# Transcript — Augmented Wellness 003: Dr. Lloyd Camper

_Timestamps are aligned to the published master episode. Lightly cleaned to remove production reset/noise sections._

[00:50] **Dr. Lloyd Camper:** Yes, time flies.

[00:51] **Demian:** Time flies. Um, and, uh, we, we got to, to, to get to know each other, get to know, um, you know, how you see the future of medicine. So I'm excited to cover some of it today, and even look at some of my own data, uh, that we got to, to collect together. So, to get started, uh, I would like to go way back. You know, you were an athlete, and how did you go from, from, I guess, being a practitioner of medicine, uh, or, uh, in yourself to, to then, uh, care for others?

[01:30] **Dr. Lloyd Camper:** Well, first, I'm very happy to be here. Thank you for the invitation, Damian. Uh, yes, it's been a year since we met, and since then, we've been looking more into longevity and ways to keep on improving the field. Now, um, I'm currently a practitioner, but as you mentioned, I started as an athlete. Um, played basketball in high school and then ran track for college. And so, you know, through, um, the discovery of my own body and injuries and, and going through, you know, physical hardships, I wanna say, this is where I had to find, um... and kinda dig deeper into what does it mean to be... one, to be an athlete, two, to be healthy and to be in shape, and then three, um, what, you know, what is going to be... in what direction is, is my, my life and my career going to go? And so that's where I started making the transition towards medicine.

[02:56] **Dr. Lloyd Camper:** That, that is... that's a great question. So, um, as a sports medicine physician, I, I really feel like, um, we, we are, uh, in a way, prescribing life, right? We know that, um, exercise prescription is one of the best things, um, that we can prescribe to patients. It's really a lifestyle, um, improvement, and this is really, in a way, the secret to a healthy life, um, besides, you know, the, the traditional approach to medicine, where, um, we are diagnosing illnesses and creating treatments and therapies. Exercise really comes at the forefront of preventative, uh, medicine. Um, so instead of diagnosing illness, we're trying to promote health, and, uh, and keeping patients, or just everyday people, healthy. And so, with the sports medicine background, um, it's not about seeing anything early, but it's about having proactive, um, proactive, I wanna say, habits, um, healthy habits. And so, sure, we can diagnose illnesses, sports medical, uh, sports medicine, or, or musculoskeletal, um, diagnosis, but when there aren't any, um, chronic pathologies, the main, um, goal, I would say, is to really retain healthy levels, healthy markers.

[04:47] **Dr. Lloyd Camper:** Absolutely. So we're seeing a big mainstream wave, um, headed towards longevity ever since the pandemic of, of COVID, and, uh, people, the population in general, realizing that they're not as healthy as, um, they might thought they were. And so now, we're seeing executive caring about their health and just being more, I want to say, just physically active, which is an, an, kind of easy way to start into longevity. And so, this is the time when, um, I just finished training in sports medicine and decided to join a longevity practice, which is Cenegenics, one of the, uh, the pioneer in the field of longevity, previously called anti-aging. Now, really focusing into ... I, I think the difference between anti-aging and longevity really is the performance, um, performance addition to that. Um, the anti-aging had a lot of maintaining and, and just kind of preventing the decline that we expect to have in the aging. But now, with the longevity, it's really pushing the boundaries of what we would call health span, um, where patients wanna increase their capabilities of, of functionality, their strength, their endurance, their, um, their cognitive function as well. So, it th- those are all the different components of longevity. And so, at Cenegenics, this is where we are, um, really creating a baseline, a full evaluation, to see what is the patient's, um, initial s- health status to begin with. And then to see, based on their goals and based on the findings, based on their history and, and where they're trying to, what they're trying to accomplish, uh, we're creating really individualized plans, where, as I mentioned, we would try to target performance, longevity, that is physical and cognitive.

[07:53] **Dr. Lloyd Camper:** Right. So, the way medicine works nowadays, it's, it's not the doctor's fault in which of, um, you know, doing wrong by the patients. The doctors are always looking for improving the patients' health. The issue is, uh, what are we testing for, what are we trying to diagnose, and what is our, our plan, right? So, I like to give the analogy of, of your gas tank in the car, right? So the way that it works is you have the empty and you have the full, um, uh, part of the tank. And so, you're going to be driving your car around and, and everything is going to be fine all the way until the needle reaches the empty sign and the light comes on. This is when you know you're going to make a stop at the gas station to fill up the, fill up the tank. The way that medicine is practiced is that nothing is going to happen until that light comes on and the needle is on the empty sign. That's when you're calling your doctor or that's when you're going to the emergency room, because a light came on, something happened, and you know you need to address it. Um, and then this is when insurances kicks in. This is when doctors are able to operate, because we are trained, um, and educated to kind of detect when the light comes on and to be able to, at the, at that point, have an intervention. Uh, but now, it's a different approach with longevity. We're really looking for optimal, uh, performance. And so, we want to stay away from that empty gas tank, so we want our tank to be at least half full, if not full, at all times, so that this is the longevity, uh, approach and perspective. And at that point, it's completely different perspective from a physician, because you're looking for healthy markers and wanted to keep healthy markers. And so, we're not trained to detect health. We're trained to detect illness. Um, and that's where here, with Cenegenics, we're starting to, um, not starting to, but we have been measuring markers for decades and compiling a database that is showing, with our most successful patients, what has made it successful in their health span, in their performance. And so, this is where their, particularly markers that are now becoming a little more popular, I want to say, in the longevity space, things like VO2 max, body composition, and then all the- ...uh, blood biomarkers that you might find testing for, in terms of inflammations and lipoproteins, and, and those kind of markers. But it's really a, a comprehensive approach. Um, you know, going back to the car analogy, and, and I'm sorry for people that are not car people. But it's, like, you might not have a light coming on for the tires running low, um, or the threads of the tires running low, even though you will need a tire change. Um, this is the, really, comprehensiveness of, of, uh, the human body, and really looking from all different angles. It's not just the blood work, it's not just the VO2 max. So it's not just one biometric or one biomarker, it's the totality of it, and really being able to assess, evaluate, and come up with a plan of what needs to be done to maintain those healthy markers.

[10:56] **Demian:** Yep. Uh, but, you know, going, going to biomarkers, for example, which is obviously something we talked a lot. I mean, at Betterness, we, we offer, um, quite a, quite a large set of biomarkers. Uh, and, and our goal is to make it accessible, right? So people could get, uh, a measure. Um, obviously understanding that, um, it needs to be interpreted by a doctor, especially if something is a little bit out of range. But, you know, there's no denying that the, the, the world in, you know, the biomarker world has changed over the last three or four years. Companies like Function Health have really democratized it, um, and, and really has lowered the cost, right? Of, of accessing this. How, how would you, you know, how would you, um, you know, characterize, um, importance of, of at least getting, you know, that blood work done? Uh, at least once a year, a couple of times a year? To at least see if there's, you know, some things that point... Uh, I have a lot of friends that say, "Oh, I'm feeling this, can I get some blood work done?" Um, and I'm like, "Yeah, you should get it, see if something comes out, and then go talk to a doctor." But how do you, how do you see it, uh, in the term, you, you know, in the context of, uh, at least getting some type of signal in, uh, better than none?

[12:11] **Dr. Lloyd Camper:** Absolutely. Again, you don't know what you don't know. And, and sometimes we would say ignore is, ignorance is bliss. But when it comes to your own health, you don't want to be blindsided by, um, any unhealthy developments and, or illnesses. And so, you might clinically or physically feel good, but you might still be, um, developing, uh, an early metabolic dysfunction. And so, blood work is, is very important. And the traditional medicine approach is, is still recommending at least a yearly exam or, or a physical. And so, along those line, those lines, you know, that's, that's still a baseline to do an evaluation. And you can push it to further biomarkers, not just the basics one, basic ones that has been done for, um, from the pred- traditional practice, uh, approach. But kind of pushing it further to look into inflammations, to look into early cancer, to look into early, again, metabolic dysfunction. And so, if everything looks good, then sure, you can do it on a yearly basis. But now if you find something that you might want to address early on, there goes the frequency changes. If you want to do it more often, every three months, every six months. Um, and so yes, in the longevity space, in, in, um, at Cenegenics or any other practices of longevity, we are pushing to address any kind of dysfunction earlier rather than later.

[14:12] **Dr. Lloyd Camper:** It, it is, it has become much more accessible, absolutely. And I, I think it's for the greater good of the patients. Um, like I said earlier, if, if you don't test for it, you won't know about it. And unfortunately, a lot of the issues with medicine comes with, um, later discoveries of any, um, dysfunctions. And so, as we know, the, the more impact or the more developed an illness is, um, the harder it might be to, um, to address and to reverse or to treat. And so, now having all this access to early testing, the general populations being more involved and interested into their own health, their own biomarkers, it, it could lead to maybe more anxiety, more confusions, more questions. But it is, I believe, to the best interests in those patients' health. Especially at an individual level. Um, if you were going to ChatGPT or Google any of your own personal findings, ultimately all those database AI or, or internet-driven are still going to compare you to the general population. But you might just be the exception to the rule. And so at that point, that's where the medical expertise becomes very important, because it is a comprehensive assessment. It's not just this one finding that, for you, might seem borderline abnormal. For ChatGPT, it might seem just borderline abnormal. But then having a medical expertise looking at history, doing an actual physical exam of you as a human being, an individual, in front of, of a, a physician, might find it more important, and to be addressed. Or vice versa, just not important and something just to monitor or, or, you know, just- ... bring up reassurance from the physician's standpoint.

[17:13] **Dr. Lloyd Camper:** (laughs)

[17:13] **Demian:** (laughs)

[17:13] **Dr. Lloyd Camper:** That's a great question. So there's a lot of technological advancement that are coming out. And the space, as you mentioned, is starting to have a lot of players involved for it being imaging, genetic testing, even biomarkers. Now, um, I would say, I come from a background of traditional medicine where too much information might not be good information. But that is, again, potentially going against the greater good of the patient. Now, um, you have to know what to do with that information. You need to bring it, bring it up to an expert. So, if you're going to go on your own as a patient, as an individual, and get those full-body MRI testing or those genetic testing, it could become a, a major anxiety-driven results if you don't know how to interpret it. And like I mentioned earlier, ChatGPT and Google and all those AI tools might not give you the appropriate answer at that point in time, um, knowing that there's really a factor of, of mental health and- associated with all of this. And there's not many tools or, or, as we mentioned, technological advancement, really measuring mental health. And anxiety and stress are, are, you know, very prominent in, in today's society. And a- as you know it, as, uh, I believe you used to have a ketamine, uh-

[18:33] **Demian:** Yep.

[18:34] **Dr. Lloyd Camper:** ... practice. And so that, again, is, is a great practice, um, that is also, uh, is, is, you know, developing the field of, of mental health and, um, and cognitive management. But we really want to utilize all those tools that are coming up to us in an efficient manner and beneficial manner for the patients without causing other issues. So, what I would do for myself is, you know, probably testing a little bit of, of everything to really also potentially test one machine against, or one results against another one, and two, seeing the accuracy of it. Um, because you might do the same genetic testing and find two different results, or this, same imaging test and find two different results as well. And so that's where there's some inaccuracies there that needs to be addressed and reviewed by, again, an expert, um, in the field. So, just testing all the different tools, knowing your body, knowing your baseline, and, and run a- run all of this by an expert.

[19:46] **Dr. Lloyd Camper:** (laughs)

[19:46] **Demian:** ... we, we, we talked a little about stem cells. Um, and, you know, and Florida being, uh, uh, an interesting state, uh, given, uh, you know, uh, the way they approach it. What, you know, educate us a little bit on, on how you see it. Um, what have you seen success, uh, in and, and, you know, how is Cenegenics, uh, uh, being involved in, in, in, in the new sort of care, uh, section?

[20:14] **Dr. Lloyd Camper:** Yeah. So stem cells is actually part of a very broad, uh, it's a very broad term, um, part of what we call the yee- regenerative field. Um, from a sports medicine or orthobiologics standpoint, um, what has shown a lot of initial development in, in this field is actually PRP, platelet-rich plasma, that, you know, has driven a lot of advancement when it comes to joint, um, joint healing and joint repairs. Now, there has been, again, this very popular move towards stem cells or MSCs, mesenchymal stem cells, or, uh, messaging signaling cells, which right now the research and the science is really trying to, um, evaluate the benefits it has, the advantage potentially above PRP. PRP being bl- a blood-driven biologic, um, that comes from the patient's self, reinjected in the same patient. Now, there's been a lot of what we call allogenic stem cells, uh, coming from umbilical cord, um, donors, where cells have been collected, harvested and grown or, or, or, um, or, um, maintained to really reinject into patients to create, again, this regenerative, this healing, um, or anti-inflammatory effect onto the patients. And so, yes, Florida has created this ad- I wanna say, this advancement here in the US, where instead of going internationally for patients who could afford it, looking into this new technology of therapeutics, um, to potentially have a shot at it here in, in the US. So, at Cenegenics, we started offering those services here. Um, again, this- those are not FDA-approved treatments. And, and the evidence behind it is- I would say a little bit past anecdotal, because it's been used for decades in certain clinics and, and certain practices. But it still doesn't... it didn't create very solid, what we call RCTs, or randomized control trial. The issue though with randomized control trial, again, it comes to a population or generalization kind of testing results and, and data. Now that we're moving more towards the longevity, performance, um, medicine, we are in more of an indi- individualized care. Like I said, something that might work for the general population might not work for that one individual, being the exception to the rule. And so, this is the approach that we have to have in, in those practices where we have to have this consent with the patient understanding that this is not a federally approved therapy and, um, it might have the ro- most robust data. It has done, I would say, tremendous benefits for certain patients, and for others it might not have created the expected outcome. And so I, I think with this understanding, uh, with the patients, that's where now we can actually create the data that needs to be created for this regenerative space. And so, as I mentioned, there's the umbilical cord stem cells, which is the one that is-

[23:34] **Demian:** Which, by the way, I, I've been paying for 15 years now for my daughter for storing them, and... so, yeah, for example, so tell me about that. I, I have it. Uh, what is, is, is there a re- real use for it? Uh, what, what is the type of use that, for example, you know, potentially someone could use, uh, the store...

[23:54] **Dr. Lloyd Camper:** Yeah, so again, you mentioning storing, so we're talking more autologous, so using your own stem cells, the, the patient's own stem cells.

[24:01] **Demian:** My daughter's, uh, been describing-

[24:02] **Dr. Lloyd Camper:** Right, right. Oh, your d-

[24:03] **Demian:** ... yeah. Yeah.

[24:03] **Dr. Lloyd Camper:** ... your daughter's...

[24:03] **Demian:** Yeah.

[24:03] **Dr. Lloyd Camper:** She would use her own stem cells and, and, you know-

[24:06] **Demian:** But can I use it, for example, her mom?

[24:07] **Dr. Lloyd Camper:** No, you would-

[24:08] **Demian:** No?

[24:08] **Dr. Lloyd Camper:** ... not be able to use somebody else's stem cells, um, because of the risk of cross-reaction and-

[24:13] **Demian:** Okay.

[24:14] **Dr. Lloyd Camper:** ... and lack of matching there. Um, but yes. You could also harvest your own stem cells-

[24:19] **Demian:** Okay.

[24:19] **Dr. Lloyd Camper:** ... which could be from bone marrow or fat cells and use that, you know, do multiple indication. The indication as your question is, um, why would we use stem cells? So there's, there's multiple indication. It could be from a joint healing standpoint where we would do more of an intra-articular, um, intervention there, and the goal here is to create healing, decreasing inflammation locally, but we also can have a, more of a systemic impact if we wanted to do IV therapy or intravenous therapy. In that sense, same thing, the indication could be targeting inflammation and we know inflammation is behind a lot of, uh, pathologies causing metabolic dysfunction, causing pain, causing, um, ultimately, potentially cancer, um, being a, a, you know, complete dysfunctioning of the cell growth, um, and cell ap- apoptosis at that point. So if you're able to mitigate or control systemic inflammation, this- those are the po- possible, um, benefits from using these stem cells or regenerative therapies.

[25:28] **Demian:** So, let- let's, let's um, move into more, uh, you know, fun part, uh, as you know, I, I like... I'm a, I'm a geek. I like to, you know, show things up. So let- let's talk about, um, you know, longevity and some of, some of the actual, um, you know, measures that, that, uh, we- we've been talking about a lot, uh, between ourselves, like DEXA scan, VO₂ max, which are a good complement, I, I would say, to biomarkers, and things that are, uh, pretty accessible. So what, what is, what would you say is the, you know, the baseline that, you know, someone looking for, for, uh, longevity, um, you know, should be looking to at least get, you know, an understanding of where they are? What, what would be those, those, those measures?

[26:11] **Dr. Lloyd Camper:** My thoughts in, in practice really still revolves around a comprehensive approach, right? It's just, there's not one measurements, not one metric that will tell you kind of everything you need to know. If you go to your doctor for your physical exam, we're not just gonna look at your blood pressure and say, "Everything is fine. (laughs) See you next year." So this is the same concept here. Uh, when it comes to biometrics and biomarkers, we will still have the baseline vitals. So your blood pressure, your heart rate.

[26:42] **Demian:** I'm gonna actually play a little bit of a video. See as, as we go through it, so maybe you could... you know, this is when I visited, uh, but maybe you... you know, we could walk into, like, what, what other type of equipment that we're seeing there? Uh, just-

[26:53] **Dr. Lloyd Camper:** Yeah, so this is the DEXA scan, so this is for body composition, so again, in addition to your vitals, we believe that your body composition is another very important vital, uh, because this is... this is your machine, this is your engine that you're utilizing every day, right? You use your body to function, so we're looking at your lean mass, your muscle mass, and, um, we're looking at your bone density. So here you go. This is you being scanned.

[27:18] **Demian:** (laughs)

[27:19] **Dr. Lloyd Camper:** Um, and so the next machine here is your VO₂, uh, max machine. So as we talked about vitals such as your blood pressure and heart rate, this here is really looking at your oxygen consumption. And so this is our own gas, right? This is what... this is our fuel, this is what we're utilizing to live every day. We breathe in oxygen, utilize it through our muscles and then breathe out the carbon dioxide. And so this machine is able to tell us, um, by measuring your heart effort and, and your oxygen consumption, what is the efficiency of your own machine. You know, so with both the DEXA scan and, and the VO₂ max, we're able to see a, a pretty good body composition when it comes to lean mass, bone density, fat mass, and then combine that with the efficiency that this machine has, right? How do you utilize... how good is... are your, are your muscles and your heart into utilizing the oxygen that you're breathing every day? And so again, we obviously want higher markers for your oxygen consumption and your VO₂ max.

[28:23] **Demian:** Yeah, so I, I actually fed, uh, the report into, into here, Betty, um, and something interesting, I, I, I just love, um... I just love, um, you know, how it inter- interprets, um, says my bone density is a bright spot, um, and it goes into, into some of the, of the aspects here. Um, what was, was interesting... Uh, actually, why don't we talk to Betty, see what, uh, you know, how she interprets this for us.

[28:51] **speaker_3:** All right. Let me pull this together. The biggest win, your bone density is above average. That's a real bright spot. The one thing to focus on today, get that rib asymmetry checked out by your physician. Any questions about anything we covered, or are you good?

[29:07] **Demian:** I'm good. Give me a little bit more. I- I'm here with, uh, Dr Camper, who's a physician. Uh, t- tell me a little bit more what I should be focusing on. Uh, my asymmetry, I don't know what that means.

[29:17] **speaker_3:** Sure. Let me clarify. The report flagged a difference in the density or shape of one rib compared to the others. It could be structural or related to bone health. The next step is getting a physician's assessment to understand what's behind that asymmetry.

[29:40] **Dr. Lloyd Camper:** The agent.

[29:54] **Dr. Lloyd Camper:** It will measure your bone density. Um, we have a higher focus on your hips and your spine, right? So she just mentioned rib a- rib asymmetry. That could have been a possible rib contusion or, or injuries that you might have had in the past or, or fracture, um, that, you know, with the healing, we know once any kind of body area is, is scarred or, or is, is healed, it's going to be a difference with the normal tissue. And so that's potentially what was picked up. But the biggest emphasis is going to be on hips and spine, because we know those are a very central part of our bones. They, they're very important in terms of mobility. Um, as I tell my patients, if you break your wrist, that's not going to get you bed-bound and, and kind of create some, um, health, mortality or morbidity issues compared to having a hip, uh, fracture or a spine fracture. Especially the older we get, um, there's a higher, much higher risk of decompensation and, and illness and, and death, pretty much.

[32:05] **Dr. Lloyd Camper:** Yeah, great results.

[32:05] **Demian:** ... I do have some CAC, um, you know, uh, there. So it says that I, I need to... And I have a low HRV, which is something I've personally been, uh, very concerned about. Um, uh, let's, let's talk to a biohacker just for a second, see what it, what, what it says.

[32:25] **speaker_4:** Great. Let's dive into your report. The headline here is exciting. Your VO2 max is measured at 41.5, placing you in the top 30 to 35% for your age. That's a solid fitness win. However, there are some signals to watch. Your low heart rate variability and elevated resting heart rate stand out against a CAC 76 background. This suggests that while you're physically fit, your autonomic nervous system might need some attention too. Do you want to hear more about what this could mean, or shall we move on to the next section?

[32:54] **Demian:** I'm here with Dr. Camper, who's helping me, uh, sort through this. Uh, anything that, uh, we should ask here, uh, the biohacker, about advice?

[33:04] **Dr. Lloyd Camper:** Is that a question for me?

[33:05] **Demian:** Yeah.

[33:05] **Dr. Lloyd Camper:** So, you know, we're talking about HRV and, and again, I, I, I like to point out the comprehensiveness of all those testing. Like, you just don't go to your primary care to just look at your blood pressure. You can't just look at your VO2 and HRV. And you brought up the sleep deprivation potentially from sleeping five hours. That's another metric that now, thankfully to the, uh, wearables, we're able to collect and, you know, things like Betterness, really have this one place to, um, to combine all, all of your results. Um, I suspect here your HRV is probably related to the lack of sleep as well. We know that if your recovery is not adequate when it comes to sleep, your heart rate variability is going to be impacted there.

[33:47] **Demian:** One, one interesting thing is, talking about measuring, is the difference between measure, you know, measurements from different devices. So biohacker, can you, can you, um, tell me what the difference is between my HRV and eight sleep and other measures? Do, do you have that information?

[34:07] **speaker_4:** Absolutely. Let's unpack this together. Your low HRV alongside an elevated resting heart rate, especially against the backdrop of a strong VO2 max score, suggests that while your cardiovascular fitness, your autonomic nervous system might be under some stress. This could very well be linked to your sleep deprivation. Getting only five hours of sleep can significantly impact HRV, as you mentioned. To address your question about the difference between HRV measurements from different devices, it's important to note that while the core principle of HRV is consistent... ... the algorithms and sensors used by different devices can vary, leading to slightly different readings. For instance, some devices might place more emphasis on certain frequency bands or use different methods to filter out noise. Given that, it would be insightful to compare the specific metrics each device reports and understand their methodologies. This can help contextualize your results better and guide any necessary adjustments in your recovery strategies. Would you like to continue to the next section to explore more insights?

[35:06] **Demian:** No, I think we're good. I think we're good, but thank you.

[35:08] **speaker_4:** (laughs)

[35:08] **Demian:** That was very insightful. (laughs) I, I actually love how he stayed quiet while we were talking.

[35:13] **speaker_4:** Yeah, no, he was able to collect... No, I, I love these tools here. And, and so, again, this is a developing field.

[35:19] **Demian:** Yeah.

[35:19] **speaker_4:** And so all those different wearables and technology develop-development, as I mentioned, I would test each, each one of them and almost compare it one to another and to see, seeing, you know, the different benefits. Being a field in development, there is no gold standard at this point in time. We can't say that one specific wearable, one specific imaging or one specific biomarker or, or labs to use the biomarker is the one that will give you the true results or the true meaning of your test. And so, a-a-again, I think having AI and, and having those tools to really combine, measure one against the other, and collect, uh, will ultimately give us maybe not a gold standard, but an understanding of, you know, utilizing different results and, and, and analyzing, you know, synthesizing everything together and, and just have, I would say a, not a clear, completely clear picture, but not so blurry of a picture of, of all of the results. And ultimately, the goal is to have a plan of action from all those testing, all those results, and, and for hopefully have, you know, a plan that is not, uh, deviating based on one of those wearables and just we're... and that we're able to really keep, keep the plan forged towards something, um, uh, to unify.

[36:48] **Demian:** Yeah, because I mean the, the... For example, I had a, a, a colleague, uh, well, friend, investor, Martin Varshavski and, and we, we, we talked about, um, you know, the measurement as a motivating factor, right? Like, for example, I'm seeing here my VO₂ max at 42 is saying it's, it's good. I know we discussed it and it was pretty good given that, uh, that, uh, you know, I, I really, I have not been focused on my health, uh, so much because of all the work. Um, but, you know, now I have a measure, now I wanna improve it, right? How, um... For example, VO₂ max, what can you do to improve it? I mean, what are, you know, what are the techniques and what should you be expecting? You know, it's like 42, can you be a 46? How hard is it to, to, you know, to, to go up, you know, to, to those next levels?

[37:39] **speaker_4:** Yeah, there is... There are different, I don't wanna say tricks, but there are different plans to approach your VO₂ max or your fitness level. Um, one, as you can see, your VO₂ max here being at, you know, 42, we're talking about, um, kilograms per minute. So your weight is also a factor there. So l- weight loss potentially can also just directly impact your, your relative VO₂ max based on weight and now we can also look at the absolute VO₂ max crossing your weight out of the equation, now we're really purely looking at how much oxygen is your body consuming. And now, um, this test for you, for example, was done on the bike. So again, different machines are different type of testing. If we were to put it on the treadmill, you might do better. Um-

[38:27] **Demian:** Or worse. (laughs)

[38:28] **speaker_4:** Or, or... Yes, and a cyclist definitely will do better on the VO₂ max biking than he would do on a, a treadmill. So those are just easy things to kind of first take note when, when we're doing those tests, and then second, how do we actually improve our oxygen efficiency or capacity. And that's really is going to be, again, the comprehensive approach of healthy nutrition, good exercise, and good recovery. Um, because, again, if you're doing too much of one of those or not enough of any of those, you, we're not going to have adequate results. And so too much sleep or not enough sleep will have a negative impact. Uh, inadequate nutrition will have a negative impact, and inadequate training would also have an inadequate impact. The best one is really going to be what is going to stimulate performance and that's going to be increasing your heart rate because we know as we're providing more effort, that's where our heart rate goes up and this is when we're utilizing probably more muscle mass at this point and that's where we have higher oxygen consumption. So getting your body trained to a higher effort, higher heart rate, and so usually I would say that the most common exercise will be a, a high-intensity interval training type of exercise. But now we can also put aside the strengthening that, you know, comes around it because you could injure yourself trying to provide efforts. You want the right structure in your body. So strength, strength kind of... Um, strength exercise is important, and the other part is flexibility exercise, so the yoga, the Pilates, um, e-even though it's also becoming mainstream, there's, I think, a lot of science behind it and benefits to, to the, to the body and fitness.

[40:10] **Demian:** One, one thing the report flagged is, uh... So I, you know, I, I usually f- I mean, I guess it's an excuse, uh, you know, finding it hard during the week. So on the weekends, I, I, I usually go at least once or two days to, to a spinning class and I, I go pretty hard. Uh, but it flagged it that, you know, it notices that I go hard, but then I only do it four times a month, right? That I should be doing it a couple of times a week in order... So how, you know, beyond the, you know, the, you know, the- Going to the max, consistency and repetitiveness, uh, is also an important factor. How do you see that?

[40:47] **Dr. Lloyd Camper:** Agreed, agreed. So consistency and... so the Sports Medicine Society usually recommends anywhere from 120 to 150 minutes of exercise every week to, to different intensities. And so, uh, I mean, you doing, I want to say, the 120 to 150 minutes, let's say, everything on a Saturday and not doing anything else the rest of the week is probably not as good as doing 20 to 30 minutes every day of the week. Right? The, the frequency, um, and, and the toll that it puts on your body is, is completely different dynamics there. And so, yes, uh, the frequency is going to be important, um, and, and over time. It's not, you know... we know that there's going to be periods of time in a year where you might be in better shape than others, but you want to keep that over periods of years. Right? So you can't just say, "Oh, I was in great shape for six months," and then just be out of, um, out of your routine for six years. You're losing any kind of healthy benefits that you might have gone there at that point. Uh, as much as we can talk about muscle memory and, and those kind of things, those are, those are things that are built over a certain period of time. So what I like to tell my patients is looking for healthy habits, routines that are, number one, sustainable over time, because I could put you on a plan and a program for three to six months that you will tell me, "Okay, I can do it for three to six months and then done for the rest of my life." And that's not the goal here. The goal is for you to integrate that as part of your routine. So as you mentioned, you're someone very busy, and most of my patients are, and we... in today's society, I think we're all very busy, uh, with, with all the responsibilities. And it's really finding that earlier time in the morning where we're not sacrificing too much of our sleep duration, um, or a time during the day, if it's our lunch break, our coffee breaks. Really find something that we can integrate into our routine that is sustainable over a long period of time.

[44:04] **Dr. Lloyd Camper:** I, I, I do love those biohacking modalities, cold plunges, the saunas, infrared. Um, a- and again, we were just talking about sustainability, consistency, frequencies. Right? So again, you're not going to get much benefits from doing 120 or 150 minutes exercise one time a week. Same thing as you getting in the cold plunge 10 minutes once and just not going back again. I, I think the consistency and frequency is probably more where the impact is going to be. Also, with, I... since you're asking specifically about the cold plunge, there's also the timing of it. If you're doing it, you know, pre-workout, post-workout, on a recovery day, it's going to have different impact. We know that exercise itself is pro-inflammatory, but in a good way. We are creating, you know, changes when you do strength training, we are causing muscle breakdown at the same time, but to create growth. And so same goes with the cold plunge, with the, the sauna. Uh, it has detox, it has antiinflammatory properties. But again, it's, it's, it's, I want to say, very complex. It's not an easy answers to give. Everybody's going to need different plans that are going to be individualized to, to their own goals. Um, just to give you an example, c- cold plunge could be anti-muscle growth in the sense if you're going to go after your heavy workout where you've pushing, it's going to restrict that muscle growth that you were trying to create during that exercise.

[45:32] **Demian:** Even for a minute or two.

[45:34] **Dr. Lloyd Camper:** Even for a minute or two, because you're really kind of causing vasoconstriction. Right? The cold really decreases the vessel size, decreases the blood flow to the area that you've just caused, uh, or stimulated increased, uh, blood flow there. On the other hand, if you were to go into a hot plunge or a jacuzzi or a sauna, then you're causing even more vasodilation, more blood flow to the area, so that would have an, an opposite effect there. So I, I like the cold plunge more for recovery and, and the sauna, um, potentially more for performance enhancement in a sense. But if you look at the bigger picture of things, recovery is still part of performance enhancement.

[46:14] **Demian:** Correct. Well, um, I think it's been, uh, very insightful. Thank you so much, Dr. Kampruh-

[46:20] **Dr. Lloyd Camper:** It was my pleasure.

[46:20] **Demian:** ... for, for your, um, your insights and, um, you know, thank you for, for, uh, you know, helping me with some of my, uh, own, uh, you know, geekiness and data gathering. Um, and, uh, and hopefully, we're gonna be doing a lot of-

[46:36] **Dr. Lloyd Camper:** Absolutely.

[46:36] **Demian:** ... really interesting things together.

[46:37] **Dr. Lloyd Camper:** Anytime. Yes. Looking forward to more.