Exploring the Biopsychosocial Model, Stress Impacts and the Significance of HRV and Wearable Tech with Greg Elliot

Speaker 1: 0:00

Hi everyone, welcome to Exploring Health Macro to Micro. I'm your host, Parker Condit. In this show, I interview health and wellness experts around topics like sleep, exercise, nutrition, daily physical activity, stress management, mental health and so much more. By the end of each episode, you'll have concrete, tangible advice that you can start implementing today to start living a healthier life, either for yourself or for your loved ones. And that's the MicroSide of the show. The MicroSide of the show is having discussions and conversations around these larger systemic issues that contribute to health outcomes. However, today's show is more focused on the MicroSide, so we have a very narrow focus on stress, heart rate variability and how to use wearable devices and data to your advantage. By the way, heart rate variability is often abbreviated HRV, so I wanted to call that out now, as you'll probably hear that abbreviation quite often throughout today's episode. My guest today is Greg Elliott. Greg is an exercise physiologist, osteopath, entrepreneur and co-founder of HealthQB Technologies in Vancouver, british Columbia. He's an HRV and wearable technology thought leader, speaker and sought after healthcare practitioner. This episode is more cumulative than many others, so we start the episode talking a lot about stress and the nervous system to get a baseline understanding so we can do a bit of a deeper dive, or a more in-depth conversation around HRV. Here we get into specifics like how to measure HRV, how to apply a holistic approach to your overall health, the best wearable devices on the market, and how you can start taking more ownership over your health with very practical and tangible advice. This is a longer episode and this was a fun conversation for me because I've had a lot of questions about HRV for many years and I just haven't had a trusted resource up until this point. So for that reason alone, I was thankful to have Greg on the show. In addition, he's a great communicator of scientific information. So for anyone who is just even remotely interested in health, I think this is going to be a very fun show for you to listen to. So, without any further delay, please enjoy my conversation with Greg Elliott. Greg, I'd love to start just with getting a better understanding of the biopsychosocial model, because I think, intuitively, a lot of people are going to understand what this is. But if you could just break down what, exactly, how exactly, you think of this, I think it's going to be a great primer for the rest of the conversation.

Speaker 2: 2:20

Yeah, this has been the biopsychosocial model. It's been kind of a new model for a lot of people, especially in the general public, of how to look at health. And I think the difficulties is we look at health right now very siloed. We look at these individually with our medical system, with the allied healthcare system, with just wellness areas, and so these are each kind of broken down. The biopsychosocial model looks at the biological, psychological and social factors that can impact health and we're starting to realize the importance of each of these areas. The medical system primarily deals with, obviously, the biocide of what's going on your biophysiology, of how to best optimize that and the type of psychiatry and clinical counseling, talking about the psychology around that, and the social aspect as well where you get into some health coaches and life coaches, the kind of these different areas and it's very siloed. But what the biopsychosocial model tries to show is the fact that each of these areas are interconnected with one another. We can work on our stress management. It will impact our sleep and our energy levels and how we connect with other people. We go out and we have a great social event, how that turns around our mindset around those areas. I think for so long individually. Look at the beginning of time of making sure that we're physically healthy. We had a big emphasis on eating right, sleeping well and being physically active, but then, probably the last 10 years or so, we had a big push into the mental health. Mental health plays a gigantic role. What I say about the pandemic is we had an unbelievable social experiment happen at a specific time where our connection with individuals was taken away from us completely the way that we know how to communicate and the way that we interact. And we saw, and we will continue to see, the devastating effects of that to our health. About being, as the years go on, not only immediately but for the long term, when you remove primary matter, the social component of our health, and there's more and more evidence around the social determinants. So the biopsychosocial in that shell tries to show that the fact that you can't look at any of these conditions or any of these kind of factors of health in a silo. They're all interconnected and they all can impact one another.

Speaker 1: 4:30

Yeah, that's great. So I think a lot of people are probably familiar with terms like holistic approaches or integrated approaches. This is just sort of a cleaner definition, I think, of those various aspects that are getting all considered when you're looking at health as a whole. So I guess what are the effects that we're dealing with now in the US healthcare system of not having this approach or this system in place up until now?

Speaker 2: 4:58

Yeah, it's, people start to be able to feel loss of what to be able to do. A lot of health agency has gone from individuals of what to do. You have people that suffer from depression, 5 miles of these, these invisible illnesses that we talk about, that are being so prevalent now that we don't have these kind of objective tests to determine differently than hypertension or cardiovascular disease that we can objectively define and say, yes, this person has this condition versus no, we rely on these subjective analyses and I think people don't feel validated, I don't feel heard by the medical system because there is these tests and so they kind of fall as wayside of what do I do? In that standpoint it's kind of disheartening and majority of my clientele base is in the invisible illness space, that chronic fatigue syndrome, fibromyalgia, ptsd and this is where everything kind of falls in line. And taking this type of approach of saying there's other areas of health well-being that aren't necessarily addressed for you, that's outside of this medical system that can best help you, I think that is you're starting to see these medical clinics incorporating psychotherapists and health coaches. Health coaches are now insurance companies are recognizing how unbeneficial they are and they're starting to be able to cover some of the costs of these health coaches and certainly the benefits. We're going that way. It's slowly. The thought leaders are starting to introduce this a lot more and in, but, as we know, with anything to do with healthcare and science in general, it just could take a long time to trickle down into the mainstream and knowing what to do exactly about it.

Speaker 1: 6:37

No, it certainly is, but that's why it's one of the biggest things I get out of doing this podcast and talking to people like you. Until the major institutions are going to be adopting this, it's going to have to be driven from individuals, and I think a big part of that is education and understanding what exactly it is you need to care about, because, at the end of the day, your doctor is going to be looking out for you, but you have to be your own best advocate.

Speaker 2: 6:59

You need to be the champion of your own health, but health is so complicated With a lot of my patients, I explain to them. Sometimes they see certain people and they're an ecologist or an internist. I don't know if I should do that. You have to be your own advocate. You have to stand up for what you believe in and what you need to do, because a lot of them just they don't feel heard or they feel like, well, maybe I don't know what's going on and maybe everything is okay. Exactly, you're right on the ball with that.

Speaker 1: 7:31

So you brought it up. Why don't we just jump into that now? What kind of demographics do you generally work with? On people individually?

Speaker 2: 7:38

Yeah, so it's typically my orders is, my caseload is very much into the chronic pain space, into the chronic fatigue. Again, those are visible illnesses, people that have been rejected by the primary care system From there. We have a team around us of various allied healthcare practitioners as well as the primary care physicians. That's the main focus now. A lot of the people are more in the physical, active standpoint. They want to get back to some sort of physical goal, whether it's a race or event. Or we deal with a lot of athletes that have a lot of chronic pain issues that are either in currently playing professional sports or after professional sports. We deal with a lot of people in those areas with those diagnoses but have more of a physical type of goal and objectives to go forward. I'd say a vast majority is going to be the fibromyalgia, the chronic pain syndromes from there. But we do have quite a bit of individuals that suffer from PTSD, from depression, and just don't have the motivation or don't know what to do to be able to get back to it physically feeling well.

Speaker 1: 8:51

Yeah, people who are dealing with things like that. It's interesting because what needs to proceed? The other A lot of people know what they need to do, but then if you're dealt with depression, the simplest thing like getting out of bed is a monumental task. Do you have a framework for how you think of health in a general sense within your practice? Do you have a simple framework that you can break it down, because people, obviously you've been studying health for probably most of your life and you're probably like, oh, I can study this for the rest of my life and still not know everything. Do you have a simplistic model that you can give people and be like, oh, here are buckets. You can think about just a framework for people to wrap their minds around?

Speaker 2: 9:29

Yeah, and this is what's great that I have a great team around me which is obviously was able to indicate, and so one of the biggest things is the framework. First, we have to be able to get this all out of assessment and into that standpoint, making sure that there's something kind of the big red flags from there. There's a lot of kind of testing that most individuals don't go through to find out certain hidden things that's going on with their physiology. But to me, what we try to be able to do is we do look at the biosecbers social model and we do try to assess each of those areas. So we have that. And so when people come to me in particular say they're referred to me, my biggest thing is I want to make sure that these individuals are in the right room. I have certain tools in what I do, but I really try to hold a standardized assessment that what we do here to making sure that we were addressing all these various. Now, personally, I have my own framework where people are in the right room and we kind of go through that standpoint. I have a certain framework that I go. It loosely follows the Maslow's hierarchy of needs, now which you talk about that type of framework but also we can judge that's very objective view. It takes away a lot of their individual's goals and values into that standpoint. So I go through a list of, based on the blood work that is done, based on the assessments that we go through of, objectively, what do they necessarily need to work on? Whether that is there some deal of physical deconditioning that's happened over the years and how to go as best go about that. There are some nutritional deficiencies, emotional regulation problems or we don't have any strong relationships and so we have an objective way of looking at the biostatic social model from the various factors that we can impact through their behaviors. But then I got to sit down and be like well, is this a value to you? Do you find the value of doing? Say it is physical activity? Is that what they want to be able to start with? Do they feel ready to change in that specific area right now, to kind of go forward in that standpoint? But if people are ready to go, use you. My framework starts with the physical activity standpoint. We deal with the nutritional side of things and asleep is those kind of big three to kind of start that framework. But that's what me as an individual practitioner where we start making sure that that's the right room for that individual at that specific time. That means with the lives of their goals, that means the line with where they're physically at that specific standpoint. We also have, again, like I said, natural paths other doctors, health coaches, clinical counselors, acupuncturists depending on what our assessment necessarily says is the right type of intervention and the right type of therapy to that individual.

Speaker 1: 12:05

That's really helpful. On the psychological side, I think it's easy for people to wrap their head around. I can lift this much weight. On the physical side, I can. I average this many steps. I can run a mile. What sort of assessments do you use to try to quantify things on the mental health side, because there are a handful of tools for anxiety, depression. Do you employ those, or are there any others that would be helpful for people to know about?

Speaker 2: 12:29

Yeah, from the objective standpoint, I mean there's a subjective analysis when it comes to looking at those types of skills. What we don't do too much of or hold a lot of weight in is more the diagnosis of people, right, like, well, someone says that depression Great, there's a doubt. Tell me anything about the deal with this individual right, very similar to the someone has low back pain Great, I don't know what to do with that. I need to be able to investigate as to why that's there. I don't have a lot of value in diagnoses and other things. So people go like. One of the things is like should I get MRI for this thing? Right, and I go, well, independent of what that MRI says, it's not necessarily going to change what I'm going to do with you, really, unless there's surgery indicated, unless there's a lot of it flies that happen from there. So, from the psychological side, one of the things that we do employ a lot is the wearable technology, looking at various cardiac biometrics like heart rate variability, like heart rate for individuals. Looking at those statistics With for us is a great whole health biomarker and we see the impact of someone's psychological state through their heart rate variability, whether in the moment, during the time or chronically, you know, through nocturnal capture of that, to give us like a good overall hierarchy of biomarker for these individuals that's easy to obtain, that's non-invasive, and then we can get direct feedback on.

Speaker 1: 13:47

Okay, so we're going to end up diving into wearables and metrics like TCRV quite a bit, but I do still want to sort of set the stage. I think the easiest place to start is getting an understanding of how stress is sort of like run through the system. So can you start by explaining, like, what the autonomic nervous system is within our bodies?

Speaker 2: 14:06

Yeah, absolutely yeah. One of the major branches of the central nervous system is the autonomic nervous system. The best way to describe this is that it's everything that we really don't consciously control. 80% of the autonomic nervous system is going through digestion and dilation of various organ systems and it's a lot of things that we don't consciously control. Some are subconscious, some is conscious, like breathing. You have conscious control, but it's also subconscious control as well, so there's some functions in that standpoint. We have two branches within that. Things that excite us through the sympathetic nervous system are flight or flight responses. Everyone knows whether or not we eat lots of sugar and our bodies are going through that stress. We're exercising like crazy, we're not allowed to sleep or we're going through stressful times. That system ramps up. We know that, with sometimes feelings of anxiety. You got your heart rates a little bit higher. You feel the blood pressure running through your veins. You start to be able to see that sympathetic response which we have a lot of these days. We have a lot of sympathetic innovation with all the access to information and all the things that our lives are now, and then we have our rest and digest our parasympathetic nervous system, the way to be able to calm down and relax and be in the kind of a healing process, and what we have now is very much an over-dominance of our sympathetic nervous system and not necessarily access to a lot of our parasympathetic nervous system, our safety mechanism, our resting, our being calm and relaxed and recovery. It's good to be in both of those states, but we don't want an imbalance of each one of those, so we want to be able to make sure that stress is a good thing. That's why exercise is a benefit to people. We add this little stress but it's taken away. We have the ability to recover from that. The typical term in exercise physiology that everyone says is you can never over-train, you can just always under-recover. And very similar with stress where it's like you can over-stress yourself but you can under-recover from that stress. That's the key. We have to be able to bounce back from that. It's good to go under stress, but it's our ability to recover from that is significantly more important and that's the key into what's going on. So we have these two branches of this where things are excitatory, things to be able to run away from, as everyone says, run away from the lion, the fight or flight response, and then we have the rest of the digest for us to be able to recover from that, to heal and to be in a nice, calm state.

Speaker 1: 16:28

Yeah, so you touched on some really important points there, one of which is that stress is not necessarily bad. I think a lot of people have really negative connotations around stress, but stress is necessary for adaptation. So if you want to expand on that, the other thing that you mentioned is along with stress is that the sympathetic nervous system also is not bad. You want both of these to be able to mobilize energy, to mobilize norepinephrine in your body. If you're being chased, you want your sympathetic nervous system ramping up to give you that energy. But, like you alluded to, it's the ability to go into these states successfully and not just get stuck. So it's like signal and noise, if you will. But if you could expand on why stress is not necessarily bad, I think that is a point that is never spoken about enough.

Speaker 2: 17:15

No, to me it's always stress. As your friend, it's actually super beneficial to what's going on and our ability to be able to you know what stress goes on, our ability to maintain a stable environment, is super important to our health and well-being. But I do this in a lot of my presentations. Right, I talk about a key. Well, you know I get into the stress talk. I go, okay, well, you know who names some positive forms of stress, right, and that type of stuff as people talk about. You know public speaking to a degree or winning an award, or you know exercise, that type of stuff. I go, okay, great. And I go, okay, well, what are some bad forms of stress? People go, oh, you know poor diet and you know financial problems, or you know fight with your spouse and things like that. I go, completely agree. I go. I go absolutely, these are good forms of stress, the bad forms of stress. And I go would it make sense if I completely switch these two and say it's exactly the same relevance if I completely switch them? What I'm saying? All those are bad stress, all these good stress Never kind of looks at me to confuse, like what's going on. I said it's other stuff and I go. It's about the dose response relationship of these. You can, you know, exercise, imagine exercising 20 hours a day, five days a week. That is not beneficial for us, that is absolutely detrimental to our health and we wouldn't last very long in this world if that was the case, right, very similar to winning an award all the time. All these different things. They're negative forms of this type of good stress and it was also very, you know, going through the bad stress in its dose dependent relationship, can be absolutely beneficial. And then I provide the study that I, you know kind of people understand, of how drastic this necessarily can be. It was the nuclear shipyard workers study. Have you heard about this one? Okay, so this was done by the Department of Energy and it was looking at nuclear shipyard work. This individual is exposed to nuclear radiation on a continuous basis and they had three different cohorts. They had one that was exposed to high dose radiation, which is equated to about, you know, a few X-rays per year. They had a medium dose radiation, which is about one X-ray per year in regards to its mount, and they had a worker group that were not exposed to any radiation at all and the sample size was 60,000 people, so 30,000 were controls with the zero and then about split halfway in between regards to the different cohorts. What they looked at is they looked at over 30 years and they looked at any cause, any kind of mortality or morbidity in regards to the individual's cardiovascular disease, cancers, anything that would have a cause. What they found out was the fact that the people that were exposed to the most amount of radiation lived about 2.8 years longer than the control group and the fact that they were less likely to develop the hemopoietic type of cancers or radiation-sensitive cancers like leukemia. As a result, I feel a little hold on a second, because the dose response, the amount of radiation, having three X-rays at a single time is a lot. But if you space that over a year time frame, it can actually be of benefit because this is a stressor for it. It's causing some sort of physical adaptations in individuals, but they're not exposed enough over that time frame. That's caused a real disorder because they have the ability to recover from that. So as a result of that, they were able to live healthier, longer lives than the cohort, very similar to people that were exercising and not exercising. It's about a two-year increase in life expectancy if people were exercising a minimal amount of physical activity versus people that were not. That's where people are like oh my gosh, it's about that dose response. It could be absolutely beneficial to have these small doses of seemingly negative types of stressors, if our body has the ability to recover from it.

Speaker 1: 21:05

Yeah, so that you very eloquently, through a story, explain the idea that you can adapt to certain levels of stress as well. It's all very adaptable and trainable and I think one of the really important things by the way, that's a fascinating study One of the really important things is to have the right mentality around stress, and people do always carry this very negative connotation around stress. I usually try to make the distinction between distress and eustress, distress being one of those negatives and eustress being sort of the positive stressors in your life. But yeah, gosh, that's such a good study and very eloquently administered as well. What was that from? Oh, it was great. Is that from the 1970s, you said.

Speaker 2: 21:51

Yeah, it was from the 50s to the 80s. They're looking at us and, yeah, we'll attach to the show notes and to that standpoint so we can read it through thoroughly. But you talk about all the things that you want from a study. In regards to longitudinal studies, I mean, it's got an unbelievable sample size, great amount of controls around the methodology and you talk about all the tests that people had to go through the whole time. It was a gigantic study and obviously the Department of Energy was not necessarily too happy with the findings, because the whole hope was the fact that they're saying, hey, when people are supposed to radiation, we need to be able to put some protocols in place at that point. But I kind of showed the opposite and the opposite and then it started to spit balls to why that is.

Speaker 1: 22:26

Yeah, it's also such an interesting metric that they were tracking right, like tracking radiation. It's not like you're tracking smoking, which is obviously one of those things where positively in the other direction, like exercise, like you alluded to yeah, radiation it's not exactly not the outcome you would have expected, no, but yeah, you got to love studies like that.

Speaker 2: 22:45

Well, it's great, but it just provides that talking point. It's like well, why is this the case? Right, and talk about, you know, like this is the same mechanism as the why exercise works. This is a mechanism of why certain stressors of things why we do sodium, why we do ice baths, like these little stressors that we possibly do how can these things, which they have, this subjectively negative? I always use an example of like, if you did not know, exercise worked right, really. And you say to the point of, like you know, someone says, hey, you should exercise because it's healthy. You go to the gym, you do these lifts, you do these weights and stuff, like you're going to lead their feeling exhausted and you feel sweaty, right, you'll be super tired to have to go to bed super early. You wake up you'll be super sore and exhausted and that type of stuff. And I go like you did no, exercise was good for you. A lot of people wouldn't necessarily do it, like subjectively, like it doesn't make you feel good really in the short term, but it's the accumulation over a period of time and it's just like yes, like yeah, it's. You have to look at the whole thing, sure, it was. Like well, what is the purpose of me doing this and what are the necessary responses?

Speaker 1: 23:42

from it. Yeah, that's a great comparison. I want to go back to your assessment where you said you typically start people with physical activity. Is there a reason you start a lot of people there?

Speaker 2: 23:52

And this is the that's kind of my area of expertise when it comes to the osteopathic exercise physiology background and this is like kind of again want to make sure people in the right room right. So when people have that as either a goal subjectively or kind of fit, one of those objective goals of we find that's the lowest hanging fruit for this individual. They typically end up in my room when we have other people when it comes to seeing nutritional changes or a kind of genetic abnormality, so we have sleep pattern issues or issues with relationships and connections of other people, or emotional regulation or self-acceptance or anything around those areas. We have these assessments that we kind of go through. We kind of say, hey, like this is the right practitioner or the right type of intervention for you, and so people call them in my room. It's not the fact that I don't dress those other things Is that usually people end up in my room or within my clinic and into this specific area with physical activity being a primary goal to them.

Speaker 1: 24:47

Okay, so I'm just going to throw some categories out there at you just to give people an idea of what I'm talking about. So if you were to take these buckets of like sleep, exercise, nutrition, stress management and relationships or connection, is it the case where a rising tide lifts all boats? Where if somebody is like, maybe deficient in a handful of these categories and you know one of them really needs to be addressed, but they're not ready to start there, can you just start with like meet them where they are and like start addressing that. It's probably going to help them in a variety of areas.

Speaker 2: 25:25

You see that all the time I get people. When it comes to this one individual that was really on in my practice, whereas he was a recently retired individual Now I was having some overall pain. He was diagnosed with rheumatoid arthritis when I was on certain medication, was just having a lot of joint pain over that period of time. One of the things is because of recent retirement, his purpose of life he didn't necessarily didn't have. He was just kind of living and going free, flowing and that type of stuff. Our assessment highlighted that and he thought, like you know, I didn't think purpose of stack, because he had such a purpose. He was a high powered suite executive for many different years and didn't necessarily realize like, oh, I guess I don't know what my next part of my life is, this is going to be like, and so part of that, we started to lay out the framework of what that is, what his values are in regards to living life, what his legacy want to be able to be and start to be able to write this stuff down and design plans. And because of that he goes. For the first time in five years I'm sleeping through the night.

Speaker 1: 26:17

It's remarkable.

Speaker 2: 26:19

Right, you're completely right to the degree they may not be ready to deal with specific areas of their health and well-being at a specific time, whether it's past experiences or trauma or whatever. But this is again. The bio-cycle social model is the fact that everything is connected. You start to address one specific area. You will definitely see shifts in other areas most of the time for the good, but sometimes for the bad into that. But it's be able to kind of look at the person as a holistic being and what's going on and realize it's like when you shift. You know one aspect you will do the big buckets If you shift someone's psychology, how they can impact their connections with other people, as well as their drive and motivation to be more physically active and eat right and everything, and so all of these kind of intertwined into play with one another completely. So you're exactly exactly on the ball with where you start to attack one area of someone's health and well-being, it absolutely is going to impact one, if not almost all, the areas of that individual.

Speaker 1: 27:19

Yep, yeah, as long as you actually end up addressing probably the root cause one at some point. But a lot of people, they just need to see progress early on. People have to get early wins, especially around behavioral change, otherwise the drop off rate is astronomical.

Speaker 2: 27:33

Oh, complete. And this is obviously to see the retention rate, as most applications is extremely low, within 30 to 10 points, because it's like, yeah, it's like you got to be able to see that change, which is, I think, the benefit of again using both subjective and objective captures of things. I think the power of wearable technology and kind of that kind of remote monitoring tracking is such a key aspect into behavioral change to get that kind of feedback that things are shifting in this and that, rather than you know. I have the story with one of my colleagues is went to get a whole kind of medical thing done and he had a little bit of high LDL cholesterol and the doctor goes oh well, you know there's probably some lifestyle changes and that kind of stuff you should probably do, and but it gave some recommendations, You'll be great. When can I test it again? Six months, who do you know is just going to be, you know, saying absolutely stingy into something and not knowing if you're necessarily working in regards to decreasing LDL for six months without any feedback whatsoever.

Speaker 1: 28:27

The people who are annoyingly healthy, like you need to like, but that's the mentality they have and, yeah, the average it's already successful.

Speaker 2: 28:37

Yeah, no, I can't believe it Right. And so you got to get that feedback for those individuals and get those other wins and realize like even small amounts of you know improvements to certain areas is having an address impact on my health and well-being. If you can get that feedback, both subjectively and objectively, you know, follow that it is, it is an absolute game changer for a lot of individuals, for sure.

Speaker 1: 28:57

Yeah, hopefully the conversation at this point for a lot of people has been able to. People can see the issues with the existing US healthcare system where, since all of this stuff is obviously related like it's one body right, like it's all connected, but the system is incredibly fragmented and getting people to talk to each other from even different verticals within the healthcare system is extremely challenging for a variety of reasons, but hopefully that's becoming clear at this point. I do want to move on now to actually talking about the main topic of this conversation, which is HRV stands for heart rate variability. I think it's becoming a much more popular metric, which is great, but I think there's a lot of confusion and ambiguity around it, so I'll just leave it up to you. I'll allow you to start this conversation however you want.

Speaker 2: 29:44

Yeah, it's again like I've done this elevator pitch now for the last 10 years. I've been utilizing, however, variability since my master's degree in 2012,. My master's thesis. I used it clinically since 2013,. You know through this whole thing. So I've got a pretty good explanation where the hiccups are for all this. Most people confuse and when you hear heart rate variability, you really do think of heart rate. You know 60 beats per minute or 90 beats per minute, and people are very familiar with that. What provides significantly a lot more information is actually the frequency at which those beats occur. So, say, you and I have 60 beats per minute as a resting heart rate, where mine beats on a consistent basis on the second, every second right. The beats per minute is how many beats approximately? Is this happening over that period of time? How many beats actually happen within that minute when yours varies? You know up and down. At rest, it kind of goes up and it speeds up and it slows down in a nice kind of rhythmic pattern. What research is showing is the fact that you're in a healthier, happier, well-stayed than I am. So we want more variability, which is completely counterintuitive, what everybody thinks Like. Well, we want a stable system. You think of the term homeostasis, our ability to maintain a stable environment. They think that it's like well, you want that stability. You want that consistency and routine which our body likes, our kidney rhythms, it's everything in the cyclical type of nature. Our heart rate variability is one of those abnormalities. So heart rate variability is the frequency which it beats our curve. We don't want our heart rate to beat like a metronome, we don't want it consistent. If it's consistent, this is indicative of a stressed state, whether physiologically, emotionally, psychologically or socially, that our body is fighting something. It is in a fight-or-flight state, more than a rest and digest state. And the reason why I find this number to be extremely valuable in as many of the different ways that it can be measured. And, as I kind of alluded to, we have so much more ways to accumulate stress than ever before, many different ways. When we talk about again social media, the news and into the activity, the complexities around society and money and all these different things, that has been almost of a part of us in a very short period of time, and so are. We have way more density in this very much of stressed state. It's evident by the amount of burnout that's occurring in many different types of practices and practitioners and exodus and very high-demand jobs, people creating their own things in entrepreneurship around it all big shift into this kind of recovery state that it's hard for us to get into, that rest and digest state. Very often To be able to recover from these things we kind of stay in this sympathetic state which we know now is linked to pretty much every chronic condition under the sun, whether it's diabetes, whether it's heart disease, whether it's Alzheimer's, whatever it may be. It's highly associated, having high levels of subject to stress, with all these kind of chronic conditions. And so Harvey Verrilli's been a fantastic metric, very sensitive metric, more sensitive than heart rate, of determining is our body in a rest and digest state or is it in a fight or flight sympathetic state.

Speaker 1: 32:41

Yeah, so that's great. What's the best way to measure HRV?

Speaker 2: 32:45

It depends really on what you're using necessarily for right. So stress can come in many different ways. The kind of the big two are acute and chronic. Right Cute stress is doing this, talking to you, having to answer all these questions. There's certain things. Obviously my heart rate is a little bit higher so in this moment now there's various ways that I can measure my RV variability to be able to say, hey, greg, be in a calm state, calm down, it's okay, and be able to be more in a relaxed, a bit more specific, rather than going super sympathetic. There's one way to be able to calm down so you can do it in the moment, you can do it right now saying, hey, is your body in a more stressed state, less stressed state? Let's do some mechanisms of various things, whether it's breathing, whether it's mindfulness or meditation, to be able to bring that kind of down, so you're kind of more in a balanced type of state. That is the chronic way of doing it and that's more the longitudinal type of measurements which is kind of more popularized in the commercial space, in the medical research space. It's more in the moment, in that timeframe where they're at the ability to be able to get a high quality signal In the sports performance and the consumer basis. It's typically either first thing in the morning, which is kind of looking at your most supposed to be your most recovered part of the day, or nocturnally, through night, through the use of wearable technology. So back in 2013, when I kind of first used hybrid variability in the consumer state, it was very much first thing in the morning. You get a polar heart rate strap and you would open your app in your phone, whatever it necessarily may be, and you would press the timer. You would wait a minute to five minutes depending on what app was used, or as you press save and you kind of go on your day and you kind of use that number to track. Now, with the sophistication of high fidelity wearable devices, we can now get that completely passively. We have to be able to kind of get any type of active state to open their phone, whatever their wearable captures it. They go on their own, they just upload the information and then you're ready to rock, which to me is, from a clinical standpoint, significantly of benefit comparatively to do the nocturnal. I know this pros and cons to each, but from a personal standpoint I personally look at more the chronic HRV state, making sure that we're building stress resiliency, stress adaptability over the long term for more health longevity standpoint. I primarily do a lot of interpretation of these more nocturnal or longitudinal type of chronic HRV measures.

Speaker 1: 34:59

Okay, yeah, so that's a very good explanation, I think, for, like you said, the performance populations, the acute measurements, those can be very interesting, right, but probably a different conversation. There's only so many professional athletes and I feel like a lot of conversations around this topic already tailored towards athletes, since, like, most people aren't athletes. So let's just kind of go to the nocturnal. Is it should people be paying attention to their average throughout a nighttime, their peak throughout a nighttime? So I have an ORA ring, but many wearable devices are going to be displaying this now. Woop has it, I think Apple Watch probably has it.

Speaker 2: 35:40

Getting there? Yeah, there's a few. They don't do it as often, so the fidelity pieces in there, the capture, but they don't necessarily have a lot of samples from the night. But, yeah, they're starting to do as well.

Speaker 1: 35:49

Okay, so which wearables? Let's just go there. Which wearables are best for measuring? Hrv.

Speaker 2: 35:56

Yeah, it's, there's a few that are out there that are doing a good job and, just like the race is happening now is everyone's starting to get up to a pretty high level. You know, there was many, many issues with wearables during the day, back in the day with all, because people were like, oh, I went for a walk and my Fitbit said that my heart rate was 200 beats per minute and I think I'm having a heart attack and I will restress tasks and nothing will come up with it, and so there was a lot of problems with that early on. And so you know there's there's people coming up and they're getting better and things like that. But the ones that I would suggest they do a couple of things. One is they provide a lot of data. I mean the fact that it's not one or two samples is they provide a significant amount of data over a period of time. So that's that's. One high level thing, too is the fact that their, their numbers hold up in regards to, and they publish a lot of the stuff, right, so they publish out there the validity around. You know their numbers versus ECGs, and so they're trying to be able to prove what they do is as accurate as possible. So I like that piece of it as well. The last piece of it is is companies that don't hide behind algorithms, where they kind of have this stress marker or this HRV marker and they don't necessarily give a actual statistic as to what those numbers are right, so it's harder to be able to determine. I always use the example of you know, people come up with biological age, like, oh, I did this test, I said my biological age was 23. I go okay, well, I need to know what's in that to be able to figure out what to be able to do to make sure that it stays that way or why it's that way, and so you kind of hide behind these things. So the three companies that I suggest that end it depends. It's mainly for comfort or kind of utilization, so one obviously is or a rank. They've been phenomenal from the stamp right from the, from the beginning, in regards to providing high quality data that provide, you know, a bunch of raw data, there's a lot of integration capabilities. They publish a lot of their stuff and they're trying to show they're trying to be as accurate as possible. I mean, they're not perfect None of the wearables are but they're trying to strive to be as as big a player as possible. So those are or rings, a phenomenal device in that standpoint, that kind of the leaders in the data quality. From where advice, big hesitation for a lot of people is they just don't want to wear a ring, right so? So you got to go on that side of things, okay. Well then, what are other type of wearables? One company that I've got to know a lot over the last 10 years well, not 10 years, probably the last five years is going to be called Biosstrap. So they were a direct consumer wearable. They're now gone enterprise or B2B standpoint, but they're a risk based wearable and they get. Their main concern is about data quality and transparency. That's what they want to be known for, that's what the key is, and more than anything else, and they want to be able to support companies with high quality data, high transparency, raw interview intervals, all that type of stuff and so again, and they strive to be as scientifically relevant as possible. So that's another kind of wearable device that they like. And last is for people that want a little more functionality, just to want some sort of you know like thing that they're wearing. They want to be able to tell time or they want to do that. And so Garmin obviously is at the forefront from the wearable devices from from, from there they bought first beat in 2020. And so they have a significant amount of data set in the back end to be able to validate what they're doing and I think they're in the forefront becomes smart watches, their standpoints and from our early testing and in data analysis from our data scientists, they hold up pretty our well to the high fidelity wearables that are out there, so they're doing a good job. So it depends, really, if you don't like rings, you want wrists. You know there's the to be or rings best. Again, don't want to ring. Wrists is talking about biostrap. You want more functionality. You want to get the best of both. The Garmin, those are kind of the big three that I would say right now, but there's so many companies that are coming out now it's it's everyone's racing to get into the wearable space.

Speaker 1: 39:39

Yeah, for sure, and yeah, so I have no right because I hate wearing anything on my wrist. So it's funny where you were like people, people sometimes don't like wearing rings and Michael, I hate wearing anything on my wrist for an extended period of time. Maybe it was a Garmin for running, but is is polar kind of in there with Garmin, like I tend to think of polar and Garmin sort of as like same same right. They've been around forever, but is Garmin better when it comes to these things?

Speaker 2: 40:05

And this is, and this is the reason why it's because of the functionality piece is the fact that it's like you know, if you want dated quality, you know like there's other, you know, the wearables that kind of purely focus on that. Not the thing that pull is bad, I love I. Again, we talk about scientific literature. You look at anything to do with exercise, physiology or looking at heart rate. You're looking at Polars right there. That's the number one kind of company reverse research aspect of it, all so phenomenal. But I think they're kind of geared towards a specific subset of individuals which is going to be more the kind of triathletes in Iron man type of individuals, which again is a smaller, a smaller subset of group where Garmin, you, you have a lot more integrations with different companies and and different things you could add into it. Like you know, with the, you know the Moxineers devices or or Dexcom is now integrated with them and so you kind of get Dexcom information through it all, and so we talk about functionality. That's arms like ball. You got some of the data quality, but you also got the ability to integrate a bunch of different things If you want more of a smart type of watch. So that's where, in regards to data quality, yeah, I mean, polar has always been at the forefront as to what's going on, for sure.

Speaker 1: 41:03

Okay, and I have to ask do you have any conflicts or relationships with these organizations? No, okay, great. So you mentioned companies hiding behind scores. Yeah, a whoop came to mind, which is, which is like it's funny, right, because, like you have to understand what the what the consumer market is, where it's probably unrealistic for the average person to sift through sleep data, resting, hard rate data, their acute and chronic workload, hrv, and be able to come up with a reasonable assessment of how hard they should be able to train today. That gives you a recovery score, a recommendation like how hard you can train today. So, from the consumer side, I can see the benefit to it, but from the provider side, when you can't get the raw data, it's hard to extract what a performance score of 85 means, yeah, or what everyone-.

Speaker 2: 41:58

I completely agree. This is one of my. Again, some of the data quality comes through from what we can see is pretty darn good. But again, they provide a lot of metrics. I just know how to interpret them or to make it actionable for people. I really don't. And so, and again, like you know, you look at the entire business side of Woop, which I completely understand as to why they go behind algorithms, because it makes them more valuable company if they want to be bought by somebody else, because they have these kind of proprietary type of algorithms with the new stress score and with their old strain score and all that type of stuff, which there's a whole business side. There's a whole their own interpretation side, and I completely agree. And when it comes to HRV we talked to those you know before we kind of jumped on. Here is one of the problems with HRV. It's always the interpretation of what people do. But when you look at the user base of Woop, it's going to be more the physically active, athlete type of individuals which it's more understandable as to what their stress is, which is going to be more about load management and training management than it is about life management To be able to deal with those things right. They're hyper focused in certain areas and so it makes it a little bit easier to be able to prescribe things, especially if the demographic is more of that athlete type of individual where you know, going to the biohacking realm or going to the clinical space when you're trying to help individuals that are recovering from a health, of wellness issues, it makes it significantly more complex to be able to understand of how to apply the knowledge of the wearable product, because you need some more contextual information around that individual.

Speaker 1: 43:29

Yeah, and it's not to talk about Woop. They're a super interesting company and they're like they spend. They do so well in their marketing. They're making this stuff much more approachable for the average person, because it's just so it's becoming more commonplace in the vernacular. But I do wanna ask kind of about the you mentioned clinical sense, I guess, when you're talking about the reliability of the data coming off of these. In the past there have been issues, but are we basically at a point now where the volume of data that you're gonna get from a consumer grade wearable device, like an ordering, for example, is it high enough? Is it good enough where, yeah, like doing a sleep study, is gonna be the gold standard, but the availability to do that repeatedly over time you're still only getting a snapshot? It's a great snapshot, but are we basically at a point now where the volume of data is basically good enough? Not good enough. But do you know what I'm asking? I'm stumbling through this question.

Speaker 2: 44:30

Yeah, I know what you're just saying, like it's not gonna be perfect to a gold standard, right, it's never gonna be absolutely to the point. And this is where you gotta be able to differentiate between this. I don't think wearables are gonna be diagnostic right In that standpoint. We're gonna be able to diagnose conditions, saying you have this or you don't have this. They'll be right associations and correlations between things a little bit better in the real world situation than isn't anything about diagnosis, where, if what you're doing in regards to behavior change, is it actually benefiting you or no? And this is where I kind of come into the standpoint of people with their oh, it said, my REM sleep was this, or REM sleep was that. It's like, well, it may not be your REM sleep, but two degree, you can probably say it, in fact, that if your REM sleep went from an hour and a half to two and a half hours and you did this stuff, you're probably improved your REM sleep. There's probably your sleep quality is probably improved, right, so it's okay, okay, great, like there's probably some information we can drive from that. But do I know that they're, for a fact, have improved by exactly 59 minutes and 22 seconds? I don't know right and it's probably never gonna be to that point, but it definitely a great, you know, gives some pretty high level of feedback. And this is where we use it, where because, again, when it comes to, say, blood work information, you know you have to go to a location you got, like blood done sometimes costs money, and so there's certain aspects and you never know when to really do it and to that area and so how we use it. If we ship certain things regards to nutritional aspects and we look at this wherever product and we start to see some plateaus or some, you know, either regressions or some areas, we know that's the best times you'll get blood work down that specific point. It gives us great feedback in regards to when intervention you know should be changed or altered or assessed or whatever it may be based upon. Where the shifts are right, we get someone's you know suit quality going up. Now that HRV goes up to a specific point, it goes from 60 to 90, so, numbers right, harvest at 90 for a couple of weeks, okay, great. Now's a good time to reassess what's going on and see what the next plan is from there, rather than just arbitrary three, six months and just kind of throw okay, well, now's the time to reassess. It gives us great feedback of you know, the individual responses of somebody to say, hey, kate, like let's reassess now to be able to kind of create those changes little more effectively and efficiently for each person.

Speaker 1: 46:45

Yeah, that's great. You know it's not to say that these things are going to replace some of the more like the established medical metrics and the more in-depth and reliable metrics that you're gonna be looking at, but it is a beautiful adjunct to it for, in between, for a much faster feedback loop. The example you gave earlier of somebody who has slightly elevated LDL cholesterol and then you're checking against six months later and six months is not even, it could be a year, like if you're young, the response is gonna be well, check it again in a year. So to have a much faster feedback loop. That's where the beauty and the power of these devices really really kind of flex their muscle. So can you describe like the relationship between HIV and stress? You've already touched on it, but let's start getting into like more specific numbers and because I'm curious for myself, like what is a good number? I know that's probably a terrible question, but what's a good number for HRV?

Speaker 2: 47:41

Well, which is funny is as I'm starting to get out there a little bit more versus space. I mean, I worked with the lead HRV back in 2016, jason Moore. There it was pretty much the most predominant app that was out there, measuring our variability of time, the most user who's using it, and we provided the foundations of HRV course, and so that kind of introduced me to a lot of the HRV community in that site. What you kind of build the brand of it. But as I started to be able to poke my head out a little bit more now is, with some of these things, you start to see some of these numbers that are going up and I'm like man, I never see some of these high numbers in individuals and sometimes I get concerned when I see it that high because primarily, my population has again, you're talking about chronic pain, you're talking about depression, you talk about anxiety, you talk about people with kind of these conditions. They're historically very, very low in comparison. So the relationship is stressed in HRV, so we'll get a little bit of kind of the physiology aspect of it all. Now is when we're stressed our sympathetic nervous system is active and our parasympathetic nervous system goes down. What HRV is a good proxy for is our ability to assess the parasympathetic nervous system, so our ability to understand is our body in a recovery state or not. So that's where that assessment is. It's not a great predictor or understander of the sympathetic nervous system or sympathetic intervention, but definitely can let us know that we're not in a parasympathetic state or we are in a parasympathetic state. So that's kind of the connection between that Little one layer. Even further down is it's an independent measure of our vagus nerve. Our vagus nerve is the main control of our parasympathetic nervous system. When it's active, high vagal tone, there's more parasympathetic intervention to our autonomic nervous system. Our heart variability increases and then obviously, as it's withdrawn, where it starts to be able to deal with for the sympathetic nervous system or we're dealing with some sort of stressor, vagal tones removed and heart variability decreases. It's very sensitive from that standpoint. So that's the connection to stress. I can't remember now the second part of the question.

Speaker 1: 49:44

If my HRV is 60, is that good, Bad, fine. Do you need more information?

Speaker 2: 49:49

Yeah, and this is where, again, the main thing is we go through these assessments and the visuals is that it provides. You have to look at all the contextual information. So the medical history right, if you have diabetes, that's gonna impact necessarily the expectations of what I anticipate someone's heart variability being, if you have some sort of genetic condition, that's gonna impact it. If you get so, from the physical standpoint that's gonna impact. Age is gonna impact it over periods of time as well. Lot of non-mortifiable factors that can impact it. Gender can be able to impact as well. So all these things we gotta go through. And then there's the modifiable factors. Right, it talks about your exercise aspect, your sleep habits, like nutrition, so all these things, and this is where we understand that we look at that as to where you're at. So, based on some of the non-modifiable things, we have a healthy individual that meets a minimum of physical activity, that's conscious relatively about their food intake, they have no kind of sleep issues or don't require, you know, have a lot of stress in their life and lots of stuff. We have these kind of guidelines in regards to that, as you start to be able to kind of go down from there Now to give very, very rough numbers into this, so we kind of go be able to go through it. Individuals kind of like say we'll say 20 years old and we'll throw out numbers and these numbers are the root mean square of successive differences. And so you look at the literature it's RMSSD is the number no point of going to the math because I don't even understand it as to what it is but that's the kind of number that research is showing to be the best kind of proxy for short term measurements of hard labor ability. We look at 20 years old. You're probably looking at the neighborhood of a good HRP score is probably in the 80s, right, 30s, 70s, 40s, 60s and so on, right, all of us out of the way down you kind of go with that type of realm is in a general population, right, and so the majority of people that I see, and more of the people that are tracking their hard work variability, don't want to be apt, right, they want to be above right. So these are kind of like what you anticipate a normal person being that has no kind of major conditions that deal with life on a normal basis. So you kind of follow that kind of trajectory all the way down into that, you kind of like hovering. You know, when people are in their 70s and 80s you're talking about the neighborhood of probably in the HRP is probably in the 30s. Now, individual ISE, chronic pain people, people that under depression, they will be 20, 30 years old and have HRVs that are 20, 25, right. I have a colleague that's she's pregnant now I'm gonna give birth anytime. But her pretty healthy individual at her HRV was 30 and being pregnant now her HRV is 12, right, and it's just like okay, well, and now I haven't worked with her in regards to investigating as to why, but you start to see there's certain things and impacts that can happen to individuals as to what's going on. So that kind of gives you rough estimates as to what's going on from that standpoint and get a red flash and you start now seeing some individuals. You know we had an individual that he was wearing a whoop and an aurorae, right, not the healthiest of individuals, very successful individual, but, you know, pretty heavy partier with various things and not a, you know, travel's loss, all type of stuff. But you know, one of the things that he does well is being physically active and so, but he goes those seeing. He's like, yeah, my friend's got a really high HRV and that type of stuff and he thinks he's the man like super, super high. And so my colleague brings me in. He's like these results normal and both right From Warring and Whoop. His average was 250. Wow, right, and I go he needs his heart checked, because I've been doing this for over 10 years, over a decade now. I've never even seen anything close to that.

Speaker 1: 53:42

Yeah, quarter of a second variation.

Speaker 2: 53:46

Right and I go like there's some sort of heart rhythm abnormality, like I'm almost like guaranteeing that's the stuff, obviously, yes, it was a benign, but to a degree it's like if people have these heart rhythm abnormalities, it's hard to make HRV an actual data point for that, right. And so you start to see individuals that have like 170, 180, 190, like oh great, I'm so above average. I'm like that's not normal. Like to see something above 100 is rare in itself, right, I think I've been doing this for a decade Olympians, high level athletes, all the way to chronic pain individuals and seeing something over 100 is extremely rare on a continuous basis, like with nocturnal capture of the step stuff, right In the moment very different story, but then there are nocturnal captures. So you start to say that there is that too high realm where it's just like, well, I would anyone's kind of above, even 120, 130, if someone's above that, I kind of go. I want an ECG on these people because I want to make sure that there's not any type of abnormal rhythm like us.

Speaker 1: 54:39

Okay, yeah, so it's good to know, cause one of my questions is going to be is a higher HIV always good? I guess the answer is no.

Speaker 2: 54:46

No, no, no, no, exactly Like one of the things, as I was an individual that didn't tell me, but he had cardiovascular disease and he wanted to get physiobactics. It was kind of in his late 60s and so we put him on our variability because we're kind of looking at a holistic agent, that's of stuff, and his nighttime average was like 95, right, I'm like 95. Like that, I didn't expect that at all. Right, I go, what's going on? And I started asking him. He had an ECG like oh yeah, yeah, like, and he's like I have a fit. Just didn't tell us, right, I'm like, well, okay, why was this left out? In regards to that, the best office, like it's all treated just kind of like. I've had a lot of people who was like, oh yeah, I don't have an ECL in that knee or whatever. It's like, oh God, it's like, how did you forget this information? But it's like, okay, now it makes sense in two degrees, like with uncontrolled type of apartment in that ability. Any assessment of heart rate variability may not be as accurate, so you would have to go into some sort of heart rate thing depending on how bad the abnormality is.

Speaker 1: 55:47

Yeah, okay. So you mentioned pregnancy, people who are women who are becoming pregnant. Should they the tracking? Should they expect their H over to go down? My guess would be yeah.

Speaker 2: 55:58

Yeah, yeah, absolutely yeah, with the weight gain and stress of all that type of stuff and having to be able to keep alive something within the. I mean it's not as drastic as it decreases as a lot of people would think it would be. I have my wife reluctantly tracker heart rate variability through both of our pregnancies and so there was a drop through it. It's not huge, but there's actually starting to be a lot of research around using wearable products, especially around heart rate variability in body temperature that actually kind of look at. Can they get an accurate prediction of when that baby is actually gonna come out?

Speaker 1: 56:33

It's interesting what would happen, indicating that it might be soon.

Speaker 2: 56:38

Yeah, so you start to see some abnormal fluctuations in regards to increased body temperature and it's a drastic decrease in heart rate variability.

Speaker 1: 56:46

So interesting, like where things are gonna be soon.

Speaker 2: 56:50

Crazy, right, like some of the stuff you start to hear, I'm like, oh man, like I read some preliminary stuff years ago about that stuff. But I'm seeing, like I saw it, I think it was yesterday morning that I saw this review paper about it all. It wasn't necessarily just one study that was done, it was a review of all the studies that were done around the specific area and using wearables, around the prediction of pregnancy, and it was like, yeah, there's some fluidities to this and you obviously, just like every meta-analysis, more studies need to be done in this specific area seems like every conclusion that happens from a systematic review or meta-analysis. But you start to see the trending in that direction where it's like, hey, there's actually some fluidity, that's around this, that's even further.

Speaker 1: 57:30

Yeah Gosh, there's so many interesting places we can go from there, but I immediately go to menopause. Is that another place where you would expect to see a drop in HRV?

Speaker 2: 57:41

Yeah, you start to see again all the whole moral changes People typically that's where you see a lot more regulation as people that do the home or replacement therapy, hrt, if they do that a lot more. If you start to see more of a mitigation, you definitely see. So one of the things that I find people going through menopause is not only does HRV go down, but the coefficient variance, so, like the fluctuation from day to day you start to see way more of like from the field of data day, like over the time it looks like more like that, like a Jagd2, than it is something that's more of like a nice rhythmic pattern where it's kind of being consistent. So not only do you have a kind of a drop, but one of the biggest changes I see is the coefficient variance. You get a lot more lows and lower lows than you would over a period of time and a lot of high highs. For some reason, like he tried to get this all over the place as the body starts to be able to fluctuate of these hormonal changes.

Speaker 1: 58:34

Okay, yeah, so I can see that being not that menopause care is like really done really well in this country, but in the future that could be something that would be integrated into that realm. So there's other metrics that come off of wearables, I think. Resting heart rate, respiratory rate, temperature, total sleep. Those are all really interesting numbers. How do you reconcile if HRV is lower than you'd want to be but everything else looks pretty good, or the opposite, where, like, hrv is maybe slightly above where you'd want them to be, based on their age range the rough numbers that you gave earlier but everything else doesn't look great?

Speaker 2: 59:17

Yeah, so, like you know where do you go with the wearables.

Speaker 1: 59:19

Yeah, like, how do you reconcile, I guess like discordant numbers from what you might expect.

Speaker 2: 59:26

Yeah, and this is, and again it takes a lot of investigation. At this point, right, you have these kind of again, no individual is the same and so you start to look at those. We'll just give some examples, right, so say, hrv is low but all the kind of wearables, statistics are fine, they're physically active, they have no body temperature, the respiration is fine, they have no subject to sleep problems and all type of standpoint. You know, my first thing is, with this clinic we always try to do is we got to get blood work done right. So the first thing is making sure there's no big red flags, right, because they could be battling some sort of a low level infection that may not be detectable right now, but our bodies we get constantly fighting it, but there's not necessarily impacting the energy levels or that standpoint. Right, this is like kind of, you know talking about the chronic inflammation, you know the silent killer which is hypertension, and so you start there's some things that we can't necessarily detect or feel that's wrong, but underlying that something wrong. So you always kind of get the blood work done from that standpoint. But you know, if they're doing all the basic things, they're physically active, they're eating well and they're asleep and that's where you got to look in that psychosocial aspect of it all. You got to be able to assess the other aspects of stress management, connection with people, how they feel to fill with their life, and kind of deeper into the psychological aspect of the individual a little bit more. And that's where a heavy amount of the work is. A lot of stuff comes out of there from that For someone that has a normal or higher-high variability and their other metrics seem to be bad right, so they've, you know they're not physically active, they have poor sleep and all that type of stuff. Again, to me it's always want to kind of rule out red flags, any type of kind of the big analysis that you've done with sleep-bub analysis or you know deeper in reverse of DNA or genetic testing to maybe something explained to what's going on. And then obviously with the higher-high variability you want to make sure that's completely worthwhile, which we can do very easily in EKG in our clinic here, or if things seem to be even more abnormal, just on the wearable device, we can do obviously the Holter monitors for the three to five days to be able to assess those things into what's going on. So if things don't add up. We do our thorough investigation as to why, and to me there's the easy pieces that there's obviously the objective standpoint and you know, from the physical health or biological health of the individual and look at those factors and I want to be able to rule those things out first because and the biggest reasons to why is people come to any type of, I think, situation that's set up like ours, like this type of clinic, the way that it is, with many different bright stages that are of the physical more you know that's where we're built on is more the physical aspect, as people want a physical solution. And until we rule all of that out, it's hard for people to be able to want to work on the social and the psychological aspects of their health and well-being right, very different than other way around. It's sometimes a difficult conversation to have. As a practitioner you try to be as empathetic as possible and you try to deliver the news of saying like, listen, there's other aspects of your health that aren't being addressed and we need to look at those things. And sometimes it's a hard conversation to have because they kind of feel judged and they're kind of judging right the way that they are, like they feel their heads aren't right or they're not dealing with stress, well, there's a problem with them and so they can be quite defensive at that standpoint. So we want to make sure that we kind of rule out all the big stuff first, and if we can do that, then that opens that conversation a little more, especially with that holistic assessment, and we start to piecemeal, say listen, like you know, you look at our biological markers, there's only two things from here, but we have eight from the psychological side of things. When it comes to these areas, it's like do you realize? Like we're not putting our effort or time into the right bucket right now. So like, are we okay, you started to adjust that and hopefully they find that a value to be able to go forward with it all. But I think it's getting more acceptable that that's an area of health that needs to be addressed more and more.

Speaker 1: 1:03:25

Yeah, for sure. But I mean just to kind of expand on your point of like where you have to start people. It really going to depend on, like what their expectation is when they come in and like, especially if it's the first time you're interacting with them, it's like you better build that relationship Like, unless you are just amazing at building rapport and building like a very quick connection with somebody, you're probably going to have to match their expectation for like what the intervention is going to be and then down the road you can start working on those hard conversations and sort of expanding their purview of what their definition of health is and then, once that definition is sort of like within their own sphere, then they're going to be much more accepting of these alternative aspects that they need to address.

Speaker 2: 1:04:08

Absolutely Right and that's a really big piece. I remember I had a psychologist visiting from the UK that came to see me based on a referral and I was kind of going through the speech. She knew the biopsychosocial model well and talked about and there's so many psychosocial triggers that were just in this conversation, this history of what's going on and that type of stuff. And like I know you're here visiting, well, I'll do what I possibly can, but I'm like I don't really know you're in the right room. I can do some things. My slice of the pie, your health journey, is probably quite small to where we need to be able to do this. And I was trying to explain this. She goes. I completely agree, you know this. I just want someone to touch and like manipulate, right For what I'm going through. And that's the expectation. That's an osteopath and that's what it is. It's like people have that expectation of that title that you have as to what type of intervention necessarily is going to be done. So you've got to be able to kind of, you know, go with the flow and try to be able to meet their expectations to making sure you're delivering good service. But again, because if I just went completely the other side of things. I'm not doing that blah, blah, blah. You know, I think it does not do anything to help the individual.

Speaker 1: 1:05:15

Yeah, so you've got to work together, even if you're not doing everything exactly to its seed. That you know would get them there fastest. But you have to think about, like, the longevity of the relationship and what you can do over. A much better relationship is going to yield better outcomes long term. Absolutely. Can you dig into some of the other metrics? So resting heart rate, respiratory rate? I think those are both very interesting. The G of general recommendations of ranges resting heart rate for sure, is confusing because the normal range is 60 to 100. And then below, that is technically a medical condition. Above, that is a medical condition, but if you're really healthy you're also probably below 60. Can you unpack that a little bit? For people it's probably confusing.

Speaker 2: 1:06:04

No, completely, and this is where you have the medical literature is what can be relatively past, what's going on. And then there's the not disease stage of things, and then there's the optimal stage of things, and this is where I love the trend of the way that functional medicine and personalized medicine is going. It's not necessarily saying, hey, this is the range of disease or not being a disease versus this is the range that you should be in, which is great. Yeah, I get concerned with people, especially with an octurnal capture of what's going on. Anything that's above 60 beats per minute there's a resting heart rate. So that's pretty consistent across all these groups which, again, when you look at some of the graphs that are out there, you look at resting heart rate over periods of time. It's relatively stagnant for year on year, on year, where you start to see the heart rate variability trend to be able to go down and down and down and down. So I don't want anything above 60. So that's the metric from there. And then, as long as a person has, from a health standpoint, everything seems to be a lot running up under 40s. Okay, but it's rare to be able to see that unless they're absolutely like a beast of an athlete aerobically. So I mean you typically run like the lowest you see is from healthy individuals that are kind of just generally fit, probably in the mid to low 40s. It's probably where I feel comfortable. Anything below 40s unless again they're an Olympian you'd be a concern. You don't want anything higher than 60 in my standpoint for the resting heart rate.

Speaker 1: 1:07:38

Okay, and what about respiratory rate?

Speaker 2: 1:07:41

Yeah, this is an interesting one. I've had a significant of conversations with individuals, other practitioners and other medical doctors over the timeframe around respiratory rate into how this necessarily plays into what's going on. So nocturnally it's not. I'm still digging into some of the literature. So what's that? Obviously, lower is better. You want to be able to be in that calm state because obviously slow respiration rate is good. But I've had people with high heart rate variability, with high respiratory rate, with no abdomen alleys. I was talking to an individual that was constantly the hundreds nothing abnormally wrong, healthy individual, biohacker in that standpoint. And she's like I've done everything under the sun to slow respiration rate down Nocturnally, mouth taping, literally everything. She's like I can't get it under 18 at all, it's typically 19 or 20. High heart rate variability, everything else has seemed to be relatively fine. Maybe we all have things going on, but a standpoint is like it seems to be really fine. I haven't necessarily found a good range in regards to respiratory rate when it comes to these captures of things, as to what I would say. That would be ideal. But as a general sense, if someone has a respiration rate, it's better to have it lower than where they were, than higher.

Speaker 1: 1:08:57

Yeah again. So I think it's a really important discussion. The idea, the range, is that if you were to just Google what's a good respiratory rate, you're going to get something for the American Heart Association or the American Medical Association or Mayo Clinic or Johns Hopkins and it's going to say the normal range is this. But normal just means not disease state or not sick, and I think people need to start understanding that that is true and then that that range is also not necessarily equivalent with health or healthy or optimal, however you want to think about.

Speaker 2: 1:09:29

No, exactly, it's as Dr Taylor says as well. It's like I'm not sick but I'm not well. Right, there's a lot of visuals that fall into that category, into health well-being, and yeah, it's like. Yeah, it's not to the point where it's like there's a metastatic condition, but doesn't this necessarily mean that it's good?

Speaker 1: 1:09:51

Right. So this is something I've thought about for a while. So when you talk about, like, the nocturnal average, is that the right term? Yeah, so if you're looking at resting heart rate, for example, your nocturnal average you're going to be lower than it's going to be when you go to your doctor's office and you get a pulse. It's like yes, do you have an idea of how much that difference should be, or is that something worth exploring as well? That's sort of your daytime resting heart rate versus nighttime.

Speaker 2: 1:10:14

Yeah, that's a great question. My view of health is the fact that in the presence of a stressor, that has as little impact to you as possible. So when people go to the doctor's office and their heart rate is now at 100 beats per minute, that's not a good thing. What is the sign when we know someone's progressing, regardless of an exercise program? We do a VO2 max, we do some sort of testing. You start to look at their heart rates at certain intensities, what their RPE is and the rating of perceived exertion is. Those are the various heart rates of their intensity. How do we know someone's getting better? Is the fact that we go at the same intensity but their heart rate's lower. Their bodies are under the same demand, under the exact same stressful situation that they were in before. So to me is the faster we can get heart rate up to me, the faster we can get it down to be more of the sound of homeostatic state. To me it's a mean of a healthy individual. So to me it's as little the variation under the stress as possible is absolutely the best benefit. You push yourself like crazy and have a relatively lower amount of heart rate compared to other people, or even yourself over a period of time.

Speaker 1: 1:11:26

Okay, yeah, that's really helpful. Yeah, because I've always known it's going to be different. But that makes sense that just a smaller gap between whatever your nocturnal or your nighttime averages versus your daytime time, that's going to be better. Can you? Is there any data around longevity and HRV? Because you mentioned VO2 Max, I was like, oh, that's one of the best metrics for the association to longevity, but VO2 Max is not a particularly fun test to go through and it's uncomfortable to like, do the mask and all that. So it's not as accessible as something you can just wear on your ring or wear on your wrist. So is there data around HRV and longevity?

Speaker 2: 1:12:06

Yeah, there's a high association in correlation between VO2 Max and Harvard Verity measurements. So that's where I, early on, I used to do a lot of VO2 Max testing for individuals. This is before it was really accepted. Are people utilize it more from a longevity health span metric, which obviously is now shifting that standpoint? People use it to get to zone training and be able to figure it out and that type of stuff. And I always had the biggest hurdle of athletes would be recommended to do VO2 Max testing me and just they just didn't want to do it. They want to know what their VO2 Max was because they want to be like, oh, I don't want to be the lower end of things, because then it's like I may not be. I mean, I get to this race or just psychologically play with me, and so you had those limitations where a lot of people do it. For that standpoint didn't necessarily really want to do it, but it wasn't necessarily accepted or well known as a health span longevity metric from there. But there's quite a bit of data out now looking at the association between high variability of VO2 Max and people that have higher VO2 Maxes typically have a higher high variability on a longitudinal scale.

Speaker 1: 1:13:17

Okay, that sort of makes sense, right? You'd be shocked if the data were coming in at every like yeah, well, that's the thing is.

Speaker 2: 1:13:25

Look at the adaptations that increasing real capacity does right. So if you have a higher VO2 Max, their ability to utilize the oxygen significantly improve. They typically have great cardiac output and high stroke volumes, and so all the things that are associated with increasing our variability are associated with high VO2 Maxes when it comes down to a lot of the physiology crossover. So it would make sense that the fact that if people have increased aerobic capacity through VO2 Max and with the you look at the anatomical and physiological changes that occur, those all enact into having someone having a higher amount of high variability, like lower resting heart rate. Why is lower resting heart rate happen as an adaptation? But that's because you could be increasing the left ventricle size, increasing the contriotility, better cardiac output, lower ejection fraction all these different things that are kind of pile into a lot of these kind of this is back to my exercise physiology days, but a lot of these metrics that we know that makes fueling the body more efficient is definitely going to tie into higher amounts of high variability.

Speaker 1: 1:14:32

Yeah, hitting VO2 Max is one of my favorite metrics for overall health, but again, the barriers to it are. They're significant, especially. I mean, at one time you can get somebody to do it, but once they go through it it's hard to be like you should do this pretty consistently.

Speaker 2: 1:14:44

It's just not, yeah, every six months.

Speaker 1: 1:14:47

No, yeah, it's just not a pleasant thing to do. No, yeah, the people who are doing it consistently are those athletes, and they're the ones who don't necessarily need that kind of help.

Speaker 2: 1:14:57

No, no, not at all. And that's the thing is. I'm guarantee you, if they had a choice in it they wouldn't necessarily do it either. But it's their coaches and their teammates that are kind of the team to be able to kind of force them to do it. See what they're at right, it's not a left under our voluntary control. Not a lot of people want to do that and I can do that with very high degree of certainty as being a significant amount of time, as being a guinea pig in my master's degree doing these VO2 max tests that if it wasn't for courses or college credits I definitely wouldn't be doing it.

Speaker 1: 1:15:28

Did you ever have to do a lactate testing?

Speaker 2: 1:15:31

No, luckily. No, I had to do it, but I never had it done to me, which was good. Yeah, that was nice.

Speaker 1: 1:15:40

Yeah, just do these sprint repeats until we max out, until we don't see your lactate going up anymore. Super fun.

Speaker 2: 1:15:46

Oh yeah, that's the best. Yeah, people are very happy. They sign up the waves in order to be able to do the testing done for a scientific researcher, you're paying for this.

Speaker 1: 1:15:54

This is your education, so I want to ask about the things that you do for your health. So, your father of two, did your HIV drop? At what point is there a threshold where you're like, oh it's going down below this point, but I really need to dial in and start addressing some things in my life.

Speaker 2: 1:16:13

Yeah, when I first started tracking HIV, it was first thing in the morning, right, and I could artificially increase that subconsciously through respiration, right. So that was fine and then not just started to realize. But this is getting one of the benefits of doctoral standpoint it's the fact that I don't have the ability to be able to alter that quite significantly. Yeah, exactly Right, because again, I try to be science first, I put this on, but I know it's like I think I'm a little bit stressed. I know subconsciously I was doing something to be able to make sure and so, yeah, with being a father of two definitely definitely took a hit in looking at where good numbers for me are versus abnormal numbers. You just have to be more efficient with what you're doing and you kind of be your own guinea pig. There's many examples that I can provide of things that I do that I know increase our variability and, for a long term, health is good for me. What examples I give is I absolutely despise, right, it is the, it is I. Every step that I take is a reminder that I have to take another step, like it's just that much of a slog, we'll do it, but looking at HRV is one of the most impactful things I possibly do, not only for like subject or sleep quality, for my sleep, for HRV, for energy levels, for consistency, you know, with my, my cognition, like it's, it's absolutely one of the best things. I've tried cycling, I've tried other things. It's, it's not the same impact. And so I do it three times a week with the fact of, of doing the fact that I know that does it. You know, switching from from a regular coffee to to mushroom coffee, not the fact that you know I'm not going to do it just because science says, because, again, science can show that it works for 99.9% of people out there. I may be that 0.1% where it doesn't, and I'm not going to take things blindly without the fact that I know that it actually makes a meaningful difference or there's a reason for me to do so. So certain things that I know individually for me, hr, if I have three nights of bad sleep, that's when HRV crashes. If I have more than two, I'll drink sober period of time. I know that's where HRV crashes. Like, I know these little things that I know now that that that impact my, my health and well-being, and then and then you throw kids in the mix. And then then all that, and one of the biggest things I had to be able to do is shift my, my bedtime right. So I wasn't really a night owl, but I wasn't, you know, I didn't go to sleep at night. I'd walk, like I do now, or it would be like, you know, 10, 30, 11 o'clock and and wake up at 6 and that type of stuff. But I had to shift that completely. You only get the stuff I want to do done. So now it's like a nine to four type of thing, so I can do the things that I want to be able to do and have time for myself. And so I'd take about six months in order to be able to shift that. And through data I knew that both subjectively and objectively of data highlighting that to build six months and kind of switch that over. But yeah, for my health and well-being it's, it's trying to be as consistent as possible with things. You know, not not restricting things, but not going over indulgent in things, be able to enjoy life. You know, having a, a be with a friend, I know it's, it's not the best thing, but I think social connections with that having one is, you know, for me it is completely fine. For individuals that may not be, but you know there's certain things that that I know is is fine versus others. A lot of self discovery over the last 10 years, that's for sure.

Speaker 1: 1:19:36

Yeah, do you find that? Did you ever get to a point where you felt like all the tracking was becoming an additional stressor and you, you became too neurotic about the numbers?

Speaker 2: 1:19:46

Yeah, I take breaks. I absolutely take breaks for a week to two weeks at a time every year. I do that with many different things. I do it with exercise, I do that with coffee, I do that with, you know, getting up early. Like there's many things that I do that I take breaks from, to kind of just reset, like recharge Do you all do that? And tracking is absolutely one of those things, the reason why I just I was stopped tracking for the last week or so, but then one of our teammates had a new device that wanted to be tested. So I'm usually the the my company usually calls me the human cyber work where I wear multiple devices at a period of time. But I, you know, I absolutely do that. I went to with some friends, I went to Thailand and it just didn't bring anything. Like I just I like, yeah, I'm gonna have some fun here, just reconnect. Like a little lot came back home, I, I I'd get to the jet lag and when everything was kind of back in the rhythm, I just and I jumped back on it Like it was, it'd be fine. So it absolutely take breaks. And again, like people get obsessed about half but a bad sleep, right and it's just like, well, yeah, that's sleep, I'll make up for it today. It's just just knowledge to me, like it's more of a warning sign. If I had a bad sleep or my HIV is low, it's like, okay, well then I just have to prioritize recovery today, knowing that saying drink a little more water, make sure that I do a little more breathing practices, making sure that I decrease intensity, was going to just put my body under less stress, because the stress right now doesn't necessarily it shouldn't weigh anything on you in that standpoint, but it's you definitely need to be able to take breaks from the staff, be able to just to live life, enjoy it and then get back into it. But I think people just they, they rely too much on it. It's just feedback.

Speaker 1: 1:21:22

Can you almost feel it Like if you, if you don't check your your dashboard, whatever device you're using, and you're halfway through the day, can you, can you kind of feel, be like I bet I'm significantly lower than I normally would be today?

Speaker 2: 1:21:35

Yeah, most of the time, yeah, most of the time. One of my, one of my health areas that I'm not the best in is is interception of understanding my mind body connection right, and this is as a formal student athlete, paying college basketball and having to play through injuries and, and you know, living abroad for for eight years and a bunch of stuff that happened with it all I had to get relatively obviously the Irish background didn't help either of ignoring feelings but having all these things kind of, you know, come through life. I had to be able to ignore, be able to push forward and be able to perform without necessarily what I'm feeling, and that's obviously as a short-term strategy, fantastic. Long-term strategy, not so good. And you still fall into those patterns of where I relatively have to, you know, try to think of I have to ignore what I'm feeling entirely, screw it, and then it's going, and so that comes in from time to time and I think that's a now majority of the time. I have pretty good understanding of the feedback. So like, yeah, yeah, I probably guess, and I usually don't check my, my wearable device, until I kind of go through my, my mortar routine anyway, right, so I don't actually know what my numbers are until pretty much. I'm about to head to work.

Speaker 1: 1:22:41

Yeah, I think it's very important for people to understand that more data is a tool to better understand and get closer to understanding, like what your body is trying to tell you. It should not be used as a tool to exclusively rely and you don't rely on your wearable dashboard to tell you how your day is going to be.

Speaker 2: 1:22:58

Absolutely not.

Speaker 1: 1:23:01

That's not a good long-term strategy.

Speaker 2: 1:23:03

No, I guess it's like logical aspect of it all, right. So again, like people that want to do the video to mass though don't want to say they do blood work, genetic testing or do MRIs or whatever it may be, it's like you see the unknown in your face and it kind of shows you what's going on, and people, but absolutely do much emphasis into that. And I tried to equate it like you know and you have, like it's it's. You're not going to have good sleep all the time, like it's not possible, right, you're not going to have stress-free days, but the thing is is like like knowing when those things are and knowing to be able to mitigate those things. It's like kind of the weight loss journey for people Like you could do everything right today and you can weigh more and more. Right, you could also do everything wrong today and wake up to be the exact same. Like you see fluctuations in the ups and downs, but it's like you need to have more good days than bad, or understand that if you have a, if you're on a you know bad day or a not optimal day, is that like hey, I need to prioritize me in my recovery today? Right, and it's just like I take a little more TLC for me. Right, be a little more helping me, be more me focused, rather than most people out now care about what these people are thinking or what these people are doing and and all that type of external stuff. It's like, hey, be a little more internal today, be a little more selfish, take time for you, go for a walk in nature, you know, call a call a friend of you we reconnect with, which I did the other day, which felt amazing, which was great. You know. Be able to say, hey, you know, I'm going to focus in, in, in, maybe cut out a little bit early for work to make sure that I kind of go out and, you know, make sure I make really good dinner and get sleep a little bit earlier. And it's just about, it's a prioritized in your health. It's just like today's a little bit more more. Today I need to focus on me a little bit more than I than I have to. It can't be as external or give everybody everything today, because I got to be able to make sure that I'm at my best.

Speaker 1: 1:24:39

Yeah, I do want to highlight something you brought up a few minutes ago is the idea of going through phases of monitoring or tracking and then phases of living. I think it's completely unrealistic for people to like put on a wearable device and be like well, I'm just doing this for the next five years, I think. I think it's very important for people to like structure, dedicated weeks, months, even off, where you know you're tracking. You can gain some insight, usually probably better with the help of a practitioner to actually tell you what you know like. You don't need to do the amateur practitioner side of things, but, yeah, you get some insights into what that is. Maybe make an intervention, try it and then you need to live for a while. It can become extremely stressful to know that you're, you have this thing monitoring you constantly forever.

Speaker 2: 1:25:28

Yeah, and it's and it's interesting is that you have, you know, you have this battle of of people that don't monitor anything at all and just kind of live life and that type of stuff. And then you do have the Brian Johnson's in this world that literally lives under a uh, uh, lives in in complete public eye of everything that he possibly does and monitor and this and that which is like my gosh, like I, I can't imagine, um, you know, doing that. You know, obviously his purposes are a little bit, you know, are specific, as if you know kind of the history as to why he's doing it. But, um, you know, it's like that is like you don't want to be that right at all, uh, uh, but you but you don't want to be completely, you know, uh, oblivious to what's going on. It's like you kind of go with these ever flows between both of those areas of like, yeah, go live life, like forget about things, like just enjoy it, not know what's going on. The unknown is absolutely phenomenal, uh, to go out there and be able to do it, and then kind of go to the point of like, hey, now that was a time to be able to focus on being where am I at and, and and go forward to there. But no, I completely. You need to be able to take those breaks. You will get way too obsessed with this stuff.

Speaker 1: 1:26:26

Yep, it's easy to um, I do want to start wrapping up. I want to be respectful of your time, but you've mentioned breathing a few times and I think breathing and breath work is a very interesting thing. Um, kind of going back to the autonomic nervous system, it's the things that you can't really control, but breathing is one of those things that sort of lives in both camps, where you can sort of manipulate. You can start to manipulate things within your body. So can you speak to some of the benefits of breathing and adopting breath work practices and mindfulness and meditation? There's a lot that lives in that world.

Speaker 2: 1:26:57

Well, absolutely Right, and this is, you know, one of the things that I think one of the stresses that we have in our life right now is rumination and magnification of issues. Right, so we, we have an issue and this is constantly on our mind and we make it much bigger than it actually is right, whether it's, you know, confronting a coworker or a uh, just being a spouse, or financial issues that are overhead. So we, we ruminate and magnify these, these, these problems, and so this constant in in for us to be able to kind of get that, that down to baseline. Get, you know, make sure that we're not into the sympathetic state. Breathing is not by far one of the best practices. You know. We can make it way too complicated, uh, comparatively to to a lot of things that are out there. It's, oh, you need to do. You know you have to breathe in three seconds with this nostril and five out of this one and hold it for five. It's like all right. Like you know, I think majority of the people, if you just kind of do a basic type of box breathing or even like a slow cadence of breathing, you know typically about the six breaths per minute. It's kind of on average for people, if you kind of follow that type of pattern, to be able to start with and keep that consistent, that is a huge game changer for a lot of people, right, it's that recognition of peace and in, I think, the people that value the value, the, the, the have the, you know the benefit that comes with breathing, um, are the people that do a lot of other things, right, but, you know, have these kind of like, you know, high stress jobs or high stress lives, uh, that are constantly that sympathetic state and they try to, you know, counteract that by making sure that their, their diet is super, you know, perfect, and they're trying to be able to sleep and try to exercise and all that type of things. And so the breathing practices are for all of those individuals. But I think one of their big problems is they can't recognize when to be able to do it. And so when I kind of coach people around, you know when, when it, when breathing is an intervention as people will do, is almost a point of like. You have to make it like on the hour, every hour or whatever it may be in between meetings. You have to be able to do this type of stuff, so they start to be able to realize like, oh, this is what relax feels, like, right, this is what it is. Be able to calm down, making sure and again it's about not being in that you know two out of your homeostatic or your normal state for too long. Right, be able to. What can I do to be able to bring that back down? Uh, uh, standpoint. Breathing is a is a phenomenal practice that I think is extremely undervalued, not only in in the allied health care alternative side of things, but even the medical system. Um, I think it's, it's extremely undervalued as to its, its ease and its potential of, of of health. Uh, when it comes to be able to manage enough of stress, mitigate that stress response, be able to adapt to it, you know much, much better that he actually be more of a use stress than a distress.

Speaker 1: 1:29:21

Yep, yeah, it's like anything, right, you can, you can really dive down the rabbit hole and you can go into the alternate nostril, stuff like you were saying. And there you know there's something there to it. But for most people, like if you're, if you're an overthinker or a ruminator like you're saying, like when you're counting your breaths or you're counting the length of an inhale and counting the length of an exhale, you know you're not doing, you're not ruminating.

Speaker 2: 1:29:43

Yeah, so like it.

Speaker 1: 1:29:45

It doesn't have to be anything crazy, just any. Then you'll drift back to those thoughts again and be like oh yeah, that's what I'm doing. I'm paying attention to my breathing. That's what I'm doing for this moment.

Speaker 2: 1:29:54

Well, absolutely Right, it's the people that kind of assess about the perfect diet and the fact that, like, they're doing nothing right at that point. Right, it's just like, like, just, it's one small step. Like you like, do the basic things first, either with exercise it's like, oh, I need to this strength days and these lifts and this and that, no, no, you're not moving. Now, get moving. Right, it's just, that's, it's physical activity first. I kind of be able to ramp up and then, if, if, that's all providing benefit, we can start going through those rabbit holes of perfecting various areas for various situations. Right, but I think, fast majority of the people, especially just from the generalized population, that aren't in the you know, the quantification side of things. So, like just understanding of how to action, very simply, some, some, some basic breathing techniques that we know can be able to balance that nervous system a little bit more, it can be a huge game changer.

Speaker 1: 1:30:40

Yeah, like from the breathwork side, we don't need the whole population to get to a point of very deep transcendence, you don't need to get there. And the same thing on the exercise side. Not everyone needs to have a VO2 max of 60 plus. Right, it's like 80% of people in this country don't meet the weekly requirements for the minimum requirements for physical activity. Like, let's stop, let's stop arguing over the nuances of exercise on the internet and just like, maybe, maybe mobilize, just getting people moving more. In general, I think that's a more productive way to kind of collectively work towards something. But before I let you go, do you have anything else you want to add? We've covered a lot. This has been a great conversation. From my end, I've always wanted to dig into HRV, so I really appreciate everything you've been able to share with us. But is there anything else that we haven't covered that you feel like you'd be remiss if we didn't get to?

Speaker 2: 1:31:36

No, I mean, the biggest thing is. One thing I probably want to share is I think people have more impact on their health than they actually think that they do. So I think a lot of our health and well-being is perceived to be the something that people need to fix for us, right? So with these medications, we need to be able to see this personal trainer. We need to be able to do this type of thing. We have a significant amount of health agency in our own. Do you know what's kind of created a significant amount of change? One of the things I always kind of write in my talks is that 50% of our health outcomes are derived by our papers, just what we can control within our day-to-day lives, and that impact and these behaviors contribute to like 90% of the medical costs that the US is spending right now, regardless of chronic disease management. So we have a lot of health agency was be able to control for people, and it doesn't necessarily have to be this whole host of everything so much information out there of like, yes, kate, we can all eat better, we can all exercise more, we can all sleep more, we can all do stress. We all have to have more people, right. But it's about chipping away at those specific areas at a time, making sure we're doing the minimum stuff from those areas, not necessarily optimizing right now, but are we meeting the minimum criteria? And then we can start to dive that rabbit hole. But I looked at a study where I think like 33,000 people were looked at in regards to doing dexascans and all type of stuff and from the minimal health behaviors of being physically active, eating well and not smoking and moderate alcohol intake, and looked at how many what's the percentage of the population in the US is doing that. That's 2.9%. Right, it's like well, it makes sense. And so the thing is is we look at the basics from there, making sure you're doing those things Right? So if you have a significant amount of control, you have a lot of power. It doesn't matter where you are in life. You have so much power that you're able to kind of make significant amount of change into your health and well-being. It doesn't take a lot to be able to do that.

Speaker 1: 1:33:30

Yeah, I think it's a great message and a very appropriate one to end on. Kind of. The tagline for our company is own your health. I think that's a very common message in your company as well, and it is. It's so important to kind of put people back in the driver's seat of their own health. It's been. I think it's largely. A lot of messaging in the past has been listen to your doctor, listen to this person. I think it's very important for people to understand. The message that you just closed with is that you do have a lot of agency and control.

Speaker 2: 1:34:00

Yeah, and thank you for obviously getting the message out there with all the people that you're bringing on, the podcast and all the stuff that you do. With all your work, it's like we got to be able to spread this message far and wide around this aspect of what people can possibly do and how to best kind of be their own health advocate and really make some major changes into the health of our being. So thank you, and all the stuff that you're doing with this area, it's great work. It's a lot of work, that's for sure, but we have some great people kind of pushing this message forward. So thank you for all that.

Speaker 1: 1:34:35

Yeah, now it does feel like I'm very encouraged about what feels like the direction of the company from or the country. From a sort of a health perspective, it feels like a lot of things are trending in the right direction. Oftentimes it also feels like you're screaming into the void, but I think at some point you do end up reaching people and I do think it makes a difference. So, greg, thank you so much for coming on. You've been a wonderful guest and I really appreciate it.

Speaker 2: 1:34:58

My pleasure, thank you.

Speaker 1: 1:35:01

Well, to those of you still here, that's all for today's show. I want to thank you so much for listening. I really hope you enjoyed today's conversation. If you want to learn more about today's guests, please visit our website exploringhealthpodcastcom. There you can find show notes for today's episode, links to the guests and our full episode archives. If you enjoyed today's show and you want to hear more, make sure to subscribe on your favorite podcast platform. I really appreciate each and every one of you listening Until next time.