190. Holiday Travel Protocol, Protein Debates, & Planning to Fail

It's just in that two week period, if you gain an extra three pounds times 10 years, like all of a sudden you're 30 pounds heavier, it's like, how did that happen? It's like, oh yeah, true. I think people will get more enjoyment by knowing that they've resisted something, even if it's a small bit. It's all do a 36 hour fast once a week, just to kind of balance out a lot of those calories and cheat nails and things like that. You're reducing the scope of what you're demanding for yourself, but you're sticking to your daily exercise routine or five days of routine. What happens is that you're still training your brain to show up and do that specific habit that you have. And over time, you start forming an identity that I am somebody who trains, produces scope, but stick to the schedules. Welcome to Medicine Redefined. I'm Dr. Altamasharaja. And I'm Dr. Darshan. Let's put the hell back in the healthcare. Hey guys, before we dive into today's conversation, I have an exciting update. My new practice, refining health and performance is officially launching soon. It's a practice built around health, longevity and performance. The Medicine 3.0 approach we talk about every week here on this podcast. And here's the best part. It's a telemedicine clinic. So you can work with me from the comfort of your home. Our founding member in Rome is now live. So if you'd like to learn more or join the wait list, visit refininghealthrx.com. All right, on to today's episode. Dr. Darshan, welcome back. What's up, man? How are we doing? We're doing good. I'm excited, man. The year's coming to a close, 2025. Year's flying. I just remember us starting of the year off. I don't know when we recorded it, but I remember our 2025 prediction episode that we did and I actually don't remember how much of that came true. If any dead or not. Some of it, some of it maybe. Do you remember which one? I think the social media won a little bit. I remember talking about how the case I was making was that parents are not gonna allow their kids to have phones, I guess, along the themes of that. But Australia just had a social media ban. So just in time for under 16 years old. So I'm a proponent of that. I don't know. The US, it's interesting, my friend and I were talking about some political things and as a result, policy change and it's much more challenging to do those types of things here. But I think 16 is a good age. In fact, Jonathan Height, I think he's a proponent at the age of 16, right? If I'm... He's a book, but I think that's probably, I guess, I mean, 10th grade, along the grade around there is when you can have a social media. Yeah, awesome. So, I genuinely today, I know this is kind of where I reached out to. I thought that we could close up the year, put a nice little bow on it and open intended for people as the holidays come around. With a couple of topics, one thing that came to mind was during some discussion with some people, some patients, people tend to really struggle around the holiday time with falling off the wagon, so to speak. And I thought that maybe we could talk a little bit about a holiday travel defense protocol where people don't really obliterate their goals. And interestingly, when you really think about it, it's like that 10 day, two big period. If you completely have to fall off your goals and have to reset after a couple of decades, you've lost a long time. And then as you get older, it gets a little bit harder to hit reset. When you're young and you're resilient, you're adaptable to going to happen, but with life and challenging, resetting is really hard. And so, that's where I thought we might start off. And then, we can kind of go from there. I'd love to do a belief audit. I know that's something that you and I talk about a lot about constantly changing our mind. Said one of my favorite quotes is, I reserve the rights to change my mind and the presence of better data. We don't know who it's attributed to. Mike Boyle or Deacon Jones or whoever it is. And then maybe we'll, for those of who want to stick around, we'll talk a little bit about the direction of the podcast and where our headset. What do you think? I'm excited, I always love to do these. So tell me, do you struggle in the holiday time with these types of things, with respect to your training, nutrition, et cetera? I don't, I wouldn't use the word struggle, but I definitely do have to restructure it. So, a couple of things that I think about here is, one, what is happening during the holiday season? So this year, me and I are traveling actually to South Korea, Christmas, so like 10 day trips. So usually we try to travel, yeah, as much as we can around that time. But if we're not traveling, then the question comes, who are we visiting? What are we eating? What kind of parties are there going to be? And then it ties into our gym's going to be closed, right? Because I'm a big, I'm a big, I can really only work out if I'm in the gym. Now, I've been trying to be a little bit more flexible because you kind of have to be. But those are really kind of the things that I think about around this time is, and what's funny is I kind of have to pre-plan this maybe six weeks before. Because whenever I travel, I tend to make my D-load week or even just complete rest for seven to 10 days. So this time coming around, I mean, going to South Korea, it's going to be more of a chill trip, not, you know, we're based in one hotel. So I think I will actually be able to train a little bit heavier and a little bit, you know, more than I usually would. But that's at least how I think about, you know, the year end. Yeah, I think, so I guess maybe it makes sense to bucket this interview for people, right? So you're talking about training, our favorite, important to remember that holidays, yeah, like we talked about as messy schedules, doesn't necessarily mean moral failure. First and foremost, I think at this point, this is probably resetting or restructuring your goals to make it more of a maintenance thing and not trying to hit PRs. And if you just don't detrain and don't spiral, that might be a win. So minimum effective dose is something that I think is a really important thing. People are traveling, so you're going to be traveling, I'm going to be traveling, I'm going to Disney World. I don't know if I told you that actually. Oh, yeah, I'm going to Disney World. Yeah. Orlando. Hold it. Orlando Disney World, correct. I'm told that's a horrible idea to go during Christmas week, but that's what we're doing. Yeah, it's crazy busy, so we're going to take a look. But we're only in a, you know, low bar, low expectations, I think it's going to be a fun time. And so I've also been told, like you're easily going to hit 25, 30,000 steps, because my initial plan was like, all right, let me check out the hotel. What are the closest ones? You know, you can't miss a workout. God forbid. And then I started thinking about this. And I was like, all right, if I'm going to be really walking 25,000 steps, which is kind of what I'm ballparking people have hit 30,000. And my average on a daily basis is around 8, like 4x. Maybe it makes sense to skip a lower body workout, right? Maybe that's the wisest thing to do, especially now ordering the age of 37 and recovery gets compromised with sleep and everything. So that's, I think, a big one is like if you can reduce the amount of time, but still tend to show it up, right? So maybe an equipment is an issue now. We also don't have to do the strategic planning of like finding a gym, a gym that actually satisfies the needs. Is it going to actually have the specific exercises that I need, if not, that I got to modify the movement, like, if they don't have a pendulum squat, they don't have a belt squat, like, now fine. So there's a little bit of a cognitive load to that. And it's like, just say, all right, I'm going to hit 100 squats, 100 this, 100 that, and then call that a day, because I've gotten some movement in. I think that's been a really big one. And prioritizing strength sessions over aerobic exercise. I know, I think we talked about it elsewhere with Dr. Matthew Bernstein, not too long ago, where actually that won't have been a release yet, but where there is a little bit of an infatuation with zone two and steady set aerobic exercise. But the reality is strength sessions, most for most people, they end up under dosing. And they tend to carry over the most longevity benefit with respect to function later down the road, things that you and I deal with with sarcopenian and just lack of strength. So that's what I personally do to try to protect as much as possible. I love that. And I think another thing that I try to do around near the year end is maybe more like mental tests, mental fitness tests, and just kind of see what I am willing to, like, bear through. So if it's more like, hey, it's cold outside, let me go outside for a walk and see if I can do like a mile. And this can, of course, you can tight treat this to whatever your need is, if you want to do a cold plunge outside, maybe it's your traveling on a three hour flight. And you've raw dog that flight. You're going to do no music, no podcast. You're just going to sit there and, right? Like these are the type of things that I like to do before kicking off point 26, just to kind of say, like, you know, I did something difficult because it's so we as humans, we have short-term memories, right? We don't really think about what happened in February, what we did in June, even though we might have accomplished those things. But find it just as a good reset to say, I'm going to do something difficult, going into 2026, it's just going to make 2026 even easier when I start off with whatever calls I have or whatever way I want to live that year. Yeah, how long is that flight going to be? Two, 22 hours with one stop. Are you planning on dogging that? Okay, nope, not I will be reading and sleeping. What's going to be your book of choice on this? Having read out live yet. So I'm probably going to bring out live really. Yeah, I haven't read that yet. I've been waiting. Yeah, yeah, yeah, I got a couple count of Monte Cristo. I just got a god in the scene to leave the entire set now too. So amazing. So I think that one is one that people struggle with a lot. Nutrition is the other one. Cookie is holiday. We had actually had a little holiday party at work today. We're amazing fudge and this and that and pizza. And so we know we talk about sometimes it's what you don't put into your body. That's far more important, but that gets really hard. And so I will tell people and I try to do this myself is you choose your indulgence. So I don't do this. But you know, for some people alcohol tends to be a big one dessert is my enemy. And so I don't have to fight that thing, but you know, don't do both at the same time. If you're going to do that or have other things where you're missing out on your regular nutrition, but you're also putting in things you don't necessarily would in your body right from a healthy perspective. So these highly palatable ultra processed foods and sweets and whatnot because you really can't overshoot in the calories. And I think we've talked about this before this. Most of the people over time you end up getting more and more weight. It's just in that two week period. If you gain an extra three pounds times 10 years, like all of a sudden you're 30 pounds heavier. It's like, how did that happen? It's like, oh, yeah, true. You know, it's harder to bounce back from. And then the other thing is, I think protein pulses are really important. This is something we're going to talk a little bit later on as well. Try to prioritize personate every meal instead of all day grazing. A couple of advantages of that, if you just lead with protein, one, we've covered our bases, right? That's been super important. I think people are paying more attention to that. Two, it tends to be more satiating. And so overall, if you are hitting your protein macro nutrient goals, then you're going to be more satiated overall. You're less likely to want and crave that stuff. And more importantly, when you're around that stuff, you will have an easier time saying, no, so I think this, and I'm trying to keep this as minimized friction as much as possible for people. So I think less is more. And I think those would be the two main ones I would have for people. What do you got? I like that. I might get pushed back for this, but I think trackier calories, especially just for a week, just I know a lot of people I can't want to enjoy. I think people will get more enjoyment by knowing that they've resisted something, even if it's a small one, even if it's like a 300 calorie slice in front of you. And you're like, you know what, I'm going to skip that because I'm already a 2700 calories or something, you know what I mean? I think there's more enjoyment in that reward the next day when you're like, I'm proud of myself for skipping something because I was able to actually see the data rather than try to guesswork it. And, you know, the next day, contemplation, I have this, I have that. What's more, I think it just takes the guesswork out. And I think you can then, you know, we talk about food noise per se, right? So I think you just kind of take away that mental chatter of, ah, should I feel guilty, should I not, should I do this? Is the holidays, you know, that whole cognitive load? I think if you just pick and choose what you want to do and you're okay with seeing the data and what it is, I think you're going to enjoy the holidays a bit more. Apparently, I'm fasting. So I mean, what I do is, I need to get back to it. So I'll do a 36 hour fast once a week, just to kind of balance out a lot of those calories and cheat nails and things like that. I used to get a lot of success with it, but it's been maybe four or five, six months that I actually done a proper fast, currently on a fast. So I'd be able to do it for my face, but you look emaciated. Yeah. Yeah. How long does, how far in there are you? How deep are you in this fat? Well, let's say I started last night around eight and it's six 30 p.m. So I'm almost at 24 hours, but our new one, 36. Yeah, probably tomorrow lunch time I'll break it. Yeah, that's awesome. I got the glucose ketone meter, by the way. That's ketomoja. Yes. Yeah, it's cool. I realized I've no, I was point two is my really moles. So we'll see. We'll see. That might be something that I tried to play around with in the new year. You did it first thing in the morning or no, I did it after I hadn't eaten for like eight or nine hours. It wasn't much. It was late the afternoon. Yeah, I know. That's good. So we'll see like actually maybe tomorrow, I'll do it first thing in the morning. The other thing I think the big pillar when we talk about this is sleep, right? Sleep and travel that gets really disrupted. So well, you know this. I have an eight sleep now. And so we got it. I got it. Everyone round of applause, round of applause for me. Everybody we made up the big purchase here. God, they're so stingy with the discount codes. They won't give it to you anything like they won't. It's that code's man. Oh, yeah. They don't need it. But yeah, I got that. And so now, of course, I'm so spoiled. Then I was like, I don't want to not sleep on this bed ever. Like, how do I take this with me right now? I think we talked about that. But that's going to happen, right? So your pillow, your travel kind of stuff. And I'm not really interested in carrying my coop big pillow and comfort her and that kind of stuff. And so that's going to be disrupted. I think we have talked about social jet lag and timing and trying to enjoy that and not letting this be the end of the world. Right? So Jade Wu, she's coming back and you know, we did at least part one with her where we talk about sleep as being so resilient. But what can we make consistent here? So in the past, you and I've talked about QQRT regularity being the most important thing and for those not familiar quality, quantity, regularity and timing, so regularity in terms of going to bed and also waking up. So not fluctuating two, three hours from both sides of that coin is going to be super important. And then earlier on, I guess I'm going to say on this theme of game to people, two actionable things earlier on in the day, getting that early light exposure and stacking movement with it is going to be super important. So I think those would be the big ones for me is be somewhat regular with your timing and try to get early morning light and exposure. Nice like that. Yeah, for me, I mean, I think about the slow time now, you know, going to South Korea, 12 hour difference. I mean, I luckily don't struggle too much with jet lag and sleeping. So I kind of power through it. But I think one of the things is trying to, you know, stay up as much as you can throughout the day, get that exercise in. We know that exercise can, you know, really help with jet lag. People talk about fasting on the flight, not having any food over that period of time. I take a re, I use a sleep supplement called remade, which I'm absolutely in love with that has helped me tremendously, but I will do melatonin, especially if I am trying to flip over the circadian rhythm. So I will add that in. So for me, it's really just sticking to my supplements, sticking to the routine. You know, I obviously will get affected, but me and Mary usually for about a day and a half, two days, it's a struggle, but then we're really in, but what's in that supplement? It is active on the magnesium, laryon root, which is probably two other things that I'm not thinking of that are in there. But it's just a, it's a promotion of things that kind of help you. It's not necessary to help you go to sleep and it makes you wake up refreshed. So if I get five hours or 10 hours, I'm kind of waking up just the interesting. Okay. Yeah. So maybe helps you promote getting deeper, quality sleep, but I suppose have you don't do all this too much. But have you, how long have you been taking it? Almost a year now. And you've had the A sleep before that to track you or do you have seen a noticeable difference for tracking? I actually don't use the tags on the A sleep to track, but I, there's like a palpable difference. So I take the one I don't. Yeah. Yeah. Yeah, like that. And I've had a couple of colleagues who take it out to and they absolutely love it. So they've been consistently taking it to remain. I'll have to look into that. Maybe we'll plug it in for people. And I've got just count and affiliation. Oh, you have a discount code to give people. So they want to, there you go. We'll throw that in there. Yeah. I think those are the big ones that people struggle with. I think if you can kind of get that dialed in, you're going to be pretty successful, right? Whether the storm, so to speak, get through this 10 days, two week period. Maybe it's longer. Maybe it is. And you want to try to enjoy this as much as possible and understand that we are resilient, sleep is resilient, nutrition is resilient. And so I think mitigating damage is going to be big. And I think it's really about mental reframes. Kind of what we're talking about. I know we're giving actionable things. So James Clear, big fans, we both are. I remember him talk about this with respect to, to habit change, right? So both implementing good habits and getting rid of bad habits. But this quote that he recently, I don't know where to listen to him. I forget, but he talked about reducing the scope of sticking to the schedule. Super important. So coming back to that example, we were giving him about training. You know, if you don't have 16 minutes to train, can you, do you have 30? If not, do you have 10? If not, do you have five? Can you do something like that? What happens is, so you're reducing the scope of what you're demanding for yourself, but you're sticking to your daily exercise routine or five days of routine, what happens is that you're still training your brain to show up and do that specific habit that you have. And over time, you start forming an identity that I am somebody who trains. I am somebody who eats well. I am somebody who does this. And then you're far more likely to have these things that stick. We know that especially when it comes to exercise and literature with exercise, once people establish a core habit of exercise and routine and their exercises and avid exercises, it becomes really challenging for them to miss on sessions. I mean, it could be taken too far. So and the same thing comes with nutrition, right? I don't drink or I'm not a drinker or something like that kind of stuff. And he talks about this and I'll try to, it might have been on Bartlett's episode where he talked about this, you know, same thing with reducing the habit. So I think that's a really big one. It's reduced the scope, but stick to the schedule. So I really love that when I want to share that with people. I like it. Nice. Amazing. So let's, let's shift gears here. Okay. Let's talk about a little bit about what has changed. What do you've reflected on? But hopefully you've had some time to think about this. And it is could be, give me, I'm curious to get it from your perspective. Certainly something from a philosophical, mental reframe standpoint. And then I also want to know maybe more actionable from a health longevity perspective if you have something. Let's do the tactical health longevity stuff first first, what you've to ask what I changed or what maybe I've something I would, I would just be curious. If I mean, information is coming so fast at us, right? We know this. And so I would just be curious if there's anything that you're evaluating, re-evaluating. I think a long time ago we did an episode of like, how do we evaluate who to listen to, who not to listen to social media and who to follow, who not to follow it? And we had talked about experts and people saying, I don't know, and changing their mind is so important in the absence of new data coming in. And so I was just wondering if there's anything that you might have evaluated, or re-evaluated that you believed strongly in January, that you feel less strongly, or the other way around. No, I think the biggest thing for me this year coming up, going to 26 is just really not being emotional about decisions. Right. So you talk about shorting the scope, right? So how to go to the gym in the morning, one time at 530, could not, I had to do trip or deadlift, needed a platform, could not get a platform. Just there at the class, I was really pissed. And then I was like, what are we getting emotional about, right? Like, yes, I can, I ended up working out later that afternoon and that morning, I did a sauna mobility walking. So I still got stuck in, but it was really, I need to start zooming out more and just be in like, this is literally a data point one day out of 365. I can still do something that promotes hell rather than getting so stuck in the weeds of making sure I'm hitting that exact movement pattern or whatever it is that I was supposed to do that day. So it's just allowing more flexibility in my schedule, knowing that, hey, if I am going to not or have a cheat meal that night, then maybe dial up the sleep or dial up the movement that day to, I think Peter Tia talks about that is that out of those five, you know, core things that we always talk about. If you know, you're going to miss on one, really hold in on the other four. And so that's allowed me to be a little bit more flexible and just realize, like, literally the last year, nothing's really changed. I haven't gotten worse, but I think I've gotten better, you know, with my goals and just learning more about my body, I think I've really cut back a lot of the strength training in a good way, because I used to just really focus on hypertrophy and strength now picking up more tennis and doing more tennis patterns. And I think that just reframe as ours, what health means? I be realistic with my age, still younger than you, but be 33. It is weird having some of those like minor pains that you're like, what the heck is that? Like I've never felt like this. We're numbness like on my ankle before. And so it's like, what do I have to do that to? So yeah, it's just kind of learning my body a little bit more now and being more realistic with it. I know you're not a fan, but did you hear that clip with the LeBron? I think he was having sciatic neurology or sciatic irritation and one of the reporters asked him, he was like, Hey, like you, you had some sciatica, blah, blah, blah. Like, you know, did you twist yourself? Did you heard it? And he goes, call me an old, you just wake up with shit that you didn't have. Yeah, you get it. Yeah, he's a little older than us, but I love that. I absolutely love that. I think that's actually been an important thing to me. So I want to share a story with you. The only guy I ever told this to you before. So I guess maybe the year between my first year in secondary or medical school, a buddy of mine, you know, we usually go down the shore like that the classic thing. And so we were going to go to the outer banks for a vacation with my college group of buddies. And he decided he said, Hey, like, why don't we write a bike sound there, make a trip out of it the week before. And it's like, yeah, that sounds like an amazing thing. So we train for it for like six weeks and stuff like a nut job. And like actually six days to work out today, six days a week in the gym, hands down for like three months straight. And I remember us writing. And so we did almost five days and we did nearly 430 miles over five days, right? So it averaged out to be somewhere like 7580 miles a day. The longest day ended up being 112 miles because we took a detour. Aside from that one day, we rode for 12 hours straight. Every other day, we would get to our destination after doing 7580 miles. And I'd just be freaking out. And my buddy, Tyler, his name is, he's like, what's going on? It's like, man, I didn't get my workout in today. He was so mad at me. He's like, we just rode 80 miles. Like what are you talking about? And it was that mentality that you're describing. It's like I wasn't in the gym and push weights. And you had a great, again, 80 miles and, you know, rain, like, wind, all that kind of stuff. It just didn't feel like it didn't get that dopamine fix that you need it. And so come a long way since then, this is this little over a decade ago. But I still struggle with this, right? Like so with a Disney thing, I was talking initially, I was planning. And then I had to pause and thankfully, I'm wise enough to say, what are we doing here? We're going to pay for this half of the fact. So anyways, yeah. So hopefully people will make those types of mistakes. I think 100%. I finished a 10k last month. And right after it, I was like, all right, guys, I think I'm going to go get my like, like, workout in. If you're like, what the hell are you talking about? All right, five, let's go trick instead. You know, like, we'll celebrate this. So we're like, all right, five, five, be more communal with my friends. And yeah, it's an issue for sure. I think as much as we were proponents of this, I think that it can be taken too far. You know, as a saying goes, anything in excess or moderation is key for me. I'll say this. So I talked a little bit about the importance of protein earlier on. And for years, I've been in the one gram of protein per pound of body weight, camp. And reason being is because for listener to show you guys know that I have a background and fitness and strength conditioning and performance and working with bodybuilders and working with fitness folks, that is almost the floor of what you're doing, especially if you're trying to get as lean as possible. It's simple. It's memorable and honestly, it helped, right? Most people are widely under eating protein. Then I'm listening to Dr. Eric Topel just destroy that recommendation on multiple podcasts and actually even on LinkedIn, I follow him. And it really bugged me enough that I want to actually say, Hey, what does a literature say? Because my bias is to completely, you know, disregard what he has to say, say that he's crazy and unfit and looks a certain way. That's what I wanted it to think. What did he say? He says it's actually nuts, right? And so the RDA recommendation is pointy grams per pound of body weight, which is that is way too low, right? That is too far on that end of the print. That is designed so people are not having nutritional deficiencies. That is to avoid that. So you have, you're in neutral or positive nitrogen balance, but that's not what we're striving on. We're not surviving, like talking about survival. We're talking about thriving, right? And so he'll say this protein craze. I think he was actually most recently heard him on Adam Grant's podcast to talk about this. And he's a pretty respected and respectable cardiologist and somebody who looks at the low longevity literature. And so, you know, the uncomfortable truth, honestly, in a very high level is the benefit of muscle health function seems to flatten out. Honestly, when I looked at the literature myself, anything lower than one gram per pound for, or excuse me, like anything about that, anything higher that, right? For most people, for most people. And so I'll bucket this into different things when I actually again, multiple studies, meta analyses, and I think context is really important, context over content. And this is where I wish he would add a little bit more to the nuance where he didn't. And so I would say for baseline health, like if you're probably covered around one to 1.2 grams per kilogram of body weight, most of this literature is looking at kilograms per body weight. So I'm just going to reference that for muscle and performance. It's more like 1.2 to 1.6 grams per kilo. And maybe in very specific contexts, get up to 2.2 grams per kilogram, right? In harder training sessions or dieting scenarios when you're trying to get lean, but 2.2 is not going to be for everyone all the time. Now, for older people who are more frail, rehab patients that we take care of, I think it's probably less important to care about the exact number. And more likely, they're actually hitting overall multiple pulses throughout the day. And a biolic resistance to something that we've talked about is pretty well known. And so this is probably somebody above, you know, the age of 60. And so you want to get solid protein into each meal. But I think the upgraded level of thinking from this is actually measuring your requirements based on lean body mass or fat free mass instead of raw body weight. And that's been the upgrade for me as I went through the literature. It's because the reality is fat doesn't need much protein at all. Muscle does. And that's what we're trying to, we're trying to feed that engine. So if I tell a 300 pound patient to eat 300 grams of protein, that's not realistic. And it's exhausting and it's just, it's a lot, right? They don't need that because I don't have the lean tissue. And that might make more sense to to base it off their target body weight. So if 200 is a target body weight, we might go down to like 1.6 per gram of kilogram, which is going to be a lot lower, right? Somewhere like 130 grams. So at that point, it's drastically different. But on the other hand, if somebody's pretty lean and muscular, body weight based just can actually underestimate their needs because more of their body weight is protein demanding tissue. So I think it's actually really important. Here's going to be a plug to make sure that you are getting not just relying on BMI, but actually figuring some way out to get your lean body mass. That's actually really important than just body fat percentage. That's the number of people focused on, but the lean body masses are really important. You'll see the literature when you look at it, some people will say fat free mass. Some people will say lean body mass. It's there's sometimes interchangeable, even though they're not exactly the same thing. And then Grant Tinsley's been talking a lot about this, about the importance of having a separate criteria of looking at muscle mass. Because fat free mass is going to be anything that's not fat, right? So this is going to be bones, organs and all that kind of stuff. And then lean body mass actually excludes the essential fat around the visceral organs as well. And so maybe it might be a little bit less. So all that to say my 2025 version is that again, here's where I'm going to arrive at. If you're generally a healthy person and you're not training hard, one to 1.2 grams of kilogram is probably sufficient. If you're trying to, if you really care about your muscle quality, which hopefully anybody who's listening to that actually does, then you might want to get to the 1.6 grams per kilogram and it gets you most of the way there. Certainly if you're in or sometimes a medication, which we have an amazing guest talking about GLP ones and muscle loss or dieting, I think that's when you start exceed that and you need to be much, much higher in terms of lean mass. Now you're looking at the two and above. Some of the literature actually that comes into bodybuilding, I think Helms at Al has a couple of minute analysis published as early as like 2014, where he said that bodybuilders, natural bodybuilders, not in performance enhancing drugs can get up to and sometimes need 3.3 grams per kilogram of lean body mass, right? Because that's what they have to do. So I think that if I had to bring it down to grams per pound, it's probably in that 0.7 to 0.9, which is going to what I'm going to continue to shift for depending what my goals are. That's good to know, because I'm always around that 0.7.9 and I'm like, do I need to get that extra protein shake in or, you know, stress things? I'll also think that another kick in the pants for me was to go back and relook at this. I heard E.C.'s in Kowski talk about this. She's been a multiple time guest. I really do respect her. I think she's pretty, you know, center when it comes to a lot of these things. And she was actually pushing back on some of this protein craze as well. And I was like, oh, E.C. I'm so disappointed initially. I thought that. And then so I wanted to go back and it turns out she's spot on. So shout out to E.C. props. Yeah. All right, so let's talk about, let's take a big step back. Let's talk about, like philosophically, because something that I've actually been struggling with, something was a perspective shift for myself, for the people that I work with training wise, any other mental approach mindset lifestyle thing that you have shifted on? Yeah. Three core concepts. Someone into this episode that I thought about. The first one ever in article on sub-stack, right, the monster you create. And so this is really just understanding the trade off of your skill and what your work is. And the person that you're going to become without knowing who that is, right? So if you're someone who constantly grinds and you know, you're doing it for the money, you're doing it for the passion, you're doing it for whoever it is or whatever it is, you are subconsciously going to be building a person that you may not know 20 years down the road where all he or she knows is to continue to grind. That is the identity you form, right, to bring it back to James Clear. So as much as possible as you are creating this monster, knowing that monster, being friends with that monster and understanding that it can be a friendly monster, right? And that you are okay with that tradeoffs. I think too many times we choose to not see what that monster is. And purposely we don't choose to see it because we think we always think, hey, in 20 years, I'm doing all this. I'm going to retire. That would be financially free. And I'm going to be fine. Only to end up saying, well, I don't know any other life. I don't know how to chill out. This is all I know how to do. And so you look back your life and say, man, I wish 20 years ago, I realized what I was getting myself into. So that's one kind of reframe that, you know, I'm kind of thinking about more and more as I pursue, you know, further endeavors and just kind of the work I'm in and what I'm doing. So I actually love that. I know we talked about it this elsewhere as well. I need to pay more attention to that. Like I feel like you're talking right to me in my soul. Yeah, it's the idea of the arrival fallacy. Like I will slow down when I will, like when I arrive and people talk about this in medicine, like, you know, you're never actually going to arrive there. But what people don't often talk about, which is so what credit is to you is like, okay, even if you do end up arriving there, you might not like what, what that state is, you might not like the person who's arrived, so to speak, because you've created and, you know, you've shaped a person and they've completely changed into a different person. So I think that's really important. And maybe to make it even scarier, if you had to take it with your loved ones or your family, maybe they won't like you, maybe they don't want to be with, maybe your kids don't want to be with you at that. Because of what you've become, the monster you've become, as you said, that's something really scary, right? And then it's like, like, listen, that doesn't matter to you. Fine. That's cool. But if it does, then I think it's probably worth considering. Yeah. 100% man, it's about knowing what game you're playing, right? And being comfortable with that game, you know, we look at Elon, we know the monsters he's created, he's admitted it. Okay, sort of being a parent, things like that, but he's so dedicated in the game that he's playing. We feel like we talk about Elon that every podcast is because he's such a unique identity and character that you can just draw also any constructs from. So it's just, yeah. Yeah. Yeah. For me, it's this concept from Oliver Berkman, you still haven't read his book. I have it. 4,000 weeks right. I'm excited to read another one. So I don't know if I heard him actually directly talk about it, or if I came across it, but it's the idea of strategic underachievement. So actually, I heard also James Lear talk about this. So James Lear and also arrived at this, but I like the other analogy about it. So I'll share it. So there's one in case that resonates with people. James Clears talks about how you can have, you know, it's the idea that you can have multiple things in life. And maybe you can have everything you just can't have everything it wants, right? So he paints the metaphor of stove burners. And he says, like, listen, if you're going to be using burning and you can turn all burners on, but if you want to concentrate the heat in one or two, you can turn those up, but you've got to turn the other ones down. And so if you have different pots in your life, whether it's your work, whether it's your family, whether it's your personal health and stuff, you know, which two are going to be turned on and which is going to turn off. Otherwise, it's going to take energy away from the other one and nothing is going to go well. So hopefully that makes sense for people, but I like the specific or verbiage in strategic underachievement. And I think Chris Williams talked about in choosing in advance what you want to fail at. Because the reality is in that same context, when you have multiple things going on and so for us is a podcast where we've got multiple jobs and consulting and this and we're taking care of all the thing you're traveling life, you'll inevitably underachieve it something simply because our time, energy is finite. And so strategic underachievement is nominating in advance areas of your life in which you won't expect excellence. That helps you focus your time energy more effectively and helps you cope, which is the most important thing with being less than excellent, which is especially important for a perfectionist like myself. I don't know if you knew that about me, buddy, but for somebody who I know this news to you after five, six years of working. But you know, so somebody, so this is the verb that some people don't love is that the, I guess, in a sense, an insecure overachiever, but I think primarily for overachievers, you know, and so what would that look like, an example? Like you decided in advance that, hey, the kitchen, the house is going to be a mess while I'm spending time with my family and addressing a work deadline and that's okay, right? Like the laundry is just going to pile up and that's fine or like I'm not going to deliver work the same quality of work. So I think that's really important. Like I think I'll share this with you is documentation. We've talked about this, right? We have this AI driven documentation and I used to be somebody who would love my notes to be narrative style, clean, really explain my thought process in detail. This has been a plan as a consultant, as a subspecialist and you realize the AI does a good job getting about 70% there, 70% and capturing in bullet format and you say it's okay. Oh my god. What's that coaching thing then? Don't like it. Be the end of the great. Well, I, yes, I don't know. I love that. But what's the coaching thing that we did? We forgot. Other intelligence. Other intelligence, right? Yeah. So one of the things that perfection is like 80% is good enough. Like be happy with 80%, right? So like that was one of my core things. And so yeah, it's something that I'm trying to pass on and teach to people. I think that especially somebody who has high neuroticism and conscientism, like, hey, this is okay. That you're going to underachieve and I think that, like I said, the verb is really important to use it like that because that's unsettling for an overachiever. Right. I mean, there's a whole theme on this. I'm like, stuff's that called premiocrity. So there's a bunch of people who write about that. So it's about how do you be mediocre at what you do, but being the premium level of it, right? So like your Starbucks is just like premiocrity, right? You can get like 7, 11 coffee or you get Starbucks and there's also like barista level Japanese, right? Like coffee. That's like cream of crop. How do you just be a Starbucks and be okay with that? Right? Because everything's relative in life. And so I always tell residents, you know, you know, this people are striving for the best residents. He's the best this because of the Nate, they're not trying to be the best version of themselves. They think they're going to become the best version of themselves based off the name, not something else. Give them. And so it's understanding the game you're playing, understanding, let, hey, it's okay to be premiocrity, right? We're not, I'm not trying to be the greatest PM in our doctor in the world. And some people that might be like, well, then what are you know, how do you practice? Well, I can still be a great PMR doctor, but I'm also trying to be the best version of myself. And you know, balance all those things that you talked about and understand what you're going to under it's deep. I love that. Premiocrity. Premiocrity. Premiocrity. Right. But I'm. Oh, yeah. Premiocrity. Yeah. I guess I guess. Premiocrity. Premiocrity. Yeah. I don't know. I didn't quite roll off the tongue as much as I liked, especially with my ESL, but we'll do our best we can. Okay. Awesome. Anything else, man? Anything else on that? A couple things. So the second thing I had here was. So it was funny. I was talking to my friend about this, right? We're talking about how there's been zero hurricanes in Tampa this year, right? There's actually not made landfall in the U.S. People have really big one. Like, what was that? The last year. Yeah. Okay. Yeah. Okay. So a lot of people moved out from like our like the city of Tampa into like the suburbs, right? And so there's a whole issue about like, or not insurance, home insurance, all this stuff, hurricanes, all this, all these things. And the whole economic landscape in Tampa has shipped it. But what's funny is like, people have short-term memories, right? Like, we live in a forever now. People forgot that there were hurricanes last year and they look at this year and they're like, no, there's no hurricanes. We're good to live on this island or we're good to live here. And so that constant just stuck with me that people have short-term memories. Like last week, I can't tell you what happened in the news. I can only tell you what's happening today. And so it's like, how do you take strategic advantage of this? So I think one is like, personally, you're allowed to f up, you know, like you can take a shot and be embarrassed and do what you want to do because no one's going to remember the next day. And so it's like, it almost gives you that confidence that it doesn't matter what you do. People are going to remember anyways. So there's almost like this component of insignificance. And so, you know, I think about that and you can extrapolate this short-term memory to it also like markets and if you invest in stocks and, you know, if you're trying to gain advantages with that too, because people aren't going to remember the bad things that you fight. So it's just an important reminder, I think, to realize that everyone else is just living their own life and in their own head. Yeah, you can take advantage of it in any way. Yeah. I mean, people talk about this all the time. It's like your people are scared and so focused on what other people will think when they say something, when they do something, how their actions will affect other people. And that's, it's nice that if you're being considered from that perspective, but the reality is other people are so preoccupied with their own shit that they're not thinking about you at all. Or like, yeah, yeah. So I like that. Yeah. You said you had one more. One more. One more real quick. So I saw this subset quote, man. A lot of people loved it. And it basically said, you should strive. You shouldn't strive to live a life to be well known. You should try to live a life to be worth knowing. And that just hit me, right? So the goal of life is not to be well known, it's to be worth knowing. And so when you think about that, it changes exactly what you're going to do in that moment and that day. It changes your trajectory in life, right? You're trying to be the most interesting man in the world rather than trying to just achieve faith and the vanity that comes behind it. And that you know, I think Mavall says this, but it's better to be rich and anonymous than poor and famous, right? And lose your freedom as somebody who has a lot of popularity. And so it's just a reframe to when it comes to social media, you know, not caring about the numbers, the likes, but caring about what you can share that makes someone say, wow, darshan ultimat to this really cool thing. Let me share that over. I want to get to know this person because he has a cool story about where he traveled. And so again, it comes out of building range, right? Which I love to talk about. So it's how do you expand that? How do you expand your stories and the adventures that you have in life so that you can become someone worth knowing that makes you magnetize other people in the room, not because you're famous, but because you have something worth sharing that I don't write that one now. I love that one. I, you know, I was fortuitous that recognized this. I think you remember me talking through this with you. I learned some interesting things about myself earlier this year and how important that specific concept is to me. And I arrived at this conclusion as we had an opportunity come to present myself, which I probably year ago would have thought would be my dream job. We won the opportunity presented itself as the job had required sacrifices that I was not interested in making. And I actually wasn't aware about the importance of some of the sacrifices that I would have to make. Right. Some of those projects that we work on, the stuff that we do is how much it actually means to me. And you know what I also realized, man? I realized that I love creating and building things. I love the administrative aspect of it. I enjoy the process of just innovating and building, I don't know if I'm an innovator, but just iterating on that art that I absolutely freaking love. And so, yeah, it was actually quite shocking because I would have never been able to vocalize that for you or put that into words, except when I was asked that question point blank is like, Hey, are you going to give all, you know, make these sacrifices and it just had unsettling feeling so much so that I actually wasn't hoping for a call back or anything like that. And so, yeah, that was quite revealing. And it really does come down to the importance of like, Hey, be somebody worth knowing rather than like having a thing of where, yes, I do this and I'm part of this group and an important person, blah, blah, blah. So I love it, man. Cool. So maybe what we'll do is here, hopefully people will stuck around and give them a little insight into what we've been thinking and where the direction of the podcast is going that we've been talking about this with our team. So we want to start off kind of tell them. I mean, I think people, hopefully, if you haven't subscribed, you have subscribed now and you're listening and you're watching and streaming on Spotify or more on video where we've been doing two episodes a month. I think the plan is we're going to continue. We're going to that. We like that rhythm. It allows us to be to create that perfect imbalance. So to speak that I spoke about earlier. So we'll stay there. But what are the things that people can expect from us, man? Changes wise, things that are exciting that you want to share. Yeah. You know, we'll stay long form in a world that's going short form over and over. I think you can't really put the health back in healthcare unless you're having longer discussions with more nuance. So that's something that we'll always pride ourselves on is not being black or white, but really pushing back on our guests and seeing kind of what their thoughts are. I think we've had an awesome line of up guests coming in early 2026. So we'll try to stay on top of that too to have some interesting topics too, right? So we'll GLP wants coming up in the January, which hopefully we can release in February. That'll be a deep dive. I mean, the whole landscape of medicine is changing, right? And I think as we grow, we fortunately have access to a lot of great founders and companies and guests that we can talk to and try to bring on. What else? I think we're going to stick to kind of the core topics. We'll probably try to delve more into AI as well. I think that's going to be a big topic for going to 26 as things change. So if we start going more into that video, video, you can expect more video from us. That's what something we're really trying to put a lot of resources as if whoever watching can see this behind me, I'm trying to create this studio for you guys. You know, the sponsors haven't really paid us yet. So we're still waiting on that. So hopefully we'll double down on that. I think we enjoy that format as well. And then newsletter, the news that is coming back. So if you're a subscriber to that and you enjoyed that, please let us know. Please let us know what you previously liked. We didn't. We're going to roll this back out on January. Hopefully it'll be more actionable bite size digestible. And if you'd like you, please do share it and just give us feedback. I think that's really important. One more thing I'll add for people who are listening and our fans is that if you have questions for us that you want to investigate a little bit further, you want to get our thoughts on. That's what we love doing the progress notes. And so we want to dive deeper into things that are interesting to us and interesting to you. As a listener, we want to give that to you. So please reach out to us on all the social media handles. We're pretty much better redefined everywhere. You can reach out to us on the website as well. You want to talk about your practice, too? Yes. Thank you. I should do that. See the bad marketer is what I am. Yes. If you would love to work with me, I would love to work with you. And so right now we're doing pretty much telling medicine. But within the states of New Jersey, New York, Pennsylvania and Florida, I'm here to help you. Actually, somebody had reached out to me from Florida a couple of years ago and at the time, I didn't have this quite set up. So it's a musculoskeletal longevity-based practice. Everything that you and I have talked about over the last five years, finally implementing it, finally, the imposter thoughts of not being able to do this a little bit behind. And so I feel confident, hopefully, and more importantly, I'm excited to work with people. So you can reach out to me. You can just refining health and performances as the name of the practice. And if you go on the website, you can contact me and we'll get going. Well, cool, man, anything else we should share here? I think we need a little bit. Yeah, I think so. All right, man, happy near everybody. Yeah, you too, wishing everyone else the safe, happy holidays. Until next time. Thanks for listening to the other episode of Medicine Redefined. If you enjoyed this episode, please be sure to check out some of the additional resources in the show notes. Please also check out our social media platforms where you can find more content like this. 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