#866: Sami Inkinen of Virta Health — Reversing Type 2 Diabetes, Rowing 2,750 Miles, and Lessons from Fixing Metabolic Health in 100,000+ People

Transcript from https://podmenti.com/t/1cb9d6b440b58d97

Hello, boys and girls, ladies and gents. This is Tim Ferris. Welcome to another episode of the Tim Ferris Show where I deconstruct world class performers. This conversation is incredibly tactical and practical. Lots of detail that you can use. I took a lot of notes. Sami Inkenen is my guest. He is the founder and CEO of Virta Health.
Which aims to reverse metabolic disease in one billion people using nutrition and technology. And based on his texts
To me.
Over months.
What he and Verta have been able to do
with people who have practically no money, practically no time.
blows my mind. I mean imagine completely transforming yourself.
If you only were able to eat a McDonald's.
As a truck driver.
I mean it's it's really
It's just mind blowing stuff. In any case, we'll get to it. He previously co founded Trulia, is a triathlon age group world champion and once rode two thousand seven hundred and fifty miles from California to Hawaii.
Imagine that with your arms. Maybe you've taken a flight between those two. It is not a short flight with his wife.
Unsupported.
Setting a world record to raise awareness of sugar's link to diabetes. His story is nuts.
His cultivated abilities
Which are all scaffolded on
Habits that you can imitate.
Are really, really consummately impressive. So I'll leave it at that. Please enjoy this wide ranging conversation with the one and only Sami Inkenan.
Optimal minimal.
At this altitude, I can run flat out for a half mile before my hands start shaking. And I also do personal questions.
No se
a cybernetic organism, living tissue over metal endoskeleton.
No
I will start
Expose.
With
Something that I can potentially use immediately or some variant thereof. Do you still schedule your week or at least workouts each Sunday? And I'm reading here. This is from a blog post.
Schedule everything. This is top five tips getting and staying in shape.
For people who are busy. I spend ten to twenty minutes every Sunday scheduling most of my workouts and details similar to any other appointments in my calendar.
Like with most unscheduled tasks and to dos, they'll fall between the cracks on the other.
And with proper scheduling, you've managed to get in your workouts with a hundred and fifty plus annual travel days, changing cities, super early wake ups and delayed flights, et cetera. So
This is kind of
A micro question that
Edges into the macro. Just around.
Planning and scheduling, but do you still take time out each Sunday?
To go through these things.
One hundred percent. One hundred percent. It's every Sunday.
I just find the structure allows
Flexibility and spontaneity.
If you don't have structure, like nothing gets done, at least in my life. And
Not that my life is super special, but you know, two pretty young kids happily married.
running a company growing that's thousand employees.
And then trying to be a kind of semi athlete in the process.
If I don't schedule it's not gonna happen. So
I spent about fifteen minutes
At the end of each week, that Sunday.
Professionally kinda list the three things that absolutely have to get done and then I schedule a few things including workouts. And it it's
Works very well. When do you do that on Sunday?
This could be a longer conversation, but it's either early morning before the kids wake up and kinda Sunday gets going, or if I don't have it done by Sunday afternoon, then it's after seven PM when everybody else kinda quiets down and
I take my own time.
Verta, how many employees do you have right now?
Yeah, very hell. So we're about thousand employees. And and the caveat these days, of course, is don't brag about employees'cause the more employees you have, less you leverage AI. So it's But uh you know, I guess mentioning thousand employees. It's a real company and
Obviously growing fast, so it it takes fair moment.
Efforts. About thousand people.
Well the good news is like so many companies in the news these days
If you did end up overhiring during Covet or something, you cannot say we made a mistake. You can just say we're using AI to improve efficiency when you have layout.
But we won't dwell on that.
The question I have is what type of training
in your life right now are you currently scheduling?
Each week.
Well what about
Training. So this is sort of physical training. So training.
It's really in two buckets.
The primary focus is really on Durant sports around cycling.
So I do a lot of mountain bike.
Racing as well as road bike racing. So that's essentially endurance training. So I'd say ninety percent is
Is cycling related and that's my core workout.
That essentially happens
In the morning every day.
Ninety nine percent of the time it's one of the first things. It's not the very, very first thing.
In the morning. So that's one.
We can go and do morning routines and stuff like that.
In in a second, if that's interesting. But I do a little bit of just sort of core work.
Pretty much first thing after waking up. So I don't even have to schedule that. That's sort of a
Non negotiable before the brain even boots up.
I've done my kind of core work.
But
Cardiovascular work is the man.
Let's not tease. Let's just hop right into it. So what does the morning?
Look like.
Upon waking up and what time are you getting up?
Let's separate into
Traveling and not travelling. Traveling for work, not traveling.
I wake up
Five A. latest.
Like this morning
Alarm was
four forty five and so wake up pretty early.
And I have the amazing privilege and luxury that
The second I roll off the bed.
I jump into a lake.
Or Pond.
You know, it's not a long time, maybe like a minute, just cold water, a couple of strokes.
But it's essentially it's like a freezing cold shower. And this is a mountain lake, so we're talking like forty degree.
Whether pretty much straight off the bed.
And

Some air squats and jumps and core.
Like literally core work. Nothing too special. So that's
Like some Superman some
We're crazy and stuff like that. And and and I do it because I
Race bicycles quite a bit.
And I have some lower back issues and core work.
It just never gets done unless it's the very, very first thing in the morning.
Then I'll throw in a couple of push ups there. So it's
You know, that's five to ten minutes.
Straight off the bed.
Jump into the lake.
Tripping wet, a little bit core, a little bit jumps, a little bit this and that and
I'm just a huge
Not just a believer, but the practical experience I've had is
Kind of mood follows movement emotion.
So before I even ruminate I think anything.
I've already been in a wake and
done five or ten minutes of core work and some jumping and
Get the heart rate up for a little bit.
And that's pretty much the first five, ten minutes.
And then the other thing I I try to do always right after is
Do something useful for other people.
Do something useful for other people.
What is that in practice when I'm not traveling? It's preparing coffee for my wife.
And emptying the dishwasher.
Sounds very simple.
Yeah, like
Fifteen minutes after I've woken up, I haven't had a second to think about a ruminate.
Oh my back's hurting or oh my God so much work or whatever that is.
It's like a fifteen minute.
sort of boot up sequence.
And it's like life's rocking and then kind of I'm ready to go and and do the other things.
Don't worry, I won't have you give them minute by minute for your entire day, but
After you have done that.
So you've made coffee for your wife, you've emptied the dishwasher.
Then what?
Are you
having your first intake of coffee. What does the next kind of thirty to sixty minutes look like for you? Man, sounds like a mind reader. So I do drink coffee.
So that's time for
An espresso or a cup of coffee at that point.
And uh
Everybody else is still sleeping in a house.
I sit down and
Basically I write down kinda my sleep, how many hours I slept and I can have a little diary. It's a spreadsheet online.
Sixteen years of data now and
I also ride three things I'm grateful for, so this kinda little
Trat to journal, super, super simple things. And I try to focus on the mundane.
Such as
You know
Leaves.
In the Aspen trees or
Warm temperature. Simple things, very, very simple things.
So I do that and write down a a f a few things.
And then I usually work for about an hour or so like clean email and Slacks or maybe I have like a twenty minute writing thing. So this is kinda my CEO job, so I try to do about
Power of that.
And then whenever my wife
Wakes up.
Then we have sort of a fifteen, twenty minute couples moment.
Drink coffee and
Talk about life.
It's a really wonderful moment there.
So that's kinda the the very morning. And then
My real workout usually happens between sort of six thirty and eight thirty. Like
Exercise.
And then after that
Get to office.
Exception would be if I have any meetings that are up across time zones, then
You know, it could be a six AM zoom or something like that, but
Before that I've always done my
swimming in a lake and a little bit of core and maybe a couple of espresso. That's the routine.
Um
Pretty much repeated that for more than a decade and
It's nothing too special. I always say people ask like what's the science behind I say listen.
If it doesn't feel good.
It's not right for you. If you feel scared
Repeated.
Yeah.
So I mean I suppose there are different types of fun, right? There's type one, type two, maybe type three.
Fun, which is just embracing the suck.
God, I can't remember who sent this to me.
It was a friend of mine.
Maybe you recall who this is,'cause I'm sure I pinged you about it.
But they were driving up some windy, incredibly steep road.
In the mountains.
They were taking a video from their car.
Of some lunatic who I think they call the lunatic. Like, look at this fucking guy. He's crazy on what you could envision listeners or watchers.
as incredibly long
Roller blades. They're basically skis.
With
A single track.

And polls.
Doing uphill
I suppose Nordic skating, let's just call it.
Going up this unending
Incline and they're like, God, who is that lunatic? And of course, who did it end up being? Ended up being Sami. Right. So they're
Fun means different things, or feeling good means different things.
in different contexts. But the reason for people who are wondering why am I digging all into all these details. Number one, I like the details and the details matter.
But you have always impressed me with
The uh number of
important pillars that you're able to
methodically schedule into your life.
And furthermore, within those pillars.
how you're able to operate at a very high level in multiple domains.
So that's why I'm asking
About specifics because
These things much like workouts.
Tend not to happen accidentally.
If you don't schedule them.
Particularly with
The number of moving pieces that you have.
And frankly the number of moving pieces that any
person probably has things will not manifest magically. And
I'm curious, we talked about
The single day.
Do you have any type of
I know for training you almost certainly do have like weekly and monthly architectures, particularly with competitions, but from a work
Could be work, could be physical.
perspective, do you have a consistent weekly architecture of any type where say you might batch certain types of tasks or meetings or otherwise
on certain days or anything like that, or is it pretty much Monday to Friday more or less the same daily routine?
I do have a system.
Well a couple of things first, kind of
I think it's good to remind when
Myself when anyone's like, Oh, he has the system and
The reality is life happens all the time. So let's just remember that. You're running a company
You have kids
The crap hits the fan.
All the time or at least frequently. So obviously you have to be flexible. So what I'm gonna share next is the kind of beautiful, clean scenario where you can kind of
Live with your structure. But the reality is
You're running a company gets in the city. It's it's twenty four seven and the Sunday afternoon walk with your kids, or or your spouse may not happen'cause you need to
address the crisis but
Let me start with
You mentioned like oh I'm kinda impressed how many things you can do.
Honestly, the biggest secret is saying no to
ninety nine percent of the things that many people consider quote unquote normal.
So
What you care?
Gets done.
And sometimes
People ask me, like, wow, so many sacrifices. Are you trying to be an athlete and
CEO and a founder and trying to be a parent as well, and you even travel with your kids like
You must have somebody sacrificed. I actually find that saying no
Is incredibly liberating.
In life.
I'm way happier that I'm married to one person versus five. It's awesome.
There's no way I could be a CEO of many companies. I love the kind of focus.
And so I actually find it
Personally in life, when you find something that's
Kind of fills your cup and is satisfying and gratifying.
Just having the one or two things that
Uh focus on and then go all in.
Rather than a sacrifice, it's like a happy place for me.
So anyway, so I would say that's my biggest secret.
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Yeah.
I think a lot of people will hear what you're saying.
And theoretically agree with it.
And yet most people
are unable to
Embrace that.
In practice.
For whatever reason. And doesn't mean they're not capable of doing it.
But they don't do it.
Why do you think people have trouble?
Saying no or
the default is people are inclined to
Over commit.
Or that they do the ninety nine percent of things that are quote unquote normal that you say no to.
Why do you think not more people?
Do what you're describing.
Honestly, if if I had a perfect answer, I'd probably write a book about it. But uh It's all your all your spare time. Yeah.
I can't tell how many times someone has it.
Must be sacrificing so much to be able to do what you do.
And I'm sure you could say the same.
for an Olympic athlete, like oh my gosh, so many sacrifices, but
If you're an Olympic athlete focus on your sport and your craft.
Sure, you can't do ninety nine percent of things.
quote unquote normal people do, but it's probably incredibly satisfying to be able to do that one thing for
The five or ten or fifteen years of your life.
So that's what I meant. So maybe it's a narrative that oh if I say no to all these
Whatever that is.
Some distraction.
Whatever.
Staying on social media and watching Netflix four hours a day.
That oh it's a sacrifice not to do that. So
That's my guess. One thing that's the narrative in our minds, like oh you wanna do all these consumption things.
Yeah.
Maybe take


Can you
Move your life or profession forward. So
So that could be one.
And then the other thing is
I think this sort of life structure that if you don't have a basic
We can go back to your original question, that what's kind of your architecture or what's your structure. If you've never taken the time to take a step back and say, Hey
How am I allocating my time? It's very easy to let
the universe of entropy to
Kinda take control of your time.
Whether that's your inbox or
Text messages from others, or phone calls or
It's actually very, very easy.
Let's
The world.
Running alive as opposed to you.
Let's talk about the weekly architecture and then I am gonna
Come back.

Particular.
question that I asked, but let's take a breather on that and
Would love to hear more about the weekly.
Architecture or
Other architectures outside of the daily.
Again, this is sort of in an optimal world, but I would say professional
I do try to group
Kind of simulative tasks.
into specific days. So just to give you an example.
Mondays filled with a lot of kind of group.
and leadership meetings and stuff like that. So there's
One kind of context switching?
That it's meetings in front of
the whole company and in front of leadership team and so forth. So so that's
Monday.
Tuesday I try to have all my
One oh ones.
Again, one type of context switching and as an introvert
That takes a lot of energy, by the way. As important as it is, and sometimes very enjoyable, but the kind of
One person after another, it's pretty draining for me personally. How many direct reports do you have?
I should say this has changed all the time.
There's been fifteen, there's been ten, and I had eight for a long time, but for the last couple of months I've had two.
Only two, which is a very small number. And again
that could be another one hour conversation. But when you're building a growth company
You always have to ask yourself.
what's most important for this year and there's not really kind of a school book perfect kind of
kind of approach. But anyways, uh is two right now.
So Tu says that
Wednesday I actually tried to reserve for thinking and writing.
Thinking and writing.
So the default is no meetings.
And one example of writing that I do, I write a team letter for the whole company from the CEO.
So I've now written
Five hundred.
Fifty three of them.
So you do that every week.
Every week and there's like a one topic and
Again.
Another topic we could
dive into but what I find is that it's
As the company has scale.
There are a few things that are very scalable.
Like whether my email hits.
Five in boxes or thousand. Obviously doesn't take any time away from me.
But I can give context.
explain what's happening, what's important, what's happening in outside world, what's happening inside the company, and then
Every employee feels hopefully some level of connection. That's one example. There's a couple of things that I
Kinda repeated ever since day one and now it
thousand employees scale.
Still very scalable. But that's just one example.
It could be preparing for board meeting or thinking about
Strategy which sounds very
high flying. But I I would say one thing that's very, very easy
as a CEO of a growth company is to fool yourself that you're productive and useful.
By being busy.
But if you miss a decision
Something around a corner.
No amount of knocking tasks off the to do list is gonna compensate that.
And it's almost like managing your own brain and feelings.
It's hard not to have a timely scheduled calendar.
But in fact having that time open for like you can go for a walk and think about
The problem.
So anyway, so w that's kind of my Wednesday and then Thursday and Fridays is
a lot of internal client work and those kinds of things, but I usually that's not too structured.
But that's that's a little bit of
A typical week.
On Wednesday
When you're doing the writing and thinking
What are some of the ways that you structure your thinking?
There's unstructured thinking. We can go for a walk and kind of ponder and
allow the void to invite, hopefully, some type of insight. But then there's structured thinking. And I guess
To the extent that I know you at all, I would say I'm inclined to think you probably have some prompts or structure or an approach.
to doing thinking.
What does that look like, or how would you speak to that?
Typically the way my brain works is the actual thinking and problem solving
It happens twenty four seven, and I'll give you a specific example.
My workouts every morning, which is about an hour I want to have, unless it's a very, very, very high intensity.
That's one of the best times when my thinking happens.
And sort of problem solving and new ideas and creativity.
happens there and then for the Wednesday I actually just block like an hour and say
It's almost like the time to get
The words and the thoughts and
Whatever that might be.
Off my brain to a paper, or
Obviously.
In the cloud.
Unless I have to do a very kind of left brain
mathematical
deterministic problem solving thing, like literally like okay, let's look at how do we improve cross margin or something like that.
The created work does not happen at the disc.
For me.
And I'll give you a
One thing that I hope.
notice this was especially during Covid
And Covid hit.
I was listening a lot of podcasts and music.
and audiobooks on a hundred percent of my workouts.
Was maybe like a year.
And I realized that problem solving and the creativity almost like stopped.
So now I have a rule that
maximum of half of my work out.
I can listen to Tim Paris.
Sorry. So if your down one numbers start going down or or listening numbers, damn it, Sami. I need all the help I can get.
So
If the brain is in a consumption mode
You're kinda just filling the cup.
And I've noticed
the creative thoughts and the problem solving that's happening kind of
You know, backwards background processing is not happening. So anyways, that's a
tactical thing that I've noticed that
Too much audio book.
Podcasts kind of filling the brain and it stops
creating stuff. It's very interesting. I that's at least my personal experience.
Some very conscious of
on those moments when I'm, you know, exercising or walking or driving somewhere that there's
kinda like a cut off point. No more listening, just let your brain do its thing. And then the Wednesday comes in
It's more like okay, now I kinda have a framework in my head.
Take an hour and a half.
to I don't know, write above next year's priorities. So this gonna the new product we're gonna launch and or even these team letters that I write.
I actually write them
In my brain.
when I'm away from the desk and then when I sit down, it just trrrr.
That
actually leads into my follow up question. I can't imagine I'm the only person wondering this
Which is when you're doing these workouts, let's just say it's an hour and a half to two hours
the real workouts, right in the morning.
I would imagine quite a lot percolates and comes up and if you're doing that
Monday, Tuesday, maybe also Saturday, Sunday, et cetera. By the time you get to Wednesday
If I have not taken some step to maybe verbally record some of that or make
short notes in a notebook for cues for later.
I would be doubtful that I would be able to recall.
the good ideas that I had earlier in the week. Do you just have a preternatural
Inclination to be able to m remember all that stuff, or do you take some type of shorthand?
After the workouts, so that you can use those then on Wednesday as prompts.
How does that work?
Essentially I write emails to myself.
Austronauts it's the same thing. So there's
Tidbits
Along the week and then uh
Uh have it.
For Wednesday and then
Half maybe in in the brain and
Half his
It's written somewhere so I don't forget it all.
And you just send yourself an email after the workout with some type of note.
Yeah. Yeah.
What is an example of what you might cover in a team?
Slash company email.
on a Wednesday. And how long is that?
That is, like you mentioned earlier, one of the things you've repeated since day one.
What would be an example.
that you can share. Could be hypothetical, but just like what might you put into that and how long is it?
Absolutely. Well there's sort of half is standard structure, so there's a quote from
Again.
We can go into details, but you know, we're in a business of
Reversing metabolic disease and helping people get healthy with nutrition. So we treat patients like real humans, hundreds of thousands.
So half of it is just existing structure. There's a quote from a patient, so we always kinda lead with
This is why we're here. And here's kind of a positive feedback from a patient. And then there's some business metrics like how much we've grown and
What are the priorities and just a reminder of this year's
Key objectives.
So half is like that, and then the most important other half is
Topic of the week.
So topic of the week is essentially my as a CEO founder essay.
I think that's what you were asking.
I would say
They're roughly in two or three categories.
One is
What has happened in the external world.
What's the context there and how does that affect us?
One example this is a real world example that I've I've written quite a bit about.
Since we use nutrition as the core tool
But obviously our providers use all the tools in a toolkit. One of the things that has really changed
in addressing obesity and metabolic disease over the last couple of years is the GLB one drugs. So these are the
Yeah. The Olympics of the world.
And so
I've had number of letters.
discussing how do these drugs potentially affect how we take care of our patients and what's the impact on our business. That would be
sort of externality and how is it affecting our strategy. So that's one example.
The other category is
career and personal advice to our team members.
Like how to make most out of your experience.
Working at Verdo?
And around that s sort of
kind of stuff that we discuss we've discussed now, like personal productivity and how do you make most out of
So that's I would say is is the second category.
And then third is just internal
This is what happened. This is what it means for us. So
Honestly, it's
I kinda like it. It's my personal outlet and sometimes um said, Hey
Five hundred thirty plus.
Essays, there's a book in the making.
All we need to do is upload it to Chat TPT and we have a book ready to be published.

So I promised I would come back to a thread, which I realize is probably a misworded question. The question I asked
was
Why
People
Have trouble.
Doing what you do, which is saying no to ninety nine percent of the things that
Normals.
Do.
Or feel compelled to do.
To your point about the narrative. And I realise that's perhaps not the right question.
The right question might be
What advice would you give to someone?
Who is it?
Having trouble.
Saying no.
or focusing on just a few things, but I can make it much more specific.
Because I think
The more
We can imagine it perhaps the easier it is to dig into this. So let's say that you had
A relatively new hire.
Who is on the younger side, but
you know, a ten X engineer or some equivalent of that. Someone who is clearly a superstar.
But who has not established the type of architecture.
And routine that you have.
in your life.
And let's just say you sense that they are
on the path to burnout, which is gonna be bad for them. It's gonna be bad for the company, it's gonna be bad for the patients you serve.
And you want to stage an intervention to help them.
Correct course.
I imagine you may have even had these conversations.
What might that
conversation or coaching.
Look like.
Well, funny enough, this has been one of the topics of my team letters, one of the five hundred thirty.
I would separate it it into
Two things, my advice.
One would be this sort of
Planning. I literally it would be very simple.
Sit down.
For five minutes.
On a Sunda evening before the week starts.
And write down
what absolutely completely needs to get done next week. Super duper simple, professionally and personally.
And
Schedule it into your calendar.
Like literally. And if you have the flexibility, then like block two hours.
In the mornings to get those two or three things done.
And then when life happens or work happens, everything else kinda comes after that. So z that to me would be the number one thing.
And then I would couple that when Monday comes or Tuesday comes.
you know, whether we work in an office or in a remote setting
Донатте універс.
Control your time. So this means
Absolutely no notifications.
Maybe if you have a good text message for I don't know, family emergence or something, but like take everything else out then you kinda
create that sacred space where you can do that work. Whether that's writing or coding or
called calling fifteen prospects or whatever that is. It's super duper simple, but it's so easy to then sort of
Again, Monday comes, Tuesday comes, and then the wall takes over and you're like, Oh my God, it's four PM, I haven't done the thing.
So I'd say that would be the one category.
And then a second category gets the second. Yeah.
If they were sit down.
for ten minutes on Sunday to write down the things that must get done.
Professionally and personally, they might have a list of twenty things in each category.
So are we talking about one thing, three things in each category? I know this seems like very
For Snickety, but
This seems like a possible failure point for people.
So
What does your
Suggestion.
There.
It's probably one or two things, but this again we could launch into another part, which is y obviously you need an architecture of annual
Thinking, planning.
what does the business need, for example. Like I have
In fact, I just have a text file, ASCII file on on my computer or something.
Here's the four things to remember as a CEO.
Now and twenty years from now.
Here's the three things for this year.
And here's the three things for this week. I literally have a
Text file and I just
Updated every every Sunday.
And a whole another topic which I'm sure some people think I'm crazy is
I have a fifteen year plan for myself.
Which I kind of accidentally stumbled.
It actually could be useful and I update it every year.
And again, we can we can take that offline or take a book mark how that came about.
It's been incredibly helpful. And again, I want to highlight
Structure.
Allow spontaneity.
And flexibility. But if you don't have that architecture, then obviously on a Sunday evening it's like, Oh
Should I write a book?

Or get a new job, or just
do these projects that my boss was asking. So if you don't have that North Star, you could be kind of spinning like a compass.
So I did take you off track because you were saying
Block these things out in the calendar like Sunday, five to ten minutes.
Block those things out in your calendar if you can. Two hours first thing in the morning. Do not let the universe
dictate your how you use your time, block out notifications, and then you said the second thing.
Yeah, second bucket, this is probably the most important as it relates kinda like a burnout and
You're just kinda you're falling apart.
And I'm gonna knock here on on my wood.
My table to
Create any any noise, but

I
founded my first software company in April two thousand.
So now it's weird.
We are here in twenty twenty six. So that's twenty six years.
Running building.
fast growth companies. And I I haven't cracked yet.
And again, caveat is it could happen tonight.
But
There's a few things I've learned. I think these are applicable to especially any knowledge worker.
where kinda like everything's just coming to your brain and it's it's very easy to, you know, get stressed and anxious and crack.
And I've written about this as well. Here's my formula that has worked for me.
Very well.
One, you have to take care of your sort of foundational metabolic health.
That's
What is it? It's sleep.
nutrition exercises. That's kind of one. If you are metabolically very, very unhealthy
It's very, very likely that you're gonna crack under pressure. So that's one.
Second one is
It's very helpful to have
Especially for kind of founder CEO types, but for anyone.
Have at least
Two oh three.
kind of identities or outlets.
For me it's
Kind of parent husband.
One.
See you all.
Two
And then
Wanna be athlete.
And so
If one's failing.
Hopefully at least two.
Are the areas outlets in my life where I'm like oh it's it's going okay. And by the way, it's never that I'm rocking and winning and ringing the bell.
In all Korea at the same time.
And it's very healthful.
Yeah, mental trick, like, Oh my God, work sucks, but at least my kids love me today. So having that outlet and particularly founder types, younger ones, it's often the opposite. They're sort of proud of the fact that
I only have one thing and I'm
Ready and willing to die for my company. Well
That's all well and good when everything's going well, but
You have the first kind of speed bump and then everything falls to bar. So that's the second thing I would say.
Third one is
Have peers outside of your company.
That you can kinda
Let your hair down.
Sorry, sorry that I know that your head on and relax. For me it's a group of CEOs.
other CEOs was Oh my
God, can you believe
Can you believe these employees start bitching again? But you obviously you can't say that in front of the company. So having that kind of
Personally for me it's been YPO, the young residents organization since
I guess two thousand eight, so
Now it's
For me it's not any more the why the young, it's just the old'cause I'm I'm old enough. So
I have that.
And then I I think the last
Fourth one I would say is
Everyone has their own tools, but just understanding how your mind works.
Could be meditation, could be some other tools, but
That's been a process for myself to just realise that
If you're just attached to your thoughts, eventually they're gonna get you and
you can't really think yourself out of the hole that you've thought yourself into. So unless you can take a step back and kinda like observe like, Oh my God.
My brain's having a life of its own.
So that's kinda the toolgit I would
Not to crack, so
Foundational health.
You know, have different outlets, identities.
Have peers you can talk to You could be friends as well.
And then
some sort of understanding and kind of way of
Taming your mind, if you will, or being able to see that the mind has the life of its own. That's been helpful for me. And I will say
Again, could happen tonight, but I I I haven't touched any prescription drug for anything sort of mind related.
Yeah.
Toolkit has
Kind of get me.
Head above the water so far for twenty five, twenty six years.
Have a
Very
Left turn question for you.
Hopefully it won't be incredibly offensive. But I was just thinking
When you were like I would knock on wood, but I don't want to make any noise and then you're like
And let my hair down, you know, no offense. Sorry. And and you're very polite. And I've only been to Finland once.
I was walking around
And of course went to the obligatory saunas and so on.
Which
I actually can tie into my story.
But I was walking around and in the maybe two days that I was in Helsinki, I thought to myself
Yeah, I lived in Japan, I speak Japanese, I'm still close to my host family.
Who I stayed with when I was fifteen, and I thought
Finnish people feel like white Japanese people. That was my feeling there. And the reason it ties into the sauna.
Different context, but if you go to Japan.
Everything is very restrained, very polite.
People don't stare you in the eye when you're walking down the street.
In Japan though.
If the boss says we need to go out and drink
When you drink
Okay.
And if the boss says you have to drink, you have to drink. But you go out
And you can get
really loud and you can get really boisterous. You can you're allowed to say things when you've had some alcohol.
That basically everyone agrees they're gonna forget the next day like it never happened. Now
I can't
Take it that far with Finland, but when I went to the saunas, one thing that I was very surprised by is that they sell.
Huge.
shine glasses of beer that people bring into the saunas. And I was like, Oh, this is where they let their hair down. Okay. Am I totally off base? I don't know if you've spent time in Japan, but culturally I felt like
In my
48 or 72 hours of exposure. I was like, wow, this is actually even Finnish itself has some of like the phonemes, some of the sounds of Japanese. I mean, it sounds like I'm really overreaching now. But
Am I just an insane person, or do you feel like there's there's something
Possibly there.
I think there's similarities and and you're definitely the connoisseur of a Japanese culture versus me, having just been to Tokyo and a few other places a couple of times, but
That

kind of space and distance and politeness that people
Well, actually there's no distance in Tokyo, obviously, but
The sort of emotionally there there is a kind of distance
In Finland and in Japan versus
when I came to America two thousand three, moved to California and it's like everyone is on your face and everything's freaking awesome. And it was yeah, it was it took a couple of years to it's like wait, wait, wait, wait, it's just come on like
Give me space.
And everything's not awesome.
So yeah, th th maybe there are similarities and then
Я
Alcohol I'm sure has been a mental health tool, not
very effective at that in in Finland for for many, many decades.
But Sauna, I I will I have to
Well, first of all
There's
Five and a half million people in in Finland.
And they are more than three million saunas.
More than three million sauna. So on average you have one to two people per sauna in Finland.
Babies used to be delivered in Sauna.
Really?'Cause it's the clean bacteria dies in a heat. Sterilized. It's warm, it's sterilized.
There's one water. I think my mom must still have it in Sana.
I was in a hospital, just to be clear.
So sauna is
Beyond being part of the culture, it's part of the DNA.
Um

It's culturally
It's an amazing place actually not just kinda let loose and your hair down.
But
You don't have your uniform, you don't have your titles, you don't have your whatever, social economic signals, symbols.
Fancy watches.
And kinda everyone.
comes together, whether that's family or your friends or your community and
Yes, Sana is
Definitely a place where
A lot of things happen in Finland.
And we could talk about Sonus and its role in a culture, but it's
Something way, way, way beyond Cold Bonds and sound. Yeah, why is that?
Why is it so prevalent?
in Finland because it seems like
And I'm sure you've seen this, but
Like there's certain studies in in the world of psychedelics where it's like they did
brain imaging and and one study that they've been slicing over and over again and torturing the data again and again to just produce more and more papers on this one study that was done so long ago. It seems like the same group of like 140 Finns has been dissected five million times in various announcements around
Sonas.
But why is it so prevalent there?
versus
Other places.
I don't know the origin story.
Yeah. And hopefully there's a historian who will check me on this, but it definitely goes back hundreds, let's say many hundreds of years where it was sort of necessary. So
You know, Finland four seasons incredibly cold.
Winters.
So Sana was the place to
Kind of
Basically heat and warm up in a winter.
I was also a place where, you know, you could dehydrate food.
So I guess kinda how it goes way back.
When
And obviously now
You know, it's not
Necessary to stay warm and it's not necessary to
dry your food. But I think that's kind of where it started.
And then in his songs we're kinda duck into the side of the mountain and
Then you just
You burn wood on double rocks.
And then you know, you extinguish the fire and then you make sure that the smoke goes away and you know the rock stay hot.
For a long time ago, and that was the original. It's called people still have that kind of sauna today. It's called smoke sauna.
Essentially you don't have a way to get the smoke out.
Other than
open the door. So there's no fireplace where the smoke just goes through a chimney.
So that's called smoke sauna and it's a special sauna experience. And obviously it's takes m much more time to heat it and make it safe and'cause you don't want to go there when where there's smoke. But I think that's kinda the history. And then
Somehow
I'm missing the link how it became sort of like a culture, but now
Nobody will build a house without a sound. Like literally there
First is worse the sauna and then s let's figure out if there's space for a bathroom. Like that's kinda the order.
In Finland.
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Yeah.
I went to this
Public.
Sana.
It's pretty fancy.
And there's a word, you could probably tell me what it is. It's like
Loyal, or something like that.
Yeah, there we go.
There we go. So this is what the act of throwing water on the stones? Is that what that refers to?
Or the sound that it makes. I don't know what the name of the actual location means. But the reason I bring it up is they had
I have never experienced so many varieties.
of sauna and they had a smoke sauna room.
And in my mind, looking at the menu of options before going in, I'm like, Okay, I get it.
It's a hot room. How different could it be? But the experiences and the feeling in the body and the way it penetrates.
Your
Being is very different.
I was shocked because I've spent so much time in dry saunas in the US and I expect and I've also done steam rooms and so on, but I did not expect.
There to be such a broad palette of experience in saunas.
Yeah, so I guess Eskimos have
dozen or so words for snow.
'Cause they know every nuance and you know, kinda detail and and thinks have
dozens of words for different things around sauna that you can't even in translate.
Lolo is probably the most important.
You judge.
The sauna.
And it's quality based on low look.
And Lolo is
Essentially it's after you throw water.
Into the rocks, the fireplace. The rocks.
And then the steam comes up. It's not the steam, it's not the heat, it's the
I guess you could say the spirit of the steam, but how it feels, how it lands.
And let me tell you, there's a million different variations how it happened. Is it too hot?
Is it too kind of sharp?
It is soft.
Does it sort of wing around and how does it feel on your body? That is Lulu and you judge
The quality of the sound are based on a lolu, and there's a whole science to it.
Kinda like how big is the space?
Like barrel soundness are very
To get the loader right in a barrel sign, which by the way I have at at my house, is very, very hard because it's too small
The fireplace you can't get.
high enough and you should be sitting kind of above the fireplace. So yeah, Lola is
If you know one word.
Lulu and you wanna impress Vince, you go to a sound and I say, What a fantastic Lulu.
I feel like I need to reach out to the Finnish Tourism Board to sponsor this episode. Get people headed over to uh Finland. I really enjoyed it. It was a very short trip, but hopefully I'll have a chance to get back.
Let's talk about
metabolic health because
Certainly Virta. We can talk about Virta. And a part of the impetus for this
Conversation was
Tons and tons of text messages back and forth.
Some of them I'm sure we can't talk about.
Publicly necessarily because it's internal data or whatever, but
I would have say a conversation with Dominic D'Agostino, who some long term listeners will know.
Synthesizes novel exogenous meaning supplemental ketones and so on.
And I was, for instance, I'll give one example facing a
A bit of a an enigma in my own experience, which was I've gone into ketosis and I know that's a very
Kind of sloppy way of putting it, but let's just say getting into ketosis.
So eating a predominantly fat based
Diet.
Or even doing it through fasting, getting to a point where I feel like my brain has switched over to ketones. And
I was lamenting to Dom Dominic.
That
My devices were telling me I was not in ketosis.
Right. And I found this implausible because
After so many years of
Experimenting with it, I feel like I have a very good bead on when my cognition clicks over.
and is actually operating at a much faster
kind of CPU capacity. But my finger pricks
With say uh
precision extra device or the Keto Mojo were telling me I was basically not ketosis. And very confusingly, even with a breath based
I think it's ketone air or something like that. Pretty primitive device.
But even with that, I was being given a negative.
And you sent me a text showing your
bar graph over the last ten years or something of measurable ketone levels going down over time, even though presumably you're increasingly and increasingly
fat adapted. And I was like
Of course Sami has this data. And then you have
Some fascinating
Fascinating data I have certainly never seen anywhere else.
Looking at
different cohorts with various combinations of things.
With or without.
Say
Dietary ketosis.
That is part of the reason I wanted to have you on. You're just such a meticulous thinker around these things and data cruncher. But let's maybe just define some terms before we get into things. What is metabolic health? And maybe you could tell your personal story because
My understanding is at some point yours need a sub ten percent body fat, but
Your report card.
in terms of biomarkers and so on came back and you were pre diabetic is my recollection. But perhaps
You could take that TED talk I just gave and

Yeah, use it as a leaping off point for discussing.
defining metabolic health and then talking about your own personal journey, maybe as a starting point.
First uh caveat.
Which is that
I I do have
Two master's degrees, but I'm not a medical doctor and I don't play one on the internet and
I'm sure in this conversation we'll kinda go into that area, so I just want to be
Clear. I'm I'm not giving medical advice to anyone and I'm not a medical doctor, but obviously have a lot of experience with
With the topic that d you just asked.
I guess the personal story so just
Rewind not
Not quite all the way back to
to Finland, but again my background is not in
medical field physicist by training and in fact started my career in a nuclear power plant way back when in Finland.
When it was still fashionable and I guess nuclear power plant's coming back to fashion now now now again.
Which is
Just to show that like my background is in sort of science and technology, not in healthcare.
However, I've been essentially an athlete all my life, cross country skier, biathlete, came to America, started doing triathlons and
Well you had to ski to school at one point, right?
Yeah, sounds very idyllic. Maybe that was a punishment by my parents. So Nordics getting to school indeed.
Uh first.
Great through sixth.
So quite something terrible, actually.
And a biathlon came handy, so carrying a rifle so I could shoot the bears when they were attacking along the way. Which may or may not be true.
But yeah, so as a I was an athlete and have been athlete all those years and then after coming to America started doing triathlon and
Pretty high level athlete. Again, not
We're not talking about the Olympic gold medals, but as an amateur and
you know, many, many Hawaii Ironmans. I think seven of those world championship races and
Even won the world championships in my age group.
As a triathlete.
Two thousand
Twelve I believe.
And I I give that all as a background context because my view
On metabolic health.
And sort of chronic disease, type two diabetes and obesity. What this is very embarrassing to admit.
Was
The following which is
It's ridiculous.
It's very simple.
People know exactly what to do.
Most people, most Americans. They just don't do it.
And as a result, we have just
Obese people everywhere.
Everyone has pre diabetes or type two diabetes. It's by the way, it's more than fifty percent of American adults.
Now the data is I think ninety three percent. This is the public spear review number.
Ninety three percent of Americans are metabolically unhealthy in one way or another, American adults.
And you know that's either you have a high blood pressure or your lipids are off, or you're obese, or you have type two diabetes or pre diabetes.
And my view
as judgmental as I was was always
Listen.
Ridiculous.
You know what to do.
But you're not doing it.
You're eating too much.
You're just eating too much and you're not exercising.
You lose her, and that's why I pay too many taxes.
'Cause health goes five trillion a year. Of which almost all of it is metabolic health related.
So that was my view.
And I'm very, very embarrassed to say that's how I was thinking, sort of judging people. Like you're unhealthy
For reasons.
that are a hundred percent in your control.
And then
I got the moment where I had to eat a lot of humble pie and I discovered that despite, you know, being
Yeah, I don't know, ten percent body fat dicks or whatever.
And you know, exercising fifteen hours a week can
Performing well as a tri athlete.
I was pre diabetic, all the numbers are off and essentially on my way to type two diabetes.
And I was like, shit.
Wait, I'm not one of those people with no willpower. I'm not one of those lazy people. I'm not one of those
quote unquote middle of America.
Three hundred pounds.
you know, seat belt extender.
Like that's not me.
Seriously?
What's going on here? And this was two thousand twelve, around the time my previous company Trulia
When public.
And I was like, Well first I have to figure this out for myself.
Because
If
I can't avoid
being metabolically unhealthy, nobody can. Well guess what? Like nobody can. Like that is the status quo in America today.
with so many people metabolically unhealthy. And that got me very interested in this whole topic of
What is actually driving poor metabolic health?
And fortunately myth with amazing scientists will kind of
Help me understand that.
Fundamentally
Obesity type two diabetes and the other conditions
that results from poor metabolic health, it's not a personal choice.
People don't wake up on a Monday morning and say, I want to gain two hundred pounds and develop type two diabetes. That sounds
Awesome.
And sticking an insulin needle to my body for the next ten years every day. Awesome. Sign me up.
No, it's not lack of will power.
However.
Nutrition.
And food is the number one driver of formidable health.
And if you know how to use nutrition, if you know how to use nutrition
To actually
improve and reverse your metabolic health?
you can take an average, let's just call it three hundred pound
Middle of America.
truck driver or average person that we people on the coast often look at like Oh, it's your fault.
And systematically reverse
The condition nutritionally.
And essentially that's what we've done at Burda Health now.
with more than quarter million patients and you know, scaling fast.
But let me just pause there. That's kinda the
How did a
Nordic skier physicist from Finbok.
Get interesting in metabolic health and and then we can
Take this down to different paths.
Let's hop in. I wanna start with
Well, as you might expect. Question about diet. I wanna know what
Looking back
what the problem was with your diet.
And also
This is of course a leading question, so feel free to
Discard it if it's not a good question. But
How large a role does high fructus cord syrup play?
broadly in the US in metabolic dysfunction, right? If that just
Or removed.
from the market, what impact would that have? But let's begin with just your personal retrospective.
Hindsight twenty twenty.
What was wrong with your diet?
When you were exercising fifteen hours a week, roughly ten percent body fat.
Performing well in competition.
What was wrong with your diet?
Number one question I get like, Oh, what was it your genetics?'Cause you were exercise so much.
Obviously genes play a part in everything, but I just want to remind that
Given about sixty percent of American adults, six zero, either have type two diabetes or pre diabetes today. Clearly it's not like our gene pool has changed.
So it can't really be genes.
Or if ninety three percent I'm
American Dell Summit about the Unhealthy. It's not like how genes have changed.
So no, it's not that Sami was the N equals one thin.
with very, very bad genes. This is happening to a lot of people. So that's I I'll say one thing.
The first one is there.
The second thing is that
It is possible to be skinny and lean.
And metabolically unhealthy.
Some
kinda people of certain background, especially kind of
In Asia it's more common that you don't
gain a hundred pounds, but you're very metabolically unhealthy.
Also, you can out exercise the calories and burn and not gain massive amount of fat, but you can still be elevated blood sugar.
Elevated insulin and be insulin resistant.
And that's basically what I was doing. It's very, very hard.
I can tell you that
I was
Hungry for fifteen years.
as an athlete. Like I'm always more hungry than I could. And if I eat to my appetite
I'm gonna get that.
I can't do that as an athlete.
So now I'm gonna answer your question. So my N equals one.
I'm absolutely convinced.
'Cause I was able to fix and improve it is.
I was eating
Six
meals a day of essentially incredibly high
car hydrate and incredibly high glycemic.
Index.
Foods and practically no fat.

Four.
Ten plus years.
So you weren't eating Twinkies. We're talking about rice, things like white rice, or what are we talking about? Rice, bread.
Apples, granola bars.
Gets up pasta.
You know, anything that's has a glucose molecule turns into blood sugar. And sure.
If it's in a apple or if it's lots of fiber, it comes very, very slowly. But if you're eating four thousand calories a day, of which
Three taussen
Is carbs.
To the math, seven hundred fifty grams of carbs a day.
Or more.
And so you're basically trip feeding sugar into your veins constantly.
Jamba juice in the afternoon, one suck a diet.
Tired. I I just remember it was my diet all the time.
When you're in your twenties
You can
Overdose people say dose makes the poison, that's true. You can tolerate
For a long time.
But uh once you get to your thirties
Yeah, it gets very hard. So
Very convinced that that was it.
Yeah.
What are some of the
more surprising things that you have seen within Ferta Health now that you have more than N equals one?
And
What do the interventions look like?
Let's start from the front end of your question.
What's the most surprising?
The most surprising
Is that
We being able to be successful.
With
Literally anyone.
And I'll give you one example. And
Why is that surprising?
Even overcoming my own
concept of it's all about will power.
I have this like
But it's like people aren't
Maybe not as educated as I am.
Maybe they're kinda busy lives, maybe they don't have my willpower or
Kind of did.
Will power off.
Will power Olympians.
See, that's been one of the most
Surprising. We work with native American tribes.
you know, eight hundred or so large employers, there's truck drivers, we've analyzed outcomes.
based on what's called ADI, so Area Deprivation Index. So you take all zip codes in America.
And you rank them by average income?
And
Exactly the same outcomes.
We looked at race, ethnicities, exactly the same outcomes. And these are like large scale tens of thousands, hundred thousand spatients.
So that's one that's been very surprising.
Which is to say if you fix the biology
You fix the outcomes.
This isn't.
Oh, you didn't even go to high school and you have a very busy life, so
We need
Some sort of extra will power training.
No, you fix the biology.
You fixed it.
body and the ultimate. So that's number one.
Number two is
The
Magnitude of improvements.
So
To give you a couple of examples.
Someone may have had diabetes, type two diabetes for fifteen years.
They are on hundred units of insulin a day, sticking the insulin needle three times a day.
For ten years.
And we can reverse that kind of
state of type two diabetes in six to nine months and then sustain it
For long term.
thirteen percent average body weight loss. And this is kinda like on an intent to treat basis, not
Thousand starred and then you
Calculate results based on five successful ones. No, you calculate the average results from all the thousand.
So thirteen percent. So in our clinical trial
That was
About
Thirty pounds or so.
Average weight loss at one a year and sustained and mostly fat,'cause we did Dex games as well.
I would say the third one is the broad spectrum effects.
Some of these are peer reviewed, so we've been able to show
Not just blood sugar down and reversing type two diabetes, not just weight loss.
Well we've been able so
Up to seventy five percent reduction in liver disease.
It used to be called fatty liver disease, but
Signed this change to deliver disease and so it's called mash and massalt. By the way, it's cost hundred billion dollars a year in America today.
There's one FDA approved drug today. One FDA approved drug today for mass.
One type of liver disease.
It costs forty five thousand a year.
No kidding.
And it came out to market last year, first time twenty twenty five, billion dollars in sales.
we deliver similar results nutritionally.
I think this is public. This is in our texts.
Paper just accepts peer review treating stage four.
There is no stage five, if I'm remembering correctly. Metastatic pancreatic cancer, right? This is bad news.
Super, super bad news. I mean, this is kind of if also if my memory serves, this is kind of like a Steve Jobs type situation. But this is treating stage four metastatic pancreatic cancer or three chemo drugs.
That's one.
ARM versus same drugs and on Verta.
trying to get patients into ketosis remotely and
Do you want to describe the result of that?
This was a very well controlled, so randomized control trial for states for metastatic pancreatic cancer.
We ran the trial with
Uh academic
Oncology centers, so this wasn't just us, a very well controlled randomized controlled trial.
And before I talk about the results, just a reminder
Cancer cancer.
He's number two or number three killer depending on
on the year of cancer in America. So it's very deadly.
It's usually diagnosed kind of two lades, so it states four metastatic
Stage.
And the life expectancy is usually sort of
twelve to eighteen months.
Or twelve months. It's
Very, very deadly.
Cancer.
And so we had a trial where we had one arm
When we randomized people, it was chemo.
Three drugs.
And then another arm, as you mentioned, same drugs, exactly same therapy, plus the verdant nutrition therapy.
And we were able to show
Just about thirty five percent life extension.
On average
In
that arm, so chemo plus verta.
Again, it's a very deadly disease, so
Thirty five percent is stunning, but of course
You know, we're still counting months. It's not that you go from twelve months to twelve years.
But on average.
But I guess that
Going back to your earlier question, that shows the power of metabolic health and poor metabolic health.
And what might be possible.
absolutely possible is reversing type two diabetes, losing weight.
Preventing
Liver disease.
We didn't even talk about kidney disease and other things. The fact that
We can
Drive outcomes.
even with some cancers and I will say some cancers. I can't say like oh nutrition can cure cancer.
Not quite.
But
Formidable kelt, and in our case
We didn't really define the for metal public health in the beginning, but
Essentially it's
high blue course levels
high fasting insulin levels and what you then might call insulin systems.
Your body's primarily burning sugar and you're constantly hungry, you're constantly craving.
So even if you're a hundred pounds overweight, you're hungry.
And you wanna eat more of that stuff.
That's kind of the typical state of poor metabolic health. And then
It manifests itself with
Type two diabetes.
Cardiovascular disease.
Fairly good seas often.
eventually chronic kidney disease and many other things.
And seems like
Again, not the medical doctor here, but
Many cancers.
Thrive in that kind of environment.
in that kind of poor map help.
I don't think that's
Controversial.
says the non doctor to the non doctor, but certain cancers, not all, are very
glycolytic, right? I mean they're really dependent on a steady fuel.
of sugar to simplify it. Dumb.
I think for people who wanna hear more on that also, Dominic D'Agostino has
Spoken about it quite a bit.
in a couple of my conversations with him. What I wanna ask you about
Because we've teased it a little bit.
the Virto Nutrition Therapy. I'm looking at
The
verta quick guide right now and
If you don't mind, I'll lay out some of it.
Because
This is where for me, this is where the
Probably the magic is embedded.
And I want to learn more about how you guys get the compliance, the adherents that you do.
Because that to me has always been
This very elusive
I don't wanna say missing link, but challenging.
Link.
with anything approaching what we might consider a ketogenic diet.
And I want you to also dispel if I'm
making false equivalence with the ketogenic diet, but you have curbier carbohydrates.
Um

around thirty grams per day just as needed.
And
You have some very important stuff in here, right? Measure total carbs, not net carbs.
This is where
People try sometimes outsmart themselves.
And then you give examples of what that can look like.
And then building your plate. Like what does an actual meal plate look like? Non-starchy vegetables, moderate protein.
Added fat.
Salt and extras, et cetera.
I'd love for you to describe
What you have found to work.
When you're getting people started.
And
Just what you've picked up over time in terms of
Then
Most helpful in
Components. I was gonna say ingredients, but not food ingredients.
ingredients for getting people to
Adhere.
Two
These diets.
Because my assumption, which may be incorrect, is
Okay. I Tim Ferris, I can go to Whole Food and buy
salmon and vegetables and this and that.
A lot of people in economically
Depressed circumstances or areas or
fill in the blank buy a lot of their
Whoa
Some people would consider sort of unhealthy food because it's very inexpensive.
And it's readily available. And like having spent time
around a number of native American reservations. It's like man, you live in there are food deserts.
In the United States. So what if you found
What have you learned?
over the course'cause your data set is so incredible. It's just like such a rich and amazing data set.
What have you learned about helping with
Adherence and compliance.
Or modifying the diet itself.
A little brack, because you said we have big data set. We absolutely have the largest data set of metabolic disease reversal in the world.
Millions of days in years of data.
And data points from each patient every single day. Not just
Qualitative information, but blood by Marcus.
Yeah, so let me try to peel the onion to answer your question,'cause it's
A lot goes into it. So so I guess just to say
Take a step back.
Yes, we use nutrition, individualized nutrition as the core therapy to treat our patients.
It is our own protocol. I say our own protocol because
Any kind of generic label that you put into it, people go to Google and they Google and
They can
Go
wrong in one thousand different ways. So anyway, so we use our own protocol, but yes
To address and reverse insulin resistance, you do have to reduce your total carbohydrate intake.
And we have those response curves to know that the more one, the better you do it, the the better outcomes you typically see. But that's sort of the number one thing I will say that yes, we use nutrition as a as a therapy.
To reverse metabolic disease.
And I will say that as a physicist
Using nutrition as
As a drug or as a therapy is harder than sort of nuclear physics.
Why for all the reasons you mentioned. Because every person
makes a medical decision three to four times a day. That's when you eat.
It's different today versus tomorrow and then it's different between individuals.
So it is a very, very hard puzzle to solve, fortunately.
Computers and software is very helpful about that.
That's kinda one, individual ascent trism.
Number two
So what does it take and how do we approach
key piece, even if you know exactly what somebody should eat, is you kinda need the support system and
I guess that's my tech background with truly an
And
Other things it comes to play that
Everything we do we do virtually. So what we can do
Is we can monitor your biomarkers remotely.
We give you tools to do that. We can track what ketones, what rubs.
your weight and other things, and then we have actual real medical doctors, not me.
who are full time employees who monitor you and coaches who can then make adjustments.
Is that collected through
Continuous glucose monitors.
And
Is it also blood draws or is it mostly some type of continuous monitoring?
It's all of the above.
Pacers get a CGM and some it's a finger brick, but not everybody gets a CGM, depends on the situation. We do lab draws one to two times a year, so that's obviously doesn't can't happen daily.
Yeah, I got it. With the finger prick, that's some type of Bluetooth enabled thing that automatically syncs the data. So they're not manually having to enter any. No, no, no.
Gets to us.
And I say that because
It's kinda like
If you say like oh here's how to eat, here's
A brochure or a book or something. It's kinda like telling to
A car driver that
Just hold on to the steering wheel.
Straight.
It's gonna be awesome and here's break and gas.
Uh gasp at all.
You know what's gonna happen. The car's gonna
Beautiful stay on the road until the first corner.

It's like ooh forgot to mention that we may need to adjust.
Turn left, turn right.
And so it's the same thing with nutrition, that unless you have this kind of a platform
There's constant adjustments and constant adjustment. It's kinda like a self driving car, but then if you have the cameras
White lane and and yellow lane align and you kinda try to s keep it in between. So with the remote monitoring
We can kinda try to keep you between the yellow and and the wildlife. So that's the second thing.
The third piece for adherents and this
We start talking about nutrition.
The most important thing early is to understand the constraints that a person has. I'll give you
Silly examples.
If we tell a vegan
To have bacon and eggs for breakfast, you know what happens.
They're gonna say S U C K. I'm out.
You there's no way to convince a vegan to have bacon and eggs for breakfast. And vice versa. Like
There's other things obviously. If you are we work with US foods, large kind of
actually food delivery, full service.
It's truck drivers.
They're
Concept of a lump is McDonald's.
We can't tell them oh here's the least go shop whole food, so er one.
And then go home and and
Yeah, go cook at home. It's like okay.
McDonald's it is, we're gonna reverse your diabetes on McDonald's diet. And by the way, we do that.
I don't want that to get buried.
What are some sample meals?
That people might get.
At a McDonald's or something like that.
Perfect. Yeah. So so that's the next step with Ford and maybe I'll give you an example. It's like, okay, now that we know
You are a truck driver and you will never become a vegan.
You can never become a vegan. I'm obviously I'm tongue in cheek here, but
Most of them don't.
I'm not a vegan either and I'm not sure if
You're probably not either, right? Yeah, and by the way, we have many, many successful vegan patients. So I I I know sorry if if I started a diet warrior, but uh so okay, so example, you track Okay, so Mathonics it may not be
the pinnacle of hell, but we can reverse your metabolic disease with that.
And let's forget the organics that we'll do that later if you can. Here's what you do. You go there
Say all right, well you want your burger.
Maybe even add extra cheese, but please ask them to drop the button.
And just have like a letter strap.
Get that.
Then you go to the condiments.
Yeah, Mayo might be fine, but don't take the ketchup'cause we can educate you and tell you that ketchup is
Collard sugar.
You can't have that. Yeah, you want your soda. You really want your soda, water is not enough. Okay, so go for the diet coke.
Don't take the soda with the sugar. Again.
somebody's listening like, Oh, diet cook's bad for you. I totally agree. I'd rather drink water, but again
Let's not
Let perfection be the enemy of progress.
So that would be a McDonald's.
kind of a session. And off you go.
So that's kinda the second step with food. And then the third one is really empowering the patients
With
We could talk about AI, like AI based tools. You go to a restaurant or
You you're trying to cook something, you're take a picture and we instantaneously say, like, hey, what kind of adjustments should you make?
And tie that to your actual
situation.
So how do you change that?
And this happens
Every day, two, three, four times a day.
And that's the kind of the self driving car analogy that
A car that goes straight is fantastic until you have a corner. And that's hundred percent of the diets in America today.
So you can't do one size fits all.
And then before you you ask the follow up question.
This is mind blowing for people, and ties to your earlier earlier question as well.
The adherents of Verda Patients, again, which are like real Americans, not Samis.
Real Americans.
Yes.
Twice as high.
At one year.
That's taking a GLB One drug.
We have eighty three percent adherents.
retention of patients at one year and
look at any of the publicly available data.
People stick to GLP once like forty percent.
Maybe fifty percent, thirty to fifty percent.
Why is that?
Number one reason is the user perceived benefits.
It's like I can't believe
I feel this good. I can't believe I've lost thirty five pounds. I can't believe
I don't need to stick the insulin needle to my body.
The stories that we hear from people is like
I'm sixty five. I thought I don't see my grandkids grow.
I have so much energy that I'm gardening the first time in twenty years, or whatever that is.
And you know this, like when you're feeling really, really bad, you're sick and everything's hurting, and then that suddenly goes away.
That's like
Life is
Fricking awesome.
And so I think the number one reason is the benefits are so strong. Versus like a calorie restricted diet where like
This sucks.
But I'm gonna look good on a beach, at least for a week.
How did the experience of benefits differ from GLP ones? Just because we're seguing directly from that and certainly
A lot of people listening will
either directly themselves have experienced or know someone who has lost thirty five pounds.
And
feels more energy because the GLP ones do make you slightly more catotic.
For the people who are wondering why they might feel sharper, that's actually one very plausible.
Piece of the puzzle.
But how do they perceive benefits?
differ in a way, and maybe there's more to explain it, and I I'm sure there is.
The uh
sort of two times GLP one.
adherence at one year, I guess that's what you said, right? So I'm just trying to
Identify where those two interventions
Diverge.
First I will say
Our vertic providers prescribe both oral and injectable GLP ones when appropriate and or necessary and when our client
The plan sponsor like an employer, Hell Plan have
them in a plan design. So I just wanted to mention that
So that nobody thinks like, Oh, this is some sort of nutrition dogma.
No, there's effective pharmaceuticals and especially GLB ones in
obesity and metabolic disease context way better than the nineteen eighties and nineties diet pills. So like it's a real, real innovation. You guys don't prescribe fan fan to your patients? We don't. We don't. By the way, there are companies that do that low cost of GLB ones to
Absolutely we don't do that.
I'll start from very basics.
The GLB wants
One hundred percent.
Affect your appetite?
So they change how much you eat.
So you eat less.
But they alone don't change what you eat.
So that's a stunning point. And if you don't change
What you eat?
You're not gonna be
Perfectly even optimally metabolically.
Healthy.
And so one example is
you lower your appetite, you eat less, but the second you come off these trucks
All the data shows that your weight skyrockets and more likely than not, you've gained fat than you've lost bunch of muscle.
By the way, we've shown
The patients will come to us.
On GLB once?
And
Once they discontinued the drop for whatever reason.
A personal choice, the side effects.
We've been able to sustain that weight loss. This is published in peer reviewed data, eighteen months out.

Longer term data, but eighteen months.
No weight regain.
Why?
Because we start chanting.
What you eat.
While you're on the truck.
And if you do that.
But do
Kinda sharpened the point to your question.
Obviously.
We know the side effects of healthy nutrition.
None.
Every drug has side effects. So that's sort of one thing. And these Joby ones are
tolerated much better than many, many other drugs, but there's a lot of things.
Nausea and stomach issues and
It's interesting. We've surveyed
The patients who
are on GLP ones in our care.
Eighty percent of them say I either want to severely reduce the dependence on these trucks, okay, completely awful.
So this idea
Which is
Prevalent at least in a press like
Americans just want to take a pill and
Keep taking the pill for the rest of their lives.
Most
People if given the choice. If given the choice.
To be healthy without they don't want to be taking drugs.
Hopefully that answers the question of
Like what are the user perceived benefits? Well, there's no user side effects when you're eating healthy food.
But with the drops you usually have that.
I'm not the expert to talk to kind of how
Energy levels.
Or
Kind of.
excitement or mood and things like that change I think
Lots of data will come out when millions of people on these shall be once for years.
But
Eager to see what happens.
Definitely a lot of things to be fully aware of like lean body mass.
In elderly populations, sixty five and plus people who lose a lot of weight than shelter once.
Yeah.
very kind of alarming reports coming up.
Mm-hmm.
S
I wanna get granular again with
Just a
Hypothetical
example of a vegan, because this word has come up a couple of times. And in a way, in my mind, I've always envisioned that as a tougher nut to crack than McDonald's.
Just because so many
How should I put this? This is true across the board. If you just walk through any grocery store, including Whole Foods, there are a lot of junk foods masquerading as health foods.
Which are full of ingredients that are terrible for you.
Incredibly high glycemic.
Meaning.
They're gonna spike your blood sugar. Maybe we could talk about like glycemic index versus glycemic load, but
Suffice to say, if you eat it and you check your blood sugar.
Within ninety minutes, it's gonna be a lot higher.
And this seems to be true of a lot of
vegetarian or vegan food also. So what would be an example of
how a a diet plan or let's just say a meal or a a day of meals for
A vegan.
Let's just say.
On the Verda program.
Again I will
Say everything has to be individualized, but to use kind of average figures
We rarely have to massively change protein intake for our
Patients.
maybe surprisingly to some people, the standard of American diet has a
No, keep or take.
Maybe it's a little bit on the low side, but
More or less the right amount of
Protein.
By the way, that's the most expensive
Maximum trend.
So sometimes people like oh and you start treating your patients, it must be so much more expensive. Well, actually
Protein is the most expensive. We rarely change that up a lot.
In vegan context, that's probably the hardest thing to get right.
To get sufficient amount of protein and
Yeah.
really have to get at least one point two grams per kilo.
Kilo.
One kilo is two point two pounds of protein, proline.
Or kinda normal body weight.
eighty kilo person, which is
One hundred seventy six pounds.
That would be a kind of mean person.
You kinda hundred grams of protein a day is sort of minimum you have to. So that's probably the hardest and
Vegans know this very well. It's
You have to look at like
Nuts and tofu and
may need to rely on soy and are you willing to eat eggs?
That would be one. So we figure out again with the patient, like, okay, what are you willing to eat? Are you able to have dairy? You know, some people are okay, some not.
But that's probably the hardest user to make sure that people get adequate protein.
And protein is really
Essentially it's the only macronutrient that doesn't really store itself, so
You kinda have to get it a couple of times, two to three times a day.
to maintain your buttomass. Then after that
It's actually interesting to get the sufficient
Calories.
If there's a lot of crap vegan food meeting.
Sugar.
Or
You know, cornflakes or whatever.
Then we start replacing those with healthy fats.
And this is also miscontrolled like oh is it must be so expensive because corn is subsidized
Hence.
You can have unlimited amount of corn calories cost nothing.
Well guess what? You can buy nine thousand
Calories. So one liter of
high quality olive oil from Costco for like a
What does it cost? Two bucks?
So it's a misconception. So the cheap subsidized
Sugar calories.
Can actually be replaced.
At the same cost.
Now if you're very, very overweight
You don't wanna be replacing those calories'cause guess what? You want your body to give the
Fat cowers.
And then
Around the kind of healthy vegan food then
we guide the patient towards
So leafier
Lists
Starchy vegetable options. So you can eat very sumptuous
Vegan food and I I think we even uh
'Cause this was a misconception in our very early days. So we've been pretty vocal, we have bunch of
patients who are vegan, if somebody googles further health on vegan diet or something, there's a couple of our patients have sort of openly shared
What they eat, but it's totally manageable. In fact
You just kinda end up throwing out the window.
The crap.
vegan food. So I don't know.
sugar frosted cornflakes would be a perfect example of that.

Or orange juice or or something like that.
I love oranges, but orange juice is
You said.
Tell me if I'm in hearing this correctly. So it sounds like if you reduce the high glycemic junk.
That someone is consuming.
You're going to
Over time.
Improved metabolic health.
But is it fair to say that for instance the truck driver who's eating the lettuce wrapped
Cheeseburgers.
And drinking diet coke, like man, you do that for depending on the size of the person and blah blah blah blah blah, obviously.
Like if it's a male, I don't know, maybe in three to five days, that person's probably clocking in.
Uh.
Who knows?
Zero point seven plus
Millibolls, millimollers say it.
ketones, beta hydroxybutyrate, I would imagine. But in the vegan example, maybe you're simply reducing
the glycemic load, but maybe not getting
deeply into ketosis just because the question in my mind was related to the protein, right? How do you consume tofu, tempeh, et cetera, et cetera, et cetera, while keeping your total carb
Cow low.
Doesn't
immediately seem possible to me. Unless there
willing to eat eggs, right? But if we take eggs off the table
then it seems like you can significantly improve metabolic health, but it may not be
through the
Vehicle of what would
technically be considered ketogenic. Is that fair to say?
Yeah, that's why we don't you're really use the general keto because again for two main reasons. One, you Google it and you get
Your version that you can either love or hate.
And likely it's wrong. And then two is
It's all on a spectrum or kind of a dose response curve and
We never want
To let sort of perfection be the enemy of progress.
And
The less you have hunger and cravings.
And the better you feel.
More sustainable and easier everything is, including just life.
And that's what we teach to our patients and
You can kinda be anywhere in the dose response curve and be successful.
The further you are
We can pretty much predict
not just your health outcomes here out, but even the healthcare cost savings, which is sort of insane.
'Cause drug companies do these trials. You take one pill, this is what happens, take two pills, this and then you kinda wanna optimize where you wanna be on a curve.
Our therapy is no different. We show this to people. We educate. We say this it's it's your choice and you get here and
The beauty is that we empower people so they can make their choice.
And then the beauty also is that you don't have to be
Perfect. And you can still be very, very
Successful.
average diet is so bad, honestly, that it's relatively easy to make early progress.
Yeah, the uh standard American diet. SAD. I just love this the acronym is SAD. It's so good. Whoever give up with that. God bless you. What a great acronym.
I want to get back to your training. So we're gonna get off of
Virta in a moment.
I want to say just for people who maybe have heard the last few conversations I've had with Dominic, I am deeply interested in ketosis and the ketogenic diet and exogenous ketones.
But
I think Verda is is approaching this the right way.
with a greater degree of flexibility and
I would also just point to, for instance, this low carb diet and the four hour body. It is not a ketogenic diet.
You're consuming.
Legumes, you're consuming a lot of fiber in the form of beans or lentils, et cetera.
It is not ketogenic in any way.
But it does reduce.
Or eliminate.
processed food, it eliminates most starchy
carbohydrates except for one day a week. And the types of transformations that you can see metabolically are just
Remarkable. And granted, you know, that is a book, so it
by nature of its format is a kind of one size.
Hopefully fits most.
Whereas Furda is much more adaptable and customized for the left right turns that you described.
But I wanted to just underscore the fact that I am not a keto
purest by any stretch of the imagination. And most of the time I am not in ketosis, although
I do spend time in that range.
So I wanna hop from Vert uh
To a question around
Training.
So just
In brief.
What is and I'm not sure this number even exists, but what is it an average
non athlete.
VO two Max and what is your VO two Max?
I think for I'm freaking old, by the way. I just turned
Do you know how old I am?
I don't know how old you are. You've got those impeccable Finnish genetics. I've no idea. Oh my God.
I turned fifty in December.
Oh nice. Congratulations. Yeah. So I'm very, very old.
This is at least what my o
Two kids tell me.
who are like ten or something. But
I think at this age in particular, or even like a thirty year old fit male
So VO2 max is measured relative to your body weight, so it's how much oxygen you can consume.
Your body can utilize so it's milliliters.
per kilo per minute.
I think it's maybe forty.
Would be on the average side. Four zero maybe or thirty five or forty or forty five.
My measure is it's more than eighty.
Eighty milliliters.
Pretty high. Very high.
The caveat is it was measured like a couple of years ago, so it's probably a little bit
Lower today.
The max VO to Max.
Tends to go a little bit down as you age.
you can still kinda increase the percentage of that that you can produce for five or ten or fifteen or twenty minutes. But yeah, it's
Kinda very, very high. I think the highest ever measured recently it's more than hundred, but
If you're ninety you're kind of
Olympic.
Eighty five to ninety gets you to
Olympic podium in endurance sports.
And again, it is it's that's not the one and only measure.
There's a lot of other things, but
If you're above ninety.
You should not be doing podcasts, you should be in the Olympics.
Well
Good news, bad news. I'm gonna stick with the podcasting. I am definitely not above ninety. So the reason I'm bringing this up is that
in conversations with my doctors and you know people I really trust as well as
A number of podcast guests like Tommy Wood, Doctor Tommy Wood.
Uh.
Is uh
Neuroscientist and phenomenal athlete also.
The topic of
Endurance training as it factors in. I hesitate to use some of these labels, but endurance slash aerobic training as it factors in. You'll see very quickly why I'm struggling with terms. Factors into
Health span and longevity.
It's become a topic du jour in the last handful of years in particular. And the way it's been presented to me.
Is
And I'm particularly interested in this for its implications for cognitive health and potential volumetric changes in the hippocampus and so on with certain types of training. But
Given that I have Alzheimer's in my family. But the way I've been taught to think about it is that let's just say zone two.
Is the base of the pyramid.
And then VO two max is the height of the pyramid, and you're trying to maximize the total surface area.
Slash size.
of that two dimensional.
Pyramid. And
I will
Confess, I'm very ashamed to confess.
I
Hate.
sitting on a stationary bike. I absolutely loath it. I find it so
Boring.
And I also just see these long term changes in the sort of kyphosis, like the hunchback.
postures of some long term cyclists and I want nothing to do with that. I have enough back
issues as it is. So my question for you is when you're trying to get a normie.
Two
do more endurance like training. And I am on the path. I have some spinal issues with the lumbar and sacral sort of kind of segments of the spine, which I won't bore everybody with right now, but I'm hoping to get to a point where I can actually do sports I enjoy.
like jujitsu or other things.
Which
at least for high intensity and full training, mimic something like the Norwegian four by four really well.
So I could do a round of four minutes, take three minutes off, do another round of four minutes.
And like maybe it's four minutes on, four minutes off, or three minutes on, three minutes off, but close enough.
If I'm doing it consistently, but as it stands right now.
I can't really do incline treadmill.
with say a rucksack or something for zone two because of the hip extension and the issues that causes in the lower back.
So
Despite my best efforts to avoid the stationary bike, I keep on ending up on this damn stationary bike. And road biking just scares me too much with the traffic, say in a place like Austin. Everyone I know here has done road biking for more than a handful of years has had some type of accident.
What would be your advice for someone who's like trying to get literally
Back in the saddle.
Yeah.
Yeah.
To do some
training. How do you think about
this type of training as it fits into a health span and so on, because I'm not intrinsically someone who enjoys
this particular type of training. And I remember for the four hour body, I was in South Africa at the sports science institute of South Africa, and they did a muscle biopsy of my
thigh, my quadricep, my vastus lateralis, and they looked at all the enzymes. And I can't imitate a good quality, strong South African accent. It's pretty good.
It's a great accent.
But
Years. I can't even say years. That's how you ferret out the South Africans or the North English. But the point is he came back and he showed me these charts of enzymes like citrate synthesis.
Which seemed to be correlated to endurance capacity. And basically his message was
Tertius, I think that was his name. He said, Here's this flat line is Homer Simpson, and here is your line, which is like
infinitely below Homer Simpson so I don't think I'm very well built for this stuff.
This was a long litany of complaints, but
How would you suggest I think about this kind of training? Because it seems important.
I'm not sure how to make it more interesting.
I do find the interval stuff a little more compelling.
And it keeps my attention more than the zone two, but
Yeah, seems like you kinda want to do both. What are your thoughts? I'm just turning this into a a therapy session.
Sure. Asking the non-coach a coaching question, uh my favorite topic, pretending to be an expert. Uh I I will take it. I will take it. Yeah. So my my my approach to I I've had a coach and then I've
Essentially ninety five percent of my life I self coached myself.
'Cause I I take it as an interesting puzzle.
To try to learn and then
Surprise, surprise as an entrepreneur. I don't
really want to be told what to do. So it's
ended up self coaching. So based on that experience and with that caveat
First of all on a high level.
My approach basically in everything in business, metabolic health training is kind of
Nail the basics.
Less marginal gains than crazy. And I know it's boring and doesn't sell a lot of supplements and stuff, but it's like
Nail the basics, less marginal games than crazy.
And when you do that, you get sort of that's when you actually get the ninety nine percent of the results.
And and for training specifically also
Whatever you want to accomplish it and you
done a lot of sports and lifting. It's the very basics are very simple. It's progressive overload.
Specificity.
Like progressive overlord and specificity. If you don't have progressive overlord, even if it's just the walking or hiking or running.
You are gonna get better.
Initially when you've done nothing, come off the couch, it's like very easy progressive overall, it's like
Do anything and you get better.
And then the other one is just a sort of specificity like
You wanna be a sprinter?
You can't train like a marathon runner and vice versa. And you know, if you want to squad a lot
Bench press isn't gonna help a lot, so.
It's literally those principles that I use, but to give specific advice to you, what you just said.
To get
The cardiovascular
Timuli.
You obviously have to get your muscles burning oxygen.
Uh using oxygen and then burning
Either
Battle carbs and your hard rate up. So you need to do something for that.
The reason cycling or any kind of a bike thing is
So widely used it's doesn't take space and if it's indoors
It's very safe and it's low impact.
So
One thing I would say for the bike is
And Arsene has a lot of good bike stores.
I have two indoor bikes upstairs. One was set up by tech from Melo Johnny, so I've got you go. So one of
Bike fit. If if there's someone who's like a P T and a bike fitter and say, Hey
I have these XYZ issues.
fit this bike to specifically work for me as much as I hate it, but
So that's one thing where you could like
Get the handlebar crazy high or something like that. Maybe even do a lot of standing. By the way, those are fun workouts.
I don't know, do like a
Three minutes standing, three minutes seated, three minutes standing, whatever.
So that would be sort of one thing to consider for the bike, that you get a fit.
That's specifically for your
back issues. It may not be the world's most aerodynamic
But if it's stationary bike
Who cares?
So that's one.
The other thing, you don't have a lot of snow around, but I know you occasionally go to places with snow.
Nordic skiing and sort of skinning.
Obviously fantastic.
Yeah. Fantastic.
Skinning I love. I love skinning. If I'm outside.
I'm not gonna get hit by a car. If I could do skinning every day, I would. And my back actually loves it. Yeah. So yes.
I'm a hundred percent behind skinning.
And then of course.
often people who kinda totally destroyed their niece and hate swimming, which I hate swimming personally as a traveller well
Elements of it are beautiful, you go underwater and it's kinda like
Meditation, but
More than twenty minutes and like please give me a break.
See, I will take the swimming over the cycling. I went in
Did some swimming yesterday. I'm up for the swimming.
And then if you live in a mountains, it's very, very easy to get sort of zone one, zone two by just walking, even without extra weight. Because you go up, up
And sort of speed walk. And then maybe the last one I say if if you have the
Self confidence to not feel too embarrassed.
is Nordic walking. Nordic skiers do summertime.
You either walk or run with them, but you basically have poles and you go uphill.
You'll probably get an extra ten beats, hard beat and kind of
a higher level exercise.
So it's kinda like jogging uphill with
Pulse. Pulse. Pulse, yeah. Yeah. Obviously you could just walk and then use that. I could get into that. I use poles.
Yeah, I could get into that.
And then to the sort of VO two max.
So building a better aerobic engine in like zone two
does help your BO two max too. And then of course if you lower your body fat, body weight, the kind of denominator in the calculation improves. But specifically BO two max training
You actually get the adaptation pretty quickly.
So like I don't do it all the time, crazy amount, because it can also burn you out. The two most common ways to really hit VO2 max
Is either you do sort of
thirty seconds on offs for a lot like you go very hard and then thirty second easy.
But then essentially you kinda
Keep hitting the VO to max oxygen consumption.
Or so to
Two to four minute so out.
They're very, very hard.
Or to the three minutes all out and then you take three minutes off and you do that whatever, four or five minutes.
Four or five times.
So those are the
Most effective, I would say.
And typical ways to specifically get your VO to max up.
But they can burn you out if you do too many of those.
And so like for me personally what I do
typically closer to like a specific event or race, it may be like three weeks where I do
Two of them a week.
So just like six workouts.
And then I drop it to
I don't know, one every two weeks or something. You can burn out then
The VO2 Max isn't just
not gonna infinitely keep going up.
Bad news.
And so
Maybe that's how I think about finer sport.
Where you can comfortably and enjoyably do an hour.
Or so of
Cardio, whatever that is.
And then this would be my advice. Think strategically when you do your like a VO two block.
And that could be just
three weeks or maybe it's two weeks every quarter or something like that, and then the maintenance does again.
I'm using dangerous terms here,'cause
Who knows what the optimal dose is, but
Constantly pushing the VO to max, I think it's just the entry risk.
It burns you out.
And it's not gonna do anything'cause once you reach your VOT max ceiling, you kinda are there.
Broader question.
I want to ask you about is sort of what
Exercise dogma.
Or sacred cows, you have
Stress tests.
Because I was looking at
Is a blog post.
that you wrote this is a while ago, and I actually don't have written down here the title, but it's about
Hacking your running.
Speed.
In four weeks.
And
I'm tempted to read this whole thing, but I'll just read some of it. So my total running time averaged one hour fifty five minutes per week.
It's a four step protocol for four weeks. So
First, and I won't read all of this, but you know, develop muscular by running ten to fifteen minutes every day.
That might surprise people. It's like, hmm, that's more achievable than I would have expected. And you contrast that with the conventional approach of doing like a long run once a week and increasing the distance each week. So I'm not gonna steal the thunder. I want you to
We could comment on this as an example, but then broadly speaking.
Just kind of like
Unfounded sacred cows'cause man, there are so many.
Everywhere. Not just in exercise, but everywhere. Number two, build your cardiovascular engine with all out.
Think this is ten by one minute set once a week.
on a treadmill for regulating effort.
So the total workout is less than thirty five minutes. You give links to scientific evidence. Number three, plyometrics for quick improvements in running efficiency.
Even highly trained endurance runners seem to improve their running times in a few weeks of plyometrics.
Which is not that much. Roughly five minute routine three times a week.
Three times twelve explosive box jumps, three times twelve jumps for max height.
Which sometimes replaced with skipping into a hill. I don't know what skipping into a hill is, maybe you can explain that.
And this approach took forty seconds or roughly ten percent per mile off my best running speed in four weeks.
Leading up to a competition.
Typically a five percent improvement per year is a huge jump. I mean that's
Kind of bananas. And then you also added the
Note simultaneously gained about a pound or two of body weight, so my speed gain wasn't due to change in body weight.
So this
Seems to and
I just confess that I hate endurance stuff, so I'm really
wading into the deep end of my ignorance pool here, but this seems to fly in the face of a lot of conventional
Recommendations. So I was hoping you could
You can speak to anything that I mentioned.
But also just broadly speaking.
Dogma.
In exercise,'cause there's so much crap.
And there's so many things that never really
get stress tested in
Daily living, health, wellness. You hear all this crap all the time where it's like you only use ten percent of your brain. That's not true. Like evolution wouldn't allow that to be the case, right? Drink eight glasses of water a day. It's like well
Really kinda depends. I mean there's so many
Recommendations that you hear over and over again. So
What have you uncovered?
Well, first of all, that particular like oh my God, I need to get fast in running came
I wanted to do a travel and this is already a couple of years, actually just about ten years ago.
Wanna do a trial on and I was training to
row across the Pacific Ocean with my wife in a robot, which is a whole other conversation we can have.
And I had stopped kinda running
And I was lifting weights, doing a lot of front squats. I was weighing two hundred pounds and like right now
I'm kind of in a cycling scene so my weight's like one hundred seventy seven pounds. So it was twenty three pounds.
Heavier. And I was like, Whoa, how do I go from zero to hero in no I I wanna be the Tim Ferris of running. Like how do I hack this and You don't want to be the Tim Ferris of running, I can tell you. That is Achilles. So how do I how do I hack this and
In that approach I basically I wanted to slice and dice
running performance or at least the minimum
fancy silicon mallet term first principles, but like into its
Contributing parts. Like what are the one or two three things you need to have? One muscular endurance, like
You can be cardiovascular fit, but
Go and run a downhill for
thirty minutes or even ten minutes. Like your legs are normal, so you can't continue running. So you need minimum dose for muscular endurance.
So that the legs don't fall apart. And I think I was training for like a
Travel and then had a half a marathon, so thirteen miles, thirteen but one miles to run. So muscle endurance was one. Then there was the efficiency you mentioned and and so forth. But anyways.
To go back to the actual broader question.
Couple of things for me
One, especially for endurance boards
One is
Try having on and for like a marathon running and other things. One is like you
massive load and volume and you kinda get more and more tired.
over like six weeks, eight weeks, maybe twelve weeks, and then you taper for two or three weeks.
And you hope that after your last crazy week, in two or three weeks, you dig yourself out of the hole.
And then you are super fast on a race day.
It's like
literally you're on a knife set all the time. And I completely changed that in the last four or five years I was really competing in trial, which is
I wanna be ready to race almost at the end of every week.
Meaning progressive overload, but stay vibrant.
And no matter how hard of a workout I do, say on a Saturday or Sunday
By Wednesday I have to be ready.
To hit hard.
And feel like I can do almost like my best numbers.
Personally I found that
More effective.
Avoided any kind of overtraining. And I think when you're lifting weights at the gym, this concept is very easier to cras much easier to crasp. It's like
Let's say do you bench press.
And for three weeks your reps or weight just keeps going down.
Everybody was like, What the F?
Like clearly I'm not either eating enough or I'm lifting too often, but Android satellites do exactly that.
They kind of keep grinding, grinding, grinding, they get more tired, then they hope they get out of the hole. So that would be one thing that
Basically training in a way where you
Progressive overlord, you hit your body
But then in sort of three to four days you are back
Better, faster, stronger than ever.
And then you keep repeating that.
Personally I found that at least
For myself.
Way safer.
Way more objective. And I always knew Oh, I'm getting stronger. Oh, I'm getting more tired. Or I'm gonna dig
Two days off or maybe uh have a full rest week.
So I would say that's one thing.
The second thing, again, I'm not a running coach or running expert per se, but especially if you have a multi sport approach.
It's way better to
train the cardiovascular engine on a low impact machine.
So cycling. So if you're like doing triathlon.
I've done more than ten full distance Iron Man, and
Fastest was eight hours twenty four minutes, which is
Pretty fast for an amateur, especially before
Or the aerodynamic games that people now have on bikes.
So maybe I could take ten, fifteen minutes off of that. But eight twenty four is pretty fast.
I run a
Two fifty six marathon.
Off the bike. I think it was
Yeah, two fifty six two hours fifty six minutes after
Swim and a bike.
The reasonably fast.
But my longest run
To be able to run a marathon in a triadlone.
Was usu one hour twenty minutes.
Which is like
I don't know, nine or ten miles.
So just as an example. So that would be the second thing that
I don't think you need
Specificity.
In that sense. If you need to build a cardiovascular engine.
do it in a way that doesn't beat your body down. So like cycling versus running. So I I think that would be
One thing. And then let's leave the nutrition aside, but that's
Like a war, like how much should you eat carbs versus this and should you do carb loading and all that.
Needless to say
I'm
personally a huge believer that as long as you sort of
fuel the work while you do it.
You don't have to gain.
'Cause glycogen stores three grams of water, so if you have
Six
Six hundred grams. Let's say six hundred grams of carbs, glycogen in your body, so that's twenty four hundred calories.
You have another
eighteen nine grams of water, so it's two point four kilos.
Just five or six pounds.
Feel like fully loaded.
I haven't
Found even for very long distance. You don't need to gain five or six pounds.
If you
Drip feed and few of the actual work.
you get to the same results. Controversial, but that's
My experience.
I recommend people read the blog post also.
And
Since you mentioned it and we're probably not gonna go for six hour conversation, I
Can't not.
mentioned, you know, the rowing twenty four
Hundred plus miles with
Your wife.
Forty three days.
Plus forty three days, three hours, something like that. Which is sounds like
I mean it really sounds like uh
Divorce camp to me.
And we could spend another three hours just talking about this insane
Decision.
To pro for that.
Two thousand seven hundred and fifty miles roughly from California to Hawaii.
I mean the flight itself is pretty long.

But my question is around
Domestic
Peace.
Or yeah, minimizing violence and
I was looking at this piece in USA Today.
And
It says that you had a written and signed formal document.
That not only described how you you would treat each other in the journey, but even how you would respond to specific complaints and cries. So
It's like the only thing more Samy than
Growing.
You know, almost three thousand miles is having this document. So I wanted to hear about this document and if it was as helpful as you hoped it would be.
And also anything else that you guys
figure it out in terms of not killing each other over that period of time.
Being stuck on a boat.
For listeners just the context is indeed it's twenty four hundred nautical miles from Monterey, California to Hawaii, Waikiki Bee it's the shortest distance. The weather wasn't really our friend, so we ended up doing
Two thousand seven hundred and fifty nautical miles.
And I think it was
Forty five days and three hours, but who's counting?
So it's just a month and a half.
Almost seven.
weeks of rowing with my wife and completely unsupported. I just want to be clear.
No helicopters, no follow boats, like there weren't like submarines around us and and helicopters dropping
Bon bombs. So it was just two of us.
First of all, there's so many life lessons and
If you team are fortunate to find a woman of your life, that's definitely a way to test
The relationships longevity and
If you survive it both.
And come out together. And I will say this
We had been married for four years. We had known each other for six years.
having gone through that experience and hopping off the boat
On a platform in on Waikiki Beach and hugging my wife
That
Still is the sweetest moment in my life.
and hugging her and knowing there's only one person on this planet.
Who knows exactly what we went through.
And it's my freaking wife.
And
The fact that we got it through, we got it through together, no amount of hardship is gonna break this.
Including having kids. But uh anyways, so it certainly was
Life transforming his friends in many ways.
The document
It served two purposes.
One
In a kind of preparation phase
I
maybe mistakenly wanted to make sure that my wife is one hundred percent in
I was like this is what it's gonna take. This isn't
show up in two weeks and start drawing is it's gonna be a half time job for six months to even get physically ready and
Kind of train and know how to
Jump into survival suit. It it's a half time job. So part of it, the document was like
I'm signing into this and I'm not gonna give up.
Which
Sounds like the husband is asking wife to do that, but yes.
That's me.
And then the other half was about behaviors on the boat.
And
The most important piece of the document that served us very, very well.
Is the following.
Any and every decision.
Once it's made.
Is water under the bridge.
Because we had to make a lot of decisions around, you know, in safety and navigation and do we go this and or that
Lots of decisions every day.
Like what do we do today? And
You would never know if that was the right decision.
Because the weather changes and and
It's one thing to do that at home and then
you go to work and you forget it. But you basically stuck in a small
Stinky box in forty five days.
This unlimited opportunity is to get back to it and kinda bigger about it.
That was incredibly helpful.
And served us very well.
The one thing I will say and then you can ask other questions.
We had a lot of time, obviously, forty five days, three hours.
We start about six seven.
Ours.
a day, so there's eighteen hours a day to talk.
Listen, be together can't escape.
Can't go to the bathroom, can't lock the door, go to the bedroom. You cannot.
And so
Some of it was silent, some of it was we had to feel the airwaves and
We had all kinds of questions to each other, and one of the questions my wife had to me was
I think we were running out of questions. They said, Listen.
Of all our friends, if it wasn't me, who would you marry?
And
As a diligent engineer.
I stepped into that trap.
And answered it.
Going through friend by friend, landing on on the very specific one. But anyways.
That is a question no married or unmarried person should ever answer, but uh I answer.
Ha ha.
Mm.
When you were done.
With your very thoughtful
Engineer's response to that question.
How did she respond? And later was she like, Yeah, I just wanted to like
I just for whatever reason wanted to throw a Molotov cocktail into the boat and see what would happen. I mean, like what happened afterwards.
Well the uh immediate response I remember it vividly sadly. It was I can't believe that's the last one I will think.

And uh I yeah, I had to explain myself.
But
Yeah, it was a life transforming trip during which
I made several big life decisions, one of which we made together, which was to to start a family, which also is
It's a complicated, obviously big decision to have Kibson
Entering the boat we were both convinced that life's too good to destroy it with children and
We literally change some minds
Within the hour.
At the same time independently.
Which is quite
Something.
So
Alright, you just had to start a family meaning you made the decision to start a family on the boat, or you actually
Started trying to have a family on the boat.
Both, actually. So I think we were about seven or ten days into the trip.
It was very, very stormy early and I had had enough kind of white space to
Ruminate about life and
It was like a lightning strike. I still cannot explain this feeling of like you know, I was in my thirties.
What is there?
to do you know, I could start five more companies and I don't know, put my name on the side of a hospital, which I don't want.
What's the meaning is it l essentially it's the existential crisis. Like what can a human do?
What's worthy of
The life.
And obviously there's a number of things, but
The lightning that hit me was
Wow.
Can you imagine raising a child?
That's incredible.
And I turned to my wife and said, Listen, this is kinda weird'cause we've talked about this and we don't want but
I just feel we should start a family and
Her immediate response was well
I've been thinking about exactly the same for the last twenty four hours.
Exactly the same last twenty four hours. And then and there it was
This is it. It's gonna happen. And
My wife happens to be even more decisive than I am, so
We had
An Iridium satellite phone, this is time way before Starlink, which is
Works, but you know, you can send like a text message Bailey.
And
She texted to her girlfriend.
Who obviously wasn't drawing
And said hey.
Can you I'm gonna give you some data. Can you
Start tracking my ovulation cycles so you can tell us, text us back.
When is the exact timing?
And we should have tried on a boat, and I will say that
was the least romantic moment for both of us.
Ha ha
And
The fun part of this story is there's a little bit of a mystery about
We got off the boat just about
Ten years and nine months ago now.
And my
Oldest daughter is ten years old.
So there's a little bit of a mystery. What happened and where it happened, but uh
It's very close.
When you had that lightning strike.
You both.
very coincidentally or not, had that lightning strike at roughly the same time.
If you tried to explain it.
Do you think it was just the
Incredible
Isolation of the two of you? Was it your wife saying, Oh my God, I love Sami, but I need at least one other person to talk to?
If you had to try to explain it.
Even if it's grasping for straws, like what do you think led to that?
Lightning strike.
My guess is
It was
The clarity of thoughts.
When there were no destructions.
Like the clarity of thoughts and
I think there's even a
theory of the brain or the mind is kind of Bayesian, but you have priors. You have so many priors and you're always stuck in your
Rigid thinking and
You know, obviously there's science that you can kind of
loosen those priors psychedelics and other things and then you kind of see things clearly.
I honestly think that they was
The ability to think
Cleanly and clearly.
Um
That's kind of what what contributed to it.
And what I found in life is
Ultimately the human experience is hundred percent subjective.
Outside of that, you know.
It's just computers, right? And algorithms.
But it's hundred percent subjective and
When you really tune into
The subjective experience
Oftentimes the biggest decisions in life are based on that, like who do you marry?
By the way, I had a spreadsheet for that too, but then I realized met my wife, I threw the spreadsheet out the window and
That was it.
Same thing.
about having children, like the truly meaningful decisions.
They are ultimately
Subjective in nature. And
When you're true and kinda touch
How does it land? How does it feel? The answer kinda comes there. And I I feel
In the middle of the roadboard, no email, no nothing, no job, no tasks, no to do's, all to space.
It was much easier to
Be in touch with that.
Kind of experience and feeling?
That's the story I tell. But
May or may not be true.
Make sense to me.
Especially after a period of time of being on the boat, right? Once you have the routine aspects.
More or less.
On autopilot.
Of course you have the decisions about angle and direction and so on, but
I wanna come back to something you said, which was
Sure, I could start five more companies or
have your name on the side of a hospital. I know, as you mentioned, that's not of interest.
It seems like you
Did not
This is from Forbes, so who knows? But did not own a car until you were thirty six.
Talks about
How minimalist, or some might even say austere.
You have been for certainly a period of time.
And
Yeah, you're talking about renting cars from Thrifty, it had the cheapest cars.
Had not bought a watch in fifteen years. Exercise clothes are all swag from various endurance competitions, which is funny because
I uh sometimes get
Shit for wearing all the free schwag that I have. Like most of what I wear is
Free stuff that I've gotten that
Never been accused of having a great fashion sense.
Yeah, and the rest of his casual wardrobe is ten copies of the same t shirts and jeans. Literally this shirt that I have. I basically have.
Crew and V neck. It's the same brand. It's the same shirt. It's just different colors. So
My question is, is that a Sami thing?
Is it
Uh finish thing.
And what are some examples of where you have found great value?
In
Overcoming
That type of
Frugality.
Where spending money is actually
produced a real improvement in your quality of life.
Feels like it's
Two part question.
It is. Yeah. Maybe the start is I think I mentioned earlier that I find people say sacrifice, or you have to say no to so many things. I actually find
Say no and focusing on the essential.
incredibly liberating and it's kinda my happy place.
And so for some of these like
Crap around and
Too much choice.
what colored T shirt or what kind of clothes do I put on?
I love the fact that things are as simple as they are.
And sure life is way more complicated now than say fifteen years ago, but
I actually like
Not
to clutter my life with money or anything else.
Let's put it that way.
And keep things very simple.
briefly give the example of the car store. So yes, I've had my driver license ever since it was possible in Finland. It was eighteen.
So eighteen, but I
Actually I didn't buy my first car, my wife bought it. Maybe I was thirty six forced,'cause I had been renting thrifty.
car from San Francisco Airport for you know
Eight years. Why that? So I just it's a funny story, but
Illustrates my point.
Well, first of all, I didn't have any credit in America and I needed a car after I came out of Stanford, so
For work reasons I
Go to Thrifty and rent it. It was like nineteen bucks a day.
No credit, I could rent it. And then I realized this is amazing. Because I travel so much for work. I don't need to wash the car.
I don't need to change the oils.
It got broken into twice in San Francisco. I could just drive the nineteen bucks a day car.
To app word.
And drive out with a new car. I was like, This is so convenient.
No worries. Ford Escape, that was my car of choice. And then one week and I came home
years, years later and my wife's like, This is it. You need to own a car. You're an adult. You can't be renting all the time.
And she bought me the same portiscape that I had been renting for like seven years. So so that was it.
So that's kinda where it's I I think mainly coming from that the sort of simplicity and convenience, focus on the things that matter. Sure, I have
Fancy bicycles to ride fast, but no cars.
What was the color? I wanna know if you threw some flourish in there. Was it white or black or was it like electric blue with a racing stripe?
They do I've unfortunately didn't have flames on the side.
It was blue, the one that she bought. I got it. Yeah, yeah, it was it was it was no spoiler on the back.
Yeah. No no spoiler on the back.
So there's that.
My approach to money is very, very simple. The less I have to think about, the happier I am.
And the fact that
Will we have success h have enough for house and food and leftovers?
is wonderful. But if I have to be thinking about the leftovers at all
Something's wrong. So it's just simplicity is is very, very
Buying time is very helpful. There's some things that just
It's good to have kind of service and helpers around.
I would say that's a good investment.
And then the one and only thing where I would say
Yeah, I I do like sort of living environment. To have a house that you can enjoy not
For the sake of it, but
To have the kind of little things and conveniences you have, whether that's be able to exercise
Or
Roll into a lake. Have a parking lot.
So I would say that, but
The less I have to think about money, happier I am. It's just focused on my life and the
Life's happening.
Forget the money. Life's happening. Go and make it happen.
Do you have any
Books that you recommend or gift
To people more than others.
I am not a big book.
Gifter other than recommend for my like Verda team and sadly they are like professionally.
And they are all too
kinda well known uncommon that they would add a lot of value. There's the Well what are they?
Score will take care of itself.
High output management. Uh I think the score will take care of itself.
The four nine of scriptures.
Walsh's book and
high output management
Actually the high growth handbook by Elad Gilwitz is much, much, much newer and you've I know you've interviewed Elod.
So that's in a professional sitting. I I do read a lot.
If you want to plug for a book that I've really, really enjoyed over the last year
Very inspiring. Shows what's possible in life and a little bit of
Leaves you wondering like what's really true in a universe and whatnot is uh Trey Hall by Danny Treho.
No. Absolutely mind blowing book. Yeah. Machete. He's appeared in a bunch of Robert Rodriguez films. Robert Trey and Austin. That story. How on earth did you end up picking up that book?
In our family, I read a lot, but there's one person who reads more, that's my wife. So I'd say half of my book recommendations come from error C screens.
Ten books for everyone that I read, so it's a good filter and
I
Cr several times, I laughed several times, and I was incredibly inspired.
And came out reading that book, Belief in Humanity and
Just it was amazing.
If you had given me a million guesses.
For what you were gonna say, I never would have guessed. Trajo by Danny Traho is a T R E J O, right?
Yes, yes.
Yeah.
Okay.
Wow.
Okay. You're full of surprises, Sami. Also, if you're ever contemplating having a family, that book also
Ківсь хіміліті.
As you think about how much gonna affect your kids' life and um I'm not gonna
Give a spoiler alert, but uh it's highly recommended.
I'll get it on Kindle today.
I mean, we have covered a lot. I have a few questions I'd love to ask as we start to wind down, but is there anything else that you would like
To cover.
Make sure that we
Discuss or
Anywhere you'd like to point my
audience. I mean I'm going to link to everything in the show notes. Of course they can find
You know, Virta Health, V I R T A, Virta Health dot com.
On the website and we'll include everything.
Where people can find it easily, but is there anything else that
You would like us
To cover?
I think you cover things very, very well. I I would say my professional duty is to be an evangelizer and say
This very sad metabolic health mess that we find ourselves in America and globally.
And this savvy the common sense thing that oh
the diseases that we've talked about, type two diabetes, obesity, cardiovascular, they are chronic and progressive, and the best we can do is to manage them?
With an ever increasing load of medications.
It's fundamentally not true.
And
Whether that's Verda or something else, I I just wanna be very clear that there's hope in the horizon.
And the hope is largely in the form of nutrition, but not in a traditional way that you need to restrict.
and suffer. So that's sort of my professional duty to
bring hope and say if you're living with type two diabetes, and by the way, people who are living with type two diabetes, usually their family members, their relatives
And you've seen people lose eyes and limbs and
alives because of type two diabetes to me
Mostly completely unnecessary for the last
Three, four decades.
At that disease, among with other metabolic health conditions.
is fundamentally reversible.
And you don't hear that from your doctor today, sadly. And it's not doctors' fault, they're well meaning, but you go to medical school.
You could literally
Zero zero point five hours of nutrition training.
And nobody tells.
That
Conditions like type two diabetes can be reversed, like systematically, not miraculously. And so
Hopefully I can be
A messenger of hope.
That these conditions are reversible.
Especially after I already
disclose that I used to live thinking
It's your fault.
It's your fault, you're just lazy, you don't have the willpower, but that's not true.
Nobody
gets these things because they're lazy or they decide.
It's because of our food environment and the food environment kinda slowly but surely poisons us, but if you little tricks and changes.
You can actually turn back the clock.
So
That's my
PSA.
Yeah.
Mm.
And I wanna say to folks, if you're a large employer, who are the actual customers of Rita Health?
Right. Like who should actually go check out the website. Yeah. Thank you. That's so nice.
Anyone who pays
healthcare costs in America could be and should be our customer. If you pay healthcare costs, you're paying for the party.
Well people staying sick and others from the sickness. So this includes
self insured employers and we work with like eight hundred of them.
So essentially all fourteen thousand employers self insure and
Thousands of those.
So all self insured employers
Obviously health insurance companies when they take risk on their patients.
And this includes the private Medicare advantage.
private Medicaid, managed Medicaid organizations.
State employee groups. I think we work with thirteen out of fifty states today.
Already?
So state employee groups and then some government entities. There's VA, there's DOD, and others. So anyone who pays any payer who pays healthcare costs.
Could be our customer now, Pixadem is
Guess what?
Will help you make money.
Yes indeed.
We'll help you make money.
And aside benefit is we also save lives.
And I say that because the law language of American capitalism
is dollars. And so when you can help someone else to make money
You're gonna be very, very successful. And I love it.
Verda has done something that I wasn't sure could be done.
you have, as you already mentioned, I mean, the world's largest data set of this type of
Metabolic health.
And disease reversal. And the way that you've been able to refine
and engineer and iterate and further polish.
a program for individualized care and
sort of mass scale adherence.
It's mind boggling to me. Like it's really, really
Incredibly impressive and
I don't wanna say I know how much work goes into it, but I think I have an idea of just
How challenging that is because I think of myself as someone who kinda specializes in behavioral change and
To your point.
You can do a lot of really innovative things once you free yourself from the tyranny of the perfect, not letting
Perfection be the enemy of progress.
And
That is the mistake of a one size fits all approach like
you need to be on the ketogenic diet and you need to hit this minimal concentration of blood, blah, blah, blah, blah, blah. It's just not gonna work.
on a mass scale. It just doesn't work. But when you have
different ways to help people improve.
Five.
Ten.
Twenty percent.
Fifty percent.
The way that moves the needle over time.
This is not the right way to put it, but it defies conventional explanation.
in the way that as you already put it.
a lot of doctors have been taught in their minimal exposure to say nutrition.
So
The science that you're doing, and I'll say it.
It's on me. But really what you're doing with the controls and with the trials, but also with the
cohort analysis and everything else you're doing internally. Like the science you're doing is incredibly, incredibly valuable. And I don't just mean that in dollar science. It's valuable to humanity. So I really
Applaud you for
builting.
Verta and I just felt like we needed to have this conversation because A, you're just such a freak of nature and I wanted to talk to you about all the things we've talked about.
But
Also because what you've built is something that I wasn't sure it could be built.
And with the many text messages and seeing a lot of stuff that just
Blew my mind.
I wanted to have you on. So I'm glad and grateful that you took the time.
Yeah, thank you so much. And
Honestly appreciate those kind words.
It's eleven years in the making and
Never take it for granted. Bigger company, bigger problems, but
Trying hard every day.
Ha.
Well
I'm gonna pick up Trey Hall.

Which is not what I expected to be my immediate next step after having this conversation.
But for everybody listening, we will link to everything in the show notes. You can find Sami.
Certainly uh you can find Verta first and foremost at Vertah.com V-I-R-T A. You can find Sami Inkenin. Good luck with the spelling. S A M I
I-N K-I-N-E-N.

All of the places. Sammy Inkin and
Dot com
On Instagram, X, et cetera.
I'm not sure how active you are.
On those. But check out the blog posts for sure. And we'll link to everything, as I mentioned in the show notes, at Tim dot blog slash podcasts. Just search for Sami S A M I. I can promise you he's the only one.
Is gonna pop up.

And till next time.
Just be a bit kinder than is necessary.
to others, but also to yourself.
And
Take those twenty minutes on Sunday.
Plan it out.
Get those things in the calendar.
Otherwise it's gonna get crowded out by the universe. And then
Woe is you. Woe is us.
So take care of that.
And
Sami.
Again, thank you so much for the time.
Thank you very much.
Alright folks, till next time. Thanks for tuning in.
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