Pod Insights The Ultimate Human with Gary Brecka 274. Dr. Courtney Conley: Dementia, 4,000 Steps, Big Toe & The 6th Vital Sign About this episode I sat down with Dr. Courtney Conley and what she told me stopped me cold…your walking speed can predict dementia up to seven years before the first cognitive symptom appears, which is why scientists are arguing it should be added to blood pressure and temperature as the sixth vital sign. We got into the mechanism behind it: BDNF, hippocampal neurogenesis, and why 4,000 steps a day can cut dementia risk by roughly 50% and I walked away convinced this is the most under-prescribed medicine of the 21st century.
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Timestamps
00:00 - Intro of Show
01:25 - Same school, same degree: the human biology connection
04:29 - Pain to purpose: why modern shoes are built on a flawed premise
07:25 - Walking as the most under-prescribed medicine & the 7,000-step sweet spot
08:16 - Why your foot doesn't need arch support & can adult mechanics change?
13:10 - Micro walks: the 5-minute prescription for chronic pain & depression
18:21 - What gait analysis looks at & exchanging function for fashion
20:27 - The big toe chain reaction: how shoe width controls your knees, hips, and ankles
25:44 - Toe strength, foot awareness drills & preventing non-contact athletic injuries
31:54 - Where to start: building your walking baseline & post-meal blood sugar
37:00 - The 24-hour shoe clock: a realistic footwear rule
40:45 - Walking speed as the 6th vital sign, dementia risk & the soleus "second heart"
49:14 - Walking as a physiological necessity, ankle mobility & aging in place
58:55 - What does it mean to you to be an Ultimate Human?
Disclaimer: This podcast is for informational purposes only and does not provide medical advice. It is not intended for diagnosing or treating any health condition. Always consult a licensed healthcare professional before making health or wellness decisions.
Gary Brecka is the owner of Ultimate Human, LLC which operates The Ultimate Human podcast and promotes certain third-party products used by Gary Brecka in his personal health and wellness protocols and daily life and for which Ultimate Human LLC and / or Gary Brecka directly or indirectly holds an economic interest or receives compensation. Accordingly, statements made by Gary Brecka and others (including on The Ultimate Human podcast) may be considered.
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Transcript 10,610 words · 2 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:00 Speaker 00 If you were to ask someone what they want to be doing in the last decade of their life, every single person would say walking.
0:06 Gary Brecka? In older populations, foot strength and the foot mechanics have got to be so inherently connected to longevity because of the fall risk.
0:14 Speaker 00 I really want to stress that walking should be a physiological necessity on the same importance as breathing and sleeping. Those three things, when optimally done, this is what it's about. This is longevity.
0:28 Gary Brecka? That's what's inspiring to me about the longevity sciences is that a lot of it is just a back to the basics approach.
0:34 Speaker 00 Us being a biped, it is literally what defines us as a human being. And it's a part of our body that was designed to handle loads. But when it's ignored or put in footwear that is ill-fitting or doesn't fit or respect the anatomy of the foot, you're going to have problems.
0:51 Gary Brecka? If we just back up for a section, somebody is watching this podcast and starting to be convinced that I need to walk more, where do they start?
0:58 Speaker 00 What I will tell my patients, listen.
1:13 Gary Brecka? Hey guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist Gary Brecka, where we go down the road of everything, anti-aging, longevity, biohacking, and everything in between. Today's guest is a really, really special guest because as I was doing the talent research and hearing from you about guests that you wanted on the podcast, and we found this doctor who specializes in something everyone needs to know about that is accessible to every single person watching this podcast, I realized we are academic brothers and sisters.
1:47 Gary Brecka? We went to the same undergraduate school, we went to the same grad school, and we got the same degrees.
1:54 Gary Brecka? I was like, wait a second, the University of Maryland National College of Chiropractic, which is, which is now National University of Health Sciences. You got a human biology degree there. I got a human biology degree there. In undergrad, I did get biology. You got kinesiology. But I was actually born in College Park, Maryland.
2:11 Speaker 00 Oh, really?
2:12 Gary Brecka? Did you go to College Park?
2:13 Speaker 00 Yeah.
2:13 Gary Brecka? Oh, gosh. I mean, that's crazy. I was like, I was like, and then I immediately called Malia. I'm like, how old is she? I wondered if I, if I tutored her in my, in anatomy. Cause I, I, I tutored anatomy for the three years that I was at National. And I was like, and he was like, no, but she's too young. I was like, little spring chicken of hers. So, I mean, such a, such a small world. It was National College of Chiropractic at the time. And now it's National University of Health Sciences. But I got a great education there. I found them to be very science-based, very, very medicinal. It was not, you know, it was not a school, a chiropractic college at the time that taught that spinal manipulation
2:56 Gary Brecka? was the be all and all of everything. You know, they really taught that whole person approach, that whole anatomical approach. And it's funny, I get asked a lot, like, what is a human biologist? I'm like, I don't know. That's where my degree is in. So I call myself a human biologist. So my degree says, conferred the degree of, so yeah, I think you're the first human biologist other than myself that we've had on the podcast. So it's vindication for me. So, but anyway, welcome to the podcast.
3:23 Speaker 00 Thank you so much for having me.
3:25 Gary Brecka? And, and it's, it's funny how similar our tracks were, you know, starting, you graduated in 2003.
3:31 Speaker 00 Yes.
3:31 Gary Brecka? I think, yeah. So was it National University of Health Sciences by then?
3:35 Speaker 00 Yes.
3:35 Gary Brecka? Okay. Lombard, Illinois, man.
3:37 Speaker 00 Yeah.
3:39 Gary Brecka? I loved the school, did not like the weather.
3:41 Speaker 00 Yes. It's one of the reasons I moved out of Chicago.
3:44 Gary Brecka? Me too. I learned to believe in seasonal affective disorder up there. Cause I lived in, well, we lived in Lombard. And then after graduating, I moved to the South Loop in Chicago. And like, you don't see the sun for six months. And I was like, everybody's just eating pizza and getting in bar fights and cranky.
4:02 Speaker 00 It's definitely not one of those areas that in the winter you can play outside.
4:06 Gary Brecka? Yeah.
4:06 Speaker 00 Not like Colorado.
4:08 Gary Brecka? No, it's not. And the Board of Trade was like, three blocks from my house. And it was such a brutal walk to go three blocks in the wintertime in Chicago. I was like, I don't know where I want to live. I just don't want to be here. Sorry, sorry, Chicago. Great city. Don't get me wrong, but terrible weather.
4:27 Gary Brecka? So, you know, your background and your journey started, like a lot of my podcast guests, with the sort of this pain to purpose journey.
4:36 Speaker 00 Yeah.
4:36 Gary Brecka? You know, you were gyneseologist, you were working in an ortho lab, building orthotics. And something about you said, this is all wrong. We're actually destroying foot mechanics. And you banged a turn and started on this trajectory.
4:54 Speaker 00 Yes, I think whenever you have a passion for something, there's this personal quest behind it. And mine has always been with feet.
5:02 Gary Brecka? Yeah.
5:03 Speaker 00 And yes, when I was in school, we learned about the foot and ankle. I think we had maybe a half a semester.
5:12 Gary Brecka? Yeah, we spent a lot of time on the spine, you know, spinal anatomy.
5:15 Speaker 00 But my professor there was so knowledgeable and passionate about the foot, and it just really sparked my interest. But at the time, basically what we were taught was, well, if the foot hurts, here's a foot orthosis.
5:30 Gary Brecka? Right.
5:31 Speaker 00 And if it continues to hurt, we know a good surgeon. And there is a time and a place for everything, but for some reason,
5:39 Speaker 00 you know, that just did not make a lot of sense to me because if you look at everywhere else in the human body, where we look at rehabilitation, for example, we don't treat it anywhere near like that.
5:51 Gary Brecka? No, we don't treat it by itself. You know, interestingly, I read a book called Born to Run.
5:56 Speaker 00 Yes.
5:56 Gary Brecka? Years ago, and it reframed my thought on foot mechanics. It was the first time that, and it was about these tribes in Mexico that would run extraordinarily long distances.
6:11 Speaker 00 Yes.
6:11 Gary Brecka? Like 70 plus miles was not odd for them, over rough terrain, and it was barefoot.
6:17 Speaker 00 Yeah.
6:18 Gary Brecka? And the whole thesis that came out of that was that basically the foot industry is casting our feet in these non-anatomical positions and causing up chain issues, knee, hips, shoulders, rotator cuff, spine, because of how we've, you know, gotten accustomed to, we need cushioning, we need, you know, support, we need high arches, we need all of these other things in order to walk properly, when the truth is the human foot is so adaptive. I think I remember from school, there's 300 planes of motion in the foot, something like that.
6:52 Speaker 00 It's always so, it boggles my mind, it's, it's an evolutionary mismatch of what we really have done to our foot. Chris McDougall's work has been an inspiration of mine for a long time. And I think when we think about the mechanics of the foot and what the foot's actually doing, it has been beautifully designed to handle loads.
7:13 Gary Brecka? Yeah.
7:14 Speaker 00 But when we ignore it, you have problems.
7:18 Gary Brecka? Yeah. You, you call walking the most under prescribed medicine of the 21st century.
7:23 Speaker 00 Yes.
7:24 Gary Brecka? And what do you think is like most fundamentally misunderstood about walking?
7:30 Speaker 00 You know, I was thinking about this on my flight here, and I love the name of your podcast, The Ultimate Human. And I was like, you know what? Do you know what makes us the ultimate human? The fact that we can walk on our own two feet.
7:42 Gary Brecka? Well, you just answered the last question of my podcast, because my podcast always ends with, what does it mean to you to be an ultimate human? So you just avoided a question at the end.
7:52 Speaker 00 It's important, though, it's us being a biped, it is literally what defines us as a human being, as a species.
8:00 Gary Brecka? Yeah.
8:01 Speaker 00 And we've wildly ignored it.
8:02 Gary Brecka? Yeah.
8:03 Speaker 00 And it's a part of our body that was designed to handle loads. When we're walking, we have multiple times our body weight going through our foot.
8:13 Gary Brecka? Yeah.
8:14 Speaker 00 And when someone says to me, the foot needs arch support, I always question that because it doesn't. It's been evolved to handle these loads, but when it's ignored.
8:28 Speaker 00 Or put in footwear that is ill-fitting or doesn't fit or respect the anatomy of the foot, you're gonna have problems.
8:37 Gary Brecka? We actually have a foot with us here today.
8:39 Speaker 00 I do.
8:39 Gary Brecka? This is Eddie.
8:40 Speaker 00 This is Eddie.
8:42 Gary Brecka? Tell me that's not an actual, real person.
8:44 Speaker 00 I am a very big Pearl Jam fan.
8:46 Gary Brecka? Okay.
8:46 Speaker 00 So all of my foot models are named after Eddie Vedder.
8:49 Gary Brecka? Oh, they are named after Eddie Vedder. Okay. I like Pearl Jam too. But this isn't, this isn't Eddie Vedder's foot.
8:55 Speaker 00 That is not Eddie Vedder's foot.
8:57 Gary Brecka? Okay, good. That'll be a little gross. So, you know, again, I remember learning that there's three hundred planes of motion in the foot. I remember being fascinated by that. I also remember this book, Born to Run, and it like reframing my, and I, so I started for months, I started wearing the toe shoes.
9:14 Speaker 00 Yes.
9:14 Gary Brecka? I got so ridiculed for these things. And they were really a pain to put on because I had to tuck each toe into these foot shoes. And I think because I had worn terrible shoes for so long, those actually started to hurt my feet. And, you know, I went back to modern footwear. But I've also noticed that as I over-pronate, which I have a very bad collapsed arch on one side of my feet, that, you know, I do get medial knee pain and then I get lateral hip pain. And it's, it's worked its way up to my shoulder and I'm convinced that, that, that kinesiological
9:55 Gary Brecka? connection between my foot mechanics, all the way up to my gait and my shoulder are connected.
10:01 Speaker 00 You're correct.
10:02 Gary Brecka? Yeah. And I think that it happens so slowly over time that we start to treat them like isolated incidents.
10:10 Speaker 00 There's no part of the body that you can treat in isolation. A lot of my patients in my clinic will present with low back pain or hip pain. And I'm always evaluating the foot.
10:22 Gary Brecka? Really?
10:23 Speaker 00 It's our first connection with the ground. It's what keeps us upright and balanced when we walk and when we move. So to not assess the foot and all the planes of motion and the ranges of motion that give us efficient movement is, you know, a disservice.
10:39 Gary Brecka? So I guess the big question is, is it fixable? Right? I mean, because every, every golf pro you talk to says, I would rather teach somebody to swing a golf club for the very first time.
10:51 Speaker 00 Yeah.
10:51 Gary Brecka? Than take somebody who's been swinging it wrong for 20 years and retrain them. Right? So, you know, by the time you get a hold of an athlete.
10:58 Speaker 00 Yeah.
10:59 Gary Brecka? Or someone with Borgate, I mean, those mechanics have been, those neural pathways have been ingrained for decades, maybe. Right? So where do you, where do you start with changing foot mechanics?
11:12 Speaker 00 I think when you look at it from the most basic perspective. If I had low back pain, we would tell people to strengthen their glutes, strengthen their core, become more active. This is the very same conversation we can have at the foot. It is, it can get stronger. We can improve mobility at the big toe. We can improve mobility at the ankle. We can improve strength of the foot. And these are the conversations we need to have.
11:39 Gary Brecka? Yeah.
11:39 Speaker 00 So yes, things can change and they will change.
11:42 Gary Brecka? And I think it translates to a lot more than just foot mechanics. You know, I, I looked into some of the research that you've done or cited. You know, you blew through the 10,000 steps myth.
11:54 Speaker 00 Yeah.
11:55 Gary Brecka? You know, saying that just getting 10,000 steps a day is, is not where it's at. 7,000 is enough.
12:01 Gary Brecka? But you talk about the pace of walking. And you, and you also talk about the relationship between the pace of your gait and longevity.
12:10 Speaker 00 Yeah.
12:10 Gary Brecka? Which is where I have a keen interest.
12:12 Speaker 00 Yeah, that fast brisk paced walking is where it's at.
12:16 Gary Brecka? Yeah.
12:16 Speaker 00 And I think people would find that it's actually faster than you would think.
12:20 Gary Brecka? Really?
12:21 Speaker 00 It's about, so on a treadmill, 3.0, 3.5, 4 miles an hour. If you look at the cancer research. It is four miles an hour, 30 minutes. But you can decrease your risks of cancers, liver, lung. I mean, it's, it's the panacea of medicine, but it's that pace. That fast pace that we're looking for. And it is quite, you know, depending upon where you live, you know, I live in Colorado. You, you have a 4.0 mile per hour, you know, pace going up a mountain.
12:52 Gary Brecka? Yeah.
12:52 Speaker 00 It's, it's brisk.
12:53 Gary Brecka? Yeah, yeah. Well, Colorado is actually one of the fittest states in the, in the nation, believe it or not. I randomly ran into that fact on another podcast. And the amount of outdoor activity they do is sort of second to none. So they're, they're year round exercise.
13:10 Speaker 00 Well, that's one of the reasons I wanted to move out of Chicago.
13:12 Gary Brecka? Yeah.
13:12 Speaker 00 For six months out of the year, you're indoors.
13:15 Gary Brecka? Yeah.
13:16 Speaker 00 For, you know, not bad mouth.
13:19 Gary Brecka? Well, we believe we've really hammered Chicago pretty. Every Chicago follower right now is like, delete us. So they're out.
13:27 Speaker 00 But in Colorado, you can, I mean, you play in the winter.
13:30 Gary Brecka? Yeah. You know? They all do, they're all outside, like.
13:33 Speaker 00 Yeah.
13:34 Gary Brecka? The ski slopes are packed and then, and then the slopes are just as packed in the summertime with mountain biking and hiking and trailing and like, you know, and, and everybody's fit.
13:43 Speaker 00 Yeah. There's something, I recently moved to the mountains. I live at about 8,000 feet and there's something gritty about it. You can't be, you have to be a little.
13:54 Gary Brecka? Tough.
13:54 Speaker 00 Tough.
13:55 Gary Brecka? Yeah.
13:55 Speaker 00 You know, it's not, it's not easy living by any means, but there's a, you know, there's a sense of accomplishment, if you will, with just daily tasks, walking around and, you know, walking your dog.
14:08 Gary Brecka? Yeah.
14:08 Speaker 00 I appreciate that.
14:09 Gary Brecka? Well, I want to get back to the 10,000 versus 7,000 steps and, and the brisk pace, because I feel like, you know, the vast majority of my audience can walk.
14:17 Speaker 00 Yes.
14:18 Gary Brecka? You call it the most underrated prescription in the 21st century. What would you do in, in terms of, what kind of prescription would you write for walking?
14:29 Speaker 00 To increase speed?
14:31 Gary Brecka? To reduce, you know, I, I saw seven to 50% reduction in cardiovascular risk, reductions in, in all cause mortality, reduction in dementia risk, which I found very fascinating, just simply by drawing your attention to regular walking.
14:46 Speaker 00 Yeah. I think it's very individualistic. So you have to consider who's in front of you. So I have patients who are in chronic pain. They've been in pain for years. Their baseline might be 2,000 steps, 2,500 steps. With those patients, if I can increase their step count by 500 steps, that's about five minutes a day.
15:11 Gary Brecka? Okay.
15:11 Speaker 00 You're decreasing your risk of all-cause mortality by 7%.
15:14 Gary Brecka? I saw that.
15:15 Speaker 00 It seems like a no-brainer.
15:16 Gary Brecka? Yeah.
15:17 Speaker 00 But it's challenging because these people, for years, now it's not just a musculoskeletal diagnosis that triggered their pain. It is now much more complex.
15:28 Gary Brecka? Right.
15:28 Speaker 00 There's an emotional side to it, there's a mental side to it. But that's the beautiful thing with walking.
15:34 Gary Brecka? Yeah.
15:34 Speaker 00 Is that you can start to increase your step count. It's a safe activity. It's easily accessible. So when we get these patients to 5,000 steps per day, they decrease their risks and their symptoms of depression.
15:48 Gary Brecka? Yeah.
15:48 Speaker 00 You get them to 7,000, now you're decreasing the risk of getting depression. And you know, I think you can attest to this. There is always a correlation, a 100% correlation between my patients that are not walking or are unable to walk in their mental health status.
16:07 Gary Brecka? I-
16:07 Speaker 00 They just go hand in hand.
16:09 Gary Brecka? Could not agree with you more. And I think a lot of it has to do with neurotransmitter function. You know, I have a saying that the presence of oxygen is the absence of disease. And the reason why I say that is, if you look at the actual neurophysiologic structure of emotion, very often, oxygen is a component of elevated emotional states. Passion, elation, joy, arousal, libido, all the hell yeah, I won the lottery emotions.
16:35 Speaker 00 Yeah.
16:36 Gary Brecka? And they're more accessible than people think. All right? And you can access them through things like mobility.
16:44 Speaker 00 Yes.
16:45 Gary Brecka? And I've seen a lot of side-by-side studies on SSRIs versus exercise. And exercise wins hands down every time, but we never prescribe exercise.
16:54 Speaker 00 Right.
16:55 Gary Brecka? I mean, I don't think anybody that's been depressed, their physician ever said, why don't you just get outside and...
17:00 Speaker 00 It should be on every doctor's prescription pad.
17:02 Gary Brecka? Yeah.
17:02 Speaker 00 The number one thing on a prescription pad.
17:04 Gary Brecka? Listen, there's what I share on this podcast, and then there's what I share with my inner circle. If you've been following me for a while, you know how I hold nothing back here. But my VIP community, that's where the real magic happens. Picture this, you're struggling with energy crashes, brain fog, or just feeling like you're not operating at your peak, and you don't know where to get real answers. But here's what really sets this apart. You're not just getting my insights. When I have incredible guests on the podcast, VIP members get to submit questions for a private podcast segment. So that world-renowned expert we just interviewed, you get exclusive access to their knowledge tailored to your specific situation. This section is under the private podcast section in the Ultimate Human Community.
17:46 Gary Brecka? And speaking of exclusive, you're getting my personal protocols, the exact tools I use for water fasting, gut optimization, and morning routines that have taken me decades to perfect. This isn't theory, this is what works in the real world. The community launches challenges throughout the year where you get direct access to me and my network of experts. It's like having a personal health advisory board for less than $100 a month. Your health is your wealth, and this investment pays dividends for life. Join the VIP community at theultimatehuman.com/vip and step into your ultimate potential. Now, let's get back to the Ultimate Human Podcast. So, so, starting with GATE analysis. If, when someone comes into your clinic for an evaluation, like, what are you specifically looking at?
18:30 Speaker 00 I love watching people walk.
18:34 Gary Brecka? Dude, New York must be high-stress for you. Like, she's jacked up, he's jacked up, this guy's got overpronated, underpronated, ankle roll, like...
18:43 Speaker 00 My fiance's always like, can you just leave him alone? They're probably happy. I'm like, I know, but I feel like I can...
18:48 Gary Brecka? Don't go to Disney World, they waddle.
18:52 Speaker 00 It's, um, I always call it a neurological window. It's like a window to someone's soul. You can tell when someone's had a good day.
18:59 Gary Brecka? Yeah.
19:00 Speaker 00 Or a bad day. The happy walk. The happy walk, the excited walk. Uh, but yes, when someone comes into my office, we will either get them on the treadmill. If they're not used to that, I'll just have them walk in my office. And I'm just getting a, a big picture view of what they look like. Do they look comfortable? The word we will often use when I teach the courses is efficient. Do they look efficient? Does it, does it look like they could walk for long periods of time?
19:24 Gary Brecka? Mm-hmm.
19:25 Speaker 00 Um, and oftentimes it doesn't. It looks like a struggle. And walking gait should not be a struggle. Because we as human beings were designed to walk for very long distances for long periods of time.
19:35 Gary Brecka? Yeah.
19:36 Speaker 00 So we look at those types of things.
19:38 Gary Brecka? And where do you fall on shoes? Don't look at my shoes.
19:41 Speaker 00 Hey.
19:42 Gary Brecka? Don't look down. I know you want to.
19:44 Speaker 00 I already did.
19:44 Gary Brecka? I know.
19:47 Gary Brecka? I was right here. This is a judgment free zone. Um, you know, where do you fall on shoes? Because, uh, let me tell you something, like, I, I think the worst thing we ever did was put women in seven inch stilettos.
19:58 Speaker 00 Oh, yeah.
19:58 Gary Brecka? And, you know, I, I have these Ferragamo, um, beautiful loafers. Um, they shed, they bring a tear to my eye every time I take them out of the closet. It's so beautiful. They hurt my feet. I, I mean, I can't even walk through an airport with these things. Little flat piece of leather, toes jammed in to the front and a hard wooden sole in the back.
20:21 Speaker 00 Yep.
20:21 Gary Brecka? And I think we have definitely exchanged fashion for function.
20:25 Speaker 00 Oh, 100%.
20:26 Gary Brecka? But where do you start with, you know, footwear recommendations for?
20:32 Speaker 00 When you look at your foot.
20:33 Gary Brecka? Mm-hmm.
20:34 Speaker 00 The widest part of your foot should be your toes. So very simply put, the shoe should respect the anatomy of the foot.
20:45 Gary Brecka? Why is there always that triangle to front of every pair of shoes?
20:47 Speaker 00 Every, if you look at the majority of shoes, they are tapered at the toe box.
20:52 Gary Brecka? Yeah.
20:53 Speaker 00 And it's this fashion over function that we've really grown accustomed to from a societal, you know, perspective.
21:01 Gary Brecka? Yeah.
21:02 Speaker 00 And that really needs to change because I truly think that if we just put people's feet in footwear that respected the anatomy of their foot, my office would be way less busy.
21:12 Gary Brecka? Yeah.
21:12 Speaker 00 Especially from structural changes that happen, your diagnoses of bunions and neuromas and hammer toes and pain in the forefoot, those go away.
21:22 Gary Brecka? Really?
21:22 Speaker 00 When you can allow your foot to splay and improve its strength. But it just doesn't make sense to take the widest part of your foot.
21:32 Gary Brecka? Yeah.
21:32 Speaker 00 Where you also have the most load when you're walking.
21:35 Gary Brecka? Hmm, the dorsiflexion, like when you push off.
21:38 Speaker 00 As you push off.
21:38 Gary Brecka? Yeah.
21:40 Speaker 00 And put that into something that's tapered and squeezed together. It just doesn't make sense. If you wanted to balance, which we all should, it's walking gait. Would you balance better with your foot looking like this? Or like this?
21:55 Gary Brecka? Yeah.
21:56 Speaker 00 It's, you know, especially with the aging population.
22:00 Gary Brecka? Yeah.
22:00 Speaker 00 It's a, it's an imperative conversation to have.
22:02 Gary Brecka? Yeah. You know, I saw, I saw images of geishas, their feet, like.
22:08 Speaker 00 Like foot binding.
22:09 Gary Brecka? Yeah, and foot binding in like the Asian culture, it was like very considered beautiful if women had really, really tiny feet. So they would actually put them in.
22:19 Speaker 00 Yes.
22:20 Gary Brecka? Wooden shoes that wouldn't allow their feet to grow and toes would grow in underneath of their.
22:23 Speaker 00 It's heartbreaking.
22:24 Gary Brecka? It, it looks like they were in a blender and, um, and then they would just sort of tap and hobble. They look like a little ballet dancer trying to tap the floor. And I guess that was considered.
22:36 Speaker 00 Yes.
22:36 Gary Brecka? Attractive too. And, but they.
22:39 Speaker 00 I see people's feet like that.
22:41 Gary Brecka? Did you do?
22:41 Speaker 00 Yes.
22:42 Gary Brecka? Yeah. I mean, just destroy their foot mechanics.
22:44 Speaker 00 Destroyed.
22:45 Gary Brecka? Yeah. So you like anatomically correct shoes should be wider at the, obviously at the, at the front than they are at the heel.
22:55 Speaker 00 Especially the big toe. Like if you were to look at, I'm going to bring Eddie out here.
22:58 Gary Brecka? Yeah, let's bring Eddie in here.
23:00 Speaker 00 If you look at the foot, the big toe should be straight. This is, that big toe is what we utilize when we push off our foot when we're walking.
23:10 Gary Brecka? Yeah.
23:11 Speaker 00 And there's a lot of strength and power that comes from that big toe. And I'm not just talking about a walking gait. I'm talking about professional athletes cutting and sprinting. A lot of that power comes from the foot and ankle, and in particular, the stability of the big toe.
23:27 Gary Brecka? Hmm.
23:28 Speaker 00 So when you compromise the function of that toe and you take it and you angle it like this.
23:33 Gary Brecka? Yeah.
23:34 Speaker 00 You're disrupting the integrity of the midfoot. You're making it harder for the big toe to engage. And you will compromise what's happening at the ankle, at the knee, and at the hip. So that's my lowest hanging fruit is just wear a shoe where your big toe can be in the position that it was designed to be in.
23:53 Gary Brecka? And can it, will it slowly come back and anatomically correct itself?
23:57 Speaker 00 Depending upon when you intervene.
23:59 Gary Brecka? Hmm.
24:00 Speaker 00 That's why I think this conversation needs to happen sooner with our children.
24:04 Gary Brecka? Right. Rather than later.
24:06 Speaker 00 When the foot is still flexible, so for someone who comes into my office that has a bunion, for example, if it's flexible and I can literally take it and move it, that's always a good sign to me.
24:18 Gary Brecka? Okay.
24:19 Speaker 00 Because then I know I can work on strength. I can utilize toe spacers, for example. We get them in the right footwear. But depending upon someone's age and how rigid the foot becomes, if that big toe now starts to tuck under the second toe.
24:34 Gary Brecka? Hmm.
24:35 Speaker 00 We've seen feet like this.
24:36 Gary Brecka? Yeah. I've seen professional basketball players' feet that are like that.
24:40 Speaker 00 If you can't move the joint.
24:43 Gary Brecka? Right.
24:44 Speaker 00 These are different conversations. This is, do I need surgery? This is, do I need some type of orthopedic shoe to now rocker me through my forefoot because I've lost stability here?
24:55 Gary Brecka? Yeah.
24:56 Speaker 00 So we don't want to get to those conversations.
24:59 Gary Brecka? Yeah.
25:00 Speaker 00 I mean, those bunions and hammer toes and a disruption of the integrity of the forefoot increases our risks of falling as we age.
25:06 Gary Brecka? Yeah.
25:07 Speaker 00 So it's a very.
25:08 Gary Brecka? Falling is the greatest risk too.
25:09 Speaker 00 It's a much bigger conversation.
25:11 Gary Brecka? Yeah.
25:12 Speaker 00 Than I think we're. We're paying attention to it.
25:15 Gary Brecka? Yeah, and I think we can make up for that in younger years, right?
25:18 Speaker 00 Yes.
25:18 Gary Brecka? Because we're a little more nimble, we have more proprioception. Maybe if we're off balance, we can just double step.
25:23 Speaker 00 Yeah.
25:23 Gary Brecka? You know, if we catch the back of our heel with our toe, we can catch a step. But in older populations, you know, grip strength and that foot strength and the foot mechanics have got to be so inherently connected to longevity because of the fall risk, basically.
25:43 Speaker 00 Yes, there is a, you mentioned grip strength. There was a great study in Japan and they looked at 1,400 workers at a Toyota facility. And they looked at their toe strength versus their grip strength.
25:54 Gary Brecka? Yeah, you talk about toe strength, I love that.
25:56 Speaker 00 And toe strength actually declines faster than grip strength. And it was also associated with other metabolic markers. And when you lose the capacity and strength of your toes, it increases your risks of falling. Because if you think about it, if I was standing and I went to lean forward, the first thing you should feel are your toes pressing into the floor. Hopefully in a wide splayed position.
26:26 Gary Brecka? Right.
26:27 Speaker 00 Right?
26:27 Gary Brecka? Right.
26:28 Speaker 00 But if you lose that strength, which we know sarcopenia is a thing, that also happens in your foot.
26:33 Gary Brecka? Age-related muscle wasting, yep.
26:35 Speaker 00 So if I lose strength in my foot and I can't feel things, and we know we lose power faster than we lose strength. So there's our reactivity.
26:43 Gary Brecka? Right.
26:44 Speaker 00 This is not a good recipe for being balanced and upright as we age.
26:50 Gary Brecka? Right. Now, what are some of the, what is a typical patient journey for someone that comes into your clinic with, and let's maybe talk about professional athlete, and let's just talk about soccer mom.
27:02 Speaker 00 Yeah.
27:02 Gary Brecka? Right? They comes into your clinic, they have disrupted foot mechanics or gait anomalies, and then you fix those mechanics. What are you seeing in those patient journeys?
27:16 Speaker 00 When we do the gait assessment, I will pick out, I'll prioritize what's necessary to make them efficient. So that depends. When I look at someone's foot, we'll start with, can you do basic things like lift just your big toe? Lift your foretoes.
27:34 Gary Brecka? I'm doing this right now.
27:35 Speaker 00 Yes.
27:36 Gary Brecka? By the way.
27:37 Speaker 00 If you couldn't lift just your thumb, you'd probably panic.
27:39 Gary Brecka? Exactly, right.
27:42 Speaker 00 We should be able to do those things with our feet. The feet, the hands and the lips have the most real estate in the homunculus. That means they have a lot of sensory input. And then our brains increase motor output. So we should be able to do these things with our feet. We also should be able to lift up all of our toes and spread them. So you should see daylight between each toe.
28:05 Gary Brecka? Ooh, I think I'm feeling that one. Yeah, I think I'm, yeah, I see some grimaces on my staff's face off camera, too. They're like, yeah, no daylight between those sausages.
28:15 Speaker 00 So if they can't do these foot awareness drills, as I call them, then that's where we have to start.
28:22 Gary Brecka? Yeah.
28:23 Speaker 00 You'd be surprised with the professional athletes that I have worked with. They will tell you too, in all of our, through college, through all of our training, they're building jet engines of bodies on paper airplanes of feet.
28:37 Gary Brecka? Wow.
28:38 Speaker 00 So we know that there's a lot of body weight going through our feet when I, when we run, for example. So with these, with these athletes, I'm saying, you should be able to produce power. You should be able to do X amount of single leg calf raises. You should be able to produce a certain amount of strength out of your big toe and your lesser toes. You should have certain range of motion at your big toe and your ankle. And if these basic markers are not met, I'm always scratching my head going, this is like elite, this is, these are elite athletes.
29:07 Gary Brecka? Yeah.
29:08 Speaker 00 And they're not using what I believe to be the most powerful part of your body to propel you forward.
29:13 Gary Brecka? Hmm. You know, you know what I find fascinating, too? I've been called in to address this in certain professional sports teams, is the level of non-contact injuries. It seems to be on the rise. It doesn't seem to be, statistically it is. And you're talking about the youngest.
29:33 Gary Brecka? Most athletically competent, well-trained, strong, capable athletes. And they're blowing Achilles' heels being whistled into a game, or they're blowing an ACL, MCL, running a normal pattern down the field without trauma, non-traumatic. So non-contact. And, you know, I always have looked at recovery.
29:58 Speaker 00 Yes.
29:58 Gary Brecka? As an issue. But the mechanics of the foot is, I gotta say, I don't, that's not going on in the locker rooms of any of these.
30:07 Speaker 00 It's the foundation. It's the foundation for what happens at the foot, at the Achilles tendon.
30:13 Gary Brecka? My face like, that makes so much sense.
30:15 Speaker 00 And what we've done is, if I have pain there, for example, we go into a shoe store and they say, well, here's this very cushioned shoe. That basically, that has a big, it looks like there's a big tilt on the front of it. It's a rocker. So then people put the shoe on and it basically rockers them forward. And we say, wow, that feels great. Why would I not want to wear that?
30:40 Gary Brecka? It's like assisted walking.
30:41 Speaker 00 It's great. And I'm like, ah, nobody gets free lunch.
30:45 Gary Brecka? You're gonna get weaker.
30:46 Speaker 00 There's a trade-off here. So we have to have our foot on the ground. And I think when we talk about these injuries, you can't say that, you know, this one factor is contributing to these increase in ruptures, et cetera. But I do think that tendons need load and muscles need to be strong. And we need to start incorporating those things from the ground up when these kids are in high school sports and all of these other activities that lead them into, you know, their later years.
31:20 Gary Brecka? Yeah. If you want protein to build lean muscle, but without the caloric impact or need to cut, you need Perfect Amino. It's pure essential amino acids, the building blocks of proteins in a precise form and ratio that allows for near 100% utilization in building lean muscle and no caloric impact. So we build protein six times as much as weight, but without the excess body fat we normally get during bulking. This is the new era of protein supplementation and it's real. If you want to build lean muscle without having to cut, you need Perfect Amino. Now let's get back to the Ultimate Human Podcast. So if we just back up for a section, somebody is watching this podcast and is like, "Okay, I'm starting to be convinced that I need to walk more."
32:05 Speaker 00 Yeah.
32:07 Gary Brecka? What would you recommend as a starting point? I mean, not somebody that has massive pain or any noticeable anatomical issues that they're aware of, right? But just an average person, it's like, "I'm going to throw some things into my calendar to extend my lifespan, health span, reduce these all-cause mortality risks."
32:28 Gary Brecka? Where do they start?
32:29 Speaker 00 It's such a great conversation because we actually have to try to convince people to walk more when it's our biological necessity.
32:40 Speaker 00 It's a core biological input. So when you think about your day, for example, if I was strength training in the beginning of the day.
32:49 Gary Brecka? Which I do every day, yeah.
32:51 Speaker 00 I have my hour in the morning. That's when I get my work done. If I go and sit at my desk and take meetings for the next eight to nine hours, you're not, you don't have that stimulus to every system in your body that basically gets it to function. So what I will tell my patients, listen, depending upon where they sit, if I need to, if someone has a very low baseline, 2,000, 2,500 steps, we figure out why. If it's pain, then we have to do something like a micro walk, which is five minutes per day. That's where we start.
33:27 Gary Brecka? Wow. And would you do these more than one time, one time a day?
33:31 Speaker 00 Depending upon what they're capable of.
33:34 Gary Brecka? Yeah.
33:34 Speaker 00 You know, it's interesting, some of the patients that I see, we will start with once a day.
33:40 Speaker 00 And we have to start with building their self-efficacy in their confidence in their movement. And sometimes that's a very big conversation at five minutes.
33:50 Speaker 00 And then we'll say, okay, things are good. They start to feel confident. Things didn't explode like they have been told. Words are important.
34:00 Gary Brecka? Right.
34:00 Speaker 00 And so then we'll add in a second one, and then we'll add in a third one. And before you know it, they're at 1,500 more steps a day, which starts to get them into that territory of decreasing the risks of depressive symptoms.
34:12 Gary Brecka? And you know what else you do to feel good doing that, you know? It's really interesting. I've been down the rabbit hole lately of, you know, I see a lot of metabolic syndrome, and obviously, one of the leading causes is insulin resistance and high blood sugar. And looking at some comparative studies between like GLP-1s and metformin, and a 15-minute walk immediately after a meal, postprandial.
34:34 Speaker 00 It's so exciting. I mean, that's why I-
34:36 Gary Brecka? It's unbelievable. Like, that should be the first prescription for your forked-down move.
34:41 Speaker 00 Literally, within 30 minutes after you eat.
34:43 Gary Brecka? Yeah.
34:44 Speaker 00 If you look at all this research, it's really cool. I mean, if you have insulin resistance or diabetes, eating directly after, or, excuse me, walking after you eat, within 30 minutes, you basically reduce your, the amount of glucose in your bloodstream. And it helps your pancreas.
35:05 Gary Brecka? Yeah.
35:05 Speaker 00 So you have two systems that grab glucose out of your bloodstream and get it into your cells, your pancreas and muscle contraction. So when you're sedentary after you eat, your pancreas has to work really hard because his friend, the muscle contraction, isn't helping.
35:21 Gary Brecka? Right. It's not sponging up any of that glucose, right?
35:24 Speaker 00 So I think that there's really cool research looking at if you were to take a 15-minute walk after you ate three times a day.
35:33 Gary Brecka? Yeah.
35:33 Speaker 00 It's equivalent to taking one 45-minute walk.
35:36 Gary Brecka? I read that same study. What I also found really fascinating was, it makes sense to me. You move after eating, you reduce your blood sugar. What I found really fascinating was their insulin sensitivity improved.
35:47 Speaker 00 Yeah.
35:48 Gary Brecka? Meaning they became less insulin resistant. So their fasting insulin went way down.
35:53 Speaker 00 Yes.
35:53 Gary Brecka? Like from high double digits into single digits. And I think that is, that's the panacea.
35:59 Speaker 00 Yep.
35:59 Gary Brecka? Right? Because the amount of things that insulin resistance and hyperglycemia are related to is mind numbing. It's like the first domino to fall in a whole cascade of.
36:09 Speaker 00 I think that's why you also see that correlation with a decrease in cancer risk.
36:13 Gary Brecka? Mm hmm.
36:14 Speaker 00 Because of the changes with that.
36:15 Gary Brecka? Probably that correlation. Yeah, no question. And, and we're so much more in control of this than, than ever. You know, I feel it too, when we, we're in Coconut Grove and, and like 15 minutes from us is the little restaurant district. When we go out to eat and walk back, just that 15 minute walk.
36:33 Speaker 00 Yeah.
36:33 Gary Brecka? It's like, I do feel better.
36:35 Speaker 00 You're gonna sleep better.
36:36 Gary Brecka? Yeah.
36:36 Speaker 00 I know you're big on sleeping.
36:37 Gary Brecka? I am huge on sleep. Yeah. I got a sleep challenge coming up.
36:40 Speaker 00 I was like, if people just walked more, the research is if you just did a little more walking than your baseline.
36:47 Gary Brecka? Okay.
36:48 Speaker 00 You're gonna sleep better. But we know this. It's if you increase activity, you're sleeping better.
36:53 Gary Brecka? Yeah.
36:53 Speaker 00 And it's, we're not asking you to run a marathon here.
36:55 Gary Brecka? Right. Yeah.
36:57 Speaker 00 That's why it's this conversation of being easily accessible.
37:00 Gary Brecka? Mm hmm. You have something called the 24 hour shoe clock.
37:03 Speaker 00 Yes.
37:06 Gary Brecka? So my, my wife likes this. She's like, yeah, I need a shoe for every 24 hours, you know?
37:10 Speaker 00 Yeah.
37:12 Gary Brecka? Like, I don't think that's what she means.
37:14 Speaker 00 You know, I'm not going to win this conversation if I tell people that they need to wear minimal footwear all the time. It's not realistic and I'm aware of that. I've also have a 15 year old and I certainly know that she's not.
37:29 Gary Brecka? Fashion over function right there.
37:31 Speaker 00 So I'm not going to win those conversations. I want people to pay attention.
37:35 Gary Brecka? Yeah.
37:35 Speaker 00 So for example, if you're going out to dinner or you're going on a date and you want to wear your fancy shoes, your Ferragamos.
37:43 Gary Brecka? Beautiful. These things are works of art.
37:45 Speaker 00 If you were in those shoes for three hours during the day.
37:49 Gary Brecka? Yeah.
37:50 Speaker 00 You want to wear something that is going to be more functional for the rest of the day that you're on your feet. So it's basically splitting up your time. If I'm gonna have non-functional footwear or traditional footwear, you cannot wear those shoes all day long. It's okay. Go wear them for a couple hours.
38:08 Gary Brecka? Right.
38:08 Speaker 00 But for the rest of the day, you're going to either put your foot on the ground, walk around barefoot in your house, wear a shoe that allows your foot to start moving, insplaying and improving its function. Because if you restrict the foot all day long, that's when you're going to see problems.
38:25 Gary Brecka? Can we put some footwear recommendations into the show notes? You obviously probably have some brands that you... What are you wearing right now?
38:33 Speaker 00 These are Vivo barefoot's.
38:35 Gary Brecka? Vivo... See, I started with the Vivo toe shoes and gave them up. But I think I could be re-convinced for these.
38:42 Speaker 00 Well, people, this is...
38:43 Gary Brecka? Those are a lot more fashionable than the ones...
38:45 Speaker 00 Yes, they're getting there.
38:45 Gary Brecka? I don't know if you can see these on the camera, but way more fashionable than the toe ones I had at the beginning. I still remember when Ben Greenfield showed up at my house and I was like, "Brother, what is on your feet?"
38:57 Speaker 00 I keep telling my daughter, I'm like, "Smart as sexy, Addie, smart as sexy. When people see your foot, they know that you're paying attention to your foot health."
39:05 Gary Brecka? I don't think the 15-year-old cares.
39:07 Speaker 00 No, I don't think she cares. I'm really trying every angle.
39:09 Gary Brecka? Yeah, she's not buying it. I got a 17-year-old, I can tell you she's not buying it.
39:12 Speaker 00 When I first started doing this, there was one shoe brand that was making shoes that respected the anatomy of the foot. Now there's hundreds. I mean, they have everything from athletic shoes, sneakers, dress shoes, casual shoes, sandals. So there's the opportunity to really respect your foot's anatomy is out there. And it's getting better.
39:33 Gary Brecka? Yeah, I love that 24-hour clock concept. Because you're right, you know, I mean, first of all, if you ever walk down the street in New York City, every woman that's passing you has her heels in her purse. They're sticking out of her purse and she's got, you know, tennis shoes on. And when they get to the office, you know, they're observing your recommendation in some form of fashion.
39:54 Speaker 00 We have a high-heel shoe rehab section in the book. Where if you wear...
40:00 Gary Brecka? You do?
40:00 Speaker 00 Yes. It's very important. If you wear high heels, just do these things.
40:04 Gary Brecka? Right.
40:05 Speaker 00 It's just being proactive.
40:07 Gary Brecka? Yeah.
40:07 Speaker 00 You know, I really hope that, you know, when you go into, say, a grocery store, for example, and you go to the foot section, all you see are these products that alleviate symptoms.
40:20 Speaker 00 Use this if you have heel pain. Here's something if you have a bunion. Here's something, and I really want to change that script. Let's look at this proactively. It should be strengthen your foot. Wear the right footwear so that you don't have to depend upon things to try to help you feel better once you've disrupted foot function.
40:38 Gary Brecka? You said that walking speed can predict mortality.
40:42 Speaker 00 Yes.
40:43 Gary Brecka? And longevity. What do you mean by that?
40:45 Speaker 00 When you go to the doctor, they take your vital signs. Blood pressure, temperature, oxygen saturation. And the reason they do that is if something's wrong there, it's a red flag. Pay attention to me. And there was a couple of scientists that looked at walking speed, making this the sixth vital sign. Because when you can detect a slower cadence. So if someone is walking slower, this can be a predictor of dementia up to seven years in advance. So we should be saying, um, okay, why are we walking slower? Is this some type of cognitive issue that you're having? Is it a problem with balance? Is it a fear of walking?
41:30 Speaker 00 Is it strength that you don't have the capacity for at your foot? So again, the fact that they touted this and said, you're going to be in the category with blood pressure and temperature. I mean, that's pretty significant. That something as simple as an assessment of seeing how fast you can walk can be a predictor of diseases that we can do something about now. It seems again, like a very simple conversation that we need to be having.
41:58 Gary Brecka? Yeah, you know, it's interesting as I chair Bobby Kennedy's Maha Action. It's this private, public, private partnership between Health and Human Services and the public sector, uh, public sector or the private sector. And They estimate that 85% of all chronic disease, which costs us $5 trillion a year, is entirely preventable. Do things exactly like what you're talking about. Like, we have so much more control of our destiny than we think. And if we just draw our attention back to the basics very often.
42:31 Gary Brecka? So let's maybe top five tips for someone who's not walking regularly, doesn't know about the proper footwear, maybe isn't aware of the science behind postprandial walking right after a meal. Let's, let's give the, you know, the listeners some practical things that they could start doing to dramatically improve either their gait or their foot health.
42:57 Speaker 00 Yeah. I think you have to, number one, find your baseline. Figure out where you are. What are your goals? That's what I love about looking at the different step counts. You can decide where you need to be. You know, if you're someone that suffers from depression or anxiety and you have a low step count, this is, this is where we need to start.
43:18 Gary Brecka? Low hanging fruit, right?
43:19 Speaker 00 Low hanging fruit. You know, depending upon what your baseline is. I think the other interesting conversation with baseline is if you are someone that's also taking 15,000 steps a day, there is a law of diminishing return when we look at the longevity benefits with step counts. So my next question to them is, well, are you strength training? And if they say to me, well, no, I don't have any time because I'm walking 15,000 steps a day.
43:44 Gary Brecka? Right.
43:45 Speaker 00 We'll dial it down. So then we'll have the conversation, hey, give me about eight to 9,000 steps a day. And then we're going to make time to strength train. So I think finding your baseline and figuring out where you want to live is important.
43:59 Gary Brecka? And because I, I have heard you say, you know, 7,000 is more important than 10,000. Because 10,000 is like this just sort of magic number that really wasn't evidence-based.
44:10 Speaker 00 Yes, no.
44:11 Gary Brecka? And it's sort of a great number for people to target. But you're saying 7,000, depending on your pace, you can get a lot more out of that.
44:20 Speaker 00 There's a difference between ambient walking and intentional walking. So ambient would be someone saying, well, I got 7,000 steps and it was because I was just around my house and I was busy all day. It's that in.
44:34 Gary Brecka? It's funny, Malia, God, what was the record?
44:38 Gary Brecka? She got 18,000 in my condo, mainly because she's running around trying to find me.
44:43 Speaker 00 Well, you could go very fast, too. If you just picked up your speed, we could call that an intentional walk.
44:48 Gary Brecka? Yeah. We've got like a little, almost like a track in here, you know, it's uh, but um, I know, I see what you mean and, not breaking it up like get hobble hobble hobble sit.
44:59 Speaker 00 Yes.
44:59 Gary Brecka? Get hobble hobble hobble sit. It's like.
45:01 Speaker 00 It's, you need that continuous. Yeah. When you look at the research, 30 minutes fast pace. You know, my marker for myself personally is every day, you want the consistency between seven to 9,000.
45:13 Gary Brecka? Yeah.
45:14 Speaker 00 And it's interesting because I'm active, you know, I do my workouts in the morning and then if I'm in the clinic, I won't be sitting. I'll be with patients for seven, eight hours. It's always surprising to me sometimes when I get home and I'll look at my step count and I'll be like, wow, I thought I was really active today, but I only have 5,000 steps. I was still moving all day long. I still got my strength training workout done in the morning.
45:37 Gary Brecka? Right.
45:37 Speaker 00 But that, I know that when I get home, I have 20 minutes in me. Cause I, that's my window. That's 79,000.
45:45 Gary Brecka? And what do you do? Just get outside and walk?
45:47 Speaker 00 Get outside and walk.
45:47 Gary Brecka? Okay.
45:48 Speaker 00 Rain, snow, wind.
45:49 Gary Brecka? Yeah.
45:50 Speaker 00 Dog with my daughter.
45:51 Gary Brecka? Yeah, that's.
45:54 Gary Brecka? A non willing participant, I'm sure a lot of those times. Um, here's, here's something I found really fascinating. 4,000 steps a day can cut dementia risk by 50%. What is the connection between 4,000 steps and early onset dementia?
46:12 Speaker 00 When you're walking, you have increased cerebral blood flow to your brain. And really in that prefrontal cortex, there's also um, something called BDNF, which is brain derived neurotrophic factor. And if you think of that as like a fertilizer to the neurons in your brain. So they basically. Help these neurons fire.
46:39 Gary Brecka? Right.
46:40 Speaker 00 Walking does that. It basically increases this fertilizer to your brain. Neurogenesis occurs, so the formation of new cells, in fact, in the hippocampus, which is where you will see the first changes with Alzheimer's patients.
46:56 Gary Brecka? Hmm.
46:57 Speaker 00 So.
46:58 Gary Brecka? That's where the memory is stored.
46:59 Speaker 00 That's where the memory is stored.
47:00 Gary Brecka? Yeah.
47:01 Speaker 00 So we have something, literally, that is so easily accessible, that has a direct impact on our cognitive function, on our brain function, and it's simply increased blood flow and all of these things that happen when we
47:15 Gary Brecka? Yeah.
47:15 Speaker 00 get walking.
47:16 Gary Brecka? And you know, it's also magically designed to circulate lymphatic fluid.
47:24 Speaker 00 Yes.
47:25 Gary Brecka? You know, which is our waste elimination pathway. So we don't think about, you know, it's a passive system. There's no pressure behind it. So these muscular contractions help circulate lymph. And you know, all the blue zone and meta-analyses and big data studies prove this too. In fact, in some of the blue zones, you would have these pockets of hypercentenarianism.
47:44 Speaker 00 Yeah.
47:44 Gary Brecka? And they're like, well, what's causing hypercentenarianism in the same sort of town? Oh, it's the grade of the slope they're walking up. You know? And you know, that's what's inspiring to me about a lot of the longevity science is that a lot of it is just a back to the basics approach.
48:00 Speaker 00 That's right. It's keep it simple.
48:02 Gary Brecka? Yeah.
48:02 Speaker 00 That's, I love that conversation because you know, the soleus has been touted, the soleus or calf muscle is the second heart.
48:08 Gary Brecka? Second heart, yeah.
48:09 Speaker 00 I will have patients where they will come in and their legs from the knees down are very swollen, so of like pitting edema.
48:15 Gary Brecka? Hmm.
48:16 Speaker 00 Their step count is always very low. And they're maybe not comfortable going for a 20-minute walk. I will literally have them start just at home, just start pumping their calf. They'll start tapping their heel just to get. Pumping going, pump the circulation.
48:34 Gary Brecka? Little minor, sort of, almost looks like I used to do that all the time.
48:38 Speaker 00 Get fidgety, I call it. That's what I do on an airplane. Yeah. I hate, nobody likes sitting next to me on an airplane.
48:43 Gary Brecka? Yeah, sitting next to you, like, this lady's about to have a panic attack over here.
48:47 Speaker 00 I'm either doing that or I stand up and start doing calf raises in the middle of the airplane.
48:51 Gary Brecka? Yeah, that's real popular.
48:54 Gary Brecka? So I just, you know, I love how it's so, you know, fundamentally simple. And if we're intentional about it, you know, we could easily fit this back into our.
49:05 Speaker 00 We need to.
49:05 Gary Brecka? Into our lifestyle.
49:07 Speaker 00 It's, um, it's not a conversation of if. If you think of, I really want to stress that walking should be a physiological necessity on the same importance as breathing and sleeping. Those three things, when optimally done, this is what it's about. This is longevity.
49:29 Gary Brecka? Breathing, sleeping, walking.
49:31 Speaker 00 If, you know, if I said to you, you can't sleep, what if we turned the situation or the conversation around to what if you couldn't walk?
49:43 Speaker 00 That gets people, you say that and you're like, okay, I think my heart rate just skipped a beat. That's scary.
49:49 Gary Brecka? Right.
49:50 Speaker 00 If I said to you, what if you couldn't walk? What if you couldn't sleep? What if you couldn't breathe? You're not living. And that's, walking needs to be in that category. It is not an option. It is a physiological necessity to get our bodies to perform well, to literally survive. And I think when we take it for granted, because it does sound too simple, we get into problems. And if you, like I said, change that conversation to what if you couldn't walk? I truly think that everything we do, strength training and HIIT training and diet and exercise, if you were to ask someone what they want to be doing in the last decade of their life,
50:34 Speaker 00 every single person would say walking.
50:37 Gary Brecka? Yeah, so true.
50:40 Speaker 00 All the stuff we're doing is to make sure we can walk.
50:43 Gary Brecka? Yeah.
50:44 Speaker 00 With our families, with our grandkids and
50:47 Gary Brecka? The loss of independence.
50:48 Speaker 00 The loss of walking is a very scary conversation.
50:52 Gary Brecka? Yeah.
50:53 Speaker 00 And we don't think about it.
50:54 Gary Brecka? You know, um, both of my parents are at the age, they're in their eighties. And they're both deconditioned. In fact, I'm doing a whole thing on Instagram now where I'm improving all my mother's cognitive score through a protocol I have her on. I'm going to put it out, you know, on Instagram. But I do notice that, you know, because they are so mobility impaired.
51:17 Speaker 00 Yes.
51:18 Gary Brecka? The amount of restrictions that it takes, restaurant choices have to be close. You know, they're going to my son's wedding and like the planning around getting them to the wedding, you know, just the, the, the loss of independence. And, you know, as we start to remove these factors of independence later in life, and I really hate to quote Peter Tia, but he talked about the centenarian decathlon in, in, in the book Outlive. And I thought it was really appropriate to start thinking today about
51:48 Speaker 00 Yes.
51:48 Gary Brecka? what you want to be doing if, when you're in your eighties. I know my parents never thought about that in their forties and fifties. They just took it for granted.
51:56 Speaker 00 And it's, it's little things. It's getting up and out of a chair. It's walking downstairs. Those things, you know,
52:05 Speaker 00 in my world, I'm always looking at the foot and ankle too. You can't sit into a chair or walk down a stair if you don't have good ankle mobility or good foot strength. Those are the, the conversations that we need to be having. It's not, you know, sell your house and go buy a ranch. So you don't have to walk up and down the stairs.
52:24 Gary Brecka? That sounds great. Sounds great to me, by the way. I like, eventually I want to, I want to ride my years out on a regenerative farm. That's on my horizon. It's like,
52:33 Speaker 00 We kind of have goals.
52:34 Gary Brecka? I want to have my, I want to have my cows and chickens and greenhouse and like that's, that's. Freedom to me. If you know me, you know I'm a huge believer in the benefits of hydrogen water. H2 Tab delivers cost-effective portable tablets that generate ultra-clean molecular hydrogen at 12 parts per million, one of the highest concentrations on the market. With over 1,300 published studies showing benefits of oxidative stress, energy, recovery, brain function, and so much more, taking charge of your health has never been easier or more cost-effective. Just drop a tablet in water, let it dissolve, and drink it back. It's less than a dollar a day, science-backed, and part of my daily routine. I never travel
53:19 Gary Brecka? without this, and it is my favorite biohack. Visit drinkh2tab.com. That's drinkh2tab.com and upgrade your hydration today. Now, let's get back to the Ultimate Human Podcast. You know, I talk about this on the podcast all the time. We have a little place in Colorado, too, in the mountains, 10,000 feet. And I've got all this fancy stuff, you know, that I showed you today. All this-
53:44 Speaker 00 Very cool stuff.
53:45 Gary Brecka? Super cool stuff, and, you know, the hyperbarracks and the red light. If I put on a weighted ruck vest-
53:52 Speaker 00 Yes.
53:53 Gary Brecka? You know, the vest I'm wearing right now is weighted. This one's about 12 pounds, I think. And after I put it on, I don't even notice I have it on.
54:00 Speaker 00 Yeah.
54:00 Gary Brecka? But I put on this ion-weighted vest, and I have this three-and-a-half-mile loop that my wife and I go on in the woods. When I come back, I feel like I took a limousine pill.
54:11 Speaker 00 Isn't it awesome?
54:12 Gary Brecka? It's so, it's almost like spiritual, and it has to, maybe it has to do with forest bathing, like, you know, they've been doing in Japanese medicine for centuries. And sometimes I come back here and I go, man, this is so nonsensical. It just seems so extreme. But then, you know, when I'm out there, just a three-and-a-half-mile walk in the woods, squirrels, birds, you know-
54:34 Speaker 00 I get giddy.
54:35 Gary Brecka? Alone with my, I get giddy, too.
54:36 Speaker 00 I do. I come back and I'm like-
54:37 Gary Brecka? I wish everybody could feel that.
54:39 Speaker 00 Yes. It's like, I get giddy.
54:40 Gary Brecka? Like, I'm ready to take on the day, and then I'm just in a better mood the rest of the day.
54:44 Speaker 00 And it's a morning walk.
54:45 Gary Brecka? Yeah, it's just a, it's just a morning walk. All right. Well, you know, this is coming. So I wind down all my podcasts by asking my guests the same question. Before we get to that question, I want to tell my audience where they can find you. This walk is coming out on May 5.
54:59 Speaker 00 May 5.
55:00 Gary Brecka? Okay. So it's right around, right around the corner.
55:02 Speaker 00 Yes, it is.
55:02 Gary Brecka? And I thought that it was already out. So I'm definitely going to link that in the show notes for my audience. But where can they find you if they want to know more about you?
55:11 Speaker 00 I started an online education company that is specifically for foot health called Gate Happens. And so on that platform, we have education on how to improve your foot strength, how to improve your foot power and mobility. So I've really.
55:28 Gary Brecka? These things people can do at home?
55:29 Speaker 00 Yes.
55:30 Gary Brecka? Okay, great.
55:30 Speaker 00 Things you, all these things you can do at home. Our Instagram account, our YouTube channel, there's all exercises everywhere. I want people to start training their feet like they train the rest of their bodies. And so, yes, we have a lot of resources out there. There's footwear recommendations on that website. I think that's also very important. You had asked about, you know, the five things.
55:55 Gary Brecka? Yeah.
55:55 Speaker 00 Pay attention to your footwear.
55:56 Gary Brecka? I'm gonna have to give up my Travis Scott, but I'll do it.
55:59 Speaker 00 Not all the time.
56:00 Gary Brecka? I'll do it to cut my dementia risk by 50%. You know, I can, I could also just wear them when I go, go out.
56:07 Speaker 00 Yeah.
56:08 Gary Brecka? And get myself a pair of these. I might revisit these guys again because.
56:12 Speaker 00 I think that there's something magical. You know how we get giddy when you start walking in the woods?
56:16 Gary Brecka? Mm hmm.
56:17 Speaker 00 When you, when your foot can start to feel the ground.
56:20 Gary Brecka? Yeah.
56:21 Speaker 00 And you feel the strength and power from the ground up and your knee pain goes away and your back pain goes away, which I hear all the time in my clinic, then the conversation becomes much easier. The patients will come to me saying, you know what, this does feel better, but there's a transition. You know, you wouldn't squat 100 pounds today and 200 pounds tomorrow.
56:40 Gary Brecka? Right.
56:41 Speaker 00 So same with the foot. It needs progressive loads. So on that site, we have footwear that you can transition to. Like maybe you start here. And then you can work your way down into something more minimal.
56:54 Gary Brecka? Okay, I love that. And where do you fall on weighted walking? Because I walk with a ruck all the time. I don't like the rucksacks that have the straps because I feel like they kind of bounce on your shoulders. They actually hurt my back. But I wear a vest called an Ion Vest, and when it zips up, it hugs your body.
57:13 Speaker 00 Yes.
57:14 Gary Brecka? And about 10 minutes after you have it on, you don't even know that you have it on anymore.
57:18 Speaker 00 I think that's important. When you see a lot of these vests that are very heavy on the clavicle and heavy on breathing becomes difficult.
57:25 Gary Brecka? Right.
57:25 Speaker 00 And so patients with neck pain, yes.
57:27 Gary Brecka? It doesn't correct your posture in the right way.
57:28 Speaker 00 Yeah.
57:29 Gary Brecka? You know, so I would, you know, I used to wear them years ago in Colorado and a compact and my back would hurt. But when I wear this Ion Vest, it actually helps hold me upright. It's tight to my body. A few minutes later, I don't even notice I have it on.
57:41 Speaker 00 Yeah, the equipment matters. Do you want to hear a funny story? When I first started weighted walking or rucking, I was like, this makes sense to me.
57:49 Gary Brecka? Yeah.
57:49 Speaker 00 Right? More load through my foot, burn a little more calories, get my heart rate up. So I had my backpacking, backpack in my garage. And so I threw a, I'm almost embarrassed to say this, a 25-pound kettlebell. And I just threw it in my backpack.
58:06 Gary Brecka? Already going the wrong way.
58:07 Speaker 00 I'm hiking around Colorado and I get home and I'm like, man, my back. And I was like, oh, because that kettlebell was smacking against my spine for an hour. So I've learned, but I don't do that anymore.
58:19 Gary Brecka? Right.
58:20 Speaker 00 Equipment matters.
58:21 Gary Brecka? Yes.
58:22 Speaker 00 But yes, it's very, it can be very beneficial for people, especially if they want to amp up their walking. If you're someone who's getting 2,500 steps, the bigger conversation is, I need more steps. If you're someone hitting those 7,000 to 9,000, you can challenge yourself.
58:40 Gary Brecka? Yeah.
58:40 Speaker 00 Throw on a vest, do some, you know, walking lunges with it on, then you're turning this into a...
58:46 Gary Brecka? It's been a game changer for me.
58:46 Speaker 00 Yes, it's wonderful.
58:48 Gary Brecka? My wife and I use it all the time. Okay, so here comes the question. You sort of answered it in the beginning of the podcast, but I'll give you another shot at it. But what does it mean to you to be an ultimate human?
58:58 Speaker 00 To be an ultimate human is to be able to walk freely, to be independent, and to be able to enjoy, really, life and getting outside and walking with our families and walking with our children. And that, to me, is the ultimate human. It defines us as a species, walking on our two feet. Being a biped is what differentiates us from every other species. And we are very, we're supposed to be very good at it. And we've wildly ignored what literally has defined us as human beings. It is a physiological necessity. And when we
59:42 Speaker 00 take care of the small things, we can become the ultimate human.
59:46 Gary Brecka? I love it. Dr. Conley, this has been amazing. My VIPs are so excited to talk to you. We're going to go into my VIP room here in a moment. But thank you so much for coming on the Ultimate Human Podcast. And you are my academic sister. So that was really cool. That was, you are the first guest that had same undergrad and grad school as I have. And one of our degrees is exactly the same. So thank you for coming on the Ultimate Human Podcast. And until next time, that's just science.
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