Extended interview: Dr. Ezekiel Emanuel

I want people to stop obsessing. Make it part of your life. You should like exercising. You should like eating well, otherwise you're not going to do it for years and years and decades, which is what's necessary for a long, healthy life. Well, everything you're talking about, I'm super interested in, wellness and longevity. You can tell I read your book very closely. And I did note that in the book, of course, too, you note about how a few years ago you read one of the seemingly endless books being published about the wellness industry complex, and it infuriated you. And how all of this exercise would not add minutes, much less weeks or months, to a person's life, but would take up a lot of time. You seem to be talking about Dr. Peter Attia. Yes, it was that book, Outlive. He goes into things like rapamycin, no evidence in humans. He talks about the mTOR pathway. You don't need to know that to exercise right and live happily. What really upset me about that book is he leaves out social relationships entirely. He leaves out being mentally focused on improving your mind and keeping mentally engaged long into life. Also absolutely critical for a healthy life. I mean, from my standpoint, the worst-- the worst outcome would be my heart's working great, my lungs are working great, the liver, the kidney. All the body's working great. And I have cognitive decline and dementia. That would be the worst outcome. So having a-- being mentally sharp and having good social relationships, we know are way more important for wellness for a long, healthy, and happy lives. And that the absence of that in Outlive,I thought, was a big mistake. Well, he does talk about his own mental health in the last chapter. He doesn't give you any suggestions about how to do it. It's not the focus. I mean, how many pages are on exercise? Over 100? And he's got a page and a half on social relationships, or just the recognition they might be important. So what's your book supposed to do, kind of fill that gap? No, it's to-- first of all, it's to say don't obsess the way Peter Attia is obsessing, or suggesting you obsess. And it's recommending six simple things. What things with Dr. Peter Attia do you agree on? We agree on a lot, actually. Where he's relying on data from human trials, we agree on. We agree on the importance of three kinds of exercise-- aerobic exercise, muscle strengthening and flexibility and balance. We agree on a fair amount about food, although he, I think, talks about it in a way different way than I do. Actually, I think a lot of the science. Where we disagree with is where he goes well beyond the trials in humans, talks about trials in animals. And again, he makes it an obsession rather than a habit that you forget about because it's just part of your daily life.

I think he would probably say it's not an obsession. And by the way, while he's been painted, I think, as someone who's about living longer, he says it's also about your health span, living-- so that you can live well into your 90s. I think he is selling people with the idea that you can live into the 90s and be physically active. I've met a lot of people in the 90s and a lot of people in the 100s. Most of them are not-- most of-- the vast majority are not traveling around, running, cycling for 50 miles at a clip. They're slowing down, the pieces are beginning to fall off. Most of the people who are centenarians, over 100 years old, pretty bound into chairs. They're not-- again, they're not traveling. They're not cooking for themselves. So beware of what you wish for because you're not likely to get that. And I've known people who have been very, very healthy. It's really hard to be physically active the way you were in your 40s and 50s in your 90s. And I think selling people you can be the same is like selling them a bill of goods. The other thing I think is, remember, exercise, you do it today for tomorrow. One of the great things about social relationships, you do it today and it's pleasurable today. And so I think getting that balance right is what I think is really important about wellness. Well, when I think about longevity and living long, the one thing I don't think about, though, is eating ice cream. What does eating ice cream have to do with living long? Well, one of the things I point out in the book is I'm actually a big fan of dairy. Not milk necessarily, but all the other types of dairy-- yogurt, cheeses, kefir and ice cream, Because they have probiotics in them? More than the probiotics. They also are rich in protein and they're rich in lots of additives. We know that if you consume high dairy, actually you're taller. I should say my position is not universal. One of my old professors, Walt Willett at the Harvard School of Public Health, he's a little more skeptical about dairy. Dairy also decreases your risk of colon cancer, we know. So there's a lot of things in dairy. The advantage of yogurt and kefir, for example, is they do have probiotic activity. And that's really important. So you get protein, you get probiotic activity, and you get-- But yogurt is not ice cream. Well they're-- so ice cream is dairy. And you've got a lot of the saturated fats. People worry about saturated fats in dairy. And they're in globules. They do not seem to cause the same problem. We know that full fat and low fat, all the data suggests they're equivalent, so you don't have to eat low fat. And they decrease the risk of diabetes, which is also very important in American society. If people ate more ice cream, it would be better. One of the things is, it's clear ice cream has a lot of sugar in it. So you can't eat it every night. I have friends who eat it every night. My wife's grandmother ate it every day of her life, and it was her last meal. And she lived to 101. Wow, Independently. But if you're going to eat it once or twice a week, that's probably fine. And it's really enjoyable. Ice cream is really good. It's really fun. I really don't know people who don't like ice cream unless they don't like the temperature. But isn't it also your idea that eating ice cream is kind of like, let's not go to the extremes about living long. I mean, I think you say, there's one truth that we all know. We're all going to die. Yes. And I think we should reconcile ourselves to that. And again, focus on living healthy, living happy. We don't want to die prematurely, I totally agree with that. But this idea of living to 100, I think is just not confronting reality of human beings. And there's other social reasons we might not want to have lots of old people and not a lot of young people. I mean, you very controversially wrote this article for The Atlantic that said you want to die at 75. That's what the title said. That's not what I said in the article. What I said in the article is, I don't want medical treatments like cancer chemotherapy if I got cancer after 75. The issue is trying to postpone death. Part of the problem is what happens to your mind after 75. Alzheimer's goes like this, and then shoots up at 75. And when you're into the early 80s, about a third of people have cognitive decline, if not outright dementia. That is, I think, the thing that is scariest. It's scariest to me. And I made very clear in that article, I wrote it to challenge other people to think about their lives. How do they want to live their lives? What happens if they have cognitive decline? So that's the challenge. I have a position. This book is about, you want to live a long, healthy life? Here are the six things you need to follow. What you wrote about your father is that he would strike up a conversation with anybody. And everybody! It would embarrass his children to no end. We would go into a restaurant and sitting at a table. He'd look at the menu, wasn't much interested in the menu, frankly. He talked to the table next to him. Or if there wasn't a table next to us, he would talk to the waitress. And this happened wherever we went. We used to take car trips. He loved car trips across America to the West, to Montana and Wyoming. And every stop was more or less the same. So do you attribute his longevity to his strong social connections? 100%. My dad was Mr. Social. And as I describe in the book, he was not Mr. Spiritual, didn't have a religious bone in his body. He was not Mr. Philosophical, let's think about the origins of the universe. Is there a God? Those questions were of no interest to him. On the other hand, how did you come to be a TV personality? What were the changes? What were the critical steps in your life? When did you have a crisis that made you rethink what you were doing? He was fascinated by that, and he just loved talking to people at all ages. I mean, he was a pediatrician and he loved to talk to kids, but he also was great with parents. And he'd walk around and he'd say, oh, that kid, he's not walking quite right. Go up to the parent says, I think there's something maybe with his hip, you might want to check it out. So he-- and he had no fear of talking to whoever it was. You do offer some great tips in the book, too, that you learned from your dad about being social. Yeah. You're not--

Not being shy. The most important one, he said to me, you're not so fragile. Yes, for some people they will answer you monosyllabically. They're not interested in talking to you. They might be having a bad day. Just let the water roll off your back and go to the next person. And I would also agree with you that almost all people are endlessly fascinating. If you ask them the right questions, they can be endlessly fascinating and have great stories. Because life is fascinating. And life is-- Yeah. And they've had different experiences from you. One of the things I like to ask people is, where have you gone that you really like? Where have you traveled that's really interesting to you? And it gets all sorts of very interesting responses. I mean, someone said, I've gone hiking in the Eastern mountains of Turkey. I didn't know anything about the Eastern mountains of Turkey and all the little villages there. So you get to learn that way. One of the fascinating things about you is you're a cancer doctor and a professor. Your brother, Ari, is a super agent in Hollywood. Your other brother, Rahm, former mayor of Chicago, ambassador, maybe running for President of the United States. What is it that your parents taught all of you that has led you-- I mean, you're all incredibly successful? Now you're going to make me cry. Because every time I talk about my parents and our growing up, I tend to cry. They taught us how to be social and interact with people. They also taught us how to be responsible. One of the things my mom did in raising us is, get out of the house and go occupy yourself. Rahm and I went to school. I was 6 in first grade, and he was in nursery school. I had to take him from school, walk two blocks across a busy street, get on a bus, pay the car fare, get off at the right spot. I learned a huge amount of responsibility. Taking care for your younger brother. Taking care of my brother. The other thing I think they did, which was super important for us, is we all slept in the same bedroom. We were a unit. Yes, we fought endlessly. And I like to joke with people, we didn't go to bed until there was blood because of all the fights. But we were also each other's best friends. And even as adults, we're super competitive with each other, constantly chiding each other. Still? To this day? Till this day. And we're super supportive of each other. If I need help or I need advice, I turn to my brothers first. We're also endlessly on the phone or texting each other or constantly talking. When people say, you talk to your brothers five times a week? I said, yeah! We're constantly-- and part of that is just checking in. Part of that is, I saw you on TV and I really liked what you did, or I would make this suggestion. We always were encouraged to have our own opinions. We were encouraged to take responsibility, but also to be-- explore the world and not be shy about the world. I mean, both your parents lived into their 90s. Your mother's still alive. Yes. I probably have good genes. Yes, exactly. OK, this book is broken into six behaviors, starting with, don't be a schmuck. Not something I would think of the first chapter for a wellness or longevity book. One of the things that is, I think, core to the book is stop doing things that aren't good for your health. And so don't be a schmuck is-- Or don't be an idiot. Exactly. Don't make mistakes that are-- Yeah, right. Don't be a schmuck is my father's reference to us when we were being stupid. And so there are lots of things that we do as human beings that can be schmucky. So list some of those things. Well, smoking, vaping, doing drugs, not taking your vaccines. I don't agree with the current administration and they're dead wrong on this. Not getting your cancer screening test, although I have a long discussion about why I'm against PSA for men, a Prostate Specific Antigen for prostate cancer. Owning a gun is another move. If what you're owning-- you're not hunting, but you're owning to protect yourself from crime, it turns out that if you own a gun compared to your neighbor, you're actually twice as likely to be killed in gun violence. I think the schmuckiest move-- and I learned this by writing the book-- is climbing Mount Everest. I have subsequently reasoned that there is one thing that's even more dangerous than climbing Mount Everest, and that is being president. So the chance of dying-- being killed in office is 1 in 11. We've had 45 presidents and 4 have been shot in office. And there have been eight assassination attempts where the people have gotten off gun, shot Reagan and his abdominal. Trump, obviously, in the ear. There were two attempts on Gerald Ford, Harry Truman, Franklin Roosevelt, Andrew Jackson. Yeah. That's the most-- probably the most dangerous occupation you can have in the world. Have you counseled your brother Rahm about that, who may run-- All of your viewers ought to rethink their desire to be president. Interesting. You are often asked about drinking. I mean, this is what everybody wants to know about, the right amount of alcohol or no alcohol. There has been a lot of research on alcohol. So here's the way I distill it. The safest level is probably zero. There are some studies, and we should be clear where it's 1/2 a cup a day, three cups a week. Nobody drinks a half a glass of wine. So you drink every other day. On the other hand, 60%, 65% of the public drinks. You're not going from 65% to 0. So have to give people reasonable advice. And the reasonable advice is, first of all, no binge drinking. That's really bad for you. Don't drink alone. That's really bad for you. If you're using alcohol as a lubricant for social interaction, which many people do. That's probably good. You're getting some benefit from the social interaction, and you're being moderate in the alcohol consumption. So you're not an absolutist when it comes to alcohol, like no alcohol. I don't drink alcohol. I tell people, these are the circumstances in which you should drink. And here's your limits. You should not be drinking two glasses of alcoholic beverage a day. That's just not good for you. To me, one of the main themes in this book is the importance of social interaction, which I know is why you think that Peter Attia's book left some of that out. And there's this-- That's a modest way of putting it, Norah. I mean, you're a little obsessed with Peter Attia. It made me mad. I tell you, it made me indignant. But there's a lot of good advice in there. I mean, different books cannot be 100% coverage. I agree. I don't think you need it 400 pages. And I don't think you need it-- I think you needed more balance. I mean, one of the things that gets me about most of the wellness books-- Sometimes really successful people can be obsessive about things. Do you know anybody like that? No. Come on! [LAUGHING] You with your family like that. I would say, actually, one of the interesting things about my family is we're not obsessive about individual things. We go in depth, but we're not-- I mean, look at the wide range of interests Ari has. There's a wide range of interests that Rahm-- and activities that Rahm participates in. OK. Right? I like to fancy myself a bit of a Renaissance man. I make a chocolate. I've got an award winning honey. Right? I've done a lot of other crazy things.

OK, good. We're not obsessive. You say in the book, too, "No amount of kale or number of steps or hours of sleep can replace the importance of building and maintaining good relationships for wellness and longevity." I wrote that?

Yeah. Yeah. OK, I think that's right. I mean, if you're lonely or-- I forget what the-- a gym rat, or whatever the phrases are, the grind set, that is not actually going to be good for you. More important are, first of all, more important is balance among the six, doing all six. And the second thing is, if you had to prioritize something, you got to prioritize social relationships. Benjamin Franklin appears a lot of times in this book. And Benjamin Franklin is a great example of a person who was constantly social. He did his electricity experiments that he made him world famous in his life. Created bifocals. Right. Created bifocals. He did it with-- almost all of the activities with other people. He founded the Pennsylvania Hospital, the first hospital in the United States. He did it with other people. He corresponded with more than 1,000 people when you actually had to write letters with a quill. He very social person. That's, I'm sure, one of the reasons he lived to 84 and was creative right up to the day he died. I like to say the quality of your life depends on the quality of your relationships. A very good phrase. I think you're 100% right, Norah. You write, "Loneliness and social isolation can be as bad for you as smoking 15 cigarettes a day." It's really deadly. I mean, there's just no other way. And it is equivalent physically to smoking 15 cigarettes. And what people say, oh, it's psychological. It's not psychological only. As you're lonely, it affects your body. Your immune system goes haywire. You don't mount the same immune response to vaccines. It actually affects the body. And they're beginning to tease out the genes that get activated or deactivated when people are lonely, those immune regulatory affects the heart and heart disease and other things. And it's really important because people think, well, it's just psychological. The separation between the brain and the body, we know that they are very closely linked. And it's not-- psychological does not mean it's not physiological in your body. So friendship and not being lonely is-- actually affects the body. And that's why when people say, well, it's not as important as exercise or diet, wrong. It affects the body just as importantly. There's so much attention now on social media, and certainly the effect that it's having on teens and young people in our lives. And people always ask me, what do people say? What did you learn from Zeke Emanuel? And there were so many things, I would say. But one point on that, too, which you cite the study to, that even having your cell phone on the table-- if my cell phone were sitting here in our conversation-- I would feel the need and I would be distracted with, as opposed to a difference between whether it's in your purse or your bag or totally in the other room. Correct, That is fascinating. That is all correct. Makes sense. That would change my behavior. Our mind is thinking about that cell phone when it's available and present. If you put it away, you stop thinking about it and you focus on the conversation. And there's data, for example, if we went out to dinner and I put my phone on the table, I would enjoy the conversation less. And I would think it wasn't as satisfying to be with you. So when I tell my children on Christmas break, there are no phones at the table, should they listen to me? And you should, standardly at meals, not have phone for anybody there. And I just literally finished teaching my classes at Penn, and I've prohibited all phones. I've prohibited computers that can hook up to the internet. So students focus on the class. And you've seen real world results. You're write about that. 100%. The students-- and not only do I see real world-- I see real world results because they evaluate me better, honestly. But I also see real world results because now they're telling me-- because I've written about it. They're telling me, yes, this was my best class at Penn because I was able to focus in on class. I wasn't looking at the cell phone or wasn't looking at the computer. I actually think if we want students to learn, the best thing we can do is get the cell phones out of classroom. And I've always found social media one of the three worst things that we've done in the last two decades. And I think it's really, really important that we reverse that to the extent we can. Australia's trying the big experiment. No social media for kids under 16. We'll see how that goes. One of the interesting things you talk about in this book, and may surprise people, is what you say about retirement. Yes, retirement leads to more rapid cognitive decline for people. I say to people, don't retire. And if you're going to retire, you have to plan retirement well, so that you stay engaged, you stay mentally sharp. And that doesn't mean well, I'm going to try to play the saxophone one day. But Dr. Emanuel, a lot of retired people like to buy books and watch Sunday Morning. Well, if they're buying books and staying mentally engaged that way, if they're going to volunteer, or they're talking to friends or they're taking up a new hobby seriously, all of that is excellent. Highly endorsed. Meaning don't retire the mind or retire your social engagement. Yes. And it's very important. You've got to be deliberate about it. You can't let nature take its course. Now, Ben Franklin is really good on this. And he actually invented retirement for working people. He was 42. He had made a lot of money in the printing business. And he retired. And he says, I'm going to be at leisure. But at leisure for him did not mean he's going to the Jersey Shore and drinking and lying on the beach. Leisure for him meant, I didn't have to worry about business, and I could focus. And everything we know about Ben Franklin, all the things he's famous for like the bifocals, like the lightning rod, like all his science experiments, like his going to France and being America's first ambassador happened after he retired. So for him, retirement was about being able to focus on things besides making money. And he said to everyone, you've got to be useful. And what did he mean by be useful? How are you contributing to other people. And I think if we ask ourselves that question, how are we contributing to other people, we will have a very successful retirement. I think the thing that so many people, too, are worried about, not only for themselves, but they're watching it, perhaps with family members is cognitive decline, dementia and Alzheimer's. So as a physician, what can we do? Well, first of all, you have to start early. So there's some recent data about things like exercise, eating well, starting in your 40s and going on. If you do exercise, you don't eat ultra processed foods. Bring them down to-- now in America, they are just under 60% of calories. You bring them down to about 20% of calories. Just want to stop you and underline that. Most Americans are getting 60% of their calories from ultra-processed foods.

Correct. Got to stop that. Well, you got to reduce it. Again, we're not going cold turkey. We're not going to 0. We're going to 20% which is what places like Italy and Greece and Portugal have. That's really important. I did, in some of the little footnotes here, one of them, too, that I wrote mentions that exercise is a magical path to wellness and longevity. There are six things you should do. Exercise is one of the six. Absolutely.

Yeah. Look. Every day I get up. I do 20 minutes of yoga. This morning, I did 20 minutes on the bicycle. Tomorrow I'll go out and ride for about 25 miles. Yeah. But doesn't that help prevent Alzheimer's, dementia, cognitive decline? It decreases your risk, absolutely. And prolongs when it will kick in. Protein pretty popular trend right now. But protein is not all created equal. And what else should we know about, since you're looking out there very closely with this-- the wellness industry, which is a multi-trillion dollar industry.

Yes. And the discussion about eating a lot more protein. Wrong. You need about one gram per kilogram. So for an average person something like 70 grams, average man. 70 grams a day. So if you're a man who weighs about 150 pounds, which not very many men do, but let's say our men or women, it's about how many grams? 70 grams. The important thing to keep in mind is every unit. 1 ounce of meat, 1 ounce of salmon. 1 cup of lentils will have about 7 to 8. An egg has 6 to 7 grams, so you have two eggs with yogurt, and put it in a little-- Because that's not what I'm hearing. I'm hearing that if I weigh 140 pounds-- You got to have it. --that I'm supposed to be having 140 of protein. Yeah. Yeah. That's wrong? Wrong. Unless I'm a bodybuilder or Olympian or-- Yeah, or you're going to run a marathon. Yeah, you're putting-- you're competing, right? And part of the thing is-- and this is why I find this obsession crazy-- And this is based on what? This is based on Zeke Emanuel? This is based on-- No, no, no. This is the recommended allowance. It's CDC guidelines. But the wellness doctor is saying that's not enough, all of these guidelines are wrong. They're outdated. There are two categories besides the people who are bodybuilding, either for a major athletic event. The other category that's important is as people age. After 60, you need more protein because your body naturally loses about 6% to 10% muscle mass per decade. And so you will need to eat more protein. But here's the thing, Norah. Almost all Americans get enough protein. That's not our problem. We're getting more than enough protein in the diet. On average, Americans eat 12 ounces of meat a day. 12 ounces, you're getting more than enough protein. That is not our problem. Fiber is a much bigger problem. Only 7% of Americans get enough fiber per day because we're not eating enough fruits and vegetables. That's a way bigger problem. And as I predict in the book, I said, in the next few years, that's going to be the next big fad. It's already starting, you can see. Let's talk about dessert. Because here you're talking about that you're an 80% vegetarian, to eat more fiber. And yet you say you're a dessert guy. Yeah. I love baking. I bake cookies, I bake cakes. And I even bake my mom's cheesecake, which, as I point out, three full fat packages of cream cheese, a lot of butter in the Graham cracker crust. On no one's wellness diet. I like it. And I know people who really love my mom's cheesecake because it's fabulous. So on occasion, I make it, and I actually enjoy it. I make it probably once every three or so months. Every night, that would be bad. Occasionally, that's fine. Look, we're on the planet 75, 85, maybe 90 years. You got to enjoy it. You can't make it all about self-denial and suffering. That's not going to be a fulfilling life. It just isn't. So can you have cheesecake? The answer is yes. Can you have it every night? The answer is no. Can you have it occasionally? Yes. And by the way, if you make it, you've got other skills that are coming out. You're challenging your mind. You say multivitamins aren't beneficial. And yet I have taken a vitamin almost every day since I was a kid, and I attribute that to a lot of my health. And then you point out in the book, too, that then there are some vitamins that you should take. So what is it? Don't take a multivitamin, but you should be taking vitamin D? Again, if you're not a doctor, you're not a scientist. that kind of advice is hard to follow. Right. So the multivite isn't going to hurt you. That's the first important thing. Yes. OK? It's probably also not going to help you. That's what the data suggests. Now, there are categories of people who need vitamins. But you are getting folate, which is important in case you're a woman and you get pregnant. 100% And I say that in the book. Vitamin D, which is incredibly important. You said, yes, you can get it from 15 minutes to 30 minutes of sunshine without sunscreen. But we're in the dead of winter. I don't see a lot of sunshine. You can walk out in the street and get some sunshine. Yeah, I think you're pointing out what could be qualifications of that. In general, multivitamins are not beneficial for you, but they're not harmful. So the biggest harm they'll have to you? Waste of money. Yeah. OK. But I think you're taking that from the assumption that everyone is eating as healthy as you are, that you're an 80% vegetarian as you are, that they're drinking milk every day, that they're eating a dairy yogurt in the morning. All those things which are naturally fortified with vitamins. But if most Americans are eating 60% of their foods from ultra-processed foods. That's not the studies that were done. They weren't regulated on what they could eat. They simply were randomized, given a multivitamin to see if they were healthier, had lower mortality, had less cognitive decline. The answer on all three, no. OK. OK? But again, and I agree with you, if you're a woman who is thinking about becoming pregnant or pregnant, you definitely need folate. And that's really important. That's why pregnant women, typically their obstetrician will give them a prescription for multivitamins and encourage them to take. And why the federal government put folate in foods. Correct! I'm not-- and we've seen the consequence of that. Really important consequence? Diseases, neurological diseases like spina bifida, have gone way down because of that. Really big achievement and really important for the children and the parents. I don't dispute that. And I think that's one of the great achievements we've had over the last 50, 60 years. On the other hand, for most of us, that's not actually going to be advantageous. But as I say, it's not harmful. If you think it's important, Norah, go ahead. Thank you, Doctor. With my blessing. Thank you, Doctor. We talked about exercise, but your advice, get off your [MUTED] and move around. Yeah. Right. So the biggest problem in America, OK, it's not you or I, where we're walking around, we're exercising regularly. It's the fact that most Americans are not exercising and aren't getting enough exercise. So it's the new year. What should people do? They should start something that they can do and stick to. And so my recommendation is walk. Walk. Measure. Figure out what a mile is and do it with someone else. That way, they'll encourage you. You'll encourage them. You'll walk. Maybe you'll see some trees in nature. So instead of meeting your friend for lunch or coffee, say, I'll meet you for a walk. Yeah. Or right, if you're-- instead of an afternoon snack, let's go out for a walk. And we'll talk. That is a trifecta, as I like to say. It's a wellness trifecta. You've got exercise, you've got social relations with someone else, and if you're out in nature, that is stimulating you in a positive way as well. So I appreciate that you said, too, willpower, it's hard. Willpower is hard. So find other ways. So if you're looking to adopt a wellness behavior, how does someone make that behavior a habit? OK. So it's, again, one of the important things of the book is I mentioned how controversial we don't actually-- it depends what the environment is, what your other stimulation is. But in general, there was a study in Canada, where they looked at people who made New Year's resolutions and signed up newly to go to a gym. And those people who did the gym four times a week for four weeks were more likely to be doing it at 6 weeks and at 12 weeks and making exercise and going to the gym a habit. So that's about it. You do it four times a week, three to four times a week. You do it and you get to a month or two months. It's going to be a habit for you. And then you construct your day around it. You say start a plan. Remove triggers that would keep you from doing that plan. Absolutely. And don't try to do all of the recommendations, all 6 at once. I'm going to eat well today and I'm going to exercise today and I'm going to work on myself. That will not work. It's way too much willpower. You'll drive yourself crazy. You can't boil the ocean. And it'll exhaust your willpower very, very quickly. So pick one, like walking, or I'm going to have-- one meal a week, I'm going to cook that meal. OK? And I'm going to learn how to cook a new meal each week. Those are the kinds of changes you can do. Don't take an enormous amount of willpower. And if you do them regularly for four or six weeks, they'll become habits. One of the New Year's resolutions that I have-- OK. --is to, one, keep the phone away from the bed at night. Great. OK. So that-- I'm with you. Doctor approves of that one, too. Yes. That will create-- You're getting a lot of gold stars here, Norah. That will create more reading at night, too. And then just it prevents you from falling asleep and the doomscrolling, as you point out, everybody knows. Also is to increase my zone 4, based on the Norwegian protocol. So you saw I did a VO2 max recently. I did the grip strength test. Do you view those as a good indicator of longevity. The data are that they're a good-- it's not me. It's not my opinion. It's the data that says they're a good indicator of longevity. I don't obsess about them. But you are going to get one. Well, I-- And your wife is interested in it, too. My wife is, as I like to say, she's a PhD from MIT and she is driven by the numbers. I'm not that. I didn't have that accomplishment, and I'm not driven by the numbers. I'm driven like, do I feel good? And I have a pretty good internal sense for numbers. So I know exactly when I wake up. I know when I've done about 10,000 steps pretty accurately. So what do you think you'll learn from a VO2 max? What do you hope to learn? On my watch-- so the one number I do look at, frankly, is the distance I go on a bicycle and the speed. And I look at that because I like to ride and I like to ride fast, frankly. And so I do look. And coming with that is a VO2 max that gets calculated on my watch automatically. And so I look at-- I look at that. And I think it's inaccurate. And I'm curious what the actual accurate number is when I push myself to the max. There are a few things that you call blatantly anti-wellness. And I want to quickly touch on each of those. Chronic stress, living on a steady diet of fast foods, social media, and dining alone. Yes, all of those are bad. And none of them are wellness. And none of them-- I mean, you might have to do them occasionally, but you should not make a habit of any one of them. So I think people would agree with all of those, with the exception of dining alone. A lot of people go to a restaurant or get home from work and dine alone. If it's an occasional thing. Don't make it every day. And if you find yourself dining alone, what you should do is call up a friend. If you're sitting at a bar, right, and you're dining there, ask the person next to you, have you been to this restaurant before? What do you do? Why are you here? Strike up a conversation. We underplay those casual conversations and how important they are for us and also for that other person. Remember, you're being virtuous. You're being a good person if you strike up a conversation. Because that other person will also benefit. So what's the biggest piece of advice you have for someone in 2026? Build your social relationships. It's definitely the most important thing for long-lasting health and happiness. And a potential digital Sabbath. Yes, I am a big fan of digital Sabbath. It's great psychologically, it's great for your interactions. It's great to reset your mind. And get rid of the phone for a day. Turn the phone and computer off. Just don't do any of it. Well, that'll help with the social interactions. Absolutely.

Yeah. That's right. Let's talk about the current state of health in America. Because an advisory board hand-picked by HHS Secretary RFK Jr. has suggested Americans stop giving newborns the Hepatitis B vaccine. What does the science say about the safety of that vaccine? RFK Jr. is wrong. The safety is fine, and it prevents kids from getting hepatitis and the consequences of hepatitis, including cirrhosis and liver cancer. We need to keep it. And parents who are having a new child, and my daughter just had a new baby, absolutely need to get that vaccine. RFK Jr. says that he is going to perhaps change the new dietary guidelines. He wants to stress the need for saturated fats and says good meat, fresh meat and vegetables. What do you make of that? No. We have overwhelming data that too much saturated fat is correlated with heart disease and correlated with heart attacks. And one of the great achievements we've had is the decrease in consumption of saturated fat. That is part of the reason that we've had this very, very substantial decrease in cardiovascular mortality, like heart attacks, like strokes. He's just dead wrong about that. And instead of using seed oils, we should use beef tallow. Wrong. He's got some things that he's right on. We have too much chronic disease. We need to focus on getting rid of the chronic disease. But adding saturated fats to the diet is not going to achieve that. It's going to increase our cardiovascular disease. But some saturated fats are good. But just increasing them, you say, is not a good idea. Yeah. Increasing the meat consumption is not a good way to get healthy. We already are over-consuming compared to other countries. And it's not healthy for us. You worked on the Affordable Care Act, otherwise known as Obamacare. What about the current state of that today? Look, Obamacare achieved a lot. Two main goals, it achieved. It gave over 25 million people health insurance. And we know that having health insurance is correlated with actually less mortality. People's lives are saved. And it actually controlled costs for 15 years. But no business puts into place a plan and then doesn't modify it and improve it for 15 years. Unfortunately, Congress does this. It puts in a plan and doesn't have a way of constantly updating and improving the legislation. And I think we are due for a big reform. I think it's a 2-step reform. One is we have to focus on affordability and implement things today that will improve the affordability over the next few years. And then we have to begin thinking about what's the comprehensive change? Our system is not working. If you think about the goals of health care-- universal coverage at reasonable cost, with consistent, high quality and satisfaction-- we're achieving zero of them. Lots of other health systems are achieving them. And we have no path to achieve any one of the five. So I think it's a real problem. And therefore, we need to think about the reforms. That's what my next book is about. I'm thinking about the reform we need for-- comprehensive reform to actually achieve all of the goals we want for our system. Universal coverage at reasonable cost, with high quality and high satisfaction. Well, before that book comes out, should we try some ice cream? I love ice cream.