dress shoe. They look kind of goofy though. I’m not ready to go to wearing those when I’m wearing a suit. And you guys talk about this, it’s okay to wear if you’re a guy, wears some Oxford’s for a couple hours, but don’t wear them all the time. And most of the time just stay in that functional shoe. 

Let’s talk about the shoe size. I thought it was interesting you said 60% of adults are wearing the wrong size shoe. What’s going on there? Why are people walking around with the wrong size shoe? I imagine it’s because probably the last time they measured their foot was when they were in high school buying new shoes with their mom at JC Penney.

Dr. Milica McDowell:

It’s so true. I mean, how many of us have our high school body weight on our driver’s license? Let’s be honest. So you’re correct. Most people have the misconception that when you stop growing vertically, and I’m almost six feet tall, right? I’ve been six feet tall since I was in high school, so I’m done. I’ve been a size 10 forever. I’m a size 10 in shoes. And another misconception is I wear a 10 in every single brand. So there’s research that came out in 2018, so we’re pushing 10 years that this study has not been refuted. And it was a big scale study looking at adults, and it was, hey Brett, what size shoe are you? So what size shoe do you wear your daily shoe?

Brett McKay:

Size 10.

Dr. Milica McDowell:

Size 10, okay. How long have you been a 10?

Brett McKay:

I’d say since high school. 

Dr. Milica McDowell:

Okay, since high school. So when we think about that, and I’m not saying you’re wrong, but I would challenge you to measure that foot, my friend – feet change length for a variety of reasons. Muscle gain, muscle loss, weight gain, weight loss, volume, change, hormones, medications. Most of us have a preconceived idea that when we stopped getting taller, our feet stopped growing. And it’s just simply not the case. So one of the ways to solve that is – do you know the name of that device that they have at every shoe store?

Brett McKay:

I know it’s named after some guy who invented it.

Dr. Milica McDowell:

It is. It’s called a Brannick device. And it is a hundred years old this year. It has never been changed. The features are the exact same. It was innovated in the US. It’s from New York, and that device is still kind of a gold standard of foot measurement. Now, you could go to a clinic and get some fancy foot scan or that sort of thing. And there are some companies, vivo barefoot actually is starting to do a custom flip flop where they scan your foot and they only fit you, which is fascinating, right? It accounts for right versus left differences, those sorts of things. But I would encourage everybody listening, if you take nothing else away, please go measure your foot in a proper shoe store. Because if you thought you were a 10 since high school, you may or may not still be. Your feet are not symmetrical, neither is the rest of you. And so you may have a foot that’s creeping toward a 10 and a half, but if you’re always buying a 10, you’re doing that foot. That’s a little larger a disservice. Another thing to think about is shoe brands are all made on different molds. And so a Nike at Adidas, a Hoka, a new balance, whatever, a 10 is not a 10 is not a 10. And so with that, when you’re switching brands, it’s very important to recognize that you aren’t probably the same size in different brands.

Brett McKay:

So we talked about the ideal shoe is a wide toe box, minimal drop heel to toe drop because you want your foot to just your toes, particularly to splay out as much as possible how they naturally want to be. What do you do if your toes are scrunched together, even when your shoes are off, due to years of wearing constraining shoes? Can you get them splaying out again?

Dr. Milica McDowell:

You can. There is hope. If you take your socks off and you look down and you’ve got a crowded elevator in that anatomy. So there’s a lot of ways to improve your toe splay. One is being barefoot at home and just spending more time barefoot if you have the availability to do that. The second is a device that’s going to cost you 15 bucks. You can get ’em on Amazon, you can get ’em at gait happens. You can get ’em from all sorts of different brands. It’s called a toe Spacer. An important note with these, they are based on your shoe size, so make sure that you are ordering the right size. If you order a toe spacer because if you just order a generic one that’s not small, medium, large, it will not fit your foot and it’s silicone that you wear that goes in between your little toes and it starts to work on restoring space.

Now, to my folks who are high fashion shoe aficionados out there that are wearing suits and wingtips and everything else, you’re not going to be able to put these on and wear them for a long period of time. If your toes were meshed together. Since you’ve been an undergrad at Penn State, this is something you may need to wear for five or 10 minutes and then take off. My husband is a retired professional, big mountain skier, and those in the ski industry know you wear ski boots that are really tight, so you have good awareness and you feel really locked in when you’re doing dangerous things. And he’s got some toe issues from it. And so when we give him toe spacers, he can wear ’em for five to seven minutes. He’s got to take ’em off. But over time, there is hope. You can wear these, wear ’em at home, wear ’em. If you have a wide toe box shoe, you can wear them in your shoes. You can restore anatomical position over time. Now, there are some people who have serious deformities and they’ve got bone spurs and all sorts of issues that may not resolve, but for the majority of us who just have some sins of bad shoes in the past, wearing toe spacers is a phenomenal solution.

Brett McKay:

Gotcha. My wife’s a big fan. The socks she wears when she runs these in ninja socks, they’re like toe socks. She likes them. I don’t have the patience to get my toes in each little holes, but I think it can. Also, putting it on is too much, but I think that it does help your toes splay out. It’s just keeping things separated. And then you also talk about toe flossing. I’ve been doing that. It’s basically you stick your fingers between your toes, creating a toe spacer with your fingers and kind of massaging it and working your foot. That’s something else you can do when you’re watching the Great British Baking Show.

Dr. Milica McDowell:

Yeah, it’s a great way to restore mobility. It’s also a great way to work on creating space. If you can get your fingers in between those toes, kind of like you’re holding hands with your foot. I mean, that just is reminding them what their neutral position was. And if we were able to be barefoot more and we were constrained by shoes less over time, those toes are going to want to go back to that natural state. You made such a good example when you talked about squatting heavy and wearing a narrow toe box lifting shoe. You’re not able to recruit muscles who can help you push into the floor to get out of that hole. If you’re in a narrow toe box shoe, when you go to a wider toe box lifting shoe, you get a performance boost. The science is there. It’s just plain true.

And so that’s not a condemnation of shoes that have a narrow toe box, but if you’ve got the ability to consider something with a wider toe box, you’ve got the budget to try a couple different pairs of shoes. It is definitely something where people see a performance boost and they have better balance. You’re more engaged with the floor. My favorite pet peeve, my husband and I owned a gym for a long time, and one of my favorite pet peeves is having people come in for, we had a CrossFit and we had a functional gym come in for CrossFit and a Hoka or a cushioned running shoe, a Brooks, and I’m just like, this is the wrong tool for a job. You’re bringing a gun to a knife fight or whatever. So you want to select the right tool for the job. And if you’re trying to lift heavy in a super cushioned shoe, you might as well be standing on a pillow.

Brett McKay:

Yeah, you’re going to just waste a lot of energy. Yeah. I noticed when I switched to the Tyr lifting shoe with the wider toe box, I was having some knee pain behind my knee, my right knee when I was squatting, when I switched the Tyr that cleared up. Yeah, I mean, it’s amazing. So the thing the toe play does, it’s going to contribute to that more efficient walking gait, which can help clear up foot pain, knee pain, hip pain, all those downstream effects. That all starts with your foot and having that proper toe display. Let’s talk about one last thing. Something else that might keep people from walking or make walking a comfortable are things like bunions, hammer, toes, calluses. What causes those and what can we do to mitigate those types of injuries?

Dr. Milica McDowell:

So one of the things we offer up in the book when we encourage people to do a little self-assessment is to start with visual inspection. Take off your socks, look at your feet, and do you have deformities? Do you have differences right to left? Are you seeing a big bunion on your left and nothing on your right. Callouses also tell a story, right? Callouses tell us where we’re loading The weightbearing tissue of the foot hammer toes are often from wearing shoes that are too short or from having internal foot weakness where your toes start to claw the ground for purchase. So if you do that visual foot inspection and you’re seeing things that don’t look neutral, again, bunion, hammer, toe, calluses, corns, which are the bumps on the top of the foot, what that’s telling us is that your footwear is affecting the shape of your foot.

Babies don’t have bunions. And there is a hot topic of debate about whether bunions are genetic or not. And I’m happy to myth bust that for those listening, there is a very small genetic component and some people are more predisposed, but years of wearing narrow toe boxes, shoes that are too short or too tight, definitely accelerates the process of that big toe drift. And once you start going down that path without counteracting it, by changing your footwear, by wearing toe spacers, by getting your feet strong, it can be a very slippery slope. So if you’re somebody who just took your shoes and socks off and you’re looking down there and you’re like, I definitely have a bunion, or I have one that’s bigger on one side than the other, it just becomes this opportunity for you to say, all right, well, what’s the, why do I wear a dress shoe to work every day?

Do I wear a narrow? Those Adidas trainers that are back and so popular right now are so narrow, and I see them everywhere. I was just in New York City for a week, and it’s like everywhere I go, people are wearing the samba or they’re wearing the tigers, or they’re wearing that Asics that’s so popular right now. And those are not a foot shaped shoe by any means. And if you’re walking super long distances in those, or spending a lot of hours in them without counteracting it in some way, it can take you down a path of those deformities getting worse.

Brett McKay:

So it all goes back to shoes. Get that functional shoe, and if you’re ready for it, a minimal shoe,

Dr. Milica McDowell:

And get strong and get strong. So it’s functional shoe calf and foot strength. And then if you want to keep going, start working your way into minimal. And the trick with minimal is you kind of dip back and forth. So as I said, just was in New York City recently. I took a pair of minimal shoes. I took a pair of functional shoes, and I can walk around the city in minimal shoes. I can’t do it all day. I can’t go take 12,000 steps or something, but I can do four or 5,000 steps in a pair of minimal shoes, which for me, with a history of foot surgery and some running injuries and those sorts of things is really saying a lot. I’m pretty proud of that, that I’ve gotten enough mobility and gotten enough strength that I can tolerate that.

Brett McKay:

Well, Milica, this has been a great conversation. Where can people go to learn more about the book in your work?

Dr. Milica McDowell:

So our book is called I, and it is available everywhere by books, Amazon, Target, Barnes and Noble, Walmart. We are doing some live events around the US and around London in order to meet the people and get to share our message. My website is milicamcdowell.com. You can find me on Instagram at DrMilicaMcDowelldpt. And yeah, I look forward to meeting people in person. It’s one of those things, if you ever see me in an airport watching people walk, come tap me on the shoulder and say hello.

Brett McKay:

Fantastic. Well, Milica McDowell, thanks for your time. It’s been a pleasure.

Dr. Milica McDowell:

Thanks, Brett.

Brett McKay:

My guest here is Dr. Milica McDowell. She’s the co-author of the book Walk: Rediscover the Most Natural Way to Boost Your Health and Longevity One Step at a Time. It’s available on amazon.com and bookstores everywhere. You can find more information about her work at our website, Milicamcdowell.com. Until next time, this is Brett McKay reminding you to not only listen to the podcast, but to put what you’ve heard into action.

This article was originally published on The Art of Manliness.

Strength training is a fundamental part of my life. One of my biggest sources of happiness and satisfaction comes from lifting weights and seeing how I can improve my fitness and shape my body.

Powering those efforts is the real engine behind any exercise program: nutrition. I track my macros each day to ensure that my work in the gym doesn’t go to waste.

A question I get a lot is what exactly I eat to hit those macros.

So today I’ll walk you through my diet: exactly what I eat each day, what its nutritional profile looks like, and what it costs me.

This setup has worked for me. The proof is in the pudding. I’ve stuck with it for years. I’ve lost 30 pounds on the low-calorie version of it and have packed on 10 pounds of muscle doing the bulking version of it.

But it’s probably not for everyone. I measure out my food and eat basically the same plain and basic things every single day. Kate laughs at how much of a robot I am when it comes to food. For me, it’s just fuel. I’m not a gourmand. I like that my diet doesn’t require too much bandwidth or work. I’m busy, and I need a system that’s fairly automatic and requires little thought.  

I know that’s not how everyone is wired. If you need variety at every meal, this wouldn’t work for you. That’s fine. Different guys need different setups, but maybe my menu will give you some ideas that you can use in yours. Or maybe you’re just curious about what I eat. I know I’m always curious about what my fellow humans are consuming each day.

So let’s take a look.

Breakfast

Prep time: 5 minutes

Cost: $3.75–$4.10

Macros:

• Protein: 51 g
• Carbs: 38 g
• Fat: 5–17 g (depending on the cheese)
• Calories: 430–500 calories (ditto)

Breakfast is a couple of egg wraps. I scramble one whole egg with 8 oz of liquid egg whites and a handful of spinach, scoop it into two Xtreme Wellness wraps, add an ounce of shredded cheese (Great Value Fiesta Blend, or Kraft Fat Free if I’m cutting), and eat it with a couple of Cutie oranges on the side.

I’ll usually have a side of kimchi too. I love kimchi, and you gotta take care of that gut.

Also taking care of my gut: the heaping helping of fiber I get with my breakfast. The Xtreme Wellness wraps pack about 11–13 grams of fiber each, and with the oranges and spinach, I get close to 25 g of fiber out of just this one meal. That’s most of my daily fiber requirement before 7 a.m. Doing all I can to poop like a champ.

Mid-Morning Meal

Prep time: 1 minute

Cost: $3.80–$4.40

Macros:

• Protein: 57 g
• Carbs: 66 g  
• Fat: 4 g 
• Calories: 500 

A couple of hours after breakfast, I have 340 g of Fage Total 0% Greek yogurt mixed with 140 g of blueberries and 60 grams of either some Kashi cereal or oatmeal. When I’m bulking, I bump things up to 120 g of oats, which jumps the totals above to about 66 g protein, 100 g carbs, and 750 calories.

When I’m deep in a cut, the cereal or oats are the first thing to go, and I just eat the yogurt and berries.

Lunch

Prep time: 4 minutes (20 minutes to make a batch, divided by 5 meals)

Cost: $1.25–$3.70 (depending on the meat/starch/vegetable)

Macros:

• Protein: 33–50 g
• Carbs: 36–50 g
• Fat: 8–11 g
• Calories: 335–400

I don’t meal prep my food except for my lunches, which I prepare on Sundays. And even this meal prep I keep pretty minimal.

Lunch has two main components: a protein and a starch. And then I do a vegetable on the side.

For the protein, I rotate between chicken breast, pork loin, and 93/7 ground beef. How I cook it depends on how ambitious I am that particular Sunday.

If I’m doing chicken and I’m feeling motivated, I’ll grill a bunch of breasts on my smoker (here’s why you definitely want your own). If I’m feeling lazy (which is most Sundays), I’ll dump the chicken breasts into the crockpot with a jar of marinara or BBQ sauce before church. It’s done by 2 p.m.

If I’m doing pork loin, I season it and put it on the smoker for a few hours. Almost no active work.

If I’m doing ground beef, I season it and brown it in a skillet. Takes about ten minutes.

Whatever protein I cook goes in a Pyrex container in the fridge. During the week, I dole out a 150-gram serving for lunch.

For the starch, I rotate between russet potatoes, sweet potatoes, white rice, and pinto beans. If it’s potatoes, I’ll boil a few until they’re soft, mash them up in another Pyrex, and that’s it. No butter or cream, just mashed potato. I know that sounds joyless, but I’m not trying to win any Michelin stars here. If it’s rice or beans, I cook a big pot of beans or use the canned variety or cook a big pot of rice. I dole out a serving along with my protein. Portion goes up or down depending on if I’m trying to lose, maintain, or gain weight.

I always add a vegetable. It’s usually frozen green beans or a California medley. Frozen vegetables are cheap, easy, and just as nutritious as fresh. And they take just a few minutes to cook in the microwave.

Post-Workout PB Sandwich

Prep time: 1 minute

Cost: 75 cents

Macros:

• Protein: 15 g
• Carbs: 52 g
• Fat: 19 g
• Calories: 410

I do my workout early in the afternoon. After I’m done lifting, I’ll have a PB sandwich. Two slices of Nature’s Own Perfectly Crafted White Bread, two tablespoons of Jif Creamy. That’s it.

When I’m in a hard cut, this is the first meal I drop.

Dinner: Whatever We’re Having as a Family

By the time we get to dinner, I’ve already eaten three to four meals, and I’ve still got plenty of macros left over. Which means I can eat whatever we’re having for dinner as a family. I don’t want to be the weirdo dad eating plain chicken and broccoli while the kids are having the tacos Mom made. That’s not how I want to do family dinner. So I eat the tacos, spaghetti, quesadillas, burgers, or pizza that the family is eating. I just eyeball the portions. After this many years of tracking, I’ve got a pretty good sense of what a serving of pasta or rice looks like without weighing it. I always try to stop eating before I get completely full.

If I know we’re going out to eat that night, I’ll pull up the restaurant menu in the afternoon, log what I plan to order, and then adjust earlier in the day to make the macros work. I talk about how to do this in the tracking macros article, so I won’t get into the weeds here.

What It Costs to Fuel Me

If I’m eating pork or chicken with my meals, the entire day comes in $9.50–$9.75 + dinner.

If beef is on the menu, the daily cost is $12 to $13 (plus dinner) because beef is dang expensive these days.

Monthly, that works out to somewhere between $300 and $390. For three to four meals a day, every day, hitting all my macros and most of my micros, that’s not bad. I’ve bought premade frozen “paleo” meals before, where just one entree was $13.

Final Thoughts

One of the interesting things about the menu I’ve landed on is that I usually no longer have to drink whey protein shakes, which used to be a mainstay in my diet. I get all my protein from food. If I’m deep in a cut, I may bring in a whey shake to get the protein while keeping carbs and fat low, but most of the time I’m hitting my protein goals with whole foods.

The setup also leaves room for treats. I like to have a few small cookies after lunch. If I’m on a bulk, I’ll have some Rice Krispies treats before training or enjoy a peanut butter cup. I’ll have the occasional dessert with the family after dinner, too. Even when I’m cutting, I don’t ever feel like I’m depriving myself.

There you go. What I eat in a day. The thing that’s made this work is that it gives me a structure that I can easily modify as needed. Depending on whether I’m cutting or bulking, I can swap things out and raise or lower portions without thinking too much about it. Also, my meals are stupid easy to prepare. Robotic, sure, but stupid easy. Beep boop, beep boop, Brett out.

This article was originally published on The Art of Manliness.

I haven’t touched a barbell much since January. I’ve been in a leaning out/hypertrophy/mobility-focused season of my training (highly recommend having seasons to your training!). I’ve been working exclusively with dumbbells and my cable machine. I’m chasing the pump. I’m loving it.

My strength coach Matt Reynolds continues to create my programming, and one of the things he’s incorporated into my hypertrophy workouts is myo-reps. I’d never done ‘em before, but after a few months of doing them, I’m loving them. They’re a time-saver but highly effective. I can knock out a complete upper-body workout in about 30 minutes, I get a solid pump, and I’m putting on muscle and starting to look jacked.

If you’re short on time but still want to build muscle, myo-reps might be worth trying. They’ll at least shake up what might feel like a boring, rote workout rut.

Let me walk you through what they are and how to program them.

What Is a Myo-Rep?

Myo-reps were developed in the mid-2000s by Norwegian strength coach Børge Fagerli. They’re a rest-pause technique, which means you’re stringing together what would normally be several separate sets into one extended set with very short rest breaks scattered between that extended set.

Here’s how it works:

Pick a weight at 60–80% of your one-rep max; something you could lift for 10-15 reps. Do an “activation set” of 10-12 reps, stopping one or two reps shy of failure (a Rate of Perceived Exertion of 8 or 9). Then rest for about 10-20 seconds. Fagerli recommends counting out 3-5 deep breaths. I just count “one Mississippi, two Mississippi, three Mississippi” until I get to twelve Mississippi.

Then you do a “mini-set” of 4 to 5 reps with the same weight.

Rest another 10-20 seconds.

Another mini-set.

Rest another 10-20 seconds.

Keep repeating these mini-sets and short breaks until you can’t hit 4 reps in a mini-set. If you’ve got the weight set at the right amount, you’ll usually be able to complete 4-5 of these mini-sets.

So one activation set plus 3-5 mini-sets. You’ve essentially done what would be 4-5 traditional sets compressed into a few minutes.

The Theory Behind Myo-Reps

Muscle growth is driven by two main mechanisms: mechanical tension and metabolic stress.

Mechanical tension is the primary driver. It’s the force your muscle fibers generate when they contract against resistance. When a fiber is loaded hard enough, specialized mechanosensors in the cell trigger the signaling pathway that tells your body to build new muscle.

Tension isn’t about how heavy the weight feels to you. It’s about how hard each individual fiber is working. A moderate weight can produce high tension in a specific fiber if that fiber is doing all the work.

That’s where the “effective reps” model comes in. In a traditional set of 12, the first 6-8 reps don’t contribute as much to growth. You’re mostly warming up the high-threshold fast-twitch fibers (the ones most responsible for hypertrophy) by exhausting the smaller slow-twitch fibers first. The last 4-6 reps, when fatigue forces your body to recruit those big fast-twitch fibers, are where the magic happens.

Myo-reps let you skip the warm-up phase after that first activation set. Once you’ve fatigued the slow-twitch fibers, the fast-twitch fibers have to handle every subsequent rep. They’re working at maximum capacity even though the weight feels relatively light, producing the kind of high-tension contractions that drive growth. Nearly every rep in your mini-sets is an effective rep. That’s the idea, at least.

The short rest periods also create metabolic stress, which can (in theory) sensitize muscles to anabolic signaling. It’s why myo-reps feel so pumpy. You’re creating a hypoxic environment similar to what blood flow restriction training does, but without the bands.

Why Do Myo-Reps?

The biggest reason to do myo-reps is that they save time. You’re knocking out the equivalent of a few traditional sets in a few minutes. It’s been nice getting through my workouts in about half an hour.

But there are other benefits, too. Because you’re working with 60-80% of your one-rep max instead of grinding heavy weight, myo-reps are easier on your joints. The limited rest time forces you to train close to failure. Most guys leave way too much in the tank on accessory work. It’s hard to do that when you’re cranking out mini-sets with 12 seconds of rest. Myo-reps break the monotony of the traditional three sets of ten. And you get a great pump, which is nice.

Basically, myo-reps will get you results that are close to what you get with straight sets with long rests in between, in less time. They’re not completely optimal for strength-building, however, as the short rests make it harder to move more weight and achieve progressive overload. That’s why they work best as a tool for accessory work and as something to use every now and then to mix up your programming, rather than as a wholesale replacement for a traditional set/rest scheme.

Which Exercises to Use Myo-Reps On

Myo-reps aren’t for every lift. Because you’re pushing close to failure with very short rests, you need exercises where fatigue-induced form breakdown won’t get you hurt.

So don’t use myo-reps on heavy barbell squats, presses, deadlifts, or the bench press. The stabilization demands are too high, and getting stuck under a loaded bar during your fourth mini-set is a good way to end up in the ER. Skip Olympic lifts entirely. Cleans and snatches are explosive movements that need to be done fresh. And if you do Bulgarian split squats, pass on myo-reps. Requires too much stability.

For myo-reps, stick with machines, cables, and dumbbell movements.

Great myo-rep exercises include machine chest presses, lat pulldowns, cable rows, dumbbell shoulder presses, leg presses, leg extensions, hack squats, leg curls, dumbbell lateral raises, bicep curls, and tricep pushdowns. Anything where the path of the weight is guided or the movement is simple enough that you can grind through the last reps without your form collapsing. You could also use myo-reps with bodyweight exercises like push-ups and air squats.

How to Program Myo-Reps

If you’re doing a traditional barbell/strength focused program, keep your heavy compound lifts as traditional straight sets. You want fresh energy and full recovery when you’re squatting or benching near your max.

Save myo-reps for the back half of your workout when you’re doing accessory work.

Here’s a simple approach: pick two to three accessory exercises per workout to do as myo-reps.

So on an upper body day where the bench press is your main lift, do dumbbell shoulder presses, lateral raises, and dumbbell curls as myo-reps. On lower body day where the barbell squat is your main lift, do leg extensions and leg curls as myo-reps.

Your activation set should feel like an RPE 8 or 9. That’s about one or two reps shy of failure. Track your reps in the mini-sets. If you’re consistently hitting 4 clusters of 5 reps, bump the weight up next session.

Frequency-wise, you can hit a muscle group with myo-reps 2-3 times a week. Just remember these are an intensity technique. Don’t turn every set of every lift into a myo-rep set. That’s just a recipe for burnout.

Give Myo-Reps a Shot

If you’re like me and trying to build muscle without spending 90 minutes in the gym every day, give myo-reps a shot. They reduce your workout time, can make your workouts feel fresh, and can help you pack on some serious muscle.

This article was originally published on The Art of Manliness.

You hear a lot today about how our ample screentime is affecting our mental health. But how is it affecting our bodies, and how is that impact on our bodies affecting, well, our mental health?

My guest today will unpack the ways that digital technology is sapping our vitality, and offer a simple protocol to get it back. Her name is Manoush Zomorodi, and she’s the host of the TED Radio Hour and the author of Body Electric. In our conversation, Manoush explains why a day spent sitting in front of screens can leave you exhausted, even though you haven’t really done anything, and how small bouts of movement throughout the day can counteract that drain and keep you feeling energized and focused. She shares how much activity you need to offset periods of being sedentary, and how to realistically incorporate these movement breaks into your routine. We also get into the specific effects digital technology is having on our eyes and ears — and what you can do to prevent the damage.

Resources Related to the Podcast

Connect With Manoush Zomorodi

• Manoush’s website
• Manoush on IG

Listen to the Podcast! (And don’t forget to leave us a review!)

Listen to the episode on a separate page

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Transcript

Brett McKay:

Brett McKay here and welcome to another edition of the AoM podcast. You hear a lot today about how ample screen time is affecting our mental health, but how is it affecting our bodies and how’s that impact on our bodies affecting our mental health? My guest today will unpack the ways that our digital technology is sapping our vitality and offers simple protocol to get it back. Her name is Manoush Zomorodi and she’s the host of the TED Radio Hour and the author of Body Electric. Manoush explains why a day spent sitting in front of screens can leave you exhausted even though you haven’t really done anything, and how small bouts of movement throughout the day can counteract that drain, keep you feeling energized and focused. She shares how much activity you need to offset periods of being sedentary and how to realistically incorporate these movement breaks into your routine. We also get into the specific effects digital technologies having on our eyes and ears what you can do to prevent the damage. After the show is over, check at our show notes at aom.is/bodyelectric. All right, Manoush, welcome back to the show.

Manoush Zomorodi:

It is so great to be back. It’s been a while, Brett.

Brett McKay:

It has — 2017 was the last time we talked. It’s been nine years and it was about your book about boredom, Bored and Brilliant, about how boredom can be good for us. You got a new book out called Body Electric: The Hidden Health Cost of the Digital Age and New Science to Reclaim Your Wellbeing. And yeah, you’re exploring the health cost of always being on our screen sitting down looking at iPads. What led you to explore this beat for the past few years?

Manoush Zomorodi:

Yeah, so I’ve been a journalist for 30 years, but my sort of specialty about 15 years ago became tech and business and everyone was talking about upgrading and valuations and all those things, but I was looking around and seeing that my technology, this sounds so quaint now, but my new iPhone was changing the way I did everything. It was changing the way I parented. I could be at the playground and on a call at the same time. Is that good? We don’t have to debate that right now, but for me, it was becoming really a anthropological experiment that was happening on us. And one of the things I noticed was that I started to think differently. So in terms of the first book, I would notice that I was having trouble sort of being more creative than I used to be. And I sort of looked around and thought, what is different now?

And the difference was that whenever I had a crack in my day, a spare moment, waiting in line for coffee, waiting for the subway, I could be productive. I could look at my phone, I could check the headlines, the weather, ping my husband, you name it. And it made me wonder what were the effects of never being bored? And as a Gen Xer, I was told, oh, only boring people get bored. But what if being bored was actually a good thing, this thing that we thought was terrible and to be avoided at all costs. So that led me down this road to understanding the neuroscience of boredom or what really cognitive neuroscientists call mind wandering. So boredom as a gateway to mind wandering, which activates a particular network in the brain that is responsible for our most original thinking, problem solving and something called autobiographical planning.

This is telling ourselves the story of our life, creating a narrative, and that helps us then set goals and work towards those goals. So to me, mind-blown. Okay, so I need to get more boredom in my life. That was like 10 years ago. Apparently boredom is back though from what I hear, Brett, it’s very big on socials. I guess the people who were 10 years old when that book came out are just facing that issue now. Then after thinking about that, I think we’ve seen in the last decade since that book came out, a greater understanding of the connection between how our brain works and our body functions. And so for me with this new book, I couldn’t understand why I was so damn tired At the end of a day sitting on my laptop, I was like, I haven’t done anything. Why am I physically exhausted? And that was the question I basically was trying to solve that ended up in this book.

Brett McKay:

Was there a particular moment where you can think about where it’s like, boy, sitting at this computer all day, this probably isn’t good. Not only for my brain, but just for my overall physiology and health?

Manoush Zomorodi:

Yeah, well, I felt it, and I think for a lot of us things came into very stark vision during the pandemic. It was literally that moment where I was on my laptop for work, on my phone, checking in on my family, ordering groceries online. Netflix was the only way to entertain ourselves, and I was bone numbingly tired. I was safe, I was healthy. I had no reason not to feel like I couldn’t spring out of my chair. And so to me that felt like a paradox. I just couldn’t understand how you could get more tired from doing nothing. And the last time I took biology was in high school. So my favorite thing is to track down the absolute experts in whatever field I’m curious about and have them explain it to me and then sort of bring that back to us normies and try to make some changes based on what the science, A lot of science is locked up in journals and my idea is like, well, let’s get it out there and let’s apply it and try to change the way we live based on what we know works.

Brett McKay:

So let’s do a sort of a big picture overview of the state of Americans sitting at their screens and just staring at ’em all day. How much are Americans doing that?

Manoush Zomorodi:

Yeah, it’s not good, Brett. It’s not good. By some estimates, the average American sits 187 days out of the year, so more than half the year, nine to 10 hours a day. We know also that the average American is interacting with media about 12 and a half hours a day. So I mean that includes double screening. So I don’t know about you, but my life revolves around chairs and sitting in the morning, I check my phone and where do I go? I go to the office to sit at my desk to look at two different screens. Then I come home, I check my phone again to make sure I know where my daughter is. I listen while I take the dog out for a walk. I meet my husband. We’re rewatching Mad Men on the couch. Essentially, we have built our lives around sitting and screens, and it’s really not that different for older or younger people either.

Like kids are on laptops in the classroom, they come home to do their homework on their laptops, they’re texting with friends, they’re watching YouTube, older adults, how do they stay connected a lot? There’s amazing online courses they can take, the WhatsApp family chat groups. And I say that not as judgment, but just as a fact that this is our connected society, but it just annoyed me that at the same time that screens have become so ubiquitous, it’s now estimated the average 19-year-old moves as much as the average 60-year-old and type two diabetes in young people have doubled. And it is estimated that by the end of this decade, 500 million more people will have at least one more chronic illness and many of those are preventable. So I think we talk so much about the mental health effects of being online, but we have been missing a key part of the equation, which is the physical health effects, the effects on our bodies.

Brett McKay:

So being sedentary increases your risk of diabetes. What else is it doing to us?

Manoush Zomorodi:

Yeah, so I mean obesity, that’s sort of a catchall term from essentially metabolic dysfunction for some people. Other people, it’s just lifestyle. As you mentioned, diabetes, I think what we’re leaving out though when we talk about the illnesses is the sort of mental health effects that come from these physical chronic illnesses. So we’re seeing rising levels of anxiety, inability to concentrate, depression, et cetera. And I think we think, oh, that’s because terrible things are happening in social media, but actually a lot of that is related to sitting and looking at screens as well. So when I went to talk to scientists to try to understand that was the question for me. I was like, what is happening in my body when I am sitting and staring at a screen for hours on end? And what I was told was really three things. 

So the first one is that when you sit, you are bent at your waistline and at your knees. And so think of a garden hose when you kink a garden hose and it gets, the water gets backed up in it. The same thing is essentially happening at your legs and at your torso. And what is happening then is that there is less circulation and your leg muscles, I had no idea, are doing incredibly important work and they need blood flow and oxygenation to do this. They are flushing out glucose constantly. They are pushing oxygen up your body, up to your brain, but they need to be stimulated in order to do that. If you don’t do that, that is when you start to see blood pressure rising, blood sugar rising and do it long enough, those chronic health issues start to creep in. Then the other thing I learned was when we sit, we don’t breathe properly.

Our diaphragm is contracted essentially, and full breaths. Again, this is oxygenation. When you don’t get enough oxygen into your brain, this is called neurovascular coupling. Usually the neurons up there can flush out the CO2 if you keep the circulation going. But if you don’t, what does CO2 do? It makes you feel sleepy, foggy, tired, that sense you can’t concentrate. It’s a metabolic thing that is happening. It is within your body. And then the third thing is kind of new and interesting. I started to learn about a relatively new field of study called a Sense called interoception. So I had never heard of this. I’ve heard of introspection or perception, but interoception is the study of the signals that our body is sending us internally. So some of those are subconscious. Our body tells us to breathe. We’re not usually aware of that or heart rate speeds up if we’re anxious about something.

But then there are other times where we are more aware of it or we should be more aware of it. Like, oh, my stomach’s growling, I should go eat. But what I had noticed and what newer studies are starting to also show is that when we are locked in on screens, we ignore what our body is telling us. It might be telling us we need a break or we need to just get some air, some fresh air, or we need to move our body, or we’re getting anxious or we can’t focus. And I think certainly I saw this in myself and I hear from a lot of other people, I just got to power through. I just got to keep going. I got some stuff on my list. I’m just just going to put in one more hour. I can get this done and like, Ooh, what’s that other thing? And then suddenly you have 87 tabs open and you’re kind of spinning your wheels and you’re sort of getting things off your checklist and you feel like you’re working really hard, but the next day you come back and you’re like, wow, that was total crap that I actually produced yesterday. So to me, I was like, oh, okay. So they’re really good biological reasons why I’m tired and cranky and anxious and can’t concentrate.

Brett McKay:

And speaking to that, sort of not being able to pay attention or read your body signals. That’s another thing I’ve noticed when I sit down a lot is that I don’t really pay attention to whether I’m hungry or not. And so it’s like I’m not really hungry, but I’m like, well, I’m kind of bored and I need something to kind of power through this, so I’ll just eat some Reese’s peanut butter cups,

Manoush Zomorodi:

I will eat and have absolutely no recollection of having eaten an entire bag of, well, in my case, it’s popcorn, but it’s amazing. And of course, that’s what our technology is designed to do, to keep us focused, to keep us swiping, to keep us clicking through, to keep us there. That’s the whole point of it. And these sort of more subtle, I would say, ancient signals that we’re getting from inside, they get drowned out pretty easily.

Brett McKay:

What’s interesting about your book is that you highlight that people have been noticing the ill consequences of being sedentary thanks to our new form of labor all the way back in the 19th century. In the 21st century, it’s a lot more cute. It’s all digital. We’re at a desk. But people in the 19th century, they’re shifting away from agrarian to more knowledge work that we think of today, or even just working in a factory where they might be sitting down but moving their hands. What were these people, these writers and thinkers noticing about how that change in work was affecting our bodies, but also maybe their souls even?

Manoush Zomorodi:

I love that you picked up on this, and that is where the title actually comes from. Body Electric is based on the poem by Walt Whitman, and back in the 1800s, there was this move from you could used to be able to, or you used to have to use a thresher to thresh the wheat. And then the industrial revolution begins, we start to have engines and combines and people can sit and do this labor and there’s increased production. And in order to manage this increased production to account for it, to ship it to the right places to create essentially supply chains, we needed clerks. We needed people who managed systems, who managed other people. And as we all know, that requires sitting at a desk, not at a laptop back then, but certainly at ledgers, there was a spate of poetry and people noticing that the clerk’s vitality, I guess is the best way to put it, was diminished.

That they were of slighter stature, that they were pale, that they were as one newspaper, put it tired, not tired because of their work, but tired with their work. And Whitman is saying his poem, the body electric is actually an ode to the human physique at its ultimate when it is relishing the world, when it is using its muscles, when it is breathing the air, when it is in the sunshine and outdoors. And that sort of joie de vivre unfortunately, was not really to be found for people who were stuck at desks indoors even nearly, well, 150 to 175 years ago.

Brett McKay:

There’s a line from Whitman. He wrote an article in life illustrating 1856, talking about clerks at their desk. He said this, I thought it was really good, described them. He said, A slender and round shoulder, generation of minute leg, chalky face and hollow chest. Great description. 

Manoush Zomorodi:

So sad, right?

Brett McKay:

Yeah. And what’s interesting too is a lot of these writers and thinkers around the same time, like late 19th century, early 20th century, not only were they noticing it affecting people’s bodies, but it gave rise to this idea of sinia, which was basically like you were just overly anxious, you were depressed, and they developed all these health cures for neuro sinnia, and the health cure was like, well, you got to get out to go to some sanitarium and get fresh air and take cold baths. It’s basically the same stuff we’re doing in 2026. 

Manoush Zomorodi:

So true. They were doing cold plunges back then. Well, it’s like you just want to feel something, right? You just want to feel alive, like touch grass. I guess what’s old is new again. 

Brett McKay:

So sitting down looking at a screen, not great for us, you feel crappy, you feel tired, diabetes, you feel creaky and cranky. But then you came across this study by this guy named Keith Diaz that offered a really simple solution to this problem. 

Manoush Zomorodi:

Almost too simple. So I was walking my dog listening to the news, and I heard about this study that had come out. This was January, 2023, and it was a physiologist at Columbia University Medical School. And Keith’s sort of mission in life is to try to understand what is the minimum amount of movement that the human body needs in order for a sedentary, and I would add screen filled life not to kill them prematurely. And what Keith had found in his lab was that five minutes of gentle movement, so about two miles per hour, not fast on a treadmill for every half hour during extended periods of sitting offset the harms of high glucose blood pressure. It made people feel less fatigued. They were able to concentrate and it improved their mood. And when I heard that, I was like, wait a minute, it can’t be that easy.

That’s it. Just move gently for five minutes every half hour. And then I was like, oh, wait a minute. That’s kind of often actually, would people actually do that? Would they be able to interrupt all their sedentary screen filled lives to add this sort of five minute break within their day? And so I reached out to Keith and I was like, what do you think people could do this? He’s like, I don’t think people can do this. And it makes me depressed because it doesn’t matter if I can show something in the lab if this doesn’t actually translate to real life, it makes no difference.

Brett McKay:

So you and Keith decided to do a big study to see if people would do it, which we’ll talk about. But you actually first tested this on yourself to see does five minutes of walking every 30 minutes, does that actually change your physiology? And so you went over to Keith’s lab and hooked yourself up to some monitors to see what would happen?

Manoush Zomorodi:

I did. So he invited me. He’s like, well, why don’t you try it for yourself and see if you disagree with me that people can do this? So I was like, great, I will be your lab rat. So for a week before I went to the lab, I wore a heart rate monitor, a very sort of fancy accelerometer, pedometer, glucose monitor, the whole jammy. And then I went up to his lab and I spent two days there. So the first day they had me in a room. They were work on your laptop like a normal day all day, just work on your laptop. I had bathroom breaks, I had time to eat my lunch. But basically I just powered through for eight hours and all the while they were collecting my blood sugar data, my blood pressure heart rate, and I was filling out regular surveys regarding my mood and ability to focus.

And then the second day when I was there, every half hour, Keith’s lovely assistant guided me over to a treadmill in the corner and she’d type in 2.0 miles per hour, and I would take a sort of gentle stroll for five minutes. And again, they measured all of those things. And when they compared the two days, it was kind of crazy actually. My blood sugar was cut nearly in half. My blood pressure dropped by five points. My concentration was so much better, and I mean my energy levels and mood were just far superior. I mean, that was so obvious to me. I could feel it the day I didn’t move. I slithered back onto the subway to go home. I was exhausted the day I took the breaks. I was like, great. This was super fine. Okay, bye. I just skipped my way out. And when I saw those results, I was like, well, this is too powerful not to try to get regular people to do this, especially since it is something you don’t need money to move for five minutes every half hour, and maybe there could be effects even if it was not quite that often.

So yeah, so Keith and I, we took our teams at NPR and at Columbia, and we launched a global clinical trial. This was exciting for me as a journalist to do a proper medical study. And we had 20,000 people sign up, which was really cool.

Brett McKay:

And what were the results of that? Did people see benefits and were they able to integrate these short walks into their daily routine?

Manoush Zomorodi:

So what we did was we had them choose a cohort so you could decide to move for five minutes every half hour, five minutes, every hour or five minutes every two hours because not only did we want to measure the effects, but we really wanted to understand the feasibility of it, who managed to stick with it the most. And I was really surprised. I mean, keep in mind of course, Brett, that this is a self-identifying audience like their public radio. Yes, for sure. They’re like, I have this problem. I want to do something about it. So we have to have that caveat. However, of the people who signed up and started the two week period of integrating these breaks into their lives, 80% stuck with it, which I was quite surprised about. They saw on average a 25% decrease in fatigue levels. Anecdotally, they told us about aches and pains going away, being able to concentrate again.

There were reports of better mood essentially, not only just being able to focus, and surprisingly 82% said that they found it doable and they liked taking the breaks. So to me, I was like the data was clear, and I should say there was a dose response relationship. So the people who took the breaks every half hour saw greater decreases in fatigue, greater increases in concentration and mood, but the difference was pretty slight. So for the book, I just thought we know broadly what the data say, but what I wanted to understand was how did people do it In a world that is in schedules and universities and offices and lives built around screens and chairs, what did they do in order to succeed? That’s where I was like, how did they hack their lives to be able to do this without being annoyed by it and without upending all the things that they needed to do?

How did they deal with the interruptions? Because I should also add, Brett, this did not impact productivity. To me. That was the most surprising. I expected people to be like, well, I didn’t get as much done, but I felt better. That was not the case. In fact, we saw a slight improvement in productivity, which is actually what I had observed when I went and did it in the lab. So I just found that every time I took a break, I did not look at a screen while I took my breaks on the treadmill, but I noticed that I would, at first I was annoyed. I was in the middle of something, but then I would sort of strategize. I’d be like, okay, when I get back to my desk, I really need to answer that one email and I need to say these three things and I would just get back and be super efficient and focused and get it done instead of faffing around and not reading all the way to the end of emails and clicking over to check one thing. I just did the work. 

Brett McKay:

When you’re on those walks, you’re thinking about your work a little bit in your head, like, okay, what do I got to do when I get back? And when you got back, you’re like, okay, I know what I got to do because I’ve already thought about it. And so you just were able to do it.

Manoush Zomorodi:

Exactly. Exactly. And I think that’s what a lot of people saw is that the quality, maybe the quantity was less, but actually if the quality is better than you’re not spinning your wheels. 

Brett McKay:

So how did people integrate this in their lives? What were some strategies and tactics that they used?

Manoush Zomorodi:

Super interesting. So what I ended up doing was going through and creating sort of three buckets. One was younger people, students and educators, and we could not let people under 18 into the study, but there were a bunch of teachers who tried to do it with their classrooms. Then I had the middle group, which was information workers, knowledge workers, people who generally make a living off of sitting and looking at a screen. And then the third group, which was older adults who maybe were retired and thinking more about the longevity and health effects for students. Some of it was, I can put it to you two ways. One was there were teachers who really felt very frustrated because there is no mandate for recess in schools. And so it is really left up to teachers to figure out how to get movement integrated into their classrooms.

And it’s not a nice to have Brett. There is a ton of research that shows that movement helps students learn better. There is a direct correlation between those things. And the teachers see it too. It’s not just the kids are wiggly, their bodies are growing and need the circulation and they need the oxygenation. So some teachers, they turned it into a science project in their class. They were like, look at this weird NPR project. This was a high school teacher. And she said, we’re going to do this to understand data collection. We’re going to do this to experience it ourselves and track ourselves, and then we’re going to talk about the placebo effect and see if that has anything. So they turned it into a science project, which I thought was such a creative way of doing it, but I also heard a lot from professors who maybe would’ve powered through a three hour workshop who then integrated breaks into their workshop and found they had a better time teaching their students were more attentive and on the whole people actually retained the information better.

So there’s a lot more into that. And my whole thing is that I think we need to teach interoception at a much younger age, teach really little ones to start to listen to what their bodies are telling them because they are surrounded by screens all the time. So that’s part of that chapter Information workers. I really went deep in trying to understand scheduling, right? Because that’s the thing. And what you saw of course, was that the people who are in power, those are team leaders or executives, they set the tone. They can say, instead of half hour meetings, we’re going to schedule 25 minute meetings. So you get that five minute break or 55 minute meetings instead of an hour. They can say, it’s okay to not have your zoom camera on and move. If you need to move during a meeting, go for it.

Some people who maybe were not in charge could just say like, oh, I need to turn off my screen. I have terrible wifi. And then they would do their movement break, which really cracked me up. And then they would start to create rules like another boss said, when we’re having an internal meeting, anyone is welcome to move during a meeting as they need to, but if we’re with clients, let’s make sure we don’t do that. It’s not socially acceptable. I think once a team decides that it’s okay for heads to be bopping up and down on a zoom, then it’s not a big deal, but it really needs that cultural sort of shift that we are able to do better work and we have higher job satisfaction and also potentially less sick days. So the winds are big. And then older adults had a completely different issue because what I heard from a lot of retired people was actually they were more active during the day.

They were volunteering or helping out with grandchildren or whatever. But come say four or five o’clock, there was sitting for the next 6, 7, 8 hours watching tv, Netflix, scrolling on their phones, and those were the hours that they needed to insert interruptions into, and they made a big difference. I mean, one of Keith’s other studies I should add for people who replaced half an hour of sitting with movement decreased their risk of an early death by 18%. So we’re not talking about huge changes here. We’re talking about just getting more movements into your life. And if you need to start by looking at your phone while you’re doing that, whatever, who cares? Baby steps. We just want you to live longer and healthier

Brett McKay:

After I read the book. So I am pretty active. I take a morning walk every morning mile, and then I take another walk. But after I read your book, I was like, I need to start taking these five minute breaks. So I just set a timer. Every 25 minutes I get up. It doesn’t matter if I’m in the middle of something, I’ll go take a walk for five minutes. Or if I can’t take a walk, I have a problem going outside and taking a walk when it’s really cold outside, I’m kind of a wuss. So I’ll just do jumping jacks. I’ll just kind of look like a weirdo moving my arms up and down, doing 1980s aerobics. 

Manoush Zomorodi:

Totally. And I think what you’re doing is exactly right. Is it time to move? Yes. But if you are like I’m in the middle of something and I am in flow, well then, okay, fine. Don’t take a movement break. It’s no big deal. What I sort of am sick of a little bit is this idea that we are so all or nothing, we’re either on the traveling soccer team for our kids or they don’t play soccer at all. Well, what about just going out in the backyard and kicking the ball around more often? We don’t need to be training for a marathon or just sitting on our butts. It’s like, what if we just got up and I like to do this works for me. I get up and I just walk around. There’s a big conference table, and I walk around that for a couple minutes and then I get a glass of water and I go back to my desk and it helps a lot.

Brett McKay:

You’re kind of like a prisoner that gets your yard time walk around the yard.

Manoush Zomorodi:

I try not to think of myself as a prisoner, but yeah.

Brett McKay:

That’s what I was thinking the other day when I was taking a walk just around in my driveway because I needed to. Why not? It worked.

Manoush Zomorodi:

Yeah.

Brett McKay:

But what’s interesting too, you highlight a lot of people may be listening to this, okay, yeah, you can get these health benefits by taking these five minute breaks. But it’s like, well, I exercise every day. I had this hard workout for an hour. I do CrossFit. I do a run. But you highlight research that that’s probably not enough if you’re sitting down the rest of the day. 

Manoush Zomorodi:

No, in fact, it’s definitely not enough. And it’s so unfair. It sounds so unfair. So Keith told me about his own journey when there started to be research into this idea that even if you do a morning workout or you go for an evening run, if the majority of your day is then spent sitting and looking at a screen, it doesn’t matter, don’t give up your workout. Obviously you’re building muscle, cardiovascular strength, all the rest of it, but it is not enough to offset the harms of sitting for long stretches for the rest of your day or evening. And he just said to me, he’s like, this was shocking to him. He’s like, we had been taught when we were getting our PhDs that exercise is the ultimate medicine, that it is the cure for everything. So to then read that, you could check it off your list first thing, but it doesn’t make a difference the rest of the day. That just sort of shocked him. I mean, I guess the good news is if you haven’t been moving at all, you are going to see benefits just by starting to take five minute walks or as you have said, if you can’t walk, there’s options with your arms. The point is to get the blood flowing and raise your heart rate just a little bit, but you don’t have to go crazy.

Brett McKay:

And then the other thing too, you highlight that this is interesting. A few years ago, standing desk became all the rage people heard sitting as the new smoking. Okay, well I got to stand up while I’m working, standing all day at work. Can that offset the downsides of being sedentary?

Manoush Zomorodi:

No. And this was such a drag too. I had people say that to me. They’re like, oh, I’m so glad I have a standing desk. And I was like, oh, I’m so sorry to tell you this. There have been massive studies looking at all the different clinical trials about standing desks, and unfortunately the consensus is that standing at the very best doesn’t really cause much harm. It gets you up, maybe it relieves some back pain, but at the very worst can actually cause circulation problems or increase your risk for stroke and varicose veins and things like that. It’s the movement that stimulates the muscles. And when the muscles are stimulated, they suck in the glucose, they push the oxygen up. Just standing unfortunately is not the answer. It’s so sad again. Yeah, but

Brett McKay:

The answer, it’s easy. It’s just five minutes of gentle movement every 25 minutes. If you can’t do that at least an hour. Just move more. Just move. 

Manoush Zomorodi:

More. Yeah, exactly. What we ended up finding was that most people, if you hate the timers, there’s another thing. Some people would just set a goal, I’m going to take four or five minute breaks today, and then just when it pops up and it feels doable, you know what I mean? And I think what I also found so interesting, and there’s starting to be more research into this, this is not in the book because the research is very preliminary, but this idea that the number one thing people did was set timers in order to get themselves moving. And that makes sense. You can’t remember to get up. You’re in the middle of something. But what ended up happening, and I’ve seen this in myself and it sounds like you probably do too, is that your body begins to send you pings and messages that even if you don’t set the timer, it’ll start to say like, yo, I’m feeling a little rough around here.

Can we please get up? Can we please get up? And many people told me that by the end of the two week study, they didn’t need to use their timers anymore. And I was just talking to some researchers at the NIH who are looking into this idea of introception and motivation and how the body begins. They think it has something to do with sort of circadian rhythms, but not what has to do with night or morning or anything like that, but that the body gets itself on a sort of rhythm and it begins to anticipate and alert the brain that it wants something or needs something, which I think is really interesting.

Brett McKay:

And as you increase your movement, you increase your interoception. So you were able to notice those urges to move more.

Manoush Zomorodi:

Totally. And like Keith said to me, he’s like, I feel like we don’t want people walking around in circles like robots. That’s not the goal. But I think for younger people, if you tell them, this will help with your anxiety, your ability to focus, we hear a lot about people having more depressive symptoms. This will help you feel more positive. And then for people of a certain age, I’ll include myself. I’ve started thinking about chronic illness. I don’t want a chronic illness, and if this is something I can do that makes me feel better and protects my health for longer so I can live not just longer, but live well, then why the hell not?

Brett McKay:

Yeah. One bit of advice I’d give to people who want to start this, and you talk about this in the book, is don’t use your smartphone or smartwatches nudges that they have. I think that the Apple watch has this where if you haven’t been moving for a while, it’s like get up and move. Actually, I talked to someone, it was a psychologist who brought up research that those nudges, those automatic nudges, they actually backfire because you start to resent them. It’s like, I don’t want to do that. And I noticed that with the apple. I set that up in the apple, apple watch when I first got, I was like, oh, I can have it remind me to move when I haven’t been moving. And I would just be like, dismiss, dismiss, dismiss. Shut up for the rest of the day. So if you want to set up a nudge, you have to make it yourself. Set up a timer. So don’t rely on the AI to tell you to move.

Manoush Zomorodi:

And the way I like to think of it is that setting it with intention is you’re making a contract with yourself, right? You’re saying, in one hour I will take a five minute walk, and instead of being stupid machine, you’re like, oh yeah, okay, I made a plan. I better get up and go. That’s not to say it’ll be easy. There are some days where I’m like, I don’t want to. I’m comfortable in my chair, but I feel better. Every single time. 

Brett McKay:

So something else you do besides exploring these overall systemic health benefits of moving gently several times throughout the day. You also talk about what staring at our screens all day is doing to our eyes and to our ears. So how are screens messing up our vision?

Manoush Zomorodi:

Well, I did not know that they are changing the shape of our eyeballs. So our eyes are extremely malleable and cooperative. If you tell them that you want to look at something that is close to you a lot, they will conform, they will change shape and become sort of egg like shapes and you will go nearsighted. And what they’ve seen is that in the past few decades, this is happening to younger and younger kids and more and more kids. I think there’s some statistic that it’s like one out of three kids is now nearsighted. And I spoke to Maria Liu at Berkeley who has been studying exactly, because for the longest time people thought, oh, if you’re nearsighted, it’s genetics like tough luck. And she was convinced that it was actually lifestyle and behavior that were these soaring rates that she saw in her native China that were starting to come to the US. This was 20 years ago.

And so she went into the lab and she actually fitted chicks with contact lenses that made them nearsighted and then tracked how their eyeballs changed shape. And we see the same things in humans that the more you stare at a screen, the better your eyes will get at doing that. It’s basically saying to your eyes, I don’t need you to look into the distance. And so they lose the ability to do so. The good news is that as long as your eyes are still growing, and this is actually into your thirties, there are treatments now that will reverse the effects. You can literally turn back the clock and you need to combine that with things like going outside. I was looking out the window. She was like, no, you have to go outside your brain when you’re inside knows that there are walls and that it won’t be able to get the full horizon effect that your eyes need. She also said, you need to go outside. They’re not entirely sure why vitamin D and sunlight are so powerful for healthy eyes. But that combination of being outside, looking into the horizon, scanning the horizon and doing it regularly tells your eyes that they need to be good at looking close and far.

Brett McKay:

Alright, so mean is especially if you’re a parent of young kids, make sure they’re not just looking at screens. Make sure they get outside and looking at the horizon. If you’re over 30 and you’re already nearsighted, it seems like the clock has already ran out on you,

Manoush Zomorodi:

Kind of. Yeah. But it does matter if you’re in your twenties, you got to be on top of it. If you work inside or you work in a lab or whatever, you will go nearsighted faster. So to me, I was like, wow, I could have done something. I could have staved it off. But you’re right, once your eyes stopped growing, you’re sort of cooked,

Brett McKay:

But it’s still good for you to get outside when you’re on that walk. Don’t look at your screen, look at the horizon. You might not be able to change the shape of your eyeball if you’re 45, but I think it’s still good for you. I mean, I got football shaped eyeballs. I’m in astigmatism, but I still like to get out there and scope out the horizon. It does feel nice on the eyeball,

Manoush Zomorodi:

And there’s a good reason why it feels nice. There’s actually been research into animal eyes. Certain mammals, they have seen that sunlight that hits the back of their retina releases serotonin. They have not been able to show this in humans because it’s hard to prove. But like you say, I don’t know about you, but when I get some sunlight, it just feels good. 

Brett McKay:

What about your ear health? Because what a lot of people use their digital devices for is to listen to stuff. They’re always walking around with AirPods in their ears.

Manoush Zomorodi:

Yes. So there has been a really fascinating study going on between Apple and a Michigan researcher named Rick Knight. This is the Apple hearing study where they have tens of thousands of people enrolled through the iPhone. So they’ve been able to track noise exposure, how long they’re listening to something, the volume, also the external noise. So do people put on noise canceling? Do they raise the volume in order to counteract? They’re walking by a construction site or something like that. And Rick told me, because I was like, well, you just need to turn down the volume. He was like, yeah. Not only that though, it’s the duration of listening your ears. It turns out also need breaks. So you know that feeling when I don’t know about you, guns N Roses man would come out and you couldn’t hear for a couple days.

Those are the clia, the little tiny hairs in your ear that have been damaged. And if you give them a break and you let them relax, they will eventually recover. They can recover. But if you do that often enough or you wear down your CLIA and you never give them a break, once they die, they do not grow back. So they are seeing and expect to see more levels of people losing their hearing at much earlier ages. And for a while people were like, well, why didn’t we see that? When we first started, when had consumer devices like the Sony Walkman, and they think that the reason why that didn’t really have that much of an effect or damage people’s hearing was because the battery life was so crappy. And now of course we charge our phones and we listen nonstop. So again, take breaks exposure. Something is being used in your body when you are exposing yourself to exterior sound information vision, and your body just needs to regroup

Brett McKay:

And hearing loss. I think they’re starting to see more hearing loss in younger and younger people. They’re always got their AirPods in really loud, but hearing loss can eventually contribute to dementia down the road.

Manoush Zomorodi:

Right? And also it’s related to people losing their balance and falling the vestibular sort of feeling of being able to hold yourself without falling over. So yeah, there’s very good reasons to protect your ear health. And there’s actually, this has not been shown yet, but there’s suspicions that having noise canceling on all the time might disrupt some sort of connection between your ears and parts of the brain. They’re not entirely sure. That’s very preliminary.

Brett McKay:

You also talk about how our digital lives are impacting our sleep. So how are screens messing up our sleep?

Manoush Zomorodi:

Well, I mean I thought I was like, it’s going to be blue light, right? Blue light is the devil. And actually they don’t think that blue light is the problem. It’s so minimal what blue light does in terms of, look, there are some people who would say, no, I’m very sensitive to it. Absolutely. And children absolutely are sensitive to blue light. But on the new thinking is that rather than the devices themselves messing with our sleep, it’s the fact that we are displacing our sleep with time on screens. So somebody can’t sleep, what do they do? They look at a screen. It’s not necessarily the screen that’s making them unable to sleep. It’s because they turn to the screen or we have the phone on next to us and it’s not looking at the phone right before we go to bed necessarily. That’s making it impossible for us to sleep. It’s constantly being interrupted. I have my phone on next to my bed nervous wreck. I have elderly parents and I have teenagers, but I did learn to set it up. So they are the only people who can call me in the middle of the night. So it’s this idea that just one more show, just like let’s keep playing game. And you lose track of what time it is. It is displacing the amount of sleep that you got and it’s not necessarily the screens itself doing it.

Brett McKay:

Yeah, we had a chrono biologist on the podcast a while back ago. He mentioned that it’s not, the light from a screen is not enough to disrupt your circadian rhythm, so you don’t have to wear those goofy Elton John blue blocker glasses. 

Manoush Zomorodi:

You need to know yourself. If you were a person who loses track of time or you can’t help but be like, oh my God, I wonder what happens in the next episode. You need to know that, okay, this is a problem for you. Turn it off. Don’t blame the screens though for you’re not sleeping well, blame yourself essentially.

Brett McKay:

And then the other way that screens can mess up our sleep or just being on screens all day is we’re not moving. And being sedentary can also mess up your sleep. You’re not building up sleep pressure. Your body needs movement to feel like you’re tired at the end of the day. And if you’re just sitting around all day, your body’s like, well, I’m not tired. We don’t even go to sleep.

Manoush Zomorodi:

I think to me, that was the best explanation for the feeling of being wired and tired. This idea that you are exhausted and yet an alert, I guess is the way to think of it. And I hate that feeling so much. And what I have noticed, I do track my steps and what I have noticed is I need to hit, if I hit 12,000 steps every day, that’s when I can sleep properly. It makes a huge difference for me. It’s so obvious. If I only get 8,000, I do not sleep as well. I need the full sort of mental and physical fatigue to be able to rest, to really enjoy and sort of let go.

Brett McKay:

Speaking of step count, did Keith Diaz, did his research find that you had to hit a certain amount of steps a day to get these benefits? Or it didn’t matter as long as you moved five minutes? No.

Manoush Zomorodi:

Okay. Keith hates step trackers, which it really cracks me up. He said that when he started wearing one, it made him weird. He would be doing laps around his living room to try to get a step count up. He’s like, it does not work for me. It becomes my master. I don’t care. He’s like, what you need to do is put in the time. You don’t need to go crazy. No sprinting needed. If you want to do jumping jacks, go for it. But you really don’t have to. It’s just putting in the time, putting one foot in front of the other.

Brett McKay:

Last question. So you’re a parent. I’m a parent too. Our kids, they’ve lived in a world where they don’t know a world without screens. They’ve probably seen one since they were one years old. What can we do to help our kids integrate screens in their lives in a healthier way?

Manoush Zomorodi:

Yeah, I mean, I think that we’ve become so negative about screens to the point where it might be backfiring. I just think shaming kids for time that they spend on their phones, when really, a lot of the time it’s how they connect with the world and with their friends. I just want us to think about what we’re missing when we are on screens. And that is movement and getting outside. So instead of like, oh my God, get off your phone. Just be like, Hey, did you get some stroll time in today? Did you go for a walk? I think if they’re younger, taking a lap around the block after dinner, a dog is actually a great way to get them moving. Having conversations about if you’re going to have iPad time again for the little ones, how do you feel before you’re starting on your iPad?

You feel good? Okay. And then afterwards, how do you feel? And if they’re grouchy, be like, okay, so now we know that maybe you spent too long on your iPad. Maybe let’s do it a little less next time so that you don’t feel grouchy. I think for teenagers, it’s hard, right? Boy is it hard. But I have seen that my kids walk themselves essentially. They make sure that they get out and air themselves multiple times a day and they don’t feel right. If they don’t, they’re like, oh, I need a walk. And that is just music to my ears.

Brett McKay:

So just have those conversations. Encourage them to develop their sense of interoception and maybe offer some gentle nudging.

Manoush Zomorodi:

And I think it’s more saying what you can do and should do as opposed to what you can’t and shouldn’t frame it as positive. Let’s frame it as enjoying the world. Let’s frame it as touch grass.

Brett McKay:

Touch grass. Well, Manoush, this has been a fantastic conversation. I think hope everyone goes out and starts taking their five minute walks, but where can people go to learn more about the book in your work?

Manoush Zomorodi:

Oh yeah. Well, I’m the host of NPR’s Ted Radio Hour, and you can find out more about the book at my website manoushz.com. And that’s me on Instagram as well. And Brett, my God, congratulations. I hope I’m on again in another nine years. 

Brett McKay:

Let’s make it happen.

Manoush Zomorodi:

Let’s do it. Alright. 

Brett McKay:

Well Manoush, thanks for your time. It’s been a pleasure.

Manoush Zomorodi:

Mine too.

Brett McKay:

My guest today was Manoush Zomorodi. She’s the author of the book Body Electric. It’s available on amazon.com and bookstores everywhere. Until next time, this is Brett McKay reminding you to not only listen to the podcast, but to put what you’ve heard into action.

This article was originally published on The Art of Manliness.

In most modern high schools, P.E. is a complete blow-off class — something to take when you don’t play a sport, and have to fulfill a health/fitness-related elective. Participants often sit on the bleachers and talk, or half-heartedly play some basketball. 

There was a time in this country when P.E. was taken more seriously, however, and it reached its absolute apex at La Sierra High School in Carmichael, California.

During the 1950s and 60s, La Sierra boasted what was arguably the most rigorous P.E. program in the country, if not the world. The so-called “La Sierra System” was born in a time when World War II was over, the Cold War was still heating up, and prosperity and technological advancements were making life increasingly sedentary and comfortable. In this atmosphere, there existed a national concern over whether Americans were becoming too soft, overweight, and complacent to not only defend their country in war, but to vigorously meet the challenges of peace.

As President John F. Kennedy wrote in “The Soft American”:

physical fitness is not only one of the most important keys to a healthy body; it is the basis of dynamic and creative intellectual activity. . . . [We] know what the Greeks knew: that intelligence and skill can only function at the peak of their capacity when the body is healthy and strong; that hardy spirits and tough minds usually inhabit sound bodies.

In this sense, physical fitness is the basis of all the activities of our society. And if our bodies grow soft and inactive, if we fail to encourage physical development and prowess, we will undermine our capacity for thought, for work and for the use of those skills vital to an expanding and complex America.

Thus the physical fitness of our citizens is a vital prerequisite to America’s realization of its full potential as a nation, and to the opportunity of each individual citizen to make full and fruitful use of his capacities.

To stem the physical deterioration of his fellow Americans and promote the idea of developing a sound mind, in a sound body, JFK utilized the President’s Council on Physical Fitness to reinvigorate physical education programs around the country, and looked to La Sierra as an example of what was possible in this line.

The first few minutes of the above video will give you a look at what some aspects of the La Sierra program were like.

The La Sierra System had been developed by WWII-veteran Stan LeProtti, who was inspired by the classical, “whole man” approach to fitness that had been championed by the ancient Greeks. LeProtti’s program sought to improve the strength, agility, balance, flexibility, power, and endurance — as well as the leadership qualities — of all the males in the student body, not just those relatively few boys who participated in organized athletics. The program not only incorporated physical exercise — a regimen that included an intense 12-minute calisthenic warm-up, sports, games, dance, combatives, gymnastics, running, aquatics, and off-the-ground work on various apparatuses like peg boards — but also involved regular meetings to talk about the philosophy — the why — behind it. Students were taught that the fitness routines in which they engaged not only built their bodies, but prepared their minds for learning and their spirits for tackling life’s setbacks. 

The “Philosophy” section of the La Sierra P.E. handbook includes both “Physical Fitness” and “Psychological Fitness” as two of the program’s goals, and lists the following among the aims of the latter:

• Pupils are systematically and deliberately required to ‘go all out’ within their individual capacities in a number of physical development activities, thereby progressively raising endurance and tolerance of pain levels.
• Pupils develop a well-disciplined attitude toward the ‘hard work principle’ in terms of heavy, energy-output type activities.

When the producers of The Motivation Factor, a documentary about the La Sierra System, interviewed those who had gone through it in their youth, they reported that the program had delivered on just this desired effect — and that it stayed with them into adulthood; when these La Sierra grads had experienced challenges in later years, they returned to their P.E. experiences as a touchstone — a reminder that they were capable of doing hard things.

Another unique trademark of the La Sierra System was its use of “ability grouping” — a hierarchy of ranks denoting different levels of physical proficiency. The boys were put in teams based on these levels, and each team/level was identified by different color satin trunks worn by its respective members (sans shirt) while they exercised. All freshmen started out on the White Team, wearing white shorts, and then could work their way up the ranks throughout their high school years. When you tested into the next level, you got to discard your old color shorts for new ones and proudly display your earned achievement. The color system was designed to harness boys’ natural propensity for competition and publicly-recognized status as a spur towards “physical excellence.”

One might be apt to wonder if this system didn’t shame and embarrass those boys who were at a lower level of fitness, and had to wear the lower-level shorts. Wouldn’t the color groups make them feel bad about having to broadcast their position at the bottom of the ladder?

A coach at the time, Richard Chester Tucker, who went on to write his PhD dissertation on La Sierra’s color system, looked into this very question. He compared the least physically capable third of students at both La Sierra and at a school that had a traditional P.E. program. What he found was that there was no difference between the self-esteem of the boys in each group. But, the boys at La Sierra were more physically fit than those at the other school; for example, on average, the lowest third of boys at La Sierra could do nine pull-ups, while the lowest third of boys in the traditional P.E. program could only do two. In other words, the color-coded shorts system didn’t make students feel bad about themselves, but it did inspire them to strive higher; maybe these kids weren’t ever going to be elite athletes, but the color-code system motivated them to become their best. As Tucker says in The Motivation Factor, “We came under a lot of criticism because [people said] ‘You’re making these kids walk around in white trunks. What does that do to their self-esteem?’ It makes them want to get red trunks!”

When interviewed as adults, those who went through the La Sierra program remembered it as being fun and highly supportive; the boys encouraged each other and helped each other reach the next tier.

Within the color system, there were four main levels: White (Beginner), Red (Intermediate), Blue (Advanced), and Navy Blue (Ultimate Athlete). Within the Blue level, there were two sub-levels: Purple and Gold. More than 90% of students were able to advance from the White Team to the Red Team by the end of their freshman year, and 60% were eventually able to make the Blue Team. For every 100 students, only one or two were still wearing white trunks by the time they graduated.

The following benchmarks had to be hit to move beyond the White Team and reach subsequent color levels within the La Sierra System.

Each color level had minimum, median, and “ceiling” sub-standards; the ceiling standard of one color level was the minimum standard of the next; hitting the ceiling standard within a color level advanced you the next color up. What is listed below is the minimum standard for each main color level:

Red (Intermediate)

• Pull-Ups: 10 
• Push-Ups: 32
• Bar-Dips: 12 
• Sit-Ups: 60 
• Standing Broad Jump: 6’9″ 
• 200-Yard Shuttle Run: 34 seconds 
• Rope Climb (18’, Stand Start): Use hands only (no feet)
• Agility Run: 20 seconds 
• 880-Yard Run: 3 minutes
• Mile Run: 7 minutes
• Man Lift and Carry: 880 yards
• Peg Board (Vertical): 6 holes
• 50-Yard Swim (Freestyle): 36 seconds

Blue (Advanced)

• Pull-Ups: 14 
• Push-Ups: 48
• Bar-Dips: 18 
• Standing Broad Jump: 7’3″
• Hanging Leg Lifts: 24 
• 300-Yard Shuttle Run: 52 seconds 
• Rope Climb (18’, Stand Start): 15 seconds, hands only 
• Agility Run: 19 seconds 
• 1320-Yard Run: 4:20 
• Man Lift and Carry: 1320 yards
• Peg Board (Vertical): 1 trip
• Extension Press-Up: 5
• 1.5-Mile Run: 10:30 
• 50-Yard Swim (Freestyle): 32 seconds

Navy Blue (Ultimate Athlete)

The median and ceiling sub-standards within the Blue level were categorized as their own colors: Purple and Gold. To test for the Navy Blue trunks, you first had to earn your Gold trunks.

• Pull-Ups: 34
• Bar-Dips: 52
• Handstand Push-Ups: 50
• Alt. 1 Arm Burpees (30 sec.): 26
• 300-Yard Shuttle Run: 47.5 seconds
• Rope Climb (20’, Hands Only, Sitting Start): 2 trips
• Agility Run: 17 seconds
• Extension Press-Up (8”): 100
• Pegboard (Vertical): 5 trips
• Handstand: 45 seconds
• Man Lift and Carry: 5 miles
• Mile Run: 5:15
• 5-Mile Jog: Finish
• Obstacle Course: Complete
• Swim (Front Prone Position): 1 mile
• Swim (Underwater): 50 yards
• Swim (Any Combination of Strokes): 2 miles
• Execute Front Hanging Float With Arms and Ankles Tied (Deep Water): 6 minutes
• Stay Afloat in Deep Water in Vertical Position (Use of Arms and Legs Permitted Within 8’ Circle): 2 hours

Representing the pinnacle of physical fitness, the Navy Blue shorts were obviously extremely difficult to earn, and as a result highly coveted. When a student earned his Navy trunks, his accomplishment was announced over the school’s PA system, and the entire student body would erupt into thunderous cheers. 

Between 1958 when the Navy Blue level was introduced and 1983 when La Sierra High School closed, only 21 students were able to achieve these trunks. Today, the standard remains as a testament to a time that had high expectations for its youth — that believed in their potential and pushed them to reach for as much of it as they could.  

Listen to this episode of the AoM podcast for more on the La Sierra P.E. program:

With our archives 4,000 articles deep, we’ve decided to republish a classic piece each Sunday to help our newer readers discover some of the best, evergreen gems from the past. This article was originally published in March 2022.

This article was originally published on The Art of Manliness.

A few years ago, red light therapy started showing up everywhere I looked, and it’s still getting a lot of attention. Fitness influencers evangelize it for muscle recovery, fat loss, and metabolic health. Beauty influencers say it will give you glowing skin and thicker hair. Biohacking bros claim it can help your mood and sleep, and that if you expose your balls to red light, it’ll boost your testosterone.

Thanks to the social media hype, gyms have started installing red-light booths next to their tanning beds. Just a few months ago, a dedicated red-light studio opened near my neighborhood here in Tulsa. $50 gets you 25 minutes in a red-light booth plus 10 minutes on something called a “power plate.” You can now buy red light therapy panels and blankets for your home, but they’re not cheap; serious at-home red light therapy can set you back $1,000 to $2,000.

As a creaky, stiff 43-year-old veteran garage powerlifter with nagging tendons, I was intrigued by the promises of pain relief and faster recovery. The potential mood lift was also a plus. Rather than schlep to a tanning studio and fork over $30 a pop for red-light sessions, I decided to buy a red-light blanket — essentially a sleeping bag lined with therapeutic LEDs — run an experiment on myself, and then share the results.

Five times a week for three months starting in January, I stripped down to my birthday suit, crawled into my high-priced red-light burrito wrap, and lay there on our gameroom floor for 15 minutes. About halfway into my session, I’d scrunch my body down so the bag covered my head too, burrowing in like I was in my mummy sleeping bag on a cold night of camping. One morning, my son wandered in to find just my gray head protruding from my glowing red cocoon. Gus finding his dad doing weird things for his man blog isn’t anything new. “You look like a weirdo,” he flatly said and walked out. He wasn’t wrong.

I’ll let you know below whether my experiment paid off. But first, let’s take a look at how red light therapy works and whether its popularly touted benefits are supported by research-backed evidence.

What Is Red Light Therapy?

Red light therapy, or photobiomodulation (PBM), involves exposing tissue to specific wavelengths of red and near-infrared light to stimulate cellular function, specifically your mitochondria. When cells are stressed, a molecule called nitric oxide plugs a key enzyme in the mitochondrial chain, suppressing ATP production. ATP is the energy currency our cells use for repair and regeneration. Red and near-infrared light can dislodge that nitric oxide and get cellular energy production running again, allowing your body to repair and regenerate. That’s the theory, at least.

When you’re doing red light therapy, there are two kinds of wavelengths that provide different benefits.

Visible red light in the 630-660 nm range is primarily absorbed by your skin’s dermis and epidermis.

Near-infrared light in the 810-850 nm range, on the other hand, passes through skin and can penetrate several centimeters into muscle and joint tissue.

If you’re treating a skin concern, you want visible red light. If you’re treating a joint or trying to reach deeper tissue, you want near-infrared. Most quality panels deliver both, largely because it makes them more versatile — you can use the same device for skin, joints, and deeper tissue work — which is why they’ve become the standard for broader therapeutic use.

Red Light Therapy’s Purported Benefits

When I dug into the research about red light therapy, I discovered that, like a lot of health fads, the marketing and social media hype around red light therapy has significantly outrun what the science actually supports.

There are some benefits to red light therapy, but they’re a lot narrower than the guys on Reels wearing blue-light-blocking glasses claim.

Red Light Therapy May Improve Your Skin

Wavelengths in the 630-660 nm range penetrate the upper layers of skin and stimulate fibroblasts, the cells responsible for producing collagen and elastin. Meta-analyses have found solid evidence for PBM reducing radiation dermatitis — skin irritation and damage caused by exposure to radiation therapy — in cancer patients. There’s also evidence that it accelerates the closure of chronic wounds like diabetic ulcers.

For general anti-aging applications, red light exposure can reduce wrinkles and improve skin texture over time.

But to get the benefits, you have to do red light therapy consistently for a long time. We’re talking three to five sessions a week for three to six months before you see any changes. It’s not a quick fix.

Red Light Therapy May Help With Hair Loss

If you’re dealing with androgenic alopecia (aka standard male pattern hair loss), the evidence for red light therapy is reasonably solid. Low-level light stimulates the mitochondria in hair follicles and increases blood flow to them. Studies have shown improvements in hair density and thickness in both men and women after three to six months of consistent treatment.

The catch: you have to keep doing red light therapy indefinitely to maintain the hair growth. Stop the sessions, and the follicles drift back to their previous state. So you have to decide whether a modest improvement in your hairline is worth putting on an $800 red-light helmet that looks like something from the Minority Report every day, indefinitely.

Red Light Therapy May Ease Localized Pain and Inflammation

For specific, targeted musculoskeletal problems — knee osteoarthritis, plantar fasciitis, localized joint inflammation — there’s decent evidence supporting red light as an adjunct therapy. Near-infrared wavelengths around 810-850 nm can penetrate several centimeters into muscle and joint tissue and have been shown to suppress pro-inflammatory cytokines and reduce pain. Again, you have to use red light therapy consistently for months before you see any benefit. It’s not a one-and-done thing. Also, it’s an “adjunct” therapy, meaning you need to do it alongside physical therapy to get the benefits.

There are devices you can buy that you can strap to areas that you’re trying to treat. They’re more cost-effective than whole body panels or blankets. Still not cheap though! Look to spend $400-$800 for these.

Red Light Therapy May Speed Up Muscle Recovery (But Probably Doesn’t Do Much for Muscle Growth)

Multiple meta-analyses — including reviews published in 2024 and 2025 — show that red light therapy consistently lowers creatine kinase levels in the blood after intense exercise. Creatine kinase is one of the primary markers for muscle damage, so bringing those levels down faster means your muscles are repairing more quickly. The same research shows consistent reductions in delayed-onset muscle soreness, or DOMS.

The muscle growth question is murkier. Recent meta-analyses suggest PBM doesn’t consistently increase peak strength beyond what training alone produces, and nothing shows that it will do much for hypertrophy.

Red Light Therapy Probably Won’t Help You Lose Fat

This is fitness influencers’ favorite claim, and the evidence behind it is the weakest. The theory is that PBM causes temporary pores to form in fat cells, releasing triglycerides to be metabolized. Small studies have documented modest circumference reductions, but these haven’t translated into meaningful changes in total body weight, and without a caloric deficit, the released fat is likely just reabsorbed. No large-scale, long-term human trials support the idea that red light meaningfully accelerates fat loss beyond diet and exercise.

Red Light Therapy Probably Won’t Fix Your Mood or Sleep

Research into transcranial PBM for conditions like depression and Alzheimer’s looks promising, but it’s still in the early stages. It’s worth watching over the next decade.

But systematic reviews have concluded that sleep quality and cognitive enhancement in healthy individuals using red light aren’t yet statistically significant.

If you notice any mood lift from red light therapy, it’s probably the placebo effect, which does have a real impact. If you feel better, you feel better, but red light therapy is a pretty expensive and time-consuming way to get the placebo effect. You can get a mood boost just by walking outside and catching some sun.

On That Testosterone Claim

The evidence that testicular irradiation boosts testosterone in men comes almost entirely from rat studies. Human data is essentially anecdotal. I’d file this under things that work in rats and for TikTok bros wanting you to smash that like button.

Did Red Light Therapy Do Anything for Me?

After three months of spending 15 minutes 5X a week under my red-light blanket, here’s what I found:

My mood didn’t noticeably improve.

My nagging tendons still nagged me.

My skin looked exactly as it did before, that is, like the face of a 43-year-old man. A scar I picked up at Thanksgiving remained stubbornly present.

I didn’t lose body fat.

My recovery from workouts didn’t improve.

My hair, which was already thick, remained thick.

I can’t say for sure that the red light therapy didn’t do anything for me, but the effect was not significant or noticeable enough for me to continue to spend over an hour each week lying on the gameroom floor in a glowing body bag.

So Should You Do Red Light Therapy?

Red light therapy didn’t seem to do anything for me, but this was of course an n=1 experiment. Your results may vary.

If you have a specific problem that the research supports — hair loss, age-related skin changes, a nagging joint issue — a high-irradiance red-light device used consistently over several months may be worth investigating alongside whatever else you’re doing for it. There’s research that backs it up. But keep in mind, even when it works, the benefit is typically modest, and if you have to do the light therapy consistently for months — and in the case of hair loss, forever.

For general wellness, whole-body recovery, fat loss, and mood, the evidence isn’t there. Yet, at least.

My takeaway: if your gym has complimentary red light therapy, it won’t hurt to sit in it for a few minutes after a workout; just don’t expect much from it.

I wouldn’t plunk down the money to go to a specialized red light salon or for an at-home red light therapy device unless you’ve got money burning a hole in your pocket, and you don’t mind losing aura in the eyes of your teenage son.

This article was originally published on The Art of Manliness.

Thomas Merton was a Trappist monk, writer, and one of the most influential spiritual voices of the 20th century — a man preoccupied with solitude, silence, and the demands of the inner life.

He’s best known for his spiritual autobiography, The Seven Storey Mountain, which traces his restless youth and eventual conversion to Catholicism.

As I mentioned in last week’s Odds and Ends, I recently re-read this book and enjoyed it. It’s full of interesting spiritual insights. But I also picked up something else Merton mentioned: a simple, practical trick for falling asleep.

Thomas Merton’s Trick for Falling Asleep When You Can’t Fall Asleep

Merton discovered the technique during his undergraduate years at Columbia University in the mid-1930s. He was doing what a lot of college students do: trying to find himself. He dabbled in Marxism and jazz. He also read hundreds of texts on what he loosely called “Oriental mysticism,” or what we now call Eastern philosophy.

While Merton came to regard most of this phase as shallow and misguided, one thing he got out of it stuck with him for the rest of his life: a trick to fall asleep when you can’t fall asleep.

In The Seven Storey Mountain, Merton describes the process thusly:

You lie flat in bed, without a pillow, your arms at your sides, and your legs straight out, and relax all your muscles, and say to yourself:

‘Now I have no feet, now I have no feet . . . no legs . . . no knees.’

Basically, you imagine your body disappearing, beginning with your feet and slowly working your way up. You imagine each of your body parts “changed into air and vanished away” — shins, knees, thighs, hips, abdomen, arms, hands, shoulders, repeating the absence of each part to yourself until it genuinely feels “gone.” You keep moving up your body until you drift off to sleep.

Merton noted that this technique usually worked for him, unless he hadn’t fallen asleep by the time he got to his head; when that happened, “Instantly, chest and stomach and legs and feet all came back to life with most exasperating reality.” Fortunately, he’d typically be conked out by the time he made his torso “disappear.”

Why Imagining Your Body Disappearing Can Help You Fall Asleep

Merton theorized the technique worked because it was a type of auto-suggestion or just plain old muscle relaxation. When you’re nice and relaxed, you usually fall asleep. He wasn’t wrong.

Most insomnia isn’t a body problem. It’s a brain problem. Your mind latches onto something (like a work email, a conversation that went poorly, whatever) and starts chewing on it. The harder you try to stop ruminating, the louder the mental chatter gets.

Merton’s technique solves this with a kind of cognitive sleight of hand. It gives your brain something specific and repetitive to do. “I have no feet. No feet. No legs.” The task is engaging enough to occupy the part of your mind that wants to spin out, but boring enough not to fire you up. You’re crowding out the rumination without replacing it with anything that requires actual thinking.

There are a couple of variations on Merton’s technique that you can also try.

I’ve long done a version of this method that comes at it from a related but opposite angle.

When I was a kid, I watched a show called Under the Umbrella Tree. One episode featured Gloria the Gopher having problems falling asleep. Her solution: she went through her body parts one by one, saying goodnight to each of them. “Time to go to sleep, leg. You’re getting heavier and heavier.” It made an impression on me and I started doing it, and I’ve been using this trick ever since.

I find imagining that each of my body parts is getting heavier and heavier easier to conceptualize than imagining that each part is disappearing. Though I’ve had the same experience as Merton: while I usually drift off to sleep by the time I get to my torso, if I reach my head, whatever relaxation I achieved instantly reverses and I’m wide awake.

You can also try the method that was taught to Naval aviators during WWII, which might solve the problem Merton and I have encountered. With this technique, you imagine each of your body parts going absolutely lax and limp, starting with your head instead of your feet; you first relax your scalp, forehead, jaw, and even your tongue, lips, and eyes, before you start moving down your body.

All of these approaches get you to the same sleep-inducing place: a relaxed body and mind. Experiment and see which one works for you; you’ll be sleeping with the beatific stillness of a monk in no time.

This article was originally published on The Art of Manliness.

Pooping. Everybody does it, but a lot of people are embarrassed to talk about it. That’s a shame, my guest says, not only because your digestive health is incredibly linked to your overall health, but simply for the fact that there is much happiness to be found in an easy, worry-free constitutional.

Harvard gastroenterologist Dr. Trisha Pasricha is the author of You’ve Been Pooping All Wrong: How to Make Your Bowel Movements a Joy. Today on the show, Trisha and I have a fun and frank conversation about the art and science of bowel movements, including the color of healthy stools, how often you should be pooping, if laxatives are safe to use, the food to eat that’s even better than prunes for getting things going, why you feel the urge to go poop at Barnes and Noble, the wonders of the bidet, the danger of using your smartphone on the toilet, how to get more comfortable pooping in a public restroom, and more.

Resources Related to the Podcast

• AoM Article: The Top 10 Toilet Books
• AoM Article: Be a “Regular” Guy — Tips for Improving Your Daily Constitutional
• The Squatty Potty
• “Mariko Aoki phenomenon” — where individuals feel an urgent need to use the bathroom when entering a bookstore
• AoM Article: You Need to Eat More Fiber

Connect With Trisha Pasricha

• Trisha’s website
• Trisha on IG

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Transcript 

Brett McKay:

Brett McKay here and welcome to another edition of the AoM podcast. Pooping: everybody does it, but a lot of people are embarrassed to talk about it. That’s a shame, my guest says. Not only because your digestive health is incredibly linked to your overall health, but simply for the fact that there’s much happiness to be found in an easy, worry-free constitutional. Harvard gastroenterologist, Dr. Trisha Pasricha, the author of You’ve Been Pooping All Wrong: How to Make Your Bowel Movements a Joy. Today on the show, Trisha and I have a fun and frank conversation about the art and science of bowel movements, including the color of healthy stools, how often you should be pooping, if laxatives are safe to use, the food to eat that’s even better than prunes for getting things going, why you feel the urge to go poop at Barnes and Noble, the wonders of the bidet, the danger of using your smartphone on the toilet, how to get more comfortable pooping in a public restroom, and more. After the show’s over, check out our show notes at aom.is/poop. All right, Dr. Trisha Pasricha, welcome to the show.

Dr. Trisha Pasricha:

Thank you so much for having me, Brett. Glad to be here.

Brett McKay:

So you are a medical professor of gastroenterology. That’s a hard word to say. I had to look up how to pronounce it. You specialize in gut health and a big part of your work involves researching and talking a lot about poop. How’d you end up doing what you do?

Dr. Trisha Pasricha:

Well, I am a second generation gastroenterologist. I grew up as the daughter of a gastroenterologist. When you grow up like that, you think that talking about poop every day is perfectly normal and you think that that’s what everyone else is doing. It was delightful. My father was, and still is a gastroenterologist, but he was also a researcher. He was just so excited to tell me and my siblings about the cool stuff he was discovering in his lab every day after he came home from work and he was describing how colonoscopies worked and all of this. I know now that sounds really bizarre, but at the time it was just what we talked about at the dinner table and how cool science was and specifically when it came to our gut. So I loved it and it was kind of what I grew up thinking was the coolest thing in the world.

So I knew I wanted to be a gastroenterologist since I was a little girl. I had never imagined wanting to be anything else. But then when I came to medical school and then I started doing my own training, I really started to realize what a weird gap there was between what other people seem to have learned about poop and their bowel movements and how their gut works and what I learned. And people, for the most part, it seems like, didn’t really talk about their guts and their poop after they turned three or four, and it was something everyone just stopped bringing up at the dinner table. And so I kind of went on this mission and it just started with me talking to my patients about trying to normalize these conversations and having them out loud. And ultimately that led to writing the book. But I really do think that people need to have conversations more loudly because 40% of Americans are suffering from bowel habits that disrupt their daily lives. But you wouldn’t know that because we’re so quiet about them.

Brett McKay:

Yeah, I mean, unlike you, we didn’t talk about poop at the dinner table. I don’t even remember having conversations about my bowel movements with my family. And that carries over, I think, for a lot of Americans to how they approach talking about it with their doctor. As you said, a lot of Americans have bowel problems and it can cause a lot of discomfort, a lot of inconvenience in their life, and a lot of it is preventable. Well, let’s talk about this. I think one of the reasons why people have a hard time talking about it is they don’t know how to talk about poop. So when they go to the doctor saying, I got this problem with my bowel movements, I mean, what should they call it? You’re always like, do I call it bowel movement? Do I get scientific and call it stool or feces, human soil, what do you call it?

Dr. Trisha Pasricha:

Yeah, liquidating your assets, whatever you want. I have found that I use the word poop usually unless somebody leads with another word that they find more comfortable. And the reason I do that is when I was in medical training, the kind of formal word that all doctors use is bowel movement. And so that’s what I was trained to start saying, and I certainly started saying that. And I had one professor who was a gastroenterologist and he was my research mentor in medical school, and I shadowed him. And he was the first guy I had ever seen, this doctor, this middle-aged gentleman. And this young patient came in and he was like, so tell me what your poop looks like. And I looked at this guy and I was like, this is so weird. You’re this doctor, this white coat. That’s the weirdest, I’ve never seen a doctor say that like that in a clinic before.

But when he said it, this young patient in his twenties suddenly smiled for the very first time and just the whole atmosphere in the room changed. And this guy just totally shared exactly what was going on with him. And you could just tell it broke the ice, it made it comfortable. And after that, I never looked back because I know oftentimes when I tell people, oh, tell me about your bowel movements, everyone stiffens up a little bit. And they too try to match my level of medicalization. And if you could just tell me what’s bothering you, I want to use whatever words make you comfortable. So I think someone should lead with the words they want to use that allows you to talk about it most freely. And my hope is that your doctor’s going to meet you right there.

Brett McKay:

Okay, that’s great. It’s funny, bowel movement. So my name’s Brett McKay. This is sort of a tangent. So when we had the initial things, it started when I was in middle school, I got really self-conscious about it, those initials BM. Oh my gosh. And I had some kid be like, oh, BM poop. And so now, ever since then I do BHM. That’s my middle initial.

Dr. Trisha Pasricha:

Oh my gosh. Now you should embrace it. I’ve embraced TP as a gastroenterologist.

Brett McKay:

Alright, so if you can do that, I can go back to BM. I’m going to embrace the BM.

Dr. Trisha Pasricha:

A hundred percent.

Brett McKay:

So you describe this idea of euphoria in your book. What is euphoria?

Dr. Trisha Pasricha:

Yeah, euphoria. It is a state that I want everyone to reach. And that is where having a bowel movement is the absolute least of your daily concerns. It’s this easy, effortless thing that happens quickly without straining, and then you go about the rest of your day and live your best life. You’re not worried about feeling heavy for the rest of the morning or day because you didn’t have that window to go, or you’re worried, should I go out to brunch with my friends or should I even meet people for dinner because I’m so worried about the bathroom situation? I don’t want you to live like that. And tragically, I think a lot of people are right now. So euphoria is a state of mind and it’s a lifestyle that I think we can all reach — some of us with just a little bit more knowledge about our bowel habits that we just never got. Because the last time we talked about our bowel habits with another soul was usually when we were potty training with our mom and dad. And that was a long time ago. Most of us cannot remember that conversation.

Brett McKay:

So a healthy bowel movement, you’re not even thinking about it, just not even on, you don’t have to worry about it at all.

Dr. Trisha Pasricha:

Yeah, you’re not obsessed about, I mean, there’s another end of the spectrum where people, I mean, and this can be quite understandable, but people fixate on their bowel movements all the time. They’re worried about, did I go yet today? If I don’t go, I feel off. And even if there’s someone who you might look from the outside and say, okay, they’re going once a day, they’re regular. But if you’re thinking about it all the time, you’re becoming paranoid. If you haven’t gone, that’s not euphoria either.

Brett McKay:

Well, let’s talk about what healthy poop looks like and hopefully we can answer some questions that people have always wondered about it. Let’s start with the color of poop. First off, why is poop usually brown?

Dr. Trisha Pasricha:

Yeah, the natural color is actually not brown. The natural color of our poop is like this whitish clay colored. And what gives it its beautiful brown color is bile. So our body produces this digestive juice and it has bilirubin in it, and that’s just this chemical that gives it that brown color. But if we were to take that away, it would actually look bizarrely whitish. And that is why if you ever see a pale, whitish creamy stool, that’s a problem. That’s an emergency. It means that that bile is somehow being blocked somewhere. Maybe it’s a gallstone, it could even be a cancer. But if you ever see that, that’s a big red flag. Go to the emergency room. But then other than that, the normal color should be some shade of brown. And then of course, everybody poops the rainbow from time to time.

I get these kinds of DMs every week where someone’s like, I had a really weird purple poop, or my poop was kind of greenish. Is that normal? And it can be normal. A lot of times we eat things that we don’t put together could impact our poop. For example, a classic one is beets. If you’ve ever eaten beets, you are probably going to have a maroon poop the next day or maybe the next day or two. And that’s just the beets. That’s okay. But if you haven’t eaten those beets and you see anything that looks like red, that would be really worrisome for bleeding. So bright red, maroon, or even pitch black and shiny, that could all be blood.

Brett McKay:

Gotcha. So yeah, black poo, that could be okay. Sometimes it suggests there’s some sort of internal bleeding going on up your tract, but sometimes there’s, I think iron supplementation can cause black poo.

Dr. Trisha Pasricha:

You can have this real chicken and egg situation because sometimes people are taking iron because they’re having some bleeding and they’ve lost blood. But then you see black poop and you’re like, is this because you’re taking iron to treat bleeding? Or is it because you are bleeding?

Brett McKay:

Yeah. And then I guess Pepto Bismol can also cause black poop.

Dr. Trisha Pasricha:

Yeah. I feel like we always forget to warn people about it can turn your tongue black, it can make your poop black, and then people are really horrified the next day. But that if you’ve taken Pepto Bismol, you’re allowed to have a few black poops.

Brett McKay:

And another interesting fact about Pepto-Bismol that you put in the book is that if you don’t want your farts distinct before a date or something, take Pepto Bismol before and that will make your farts less stinky. 

Okay. So poop’s naturally clay color until it meets with bile. But this is one of those things that can freak me out because I mean, you hear if you have a clay colored stool, that can mean you have pancreatic cancer or a bile duct blockage. And I can be looking at a light poop thinking, is that clay color? I think there are different colors of clay, and I think, well clay’s maybe a light tan. So maybe my poop is looking like clay, but we’re talking about white clay. It has to be basically white.

Dr. Trisha Pasricha:

Yeah, I guess you’re right. There’s differences, there’s earthy tones of clay. This I’m talking about more like a whitish creamy color or kind of gray. And I would say when in doubt, I mean everyone’s poop is going to look a little different. If you have any doubts, I always tell my patients, picture or it didn’t happen. Take a picture of it and then send it through your electronic medical record and show your doctor and just have them lay eyes on it. A doctor will be able to tell you really quickly, am I worried or excited about this or not?

Brett McKay:

Gotcha. And then red, if you haven’t eaten beets, if you see red, that’s another thing you want to go see your doctor about because it could be colon cancer, but it could be something as benign as a hemorrhoid or an anal fissure or something like that.

Dr. Trisha Pasricha:

Totally. Yeah. And most of the time it is going to be something not worrisome, it’s going to be a hemorrhoid. But what I never want someone to do, especially in this stage in 2026 where we are seeing this really disturbing rise in early onset colorectal cancer, is for someone to see bleeding and brush it aside. I mean, this is the trend we’re seeing in studies and with this rising cases that young people, when they see blood, they’re like, this is just my hemorrhoid, or I’m pretty sure this is no big deal. It’s always better to just quickly let your doctor know and let your doctor reassure you and be like, oh yeah, we’ll just do a quick exam. We’ll make sure it’s your hemorrhoid. No problem. But make sure that someone’s taken a look and giving you that reassurance rather than just brush it off yourself.

Brett McKay:

Let’s talk about the shape and consistency. What does a healthy poop consistency and shape look like?

Dr. Trisha Pasricha:

Yeah, I think most people think that a perfect shape would be this nice smooth sausage shaped, and then you go and people really aim to get is wipe less, and that is wonderful. That is a nice consistency that a lot of people have. But there’s really such a range of what could be normal. And I would tell people that for the most part, if you start eating a lot more fiber, which a lot of us are not doing, like 95% of Americans are not meeting our fiber goals, if you start to do that, it actually becomes less and less likely that you’re going to have that smooth little sausage that everyone wants. You’re going to start to have fluffier and fluffier stool. You might even start to go more often. That’s perfectly normal. It can be totally normal. And people sometimes when they do that, they’re like, I have diarrhea.

I’m going three times a day. And it’s so soft. That’s fine, as long as it’s not interfering with your social life. There’s a range of normal. And in fact, you should embrace that new you because it means you’re doing something healthy for yourself. And then on the flip side, sometimes when people are having these really, really tiny rabbit pellets, usually I say that that indicates that there’s an issue with constipation, but sometimes the fix can also be quite simple. It can be you need to hydrate more or you need to not hold it in. We do that as adults. We have this urge to go. Sometimes it’s like when we’re at work or we’re on a date at a restaurant and we say, no, no, no, I’m not going to go right now. I feel the urge I’m not going to go. And when you do that, you’re setting yourself up for failure because that stool is just going to dry up and become more hard so that when you decide you want to go later, it’s not the same one that you started with 12 hours ago. It’s a totally different one. It’s going to be more pebbly. So it’s better to try to go when your body tells you to, and you’re going to get a little bit closer to that median.

Brett McKay:

Gotcha. So what happens to our stool whenever we get diarrheas? Why does the body decide this stuff needs to be liquid and get out fast? What’s happening there?

Dr. Trisha Pasricha:

Yeah, there’s lots of different causes, but in terms of your anatomy, your small bowel, which is that first part of the tube after your stomach, the main point of your small bowel is to absorb all the nutrients and it’s sucking out everything that it wants and breaking it down. And then the stuff that it can’t break down, which is usually like the fiber, which we actually don’t possess the enzymes to break down. It makes its way to our microbiome in our colon. Well, the colon has several jobs. One of them is to suck water out of the stool as it passes through. And stool passes a little bit more slowly through the colon. So your colon has a lot of time to get that water up. But if something happens that triggers that poop to move forward, and sometimes it’s stress. Stress can cause our colon to suddenly start to contract.

That means we haven’t had time to remove and absorb all the water out of it yet. So it’s going to gush out like diarrhea when we’re stressed, spicy food, does that spicy food sense this signal down to say, okay, evacuate everything we have. That too will make whatever comes out to be a little bit fiery, a little uncomfortable, and it’ll also be pretty liquidy. And then there’s other things like infections or just depending on how things are going with other aspects of your life’s travel and exercise, those things can also help speed things up. But before you’ve really had a chance to absorb all the water.

Brett McKay:

Gotcha. And constipation is just the reverse. It’s been in the colon too long, so all that water has been sucked out.

Dr. Trisha Pasricha:

Yeah, exactly. And there’s a ton of different reasons why we think slow down and why we can get constipated. And you’re right, the longer we sit there, the longer that stool is just your colon is going to keep doing its job and it’s going to keep making it harder and harder, which is why I sometimes think the most important thing people can do who are constipated is just as soon as they hear that call, feel that urge respond because it’s not going to be the same poop later on.

Brett McKay:

What causes constipation? You said there’s lots of potential sources?

Dr. Trisha Pasricha:

Yeah. Well, when someone comes into my clinic and they have constipation, I try to explain the way the colon works in terms of trying to get toothpaste out of a toothpaste tube. So sometimes the issue is that we’re not squeezing that toothpaste tube, and that means that maybe there’s something that’s stopping the colon from contracting so much. We need to do that. We need to generate pressure in order to push the stool outwards. And maybe the problem is actually not that we’re not squeezing the tube, but that the toothpaste itself is rock solid. And sometimes that happens because maybe we’re not getting enough fiber, maybe we’re not drinking enough. Maybe there’s something else that’s making that stool really, really hard. But then the third, and I think most underappreciated part of the problem is that, yeah, we’re squeezing hard enough. The toothpaste is super soft, but we forget to take the cap off the toothpaste tube and then we’re just pressing up against this pelvic floor that is not cooperating.

And that is very common. That happens to about one in three people who have constipation and who have tried different laxatives and different things than they’ve failed. And basically what that means is that our pelvic floor, which is this set of more than a dozen muscles sitting there at the bottom of our rectums, and they need to coordinate in this really highly orchestrated dance, some need to contract at the right time, some need to relax. And for a lot of people, the sphincters that are supposed to be relaxing actually contract. When we bear down, if you think about it, we’re generating all this pressure to try to push our poop out and people’s sphincters contract, and that’s very paradoxical. It’s not supposed to do that. So sometimes when you’ve tried everything, the most obvious answer is actually something that doesn’t involve anything related to your colon, but actually it’s all the muscles in your pelvis that’s the problem.

Brett McKay:

You just went through what you call the three Ps of a good poop. So propulsion, that’s that bearing down that vasalva maneuver, we kind of and get that thing going. Then the consistency, it’s the pliability, the softness, if it’s hard, it’s not going to come out. And that pelvic floor aspect, sort of the cap on the toothpaste.

Dr. Trisha Pasricha:

And I think for someone to reach euphoria and to have healthy effortless balance every day, you have to think about how you’re optimizing all three of those things. All three of those things need to be working at their best in order to have a bound move. If even just one of them is off, it’s going to be hard to overcome it with just the other two.

Brett McKay:

With the pelvic floor piece, I think we think about that with just women because pelvic floor problems can result after childbirth, but men can have pelvic floor problems too. And you recommend that if you have a pelvic floor issue to go to a physical therapist who specializes in that. We’ll talk about something else you can do, tell your pelvic floor when you’re pooping later on in our conversation, going to the pliability part of the three Ps of a good poop, this is the consistency of the poop. Why does poop float sometimes?

Dr. Trisha Pasricha:

Yeah, a couple of different reasons. Sometimes if it’s just soft enough because it has enough soluble material, like enough fiber, it’ll float. Sometimes fat floats in poop. So it depends on what you’ve eaten and how well you’ve absorbed it. There are certain conditions where people do not absorb nutrients and the food that they eat as well as we’d like them to. And traditionally we think about those as resulting in really serious floaters. So there’s a range that could be normal, but if this is your consistent pattern and you have any other symptoms, like you get pain, bloating when you eat, if you have a lot of floaters in your stool, you should actually just run that by somebody and make sure that you don’t have an issue with absorption.

Brett McKay:

Gotcha. I mean, so this is always a concern for me. I read these articles like, oh, pancreatic cancer, colon cancer. And it’s like, oh, floating poop. And I’m like, okay, I’m going to be TMI here, but mine, regular floaters, but they look normal. They feel normal. I think I just eat a lot of fiber. I eat like 60 grams of fiber a day. 

Dr. Trisha Pasricha:

Good for you

Brett McKay:

So I think that’s what it is. Am I right? Should I go see my doctor?

Dr. Trisha Pasricha:

Well, you should always run anything by your doctor you’re concerned about. But what you’ve described sounds very, very typical for somebody who’s just eating a lot of fiber. Once we start eating a lot of fiber and 60 grams is like an A-plus amount of fiber, then people’s poop does change and people are really caught off guard by it. The reason people say that floating poop is a sign of pancreatic cancer is because the pancreas helps break down and helps you absorb that food. And when suddenly that stops working so well, then you might see new floating poop for the first time. But that’s not the only sign. Often, sometimes people, their skin turns a little yellow, they have pain in their stomach. So if you’re otherwise living your best life, run it by your doctor. But it’s most likely just because you’re eating a ton of fiber, which is a great thing.

Brett McKay:

Yeah, I’m a fiber machine as the kids are saying these days.

Dr. Trisha Pasricha:

Yeah, yeah, me too.

Brett McKay:

Let’s talk about the schedule. What does a healthy bowel movement schedule look like? I think there’s this idea that you have to have a daily constitutional to be healthy. Is there anything to that idea?

Dr. Trisha Pasricha:

There definitely is something to that idea. And I think that this is because our bodies are naturally primed to have a bowel movement first thing in the morning. And the reason for that is one of the things that makes the colon a little bit different and special compared to other organs in our bodies is it really operates on a circadian rhythm and it’s a creature of habit. So when we go to sleep, the colon goes into this really quiet state. It doesn’t move around too much. That’s why for the most part, people sometimes talk about waking up in the middle of the night to go pee. It’s pretty rare for people to wake up in the middle of the night to have to poop, and that’s because your colon’s not really moving. But when it wakes up, when you wake up and it operates on the same circadian clock as you, then that first one to two hours upon waking is when you see some of the strongest contractions naturally occurring in your colon that you’re ever going to get the rest of the day for that 24 hour period.

It’s during those first one to two hours that your colon is doing the work for you. And if you have a bowel movement when your colon is already contracting, it means you have to do way less work. You have to bear down less. You don’t have to strain as much. So it’s a nice window. And then people often in the morning start to stack on other habits that help the colon contract too. Like for example, a third of people who drink coffee, their colon is going to start to contract pretty quickly. People who go for walks in the morning, just a little exercise, can help stimulate those contractions. And we do a lot of those things early in the morning, so it’s a great time to have a bowel movement. All of that said, there’s a large portion of people whose mornings are totally hectic, totally crazy.

They don’t have time for any of this, and they don’t go. That doesn’t mean that you have a problem or that you’re weird. It just means that you need to find a time to respond when your colon’s ready. And some other times during the day, the colon will start contracting if you eat a meal. So oftentimes there’s another wave of people who poop after dinner or poop after lunch. That’s totally normal. A lot of times people come to my clinic and they’re like, it’s so weird that I have to poop every time I eat. And I say, no, no, that’s a completely normal reflex. In fact, it’s like a reflux that we’re born with. Kids are pooping multiple times a day in response to eating, and then later on as adults, we try to suppress that and try not to respond to that reflex for no reason whatsoever.

We should just respond. But it’s actually a perfectly normal part of our human physiology. So there’s a range of what I’d consider normal. And what I usually tell people is, no, it’s not once a day. If you go once a day, wonderful, but you don’t have to do that in order to be closer to God. What I do want you to do is have an effortless bowel movement whenever you go. It should be easy if you go once a day, but you’re straining your eyeballs out for 20 minutes. I wouldn’t consider that normal. So they’ve done a study in the US where they found that people who consider themselves to have normal bowel movements go anywhere from once every three days to up to three times a day. And anywhere in that big range could be considered normal, as long as it’s effortless and you’re comfortable and happy with that pattern.

Brett McKay:

I imagine if you see a change in your schedule that lasts a long time, you’re like, well, maybe I should look at this. So if I usually do once a day and then I’m going three times a day, well, that’s interesting. I should probably check that out.

Dr. Trisha Pasricha:

Yes, I tell people to get to know your own schedule and everyone’s going to be different and have some variation in their own life. You might be somebody who goes like clockwork every day, and that’s perfectly wonderful and healthy. But you may also see that you have some variations depending on whatever else you have during your week and how you travel and how you exercise. These things will change, but get to know what kinds of patterns are normal for you. And then most importantly, you should start looking every day before you flush, have a peek. The number of times I ask people, what did it look like? What color is your poop normally? And people just get all embarrassed and say, oh, I don’t know. I don’t really look well, I mean, first of all, how can you not look? I dunno how you resist that temptation, but you should look so that you then when something is different.

Brett McKay:

Yeah. Speaking of looking, have you kept up with these new AI devices you can attach to your toilet that takes a picture of your poop.

Dr. Trisha Pasricha:

I’ve seen some of that chatter, I’m excited about it. I mean, one, well, I think we’re all like, oh my gosh, a little horrified about the idea of a camera down there. But I’m sure they’ve sorted out the privacy issue. But I think, well, yeah, I am excited about what those could show us one day. 

Brett McKay:

Speaking of schedules, and let’s say someone they like, I don’t poop as often as I want. It makes me uncomfortable. I need to take a laxative. But they’re like, well, I don’t want to take a laxative because I don’t want to become dependent on it or something. Is there a problem with taking laxatives to have a bowel movement?

Dr. Trisha Pasricha:

So I have a few thoughts about this. One is that just to take a big step back, I don’t think there’s any problem with someone taking a laxative, especially because I know that for some people we can help and improve constipation with a lot of these different tweaks and lifestyle changes and a lot of the sort of things I lay out in my book, but there’s also a group of people who have conditions and diseases and changes in the neurons, the nerve cells of their colon, that some of these lifestyle changes are just not going to fix. Constipation can be a disease like any other disease, like high blood pressure, like diabetes, and there’s no shame in taking a medicine to treat that. And so I do feel that there’s often a lot of shame and a sense of self failure for when you take a laxative and if that’s what you need to be.

Well, I don’t think that that’s the case. Now, that said, there are a lot of ways to treat it that don’t require laxatives, but know that laxatives are safe. You should use them as directed by your doctor. And a lot of the earlier studies that kind of got people worried that you could become dependent on laxatives, you were somehow damaging your colon. Ultimately, that data was not very consistent or proved to be robustly true. So I worry a little bit less about that. But I will say there are a lot of ways that you can improve your bowel habits and become less constipated just by changing things about what you’re eating and what you’re doing, and even the position of how you’re sitting on the toilet. I mean, it’s very common that people don’t want to take medicines, but you can take things as natural as like kiwis, right?

In our grandparents’ times, people were taking prunes and prunes are incredibly effective. But I have never successfully convinced a college student to take prunes. It’s one of those things that people just don’t reach for anymore these days. But kiwis have been shown in multiple randomized control trials, two kiwis a day that they are as effective as prunes, but they also don’t cause bloating. A lot of these fiber supplements and prunes can cause, kiwis don’t seem to do that. So it’s a pretty simple fix that’s relatively effective all things considered. And it’s not really a laxative, it’s actually just something that’s high fiber, got a lot of nutrients, and is good for you in other ways.

Brett McKay:

I like prunes. I’m a prune booster.

Dr. Trisha Pasricha:

You’re pro prune.

Brett McKay:

I’m pro prune. I mean, it’s a dried plum. What’s not to like.

Dr. Trisha Pasricha:

I think they’re fantastic. And I’m sure you’ve noticed they’re very good at their job.

Brett McKay:

Oh yeah, for sure. Yeah. You mentioned something that I thought was interesting. I want to talk about, say if you’re having problems getting your poop out, you’re constipated or it’s a struggle, the position. So I think you might’ve seen these things on Instagram, the Squatty Potty. Is there anything to that, does that actually help?

Dr. Trisha Pasricha:

Yeah, so this is an interesting thing that we’ve done to ourselves as a mankind. We thousands and thousand of years ago, I mean they have found these upright chair like potties back in the Roman Empire, but well before that, we were just squatting. All of us squat in our most comfortable, natural way to poop. And we’ve trained ourselves out of that. But I have a 2-year-old and a 4-year-old, and if you ever go to a daycare and you see a bunch of kids in diapers, waddling around, they all pop the deepest squat when they are pooping, they don’t go sit in a chair and poop in their diaper. They squat. And that’s because that’s the easiest, most natural way to have a bowel movement. And here’s why we talked about the pelvic floor, and there’s so many muscles that make up the pelvic floor. One of the muscles there is called the puborectalis muscle.

And if you think about your colon, like a long tube, this puborectalis muscle is like this sling that goes across the tube and chokes it closed. It’s almost like your body stepping on its own hose. And it’s like that when we’re just sitting around in our chairs at a desk at work, for example. And that’s kind of a good thing. It’s nice to have that little extra closure of that door so that there’s nothing leaking out. There’s no pressure, but you don’t want that door to be closed. You don’t want there to be a kink in that hose when you’re trying to poop. And that’s how we poop though when we sit at this 90 degree angle. Well, it turns out that if we try to recreate a little bit more of those dynamics of squatting, and we don’t have to actually squat, because I recognize obviously nobody wants to do that, but if you just raise your knees above the level of your waist, everybody will poop more easily. They’ve done these studies that show that, yeah, people who identify as having who’ve been diagnosed with pelvic floor dysfunction identify as constipated. They poop better when they do that. But even healthy people who think that they poop just fine. Studies have shown that when you raise your knees up, even if you think you’re already doing really well, you would be amazed at how much better you do.

Brett McKay:

That’s awesome. So bring your feet up with the stool. I’m a fan of the Squatty Potty. Speaking of the scheduling, there’s this famous bit in 30 Rock, the television show where Liz Lemon talks about every time she walks into a Barnes and Noble, she has to poop. And I’m like, that happens to me. I don’t know how many times, I mean, I’ve pooped in Barnes and Noble several times. As soon as I walked through those doors, I’m like, I got to poop.

Dr. Trisha Pasricha:

Yes.

Brett McKay:

What’s going on there? Why do you have to poop when you go to Barnes and Noble?

Dr. Trisha Pasricha:

Yeah, you are not alone. That is such a thing. And it’s funny, it’s Barnes and Nobles. For some people it’s like the Target. I think the Target is a big one for a lot of people. And it’s been described, I think it was back in the 1980s, it was described in the Japanese literature. What is it about bookstores that make people poop? And there are a lot of theories about this, and I’ll give you mine. I mentioned earlier that your colon is this creature of habit. And the interesting thing about your colon is that it can be trained to respond and react to external cues, cues in your environment that will start contractions and start things to change. And if you go way back in time to remember Ivan Pavlov, the scientists we all learned about in middle school, who used to ring a bell and then the dogs would come and start salivating because when he rang the bell, he brought food in.

But eventually he would start ringing the bell and not bring food in. There would be no, they wouldn’t see that there was food, but they’d start salivating anyway. And that idea tells us that just something about our environment that we’ve associated once with a good poop or a good moment in our digestive history can start to trigger those same cues and those same movements again when we start to build that into a pattern. So I think what happens is, one, in order to poop, you have to feel relaxed. That is a fundamental truth about pooping because your sphincter has to relax at that final part. And I think bookstores put people in that relaxed place, and a lot of people actually find that they have to read in order to have a bowel movement. We can talk a little bit more about that, but just a quick light read, it’s just distracting enough.

It gets things moving and it helps them feel good about it. And I think for some people, I’ve heard this, it’s the smell of the pages. Something about it triggers disassociation. And maybe you go poop once in a Barnes and Noble. Now the second time you walk in, now you smell the same pages, you feel relaxed and happy. It was a pleasant experience last time. So you go again, and now you’ve ingrained this pattern and it keeps happening. And now you’ve got this whole sensory experience every time you walk into a bookstore that it’s like a safe space and it’s pleasant, and you go. And I think that’s how we build habits. And I also think that’s what happens in the target. You go in there, you pick up your coffee, you’re by yourself, you’re having a nice walk around, and it feels safe, and it feels lovely. And then you have a nice bowel movement. That’s my theory.

Brett McKay:

Okay. Yeah. Yeah. I think there might be something to that. And if you’re going to read in Barnes and Noble, leave the books on the shelf.

Dr. Trisha Pasricha:

Yeah, don’t bring the merchandise in.

Brett McKay:

Yeah, no merchandise. They have a sign that says, don’t do that.

Dr. Trisha Pasricha:

They know.

Brett McKay:

Right. Well, let’s talk about reading on the toilet. A lot of people do this. When I was growing up, you didn’t have smartphones. And so I would read the back of my deodorant. I read about tampons, my sister’s tampons were there and be like, what’s going on? Because it’s the only thing there. 

Dr. Trisha Pasricha:

You learned so much. 

Brett McKay:

I learned so much while I was on the toilet. But a lot of people these days, they take their smartphones in there and they’re on there for a long time. Why is that a problem?

Dr. Trisha Pasricha:

Yeah, yeah. I was like, I would learn all 30 weird ingredients on the back of the air freshener. I would read the far side comics. People used to have these little discreet bathroom readers that were just the kind of reading material that could not actually suck you in toilet books. It would be toilet books, and it would be a quick read just to distract your mind for a few minutes. It would be like last week, sports section of the newspaper, whatever it was, you do it, you’d relax, you get the jet and you’d move on. Today, you never see those little bathroom bookshelves anymore. Nobody has that because we’re all bringing our smartphones in. And the problem is that just like we’ve learned in other spheres, like when we’re trying to go to sleep or when we’re trying to have some social connection at the dinner table, the smartphones distract us and really hijack our brains to keep us fully engaged with whatever app we’re on.

The same thing happens in the bathroom. And so we did this study in my laboratory two years ago where we asked people who were coming in for their screening colonoscopy, all about their bowel habits and whether they used their smartphone on the toilet. And then we looked to see when we did their colonoscopies, whether they had hemorrhoids or not. And it turns out that one, yes, all of us are bringing our smartphones in two thirds of the people who we interviewed were bringing their smartphones into the bathroom. But the ones who did, they were 46% more likely to have hemorrhoids, so yikes. And then two, they were five times as likely to be spending more than five minutes at a time in the bathroom just bringing your smartphone in. And that was after controlling and taking to account how constipated they were or how much they strained those things were actually, there were no differences between the smartphone users and not.

So really what we think is the problem is the time, the amount of time you spend there sitting on this open bowl with no pelvic floor support, hemorrhoids are just these cushions of veins. And those veins eventually start to passively fill with blood. And when they become engorged, they pop out. That’s when we call them hemorrhoids, and that’s when we say they’re uncomfortable and painful. But if you sit there like that, it’s not going to happen after just doing it for one time. But if that’s your pattern, you do that every day for weeks to years, eventually we think that connective tissue around them weakens and you get a problem. So that’s why we tell people, one, bring back the old fashioned bathroom reader. Throw in that weird old comic book that you actually can only read one page of before you have to move on, or just set a two TikTok limit. But sometimes I go into these public bathrooms at work and I’ll hear somebody watching an episode of the Pitt, that happened to me last week, and I was like, first of all, I know what episode you’re on, and this is not the place. Just pull your pants up and go watch it at your desk. You don’t have to do this in the current compromised position that you’re in.

Brett McKay:

Alright, so you limit your time on the toilet unless you want hemorrhoids and hemorrhoids aren’t fine.

Dr. Trisha Pasricha:

Exactly. No, indeed.

Brett McKay:

Speaking of going to the bathroom in public, a lot of people have problems with that. And some people we talked about earlier, they feel relaxed enough to poop at Target, but some people don’t feel comfortable pooping in a public bathroom. But as you said earlier, if you fill in that urge, you should probably go if you don’t want to get constipated. So how do you get over that? I don’t know, reluctance to go to the bathroom in public?

Dr. Trisha Pasricha:

Yeah, it’s a lot of strategizing, but I do feel really strongly about this that you should go when your body tells you it’s time to go, because you’re going to make it harder on yourself and you’re going to strain harder later if you don’t respond. And so one, I think, and this is something that medical doctors are just surprisingly very good at, you should identify well in advance, do a reconnaissance mission. What are the safest bathrooms in your building? What is the safest bathroom? If it’s not in your building, in the cafe next door or at the Barnes and Nobles nearby, if you’re out in public, find what the safe quiet bathroom is well in advance. And then don’t share that secret with anyone. Keep it to yourself. But if you’re in a situation where you are just caught with whatever bathroom is on hand, and there’s lots of people there, I actually sometimes tell people, put some headphones in and just tune out.

Do a noise canceling thing, or play some nice music so that you’re not distracted and worried and thinking about what everyone else is doing. And you’re so worried that everyone’s thinking about you and they’re listening for any sound you might be making. And once you just tune them out and put the headphones in, it can really help you just focus on the moment at hand because your goal is to just get in and out too. And this actually goes two ways. If you’re somebody who’s sitting in a stall and since somebody else comes in next to you and has to go and you’re just sitting there on TikTok, you have to be a good citizen and pull your pants up and get out of there. Don’t keep scrolling because you have to do unto others as you’d like to be treated yourself. And I guess the other thing I tell people to do is you can make a little bit of white noise if you need to, if you really feel like you have to. You can shake the toilet paper holder, you can play some alarm ringtone on your cell phone and something to distract yourself and distract everybody else. If you really feel like you want to.

Brett McKay:

Actually, I don’t mind going to the bathroom in public. And when other people are taking care of business, I’m like, okay, you’re taking care of business. That’s what you’re supposed to do here. 

Dr. Trisha Pasricha:

Yeah, good for you.

Brett McKay:

You’re in the right spot. Besides pooping in public, one thing that can throw off your bowel movement schedule is traveling. I’ve got an issue with this. Whenever I travel, my intestines are just like, we’ve closed up shop.

Dr. Trisha Pasricha:

Yes.

Brett McKay:

What’s going on there?

Dr. Trisha Pasricha:

Yeah. This is very, very common when we travel, a lot of different factors conspire against our colon at the same time. So first off, your colon operates on a circadian rhythm. And let’s suppose you’re going to Europe for spring break, and suddenly your colon is waking up at 2:00 AM and it’s not actually time to go and it’s all thrown off. Or you start to sleep in late. You don’t wake up on time, you sleep in. Maybe you would usually drink coffee in the morning and take the dog for a walk. Now you’re not doing that. Now you’re lounging in bed and just transferring your body from bed to beach, and you’re not doing all those things that usually prime your body successfully for a bowel movement. And then second, I mean a lot of us, this is myself included, the best part of travel is the food.

Half the time we go, we want to try local cuisine, but when you go to Europe, and this is what I see with a lot of college students who are my patients, you should go eat the local food for sure. But you can’t eat six bowls of pasta in a row without any form of impunity. And I really think that people need to aggressively seek out fiber when they’re on vacation, more so than they would at home. If you eat a ton of fiber at home and then suddenly you eat half of that or less than half of that, your colon’s going to respond and react and it’s not going to be happy. And then lastly, I think people do get dehydrated on vacation. People are drinking more often like alcoholic beverages. They’re out walking around being tourists. They’re just not drinking as much water and all of these things together. And let’s not even forget about the fact that we’re stressed because we’re traveling with our families half the time, or maybe we have to share a bathroom with our cousins. All of these things come together at once, and it makes it really hard to stay regular.

Brett McKay:

Okay. So I think we’ve covered a lot here about poop. Let’s say we’ve taken care of business. There’s the wiping part, but you make the case for the bidet.

Dr. Trisha Pasricha:

Oh yeah.

Brett McKay:

Why do you think everyone should get a bidet?

Dr. Trisha Pasricha:

I love a bidet. And you’ll never meet somebody who has a bidet who feels like just medium about it.

Yeah. We got a bidet a couple years ago, and I’m like, everyone should have this. What have we been doing in the United States that we haven’t had this?

Dr. Trisha Pasricha:

Exactly. You feel like you’re born again. It’s like you want to make sure everybody knows about this. You make people feel bad if they haven’t seen the light. That’s what a bidet does to you. It’s obnoxious. But bidets are so wonderful. And the weird thing is, and I talk about this all the time, and normally the pushback I get from Americans who haven’t tried them before is, this is one, this is really weird. Why would I want anything touching me back there? And first of all, obviously bidet are for external use only, but it’s not any weirder. If you take a step back, wiping is the weirdest thing we can do. Right. I mentioned I had a 2-year-old, if I’m changing his diaper when he was a baby and I got a little poop on my hand, this happens. The last thing I would do is just wipe that poop off my hand with a paper towel and then just go about my day as normal.

Brett McKay:

Yeah. The analogy I’ve heard is if you’ve out in the garden working, you got mud on your arm, you wouldn’t get a paper towel and just rub the mud because it wouldn’t come off. You would put it underneath the sink. 

Dr. Trisha Pasricha:

Yeah. You got to get some water on that. And yet, for some reason, this absolute most delicate part of our body, I think this part is underappreciated. That area is that skin is actually quite delicate. I think. We think it must be so sturdy standing up against yucky poop, but actually it’s really soft and delicate and it can tear quite easily. A bidet is gentle, clean, hygienic. And I found a lot of people who don’t even realize they’re the kind that would benefit from it. I tell people who I treat, a lot of patients who have Parkinson’s disease or trouble moving, they love bidets because they don’t have to worry about balancing and reaching back there. Bidet just takes care of that. But actually everyone would benefit from it. Think about women who are on their periods. A bidet is so delightful because you have a lot going on at once. Half the time when you’re postpartum, a bidet is lovely because you want to be very gentle. People who have hemorrhoids, people who have fissures, people who just have really hairy bums. People feel like just wiping and it doesn’t really get everything out. When you have a lot of hair back there, a bidet solves all of this for you.

Brett McKay:

Yeah no more dingle berries.

Dr. Trisha Pasricha:

And then you can get the kind with the heated seats and stuff. 

Brett McKay:

Oh yeah, that’s what we have. And then it’s got a fan. So after you’re done, it dries your butt.

Dr. Trisha Pasricha:

Just drive full service.

Brett McKay:

And they’re affordable. They’re not that expensive, and they’re easy to install. You don’t have to get a separate bidet that you put next to your toilet. It’s an attachment right on your toilet.

Dr. Trisha Pasricha:

And let’s just emphasize it’s an attachment that runs through your clean water supply. This is a common concern. Are you just splashing dirty water back at you? Absolutely not. This is splashing clean water. It goes to your clean water supply. There’s no risk of weird back splash.

Brett McKay:

And then some people, if they don’t go bidet, they’ll all just use the wipes like adult diaper wipes essentially. Those are nice, but the problem is you’re not supposed to flush ’em down the toilet.

Dr. Trisha Pasricha:

Exactly. Even the ones that say flushable, which a lot of them do, you actually can damage your pipes, and they’re not actually as degradable as we’d like. So if you’re starting to throw those in, the little can next to your commode. Eventually when those build up, you’re like, why didn’t I just get a bidet? That’s not pleasant either.

Brett McKay:

It’s interesting the cultural differences about wiping. So I lived in Mexico for two years when I was in my twenties, and I remember when I first got there and I was living with some Mexicans, a lot of them don’t flush the toilet paper. They’d have a waste basket and they just wipe and put it in the trash. I’m like, that’s interesting. So I had to start doing that. It was kind of weird for two years to wipe and then throw it away. It was weird. 

Dr. Trisha Pasricha:

I saw that a lot in Europe too, where there was no bidets in Morocco when I was traveling. And I think it’s a plumbing issue. The pipes were really old, and you have to be really careful. But good God, what if ever there was a sign to get a bidet. 

Brett McKay:

But if you do have to wipe, you suggest not to wipe, but to blot.

Dr. Trisha Pasricha:

Yeah, I’m a blotter or a dabber. I like to dab. And again, that’s because I see people in my line of work. People are often prepping for colonoscopies or they have some condition where they have diarrhea and they’re constantly wiping — that area just gets inflamed and red and unhappy very, very quickly. If you’re doing a lot of wiping just dab, you don’t need to go overly aggressive. Just add, because that skin is so, so delicate.

Brett McKay:

So speaking to this pliability of the three of pooping, making our poops easy to get out, what can we eat for optimal poop health?

Dr. Trisha Pasricha:

Well, there’s three layers of what I tell people to do. So the first one is eat more fiber. And actually, if I could do nothing else, that’s one, two, and three, because we are all struggling, I’m actually delighted that you hit 60 grams for men under 50. It’s like 38 grams. For women, it’s 25, and a lot of us just aren’t meeting that. So if you can do that by any means necessary, even if that’s a fiber supplement, I would chalk that as a win. But the second sort of thing that has been shown, if you’re doing that and you’re ready for the 102 level course, the second thing that’s really been shown to help with your gut microbiome, so those are the trillions of microbes living in your colon and their genetic material is to have a diversity of plant-based sources in your diet every week.

And that contributes to the diversity of those microbes. And you want that. That’s a marker of good health and of a healthy microbiome is the different numbers of species in there. And those microbes just remember, they’re not just sitting there. They’re not passive actors in your colon. They’re taking what you’re feeding them and fermenting it and creating these new compounds, which sometimes are called postbiotics, but they’re like things like short chain fatty acids that get absorbed into the bloodstream and go to other parts of your body. So it is really important what you feed them and how you think about them. So eating a diversity of plants is the second thing that I tell people to try to aim to do. So meaning don’t eat the same routine thing every single day for lunch every single day for dinner. Start to diversify that. But then three, and this is I think the hardest one, the 103 level course is to start incorporating fermented foods into your diet.

This is the thing that every gastroenterologist loves to preach about. But there have been some really powerful studies showing how even two groups of people both eating a high fiber diet, when one of them adds fermented foods, their microbes produce even more anti-inflammatory compounds. And you can measure those in the blood. And so fermented foods are kind of hard sometimes. They’re not necessarily the obvious things that we think of in a typical American diet, but you can get them through just Greek yogurt, which is the most common thing that I usually eat and incorporate into my diet every day because it’s very filling. It makes a great breakfast. I eat it that way. But it’s also stuff like kombucha, sauerkraut, kimchi, they’re even present to some extent in sourdough bread or soy sauce. They’re there. So the more you can incorporate and start getting in the habit of throwing in fermented foods into your diet, that’ll give you even that extra boost.

Brett McKay:

So yeah, my morning, my diet in the morning is like my colon morning, so the morning I have eggs with these fiber wraps. That’s where I get a lot of the fibers, these fiber wraps. And then I have a mid-morning meal where I’ll have oatmeal, or it could be like a high fiber cereal, and then I’ll put some Greek yogurt in there and then some blueberries. And then I also eat some either sauerkraut or kimchi with my eggs first thing in the morning.

Dr. Trisha Pasricha:

Oh, wow. I love that. That’s like a perfect breakfast. You’ve got all of the components in there.

Brett McKay:

Yeah. Well, Trisha, this has been an amazing conversation. I’ve been doing this for 17 years. I never thought I’d have a podcast about poop, but I did. Where can people go to learn more about the book and your work?

Dr. Trisha Pasricha:

Well, they can get the book, You’ve Been Pooping All Wrong. Anywhere that they get books and they can follow me on Instagram.

Brett McKay:

Fantastic. Well, Dr. Trisha Pasricha, thanks for your time. It’s been a pleasure.

Dr. Trisha Pasricha:

Thanks, Brett. This was so much fun.

Brett McKay:

My guest today is Dr. Trisha Pasricha, the author of You’ve Been Pooping All Wrong. It’s available on amazon.com and bookstores everywhere. You can find more information about our work at our website, www.trishapasricha.com. Also, check out our show notes at aom.is/poop, where you can find links to resources where you can delve deeper into this topic. Until next time, this is Brett McKay reminding you to not only listen to the podcast, but to put what you’ve heard into action.

This article was originally published on The Art of Manliness.

I’ve been writing about testosterone on this site for over a decade because testosterone is an important part of a man’s overall health and wellness. It helps with strength and muscle mass, strengthens your bones, improves your sexual health, and boosts your mood.

You’ll find a lot of information out there on the interwebs about how to increase your testosterone naturally. Cold showers, taking testosterone-boosting supplements, and even exposing your balls to red light.

But after talking to experts on the podcast about testosterone and reading a ton of research on the topic, the conclusion I’ve come to is this: hormone health comes down to consistently doing the boring stuff.

Several years ago, I spoke with fitness coach Vic Verdier on the podcast about how men can combat the fall-off in vitality that can come with aging, including the natural decline in testosterone. His answer was taking care of the fundamentals.

Vic uses an acronym he calls SEEDS to capture the basics of what you need to do to keep your T-levels healthy. It stands for Sleep, Exercise, Environment, Diet, and Stress.

Let’s talk about each of the testosterone-improving components of the SEEDS framework:

Sleep

A large portion of daily testosterone production happens during sleep. So if your sleep consistently sucks, your testosterone drops. When researchers at the University of Chicago restricted young men to five hours of sleep a night for one week, their testosterone levels fell 10-15%. Aim for 6.5 to 9 hours a night.

If you’re looking for ways you can improve your sleep, check out these AoM articles and podcast episodes:

• What Every Man Should Know About Sleep
• 22 Ways to Get a Better Night’s Sleep
• 45 Tips — That You Haven’t Heard a Million Times Before — to Improve Your Sleep
• What to Do When You Can’t Sleep
• How to Fall Asleep in 2 Minutes or Less
• The Importance of Building Your Daily Sleep Pressure
• Podcast #661: Get Better Sleep by Stressing About It Less
• Podcast #1,055: Sleep Like a Caveman

Exercise

Exercise helps to boost testosterone by increasing muscle mass and decreasing body fat. Carrying around too much body fat isn’t good for T because body fat converts testosterone into estrogen; the less fat we store, the more T we have.

Two forms of exercise are particularly helpful for increasing testosterone. The first is lifting heavy weights with compound lifts that target large muscle groups, such as the squat, deadlift, and shoulder press, and taking adequate rest between sets. The second is HIIT or “High Intensity Interval Training,” which calls for short, intense bursts of effort, followed by periods of less-intense recovery.

But beyond regimented exercise, Vic recommends just staying active throughout the day. Your body wasn’t designed to do 45 minutes of structured exercise while being parked in a chair for the other 15 waking hours. Walk. Do yard work. Play catch with your kids. All those little “movement snacks” can keep your body running like a finely tuned machine, including the parts that manage hormones.

Environment 

Vic’s specific point here is about sunshine and vitamin D, which is closely linked to testosterone production. If you’re spending most of your waking hours under fluorescent lights and only seeing the sun through your windshield on the commute, you’re probably falling short. So get outside more. Eat lunch in the sun. Take your phone calls on a walk. If you live somewhere that gets dark for months during the winter, use some tactics to get more sun during this cold and dreary season. It may be worth supplementing with vitamin D3. But actual sunlight on your skin is the goal.

Besides helping with vitamin D production, getting outside can also help manage stress, which, as we’ll see in a second, is another important factor in hormone health.

Another factor to think about when it comes to your environment and healthy testosterone levels is to make sure you’re not bathing in T-killing chemicals. Pesticides and industrial chemicals can dampen testosterone (and can cause cancer), so definitely limit your exposure to that stuff. Wash produce thoroughly, eat/drink from glass or stainless steel containers when possible, and limit use of products with heavy chemical fragrances or pesticides around the home.

You also want to reduce your exposure to xenoestrogens that are found in a lot of consumer products. Xenoestrogen is a chemical that imitates estrogen in the human body. When men are exposed to too much of this estrogen-imitating chemical, T levels can drop. The problem is xenoestrogen is freaking everywhere — plastics, shampoos, gasoline, cows, toothpaste. You name it, and there’s a good chance there’s xenoestrogen in it. I wouldn’t spend too much mental bandwidth trying to buy products that are completely xenoestrogen-free. Just don’t microwave your food in plastic containers and don’t lick your CVS receipts, and you’ll probably be fine.

Diet 

You don’t need to do any special T-boosting diets like eating Ron Swanson amounts of eggs or consuming three Brazil nuts before you go to bed because the selenium will boost testosterone production while you sleep.

Just eat a balanced and varied diet. Get enough protein. Get enough carbs to fuel workouts. Get a moderate amount of fat for hormone health. Research suggests that about 20% to 40% of your calories should come from fat for healthy testosterone levels. Eat plenty of fruits and vegetables to get the micronutrients your body needs for hormones. If your diet is solid, you’ll probably have no reason to supplement.

Diet can also help with fat loss, which will help reduce estrogen and increase T. For help with nutrition, check out these articles and podcast episodes:

• How I Used the AoM Podcast to Lose 20 Pounds in 3 Months
• How to Eat What You Want and Still Lose Weight
• Podcast #1,011: Lose Weight and Keep It Off With Flexible Dieting
• Podcast #721: The Psychology of Effective Weight Loss
• Podcast #636: Why You Overeat and What to Do About It
• Podcast #475: How to Lose Weight, and Keep It Off Forever

Stress

Cortisol and testosterone compete for resources in your body. When cortisol is jacked up all the time from work, doomscrolling, or a schedule crammed too full, testosterone suffers. I think managing stress is particularly important for guys in their 30s, 40s, and 50s who are running hard and wondering why they feel depleted. Vic’s prescription is to build a life with some margin. Give yourself some time to chill the heck out. Take up a hobby. Become a cinephile. Download the Headspace app and meditate if you have to. Getting better sleep will also help with stress, so make that a priority.

None of these are exotic interventions for boosting T-levels. They don’t require a lot of time or money or exposing your balls to red light. Do them consistently, and your hormone health should be fine.

But…

If you’re doing all of this consistently and you still have symptoms of low T (low energy, brain fog, declining strength, low libido, low motivation), get your levels checked and talk to a doctor about whether testosterone replacement therapy makes sense. But make it the last option, not the first. Get the basics right and your body will usually handle the rest.

More testosterone-related AoM podcast episodes:

• Podcast #893: Optimize Your Testosterone
• Podcast #761: How Testosterone Makes Men, Men

For more tips on maintaining your edge as you age, listen to our whole podcast with Vic Verdier:

This article was originally published on The Art of Manliness.