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Scot: Does it feel like it's a struggle to be healthy? And the Core Four that we talk about here on the show, nutrition, activity, mental health, and sleep, can seem simple, but in practice actually execution can be challenging.

Troy, I've got a question for you. What's your biggest kind of Core Four or other health challenge?

Troy: Sleep, without question.

Scot: I knew you were going to say that.

Troy: You knew I was going to say it. It really is. Sometimes I feel like I'm making progress and I feel like, "This is good," and then I'm just like, "I am just doing miserably with this." I'm waking up at 2:00 in the morning and I'm lying there and I'm just kind of staring at the ceiling for two hours. So sometimes I think I'm doing well. Other times I'm just like, "I have no idea how to sleep."

Scot: Huh.

Troy: Yeah. It's just a crazy thing.

Scot: What's that do to your self-esteem?

Troy: Exactly. As Mitch said before, "Babies do it. Why can't I do it?" Babies do it. My baby sleeps better than I do at this point.

Scot: Mitch, how about you? What's your biggest Core Four challenge or other health challenge?

Mitch: So I think the biggest thing that I've been kind of dealing with lately is getting back up to the activity levels I'd like to be at, but that's mostly because I injured my ankle again. I'm back in physical therapy. Where going for a jog and listening to a murder podcast used to be really fun, these days it's like, "Oh, I've got to make sure I'm going slow. Oh, I've got to make sure I'm babying my ankle, blah, blah, blah."

So it's right back to that situation of having to scale everything back a little bit for where I'm at right now, and that's been kind of a frustrating situation.

Scot: Already, at this point, I love what you both said. It makes me feel so much better that you said at one point things were good, but you're struggling to get back to the way they are, because that's what I constantly struggle with. I constantly struggle with, "I do pretty good, and then all of a sudden I don't do great at all." It's so intermittent. I'm just not very consistent, and both of you kind of brought that up.

For me, it's activity. That's the thing. I cannot seem to be consistent. I will go pretty well for a month, month and a half, do some weights, maybe get out and do some other sorts of things, get my heart rate up, and then all of a sudden it just all comes to a screeching halt, and I'm not exactly sure what's going on.

So here's something you as a listener should know up front. Some of the episodes we have very specific recommendations of things to do, and others, like this one, are just guys talking about their health and health challenges as a way to create some new understanding or knowledge that might help with some insights that could help us and hopefully you on your journey to be eating healthier as well, and maybe even being a little kinder to yourself.

That's one thing I've already picked out of this, is I've got to go back to that. Maybe always being perfect isn't the standard I should be measuring myself to. So that's today's show.

This is "Who Cares About Men's Health," with information, inspiration, and a different interpretation of men's health. I'm Scot Singpiel. I bring the BS. The MD to my BS, Dr. Troy Madsen.

Troy: Scot, I think this is a great topic for the middle of winter when everything just seems like you're just getting by. This is a good topic.

Scot: And the hardest working guy that I know of . . .

Mitch: Oh, man.

Scot: . . . when it comes to his health . . . I'm serious, man. I know that you feel like you have your struggles or whatnot, but you're working hard and getting it done. This is Mitch Sears on the show.

Mitch: Well, thank you. Yeah, it is a constant struggle, but yeah, it's something I do try to work hard at. I appreciate that.

Scot: I think for this conversation that's about "Why does it seem like it's a struggle to be healthy?" I think a great place to start is what is healthy even? What is this standard that we aspire towards? Because society has a different definition than perhaps maybe we have or what a more realistic kind of definition is.

So what is healthy from a man's perspective? What is the pursuit of health? How do you define that, Mitch?

Mitch: Well . . . Oh, man.

Scot: I totally understand where you're coming from. That's a good question.

Mitch: That's such a big question, because yeah, it's like . . .

Scot: Here's the thing though. You have to consider that question in order to figure out what are you even comparing yourself to, and is that fair to yourself?

Mitch: For sure. And that's kind of the thing that has been really interesting, having been someone who's started to take interest in their health over the last few years with this podcast and everything.

It seems like men especially, and this is just my kind of experience, are getting all sorts of goalposts and gold standards from a bunch of different places, and very few of those places are actually backed by research or everyday regular people, etc. So much of it is focused on getting ripped, getting tons of muscle mass. "Men's health is sexual health" is one of the mantras that I hear all the time.

I think that it makes it hard, because when you first start to really care about your health, unless you're actively trying to participate and check in and think about what it actually means to you as an individual, it's really easy to look at a cover of a "Men's Health" magazine and be like, "Oh, man, I am not as handsome as Ryan Reynolds, and therefore I am unhealthy." I don't know.

Scot: Or the influencers on social media.

Mitch: Oh, yeah. They're terrible. They're the worst. It's garbage.

Scot: Okay. You kind of talked about your opinion of how the media and society defines health. How do you define it then?

Mitch: Well, it's a constantly changing and shifting idea. And for me, the big central idea is "Am I feeling my best? Am I able to do the things I want to do? Is my health in one way or another limiting me from enjoying my time on this beautiful planet of ours?"

And so that's how I do it these days where it's like, "Eh, do I have 12 abs? No. But can I go for a hike in a pretty trail in the mountains? Yes or no?" That's kind of where I'm at.

Scot: Hey, Troy?

Troy: Yeah.

Scot: Do people have 12 abs?

Troy: Twelve abs? Yeah, good question.

Scot: I thought eight was the . . . Can you have a 12-pack?

Troy: A 12-pack.

Scot: You're the doctor here.

Troy: That's a good question. Yeah, I don't know. We'll have to go back to the cadaver lab, which I dreaded in medical school, and count the abs.

Scot: Troy, how about you? How do you perceive society's kind of definition of health versus how you define health?

Troy: I mean, I think society . . . I think Mitch hit on that already. It's a lot about image and how you appear to other people. I think that's a big piece of health in terms of societal definition, where I like to think of health . . . I think Mitch kind of touched on it already. My definition would be having the physical and emotional capacity to engage in the activities that I find rewarding, and hopefully having that capacity for many years.

And I think for different people, that means different things. Someone in their 60s, they want to engage maybe not in high-intensity activities or endurance activities or things like that, and that's their definition of health. They want to play with their grandkids or they want to spend time with friends and they want to have that capacity. And for them, that's what health is, versus maybe someone who's younger who wants to be more engaged in activities.

So that's how I see it, is having that capacity to do that. And again, I think it just means different things to different people.

Scot: Yeah. I'm sensing, getting back to what Mitch said about it can mean different things at different times, that it's an evolving idea, right?

Troy: Yeah.

Scot: It's not a destination. It's something that you're always kind of pursuing.

Troy: Yeah, for sure.

Scot: And then also I'd like to add to what both of you said. It's an external thing. I think that's huge, right? You look at somebody and you go, "Oh, they're healthy," but really maybe they're not. Maybe inside things aren't that great because of other lifestyle choices they're making, right?

Troy: Yeah, and it's so true. I think one thing, really, I appreciate about my job is that you do meet a lot of people who definitely have very much a public persona being very fit and having a wonderful life, and you gain a lot of insight into what's actually going on in their lives and you realize it's not always that way.

And so I think we often compare ourselves to other people and we compare ourselves to that image and that persona, whether that's the image of health or happiness or whatever it is, but everyone has their struggles.

I meet these people. Sometimes they're local celebrities or whatever it may be, and you realize they have their struggles too. We all do. And they're struggling with personal health issues, or maybe it's substance issues, other things they may bring up, emotional health issues.

And so I certainly don't take any pleasure in the struggles that they're facing, but I think it just puts things in perspective when we do start to compare ourselves to those people who really do seem like their lives are just perfect.

Scot: We're on the same podcast together, so maybe this is why our answers are so similar, because we all kind of have the same bit of thinking. But I'm really surprised because my definition of health is very much the same.

It empowers me to do the things I want to do. It's feeling good, it's functioning well, it's not being tired, it's not hurting or aching more than I really need to do, my brain is working, and I feel happy and finding satisfaction in my work because, from a mental health standpoint, I'm feeling good. I'm doing things that are going to help me with my longevity and ability to function as I age.

So that is my definition of health, but it's also something I feel like I have to manage every day. And this is one thing I think about, is how the modern world almost makes it more difficult to be healthy.

You ready for a soapbox moment? I'm going to go ahead and climb up on my soapbox.

Mitch: Yes.

Troy: Ready or not, I think we're going to get it, so let's hear it.

Scot: So I think about this a lot, and I don't know how much of this is true, right? But for example, activity used to be something that was a part of life. In order to survive, physical activity was involved. Now, there are a lot of people that still do have physically active jobs, but I spend a lot of time at a desk, so I've got to figure out a way to then fit that into my life.

And I feel like eating was a lot more simple, right? But in today's age, I'm constantly bombarded by commercials for food that's been chemically created to be addicting. And billions of dollars are spent on this to get me to eat this food that's convenient and not necessarily great for me.

And then I have a phone with apps on them that seem to suck up more time than I ever want them to, that I could be spending on healthier activities like exercise and sleep. And again, using psychology to making sure that I'm addicted to these apps, right? And I'm watching more and spending more and more time.

And then these daily images and messages about what it is to be a man and a healthy man that doesn't necessarily resemble me at all. I feel bombarded by that. So I feel like I'm constantly thinking about it and constantly having to manage that.

And don't get me wrong, I'm not saying, "Let's go back to the way things were," but I don't think health is something you can take for granted. I think you have to have kind of a plan and be mindful about it. Do you guys buy into any of that or am I just spouting crap?

Troy: No, it makes sense. Sometimes it feels like the cards are stacked against us. Again, you're exactly right. So much has been based on human psychology and addiction and feeding into those patterns, whether it be with diet or with, like you said, apps, or engagement with social media, those sorts of things.

It really has played off a lot of, I think, addictive tendencies that we have as humans to do those things, and so we have to be aware of it, and it's a struggle. I think that alone, the fact that there is so much understanding of our psychology and so much of that plays into our psychology and tendencies toward certain addictive patterns, it's a battle. There's no question.

Scot: And I feel like this can be going on without you even realizing it.

Troy: The simple reality is you can't just go with the flow and be healthy. You just can't, because the flow really pushes you toward those things.

Scot: I love that analogy.

Troy: Yeah, you really can't.

Scot: You're right.

Troy: You figure most Americans are overweight or obese, and that's the flow. That's the majority there. So if you're just going with the flow . . . Yeah, you kind of have to swim upstream in a sense to really be able to get beyond so many of those things that just draw you in. I think it is a huge struggle.

Scot: What are some of the challenges that you guys have experienced with either the Core Four or some other health things, and how did you overcome those?

Troy: Obviously, a big one for me has been sleep, and I can't say I've overcome it, but I think a lot of what we've talked about has been healthy, of trying to have more regular patterns in place and addressing that.

But I think some of the bigger issues for me where I have felt like I've had some success have been definitely activity. And for that, I think it's just been saying, "I'm going to do this and I'm going to try and do it every day and be consistent." And not expect heroic efforts on a daily basis, just to expect a consistent effort and just keep it up. And for whatever reason, that seems to have worked for me so far on the activity side.

But I think it's always a struggle of just saying, "Well, why am I doing this as much as I am? Do I really need to do this to get the results that maybe I want?"

So that, for me, I think is the struggle in other areas where I feel like I'm doing a pretty good job. It's more kind of that temptation to ease up on it or maybe say, "Well, this isn't really necessary," or, "Maybe it's not worth it," or, "Maybe I can get results by not doing what I'm doing and maybe cutting that in half," or something like that. So that's, I think, the challenge I face in some of those areas outside of sleep.

Scot: I want to ask you a question about sleep. I mean, is there really anything you can do? I know you've done some stuff, but part of it is just the job you have, which is, again, a result of the society we live in.

Troy: It is, yeah.

Scot: I mean, then the question is, do you beat yourself up too much about it or . . .

Troy: Yep, I do. And then it's just that spiral. And I think we've talked about that before. I think Mitch has talked about it.

Scot: The shame spiral, he calls it. I love it.

Troy: It's the shame spiral or it's the anxiety spiral. I think we get so anxious about not sleeping that we can't sleep. And that happens to me. And so sometimes I'm just like, "Just don't worry about it. Who cares?"

But you're right. That is very tough to do. And I think, again, there are just certain realities of a 24/7 society that needs people who are available for services or emergencies or whatever it may be at hours when people used to sleep on a regular basis. So I think there's that reality too.

But even that aside, sometimes I feel like I'm in a pretty good sleep pattern and then I might have a week or two without a late shift and I still find that I'm struggling. But again, maybe that's just that cumulative effect of working late and working nights.

Scot: And as far as your activity, what's the difference between you and then Mitch and I? Do you just have more willpower? Do you just have more discipline?

Troy: I was going to say obsessive-compulsive disorder, because that . . . No, I'm saying for me, it's the obsessive compulsive . . . I don't know.

Scot: A lot of times when we talk about health and fitness and the Core Four, it could be easy to go, "Well, you just have to have more willpower. You just have to have more self-control. You have to have more discipline." And maybe that's true to some extent, but are there other things at play that have helped you do that? Or are you just mentally made of sterner stuff than we are?

Troy: I don't know about sterner stuff. Maybe more disordered than you are. Yeah, I don't know. I tend to pride myself, I think, on trying to be very consistent on things, and it's been very good in a lot of ways. I think in terms of just medical school, you do have to have very much a Type A personality and you have to have a certain level of kind of that OCD tendency of very focused and like, "I'm doing this every day."

So I think it's been helpful in some ways in terms of success. It also kind of drives you crazy sometimes, so yeah. And maybe that's part of it for me, honestly. That may be a part of it for me, is just for whatever reason with this routine in particular and just with running in particular, it's been very much . . .

And then you get in a pattern where you've done it every day and it's like, "Well, I can't miss a day." I honestly have not missed a day in almost eight years, so it's been good. I feel like I'm in the best shape of my life, which I love feeling, and I've seen my cholesterol numbers continually improve. So I think there's been great reward there.

But again, I think my point in saying all this is it doesn't come easy. You do get in the habit and you have that habit and that helps you get out the door, but still it's hard. I enjoy it once I'm out there, but often it's hard to get out the door.

Scot: Mitch, what's your take on willpower or discipline being the reason that maybe some of us struggle to maintain these healthy things?

Mitch: That's actually something I have been spending a lot of time thinking about lately with the new diagnosis of ADHD and kind of figuring out what works for me, what doesn't.

A lot of times in the past, I would beat myself up that I was not performing, that I was not able to have enough willpower, that I was unable to do certain things, right? And these days, it's more recognizing that sometimes it's not all willpower. It's just consistency, a general trend towards positivity, a general trend towards doing a little better, the dao of Kaizen, little improvements every day.

It's not necessarily an all or nothing, and if you hold yourself to such a high standard and you don't meet it, it doesn't necessarily mean you don't have the willpower. There are a lot of other things that could be going on too that are preventing you from getting there.

Scot: Mitch, what's kind of your overall challenge then?

Mitch: We've mentioned a couple of times over the last year, my health got a whole lot more complicated than I was expecting. Everything from mental health issues, to physical injuries that I'm back in physical therapy for, to hormonal things that we have figured out and got me on some medications, etc. There's a lot of small progress being made on a lot of different fronts, but it does not feel like I'm actually accomplishing what I want to some days.

Scot: Yeah, I feel you completely. It's like you go on Instagram or TikTok and they've got a Reel, and it's somebody who wanted to get in shape at the beginning of January, and then within that 15-second video you see the before and the after awesomeness. And even though you know better, it just seems like, "Oh, that was an instant transformation."

Mitch: Yes. You get that before and after effect, right?

Scot: Yeah.

Mitch: For me, like we talked on a recent goal episode, it was like, "I want to get back to having X amount of activity all the time. I want to feel better about my mental health. I want to sleep better, etc." I'm doing okay at a bunch of those, but it's so easy to just say, "Well, I don't have enough willpower. Oh, this sucks," when I've got to keep reminding myself that I am not a Instagram influencer, that their whole job is to look happy and look fit, right?

I have a lot going on. I have a lot of stuff on my plate. I've got a job. I'm teaching classes. I am overcoming an injury, mental health stuff, whatever. Oh my god, I am doing okay for where I am right now. And that's kind of some of the stuff that . . .

It's so easy to just be like, "If only I had more willpower, I could be like these other people. If only I had enough willpower, I could be like Troy Madsen." But "right now, I'm doing okay" is where I feel some days.

And so it's just this kind of different approach to it that I've been taking and being a bit more kind to myself. And I find it's easier to do little good things if you're in a good headspace than beating yourself up that you weren't perfect every day.

Troy: Yeah, there's no question. And we've talked about that a bit before too, but I think that being kind to yourself is so essential because it's when we're not kind to ourselves that I think we really do kind of fall off the cliff in terms of our activity. When we do expect perfection or we compare ourselves and just get frustrated, that's when we just kind of throw in the towel and are like, "Ugh, this isn't worth it. Why am I doing this? I'm accomplishing nothing." So I totally agree. We have to be kind to ourselves.

And for me, like I said, in terms of the activity, I feel like I've been very, very consistent there, but then there's the diet piece. That's kind of improved and then it's gotten worse, and sometimes I'm wanting to eat some sweets and I want to drink soda and these kinds of things. But there, sometimes I do kind of feel that tendency. Certainly when we travel, I'm not eating like I should. Then you kind of get frustrated and unhappy with yourself.

But again, I think you just kind of have to look big picture and say, "Overall things are good and I'm not going to be perfect with this, but I'm happy with where I am, and I'm better than where I was 10 years ago. So that's good."

Mitch: Right. So, in that same vein, as someone who deals with a lot of anxiety, someone who deals with the shame spiral, as I've come to call it, this idea of, "Oh, no, I'm not performing as well," and then you feel bad about feeling bad and then it just gets worse and worse, one of the mantras for 2023 that I'm adopting from the younger generation is this idea of if it's worth doing, it's worth doing half-assed.

I don't know how else to say that. We'll have to bleep it because half-butted doesn't sound right, but . . .

Troy: Halfway?

Mitch: Halfway, sure. There you go. Yeah. But it's this concept that perfectionism and the idea that you have to hold yourself to that 100% standard and you have to hustle for it and you've got to push for it can be so detrimental, because what if you don't achieve it? What if you don't hit that 100% mark?

So, as such, the kind of approach is . . . Say you want to work out six days a week, whatever that is. It's better to be consistent, so even if you can't get your butt to the gym three to four times a week like you'd like, going for a walk for 20 minutes is still activity and it's still good for you. Will you see as much of a result as if you were to go in and do whatever? No. But at the very least, you are still doing it, right?

And so, for me, if I can't get my strength training in, if I can't get enough of a jog in or whatever because of my injury that I'm dealing with or whatever, I'll just walk around the block a couple times. Because even doing it just half of what you wanted to do is better than nothing at all, or hating yourself that you didn't hit that.

And it goes to nutrition. If you're not eating healthy every single day, that's okay, right? Just get yourself a chicken sandwich instead of a Baconator. Those kinds of small choices that are like, "Is it the best thing you could be doing right now? No. But it's good enough and it's at least a step in the right direction."

Troy: That's so true. Yeah, I'm a huge believer in that as well and just this idea of . . . I think you're far better off doing something and doing it halfway and doing an okay job of it, but doing it consistently, than you are of doing something extremely well but doing it irregularly. I think you're going to get more results if you just try and stick with it.

Whatever it is, just kind of do whatever you can, and maybe it's not great, rather than having these huge workouts at the gym, but just feeling burned out by it and not wanting to do it more than maybe once or twice a week.

Scot: I'm going to go ahead and throw mine out there. And actually, in homage to Troy, I'm going to recognize what I feel like I do well most of the time. My nutrition, I feel pretty good for the most part, if I'm being honest with myself.

It's easy to beat myself up. Over Christmas break, I ate a lot of salted caramels at 100 calories each, four or five at a time. But I'm off those, right? So that wasn't great. But generally, I feel pretty good about my eating. I don't eat a lot of processed foods or anything like that.

Generally, I feel pretty good about my sleep. Generally, I am feeling better about my mental health, but that activity thing, especially weight training, is always a challenge.

And the thing that I'm trying to do . . . Like I said, I always come up with these little tricks. Sometimes at the end of the day I'm so tired, I just want to do something mindless, and then that's when I go to the phone and I start scrolling, right?

And I saw something that said, "There are these little moments in our day where we make a decision that's going to dictate what happens for the next hour of our life." So I think about that a lot.

I'll pull out my phone when I know I want to exercise and I'm like, "This is that moment. This is that little decision that's going to take the next half hour of my day, or hour, and going to prevent me from doing the thing that I want to do." And then for some reason, it's easier to make the choice of the thing I want to do.

So that's been helpful for me, and I think it could apply to a lot of things. It could apply to eating. It could apply to a lot of stuff in your life. So just that notion that there are these little small moments throughout our day that the next thing we do is going to dictate what we're going to be doing for the next half hour.

Troy: That's true. I think also, though, I like kind of rewarding myself by just mindlessly scrolling on the phone and feeling like I've earned that time because I did exercise and I did the things that I wanted to do. I'm like, "I'm just going to sit here."

And sometimes Laura will make fun of me because I've got a game on the TV, and I've got a game on my iPad that I'm watching, and I'm scrolling through ESPN on iPhone, and I'm like, "I'm going to do this completely shamelessly because who cares? I already ran today." I think there's kind of a trade-off there too.

Scot: But it's a mindful decision. You mindfully made that decision, which took active management again, right?

Mitch: Yeah. Intention versus just defaulting.

Scot: Going with the wave, as Troy said.

Troy: That's true. Yeah, you're right. It is. You're right. You do have those choices you can make, but then at the same time, you can make the choice later and be like, "Hey, I've earned this. I'm just going to enjoy this time. I'm just going to turn my brain off."

Scot: But the worst thing, Troy, is when I reach one of those little moments in my day, and yet I still choose the thing that I shouldn't choose. And I'm willfully doing it and I'm even admitting it to myself at that point. I'm like, "This is that moment and I've chosen to do this instead." It's just almost like waving my fist at authority.

Troy: Yeah. Exactly. But then hopefully you can just kind of forgive yourself and move on from it. That's part of it too, is recognizing, "Hey, I willfully made this choice. It's probably not the choice I should have made, but I'll maybe make a different choice next time."

Scot: All right. Did we get any insight from this conversation? At the top of the show, I mentioned that some shows we have some great solid steps that you can take and things you can do. This one was more of just trying to make some sense out of some things that are going on as we struggle with our own health and our own health issues and the things that give us challenges and trying to explore why that might be. Did we create anything new? Mitch, do you have anything?

Mitch: For me, it's nice to hear that other folks are going through this too, right? It's so easy to get in your own head and only be watching the influencers and thinking you're not doing well enough. I really do appreciate, Troy, to know that you struggle with stuff too. I don't want to say I love that, but it is very appreciated that . . .

Troy: You can love it. Please love it.

Mitch: I love it. Best thing. No, but it's nice to know that, "Hey, there are other people also on their own journey and maybe I need to quit comparing myself to everyone."

Troy: Yeah, I think for me too, hearing about some of your struggles and just talking about some of my struggles. I think that's probably the takeaway for everyone, is I don't think you've ever got it made. I think that's the bottom line. With fitness, you've never got it made. It's never easy. It's always challenging, no matter what habits you've developed.

That pattern can help you to keep that habit going, but I still think there's a mental challenge every day and you're always going to face those decisions, like you talked about, Scot, of "What am I going to do with this moment right now?"

And you're always going to face just the flow and avoiding the flow, which just seems to kind of drag you into a lot of the stuff you just don't want to do in terms of the eating habits and being fully absorbed in social media or whatever it may be. So I think that's my takeaway.

Scot: I feel like my takeaway was something that Mitch said, which is that health to him is something that you're . . . It's a work in progress, right? And sometimes . . .

Mitch: WIP.

Scot: Sometimes in your work in progress, you're in a better position than you are at other times, but it's just always kind of a work in progress.

And I agree with Mitch. It is also good to hear that this feeling that you're constantly managing it is something that goes beyond just me.

Well, we hope this episode was useful to you as we discussed some of the struggles that we have. And a lot of times when you're talking about the Core Four and our health, there are some things that are playing against us that we don't even realize, whether it's society or whether it's our own attitudes.

What is your struggle when it comes to the Core Four and being healthy? And have you figured out how to overcome it yet, or do you still struggle with it? Are you still looking for answers? We would love to hear about your journey. Send that email to hello@thescoperadio.com.

And regardless, whatever your struggle is, good luck and be kind to yourself. Thanks for listening, and thanks for caring about men's health.
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This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Getting up at 5:00 in the morning and then grinding into the night to get things done, that's a badge of honor. "I'm not lazy. I'm getting it done. I'll just get a couple energy drinks and do it again tomorrow." Probably heard the saying, "I'll sleep when I'm dead." That feels pretty manly to say, by the way.

Regardless, if it makes you feel good to tell people how little you sleep, or there are other reasons you're not getting sleep, sleep has proven health benefits and not getting enough can have similar downsides as not getting enough activity or good food.

You could have the other three core four dialed in and if you're not getting enough sleep, it could sabotage at all. That's how important sleep is.

So today, on the "Core Four: Back to Basics" series, we're going to talk about sleep, how good sleep improves your life and how to get better sleep.

My name is Scot Singpiel. I bring the BS to the proceedings here, and the MD to my BS is Dr. Troy Madsen. And before you say hi, I want you to say, "I'm Dr. Troy Madsen, and I'll sleep when I'm dead," in your manliest voice.

Troy: I'm Dr. Troy Madsen, and I'll sleep when I'm dead.

Scot: Also we've got Mitch Sears in the mix. Same thing.

Mitch: I'm Mitch Sears, and I'll sleep when I'm dead.

Troy: Sounded like you were thinking about it. You're like, "I'll sleep tonight."

Scot: We have one opportunity for our manliness to be saved here, and that's Thunder Jalili.

Thunder: I'm Thunder Jalili, and I will sleep when I'm dead.

Scot: There you go. All right. So, today, we are going to talk about the benefits of good sleep. And for some reason, I think society kind of undervalues sleep. What do you guys think of that? When we think about being healthy, it's pretty common to come to nutrition or exercise, but sleep is just as crucial as we're going to learn in a couple of seconds. Is it just me, or does society kind of devalue it? And why do you think that is?

Thunder: I think actually American society maybe does devalue sleep. I think it's part of our work hard work ethic, get it all in and don't be a wimp, and get your stuff done, because other cultures around the world aren't like ours. The Spanish, they value sleep. They have a nap built into the day. We're not like that.

Troy: Yeah, I agree. I think we definitely undervalue it and it certainly is a badge of honor for a lot of people. And as someone who works in the healthcare profession, I can say it is absolutely a badge of honor. If you can talk about how little you sleep or let's say you say, "I just came off a night shift and I didn't go home and sleep, and now I'm here in the office working all day," that's a badge of honor. It's not like, "Wow. That's stupid." Yeah, no question about it.

Mitch: I remember when I was working in broadcast, you would come in and the night shift would be coming off and they would have their pile of energy drinks and they would just be very proud of how much caffeine they were functioning off of and "still getting a good job done." That was always very like, "What are we doing?"

Scot: Dr. Madsen or anybody, do you think that people just don't realize the benefit of sleep? Because a lot of times it's the first thing to get jettisoned, right? When things get tight in your life, that's where you'll cheat, either getting up early or staying up late to get things done. Do you think it's just because people don't realize what that tradeoff is actually costing them?

Troy: Yeah, it may just be that we don't quite realize the magnitude of the effect. I think we recognize, "Yeah, there's some detrimental effect, but those effects are more immediate. I'm tired, but I can use caffeine. I can drink some caffeine or whatever, and that will eliminate that short-term effect." But I do think we definitely undervalue the long-term effects.

Thunder: Yeah, I agree with that. I think cutting sleep is an easy thing to do in the short-term to get things done, and there are ways to get around it, like Troy said, with caffeine. So I agree with him completely.

Scot: All right. I think that's a good segue into talking about the benefits of getting enough sleep and how it can impact your health. Thunder, go ahead and kick us off on that.

Thunder: So there are many benefits to getting good sleep. I'll just share a couple with you. One is sleep is actually tied into maintaining healthy body weight. And I know that's a big focus of what we've talked about on this show in the past. We talk a lot about the exercise and the nutrition component, but getting enough sleep is also a valuable contributor to healthy body weight.

The other thing that's great about sleep is it helps you keep your stress levels low and it helps improve your mood. If you think about it, think about the nights that you haven't gotten a good night's sleep and you wake up the next day and you're just kind of a little grumpy or a little off and things are bothering you. That's something everyone has experienced, and that's really that function of not getting enough sleep.

So having that regular sleep schedule can definitely improve with that. It gives your mind a chance to reset at night and reduce your stress level.

Troy: Yeah. Thanks, Thunder. And the other thing too that I've definitely seen plenty of studies that have shown that sleep lowers your risk for diseases like diabetes and heart disease and cancer as well, like long-term studies.

It's a little scary because I've often seen these studies done with shift workers like myself, which is kind of depressing, but it is one of those things. They do find those who don't sleep well do have higher risk of diabetes, heart disease.

I think the obvious thing we've talked about already is it does help you to think more clearly. But this is something that's been quantified in multiple studies. They've kept people awake for 18 to 24 hours and just noted their ability to perform tasks just declines over time to the point where . . . At 18 to 24 hours, you're at a point where your technical skills, and your focus, and your attention are on par with if you were legally intoxicated. So definitely effects there.

I think we all know we've had those experiences when we don't sleep well, we get sick. Sleeping well helps us to stay healthier, get sick left less often, and helps us look better too. We look better. We look healthier. Our appearance is improved when we sleep well, when we're well-rested. So that's a big thing as well.

Thunder: Don't have those bags under your eyes.

Troy: Exactly. Get rid of the bags.

Scot: I'm noticing the last two episodes that that's been Troy's thing, appearance. So do you want to talk about something?

Troy: I'm feeling self-conscious about my appearance and I need to sleep more. Maybe that's it.

Scot: You look wonderful.

Troy: Thanks, Scot.

Scot: We're going to hit up here some of our sleep struggles and then what we've done to try to work through those or not work through those.

But first, Mitch, let's talk about, like we have in past episodes, the basics. These are kind of the rules that you want to try to incorporate when you're talking about sleep.

Mitch: Yeah. And these are the ones that have been kind of tried and proven from research and studies, etc. So these are kind of the things that have the most evidence behind them.

The first thing that you want to do with your sleep is to prioritize it. And it's important to realize that when you prioritize sleep, it also means that it's not just quality of sleep. It's also quantity of sleep.

So what they're saying is that you need to get at least a minimum of seven hours and that you can't really just make it up. You can't sleep four hours one night and nine the next and expect it to be as healthy as if you were to get seven hours each night.

The other thing is that in order to get a better quality sleep, try to go to bed at about the same time every night and wake up at the same time every morning, which is something that we've kind of talked about before with Kelly Baron on a previous episode about everything from your sleep hygiene to making sure that you're going to bed and waking up at the same time every morning.

Now, the other thing you want to make sure to do is to not underestimate how things you do during the day can impact your sleep. A lot of things you do throughout the day can really impact not only the quality, but the quantity of sleep that you're actually getting. So make sure that exercise, nutrition, and mental health are all big factors that go into your sleep.

Stress, anxiety, depression can all impact how well you sleep every night. Activity, exercise during the day is good, but not less than two hours before bedtime. They've shown that that can kind of interrupt your sleep cycle, if you work out too close to going to bed. And finally, caffeine, alcohol, and nicotine four to six hours before bedtime and big meals before bed can impact your quality of sleep.

So you just want to make sure that you're not working out too close to bed, but you should be working out through the day, and to kind of avoid some of these different chemicals that can really impact the quality of your sleep.

The other thing is that sleep environment needs to be dark, quiet, and a comfortable to temperature. By making sure all of those things are kind of in place, it will really improve the quality of your sleep.

And make sure that you are not doing things that engage your brain like screens, TVs, games, radio, talking on the phone. If you do those things too close to sleep, it can also impact the quality of sleep that you get.

And finally, if you've tried everything else and you are still having trouble with sleep, go talk to a doctor and rule out that you don't have a sleeping disorder.

Scot: Some good basics there. So let's hit the sleep struggles. I want to start with Troy because you work in the ER, you work crazy shifts, you might be working during the day for a few days and then you do an overnight shift. What is one of your sleep struggles?

Troy: My sleep struggles are so plentiful, it's difficult to choose from them. But like you said, Scot, I do shift work, so I end up working nights, evenings. And for me, evening means I get to bed at like 2:00 or 3:00 in the morning. Night means I get to bed at like maybe 9:00 or 10:00 in the morning.

Scot: Wow.

Troy: Yeah. And so I'm trying to do that and then turn around double back and do a 7:00 a.m. shift the next day and do a 10-hour day on that.

So I have no doubt, and I think talking to Kelly Baron, it was very clear I do suffer from shift work sleep disorder. It's not something I really had prior to doing shifts when I started my residency training.

I have plenty of times where I think I don't struggle so much to get to sleep. I generally fall asleep once I get back into my regular routine, but then I will often find that I'm awake four hours later and just lying there and not sleeping. So that's probably the biggest for me.

I feel like I can get to sleep, I can fall asleep, but then I'm often awake a few hours later and not sleeping at that point. So that's definitely a struggle and I think not an uncommon struggle, definitely for people who do shift work, but I think a lot of people I've talked to have that issue as well.

Scot: Yeah. I look forward to hearing if you have some things that you've figured out of work around that. I mean, you can't totally fix it, right? The best you can do is kind of make the best out of a worse situation.

Troy: Yeah.

Scot: Thunder, how about you? Do you have any sleep struggles or you do all right?

Thunder: In general, I do all right. But my sleep struggle that does come up from time to time, believe it or not, is temperature. If it's too warm, I have trouble sleeping. So I have to be aware of that. Most of the time it's fine, especially in my own house, but when I travel, sometimes you're out of your comfort zone and you're someplace where the temperature may not be right.

So I try to do what I can, make sure I'm not putting too many covers on the bed because if it's too warm, it's tough. Hopefully I can adjust the temperature in a room, things like that. But that's my main challenge.

Scot: I'm pretty fortunate that I haven't had a lot of struggles. I have a job that allows me to have a pretty regimented sleep schedule. And for the most part, I fall asleep. For the most part, I sleep through the night. And then for the most part, I'm able to wake up in the morning when I need to. So I am pretty fortunate.

I think my biggest challenge, though, is I'm always thinking. My brain is always going, and sometimes I'll just lay in bed and I can't quite shut it all off. And part of it might be my fault. Maybe I was doing something too close to bedtime, but that's kind of mainly the struggle that I have.

How about you, Mitch?

Mitch: So I guess I have a slightly different story here. I have always struggled with waking up feeling refreshed. Every single night, it just feels like I haven't gotten any sleep the night prior and it's day after day after day, month after month.

I've been working with my doctor for the last year to try to figure out what I should be doing. And from stuff that we've talked about on the show, I've made sure that I go to bed at the same time every night. I'm waking up at the same time in the morning. I've played around with using a little bit of melatonin sometimes before bed. I've tried making sure not to look at screens or anything beforehand, and it doesn't seem to help.

And it was just recently after trying all of these things, my doctor had me do an at-home sleep study and they think they have found that I have sleep apnea. So I am waiting to go to do a formal sleep study in the next month or so and kind of figure out what's going on.

The struggle I've been having is I try everything and I still feel so tired. And when it comes to the Core Four, I'm working on my nutrition, I'm working out, I'm doing all the mental health things I can, but sleep has been one that's been really troublesome. And it eventually led me to talk to the doctor and we might be able to actually fix it now that we can find what's going on.

Troy: That's great you did that, though, Mitch. You talked to them and you went and looked for help. Yeah, that's a common story I hear from people where they say exactly that. They feel like they're getting plenty of hours of sleep, but they are just awake and they are not refreshed.

And I'm guessing they talked to you about in your sleep study, or in the sleep study you'll do, if they do see that, you wake up so many times at night due the sleep apnea that you're really not sleeping a whole lot, or at least good, deep REM sleep.

Mitch: Yeah. And that's kind of what they've explained. It's like, "Hey, if you have a sleep disorder, whether it be apnea or . . ." They talked about some restless leg syndrome. They talked about all these different kinds of things that can keep you up through the night. It doesn't matter what you're doing. It doesn't matter how often you're going to bed. It doesn't matter how healthy you are with your sleep hygiene and your hours and everything. If your body has something a little messed up that is waking you up all night, it doesn't matter. So that's where I'm at.

Troy: You're going the right direction. That's good. That's good to hear.

Scot: Mitch, do you find that impacts you, any of your other Core Four, like your nutrition, your . . .

Mitch: Oh, yeah.

Scot: How so?

Mitch: So I find that on days where I have not had any restful sleep and it's been day, after day, after day, when your energy level is so low, the idea of cooking a meal goes right out the window, right? In my sleep deprived state, all I want is a Big Mac. You go straight to the fast food whenever you can.

When I'm tired, I find that I can't work out the way I'm supposed to. When I go out for a jog or something like that, I can't go nearly as far as I think I need to. The whole process is really kind of frustrating and your heart rate gets up higher than it's supposed to, etc.

And mental health-wise, things . . . We're living in a very stressful time right now and I find that on the days where I don't get enough sleep or I'm not able to sneak off and take a nap in the middle of the day, I get really stressed and my anxiety gets high and I'm quicker to be frustrated and all sorts of things.

And it's been really surprising, ever since starting working on this podcast, that I'm focusing so much on all aspects of my health, but sleep was the last one. Sleep was the one that was like, "Eh, that one will figure itself out." But here I am learning that maybe I have something else going on. And hopefully, by working with my doctor and finding out a treatment plan, maybe in the next little while I can start seeing better results elsewhere.

Scot: That's a great point about how "maybe it'll just work itself out," right? This notion of "something might fix itself," I think that can be kind of dangerous, and I think a lot of us guys have that.

Mitch: And that was kind of the thing that was interesting when I first started speaking with my doctor. He was like, "Well, yeah, if you're having trouble sleeping, you might be having mental health stuff. Why don't you go talk to someone about that?" and, "Oh, when you start getting more activity, I'm sure you'll feel tired by the end of the day," and, "Oh, if you improve your nutrition and drink less caffeine, I'm sure your sleep will kind of fall into place."

And so, for the last year, I've really been working under that assumption that sleep is easy, sleep is going to just happen if I do all these right things. But if you're out there and you've been trying everything, maybe it's time to talk to a doctor.

Scot: All right. Let's go ahead and talk about maybe three struggles or three things that we've learned and what we've done to overcome those. And again, the hope is that if somebody else is struggling with something similar, this might be a new, fresh idea for them.

So I'm going to kick things off with this notion of a dedicated bedtime, being sure that you get to bed at the time that you've decided to get to bed. For me, it was 10:00. And it was challenging because if it was 9:15 or 9:30 and my wife and I were up and we were hanging out and she wanted to start a show, I'm like, "Well, it's going to be 52 minutes. I can't do that. That's going to put me past my bedtime."

Or sometimes I feel like I don't have enough time in the day to get things done. And I'm sure that's something that a lot of men deal with. And so, as a result, you push into the night, or what I've learned is you kind of have to prioritize what's important or ask for help to get all the things done that you need to get done. You can let go of some of those things.

So a dedicated bedtime has really, really helped me, and it helps me wake up a lot more refreshed, but it is challenging for those reasons and other reasons as well.

Troy: Scot, I'm going to jump right on that, and I'm going to say also a dedicated wake-up time. That's been big for me. We talked about that also with Kelly and just saying, "I'm going to get up every day." For me, it's, "I'm going to get up every day by 7:00 a.m. regardless."

And certainly, I have shifts where I have to get up early. I don't care if it's the weekend, whatever. Granted, I did mention there those times I'm getting to bed at like 3:00 or 4:00 in the morning, so I might sleep in a little after that. But once I'm in my regular routine, I'm up at 7:00, and I know I'm going to get up at 7:00.

Just knowing that, it kind of helps mentally, because before, I would kind of give myself this nebulous wake-up time. If I didn't have a shift or if I didn't have something going on early, I'd be like, "Well, I'll just get up when I wake up, because I have to make up for my missed sleep."

And then during my night sleeping, I would just lie there and I wouldn't really fall back asleep and I would just be like, "Well, I don't really have to get up. Okay. Maybe 9:00. Maybe it'll be 10:00." Kind of this mental thing where I just kept putting it off in my mind.

But I think knowing, "Hey, I'm going to be up at 7:00," something about that mentally just lets me know, "This is my sleep time, and I'm going to take advantage of it and I'm not going to sleep past that, so don't think I'm going to be able to make up what I'm missing now by sleeping in until 9:00."

Thunder: So I'm going to jump on the regular schedule bandwagon as well. I'm also all about that, going to bed about the same time and waking up about the same time.

I will add one thing about the waking. I usually wake up around 6:30, give or take a little bit, and I never have to set an alarm because I'm used to waking up at 6:30. So all the things that you have to do in life that you have to wake up early for and you need to set an alarm for, I never do that, and I find it cuts down on my stress level the night before. You're not thinking, "Oh, I've got to wake up extra early," or, "My alarm is going to go off," or something. You just wake up at your normal time.

The new thing I'll add to that is I have a bit of a relaxation routine that I engage in almost every night, and that is I read a little bit before bed. And for me, that works. I'm talking reading out of an actual book, or a magazine, or sometimes I'll read on my Kindle with a black screen.

So that kind of helps my mind disconnect from whatever was going on during the day and get lost in something else for a little bit. And I don't last too long reading. Maybe I can do like 10 minutes to 30 minutes, depending on what it is. So that's part of my routine, that little relaxation moment.

Scot: All right. Mitch, you're up.

Mitch: So the thing that it really helped me out is I'm the worst millennial. I am on my phone up until . . . I used to be, at least. I was on my phone up until the moment of my bedtime. What I have found is that regardless of your phone, most modern phones, whether it be an iPhone or an Android, they have digital wellbeing settings. And if you can go into there and turn them on and respect them, it has really helped me make sure that I'm not doing too much screen time before bed.

On my phone, at least, I set in my bedtime. I'm like, "Hey, I want to start winding down. I want to stop using my screen for an hour before bed. Here's when I want it." And when the phone hits that time period, it turns off all my notifications, it turns super-duper dim, and black and white.

And it seems kind of dumb because it's like, "Well, I can still use the phone." But for some reason, the lack of color, the fact it's super dim, the fact that you can't hear anything, it really helps just kind of disconnect and set it aside before I go to bed.

Scot: That was a big thing for me too. Up until recently, I would go to bed and I'd get out my iPad and I'd scroll social media, and then I'd find something that enraged me and then I couldn't stop thinking. Somebody would make some comment and then I would spend the next hour coming up with what my comment would be back to them, right? So, for me, getting rid of that social media has been absolutely crucial.

And the other thing that I struggled with too, and, Mitch, tell me if you did this, are the Instagram Reels, which are like TikTok videos, right?

Mitch: Oh, yeah.

Scot: I'd watch those. And even if I'd quit an hour before bedtime, then I'd have one of those stupid songs playing in my head and I couldn't get it out and fall asleep.

Mitch: Well, it's so easy to just get sucked into that hole too. You're just scrolling, and swiping, and swiping, and swiping and the next thing you know, it's like, "Oh, man, I've been doing this for two hours."

Troy: And how much of our life do we waste just thinking about snarky replies to other people's snarky replies?

Scot: Right?

Troy: I totally hear you on that. It's like, "What am I going to say to this?"

Scot: That I would never ever actually enter in, but I'll spend a lot of time thinking about what it's going to be.

Troy: Yep. I'm going to think about it, and it's going to be good. It's going to keep me up all night.

Scot: All right. Number two for me. Now, I don't know if this is a type of meditation or what, but it's a little exercise I do. It could be considered maybe a form accounting sheep or whatever. But if I'm struggling falling asleep, I will pick a color. That kind of tends to be my go-to. So I'll pick the color green, for example, and then I'll just let my mind go and think about things in my life that are green or in my past that have been green.

Troy: Oh, wow.

Scot: It takes me down this kind of memory lane. My parents' first car that I remember was this big green Plymouth from the 1970s. And then I'll think, "Oh, I had a toy box. It was a frog, and it was green." I just kind of let my mind go where it wants to with whatever color I've picked, and I find that after a few minutes of that, I feel kind of tired or I might just fall right asleep. So it's a little weird, but it's worked for me.

Thunder: So it's so boring that it puts you to sleep?

Troy: I guess so. I just feel like that would be too engaging. You would really be thinking way back into your childhood and trying to come up with all different things. I don't know. That's interesting. You just kind of let your mind wander and somehow that puts you to . . . I've never heard of people doing that, but whatever works.

Scot: Yeah. I mean, I get the engaging part because I have caught myself in the trap where I'm engaging and thinking about it too much. I think, for me, the trick really is just to let your mind wander through your past and just those things that were green. So anyway, that's mine.

Thunder: It almost sounds like a type of meditation. You pick one thing and you just kind of reflect on it and just let your mind go on it.

Scot: I don't know why it works, but it works. Who's next?

Thunder: Another thing that works to me for me is related to . . . We talked a little bit about temperature of the room is important. So we have this Nest thermostat in our home and it's programmed to start reducing temperature around 9:00. And it's great in a winter because by the time I want to go to bed around 10-ish, the temperature of the bedroom is probably like around 65 degrees, which for me is a good temperature.

So it's kind of good. It's automated, so I don't have to do it. It just happens every evening, and that is part of what helps with my sleep schedule.

Troy: Well, kind of along the lines of making sure you're addressing external factors, for me, it's about white noise and sleep mask.

Six years ago, I reached a point where I said, "I'm going to do everything I can to try and optimize my sleep and do what I can to optimize it and control what I can in terms of environment." For me, that meant white noise.

And for me, white noise means I actually have earbuds I sleep with that are made for sleeping. They're comfortable. They're soft. And then I just have a white noise thing I play that I listen to there, just kind of a sound of a fan or something. And I wear a sleep mask.

For me, that's made a big difference just being able to have that, control what I can, trying to eliminate the light, and noise, and all those sorts of things.

Mitch: And even for people who aren't doing shift work where you might be trying to sleep during the daytime, there are a lot of little itty bitty lights that are turned on in every room, in my house at least, whether it be a little power indicator light, or whether it be the light on a fan, whatever. And it has been night and day since I've gotten my sleep mask how quickly I'm able to fall asleep and stay asleep.

Scot: Tell me more about these earbuds that you have in because I've seen Bose advertise these sleep-only earbuds, but they're super expensive, right?

Troy: Yeah, crazy expensive.

Scot: Yeah. So did you find a cheaper alternative, and how do they work?

Scot: Mine are super, super cheap. It's like $10. They're designed to be ergonomic flat. They're noise-blocking. So they're just earbuds. They're soft. It did take about a couple weeks to get really used to them and comfortable with them.

Thunder: Hey, Troy, have you ever tried just foam earplugs?

Troy: Yes, I have.

Thunder: I've done that on occasion when I'm somewhere where there's a lot of ambient noise.

Troy: Trust me, Thunder, I've tried everything. And once again, I'm probably going to admit things here that are very embarrassing, but I not only have tried foam earplugs, I've tried foam earplugs with construction-type . . . like those noise blockers, those big headphone things that construction workers wear.

Mitch: Oh, my.

Troy: I'm a side sleeper, so I actually took an old pillow and I actually hollowed out a little spot in the pillow.

Scot: Oh, my.

Mitch: Oh, wow.

Troy: I was that desperate to try and block noise that I tried it. And I actually used that for a couple months. I took a lot of heat from Laura, from my wife, making fun of me, that I was that desperate that I tried that.

Finally, just these ergonomic things, these earbuds with just white noise going through it, that's what worked for me. So trust me, I've tried it.

Scot: Mitch, what do you have?

Mitch: So one of the things that is a constant struggle for me is I'm a list maker, like, "What is my to-do list? What am I doing next?" And when I try to fall asleep, for the longest time, it would just be, "Okay. What do I have to do tomorrow? I'm waking up, I'm doing this, I'm doing this, I'm doing this."

And what I found is that I keep my day planner . . . When I'm going to bed, as part of my ritual, I take the day planner, I climb into bed, I take my little pen out, and I write everything down that I'm going to be doing the next day. And for me, at least, that has really helped cut down the anxious thinking about the next day that typically happens when I try to fall asleep.

Troy: Yeah. I've heard of people doing that. And just doing a notepad, not typing it on your phone because you don't want the blue eye to mess you up. You just have a notepad, something is on your mind, write it down, deal with it later. That's a great idea.

Scot: My last one is another weird one. It works for me. I don't know if it'd work for anybody else. But sometimes when I have a hard time falling asleep . . . I'm a side sleeper, but I will lay on my back with my knees bent. Can you kind of picture what that looks like? What? Why are you laughing?

Mitch: You're just curled up and thinking about colors, and that's . . .

Troy: That's called a fetal position, Scot. You're doing it on your back.

Scot: No, I'm not on my side in the fetal position. I'm on my back and I've bent my knees, right? So if you were to come in the room, you would see this big bump of where my knees are in the comforter, right?

Troy: Yeah.

Scot: So I will lay on my back with my knees up. I mean, 99% of the time, if I can't fall asleep within five minutes, if I do that, I will fall asleep.

Troy: Wow.

Scot: I don't necessarily fall asleep on my back, but I get so tired from that position that I will turn over to my side and I can fall asleep. I don't know why it works. I don't know how I discovered it, but there it is.

Troy: I just want to be a fly on the wall in your house, Scot, and just see this, just see you lying there and sleeping with your knees brought up to your chest.

Mitch: And then talking about snakes and cars.

Scot: No, it's not all way up to my chest. I'm not that flexible. It's just like a 45 . . . Yeah, it's like a 45- or 90-degree of your knees.

Troy: I'm trying to think of the physiology of this, how this might work. I will tell you there are certain things called vagal maneuvers that basically increase the blood flow to the head and slow the heart down.

If someone comes in with a very rapid heart rate in the ER and something called super ventricular tachycardia, we will do a procedure where we lay the head of their bed down and lift their legs up at the same time to increase that blood flow. And that sort of has a calming effect on the heart rate.

So I'm trying to think of this physiologically, Scot. I don't know if there's anything to that, but it's interesting you do that and you found that works. Maybe there's something to it.

Scot: Thunder, you're up next.

Thunder: Well, this last one may be kind of old fashioned, and it doesn't actually pertain to me exactly. But I think having a television in the bedroom, a lot of people have that. I think that could actually interfere with sleep. I've never done that, but similar to being on the phone, being on a tablet, laptop, whatever, I think having a TV on when you're in bed trying to go to sleep . . . Again, it's something to engage your mind and keep you active. So that's something I think we should consider.

Scot: And Kelly Baron, when she was on the show, talked about the bedroom is for two things. It's not to watch TV. It's to sleep and to . . . I guess we're going to go to Troy next.

Troy: And to make sweet love. Is that what you want me to say, Scot? Anyway, Scot, moving on from that, this third thing I'm going to say is something I am going to try. And I will tell you I recently celebrated a birthday. For this birthday, I received a gift, and my sister was so excited to send me this gift. She said, "This is something I heard about on the podcast." The gift I received was a toilet light. So Mitch suggested this. This is one of the gifts Mitch suggested getting.

Mitch: Yes.

Troy: And I have now been using it for about a week. It's awesome. It's got a motion sensor, Mitch. It's everything you described. You come in . . .

Mitch: I told you.

Troy: Yeah, it's so cool. It's like a joke kind of gift, but I've used it and I'm like, "I love it." You come in and it just . . . I've got it on this very dim, purple light. It just hangs over into the toilet. It just lights up the bowl like this little beacon in the night, like, "Oh, there it is." I don't have to flip on lights. I'm not struggling to find the toilet. It's great.

I think it definitely helps you to avoid those interruptions in your REM sleep where you're flipping on lights and you're too focused on the task at hand, so to speak. Instead, you've got the toilet light, great, in and out, go back to sleep.

Mitch: I love that. A couple of my friends also purchased. So I don't know how much reach we have in this podcast, but some toilet lights were bought this Christmas season because of what we were saying. And I cannot be more delighted because everyone has been saying, "This is ridiculous. I can't believe I spent $10 on this." And then the next day they're like, "It's wonderful. This is the best thing. I don't have to wake up. I don't have to turn on the lights."

Thunder: Yeah. Add me to the list. I also have a toilet light.

Scot: What?

Mitch: Yes!

Thunder: Yeah. And it is, it's awesome. The only thing that I don't like about the toilet light is it . . . or maybe it's just the one we have. When the batteries start to go low, it flashes red like a police siren.

Troy: Oh, no.

Mitch: Yeah.

Thunder: So that's the one thing. You walk in there and batteries are always like, "Flash, flash, flash." It's like, "Oh, my gosh." It's very bright red. But love it.

Mitch: It's interesting you thought police siren. I thought poltergeist the first time I woke up in the middle of the night and there was a flashing light in my bathroom. I was like, "My house is haunted. I've got to go figure this out."

Troy: Your toilet. Something is going to emerge from the toilet.

Mitch: Yeah.

Thunder: But all in all, it is really a great invention.

Troy: Well, we've got three believers here, Scot. I think you're next.

Scot: Yeah, I guess.

Troy: Now I know what I'm going to get you for your graduation.

Scot: Oh. Yeah.

Troy: Because we know that's coming up soon.

Scot: Oh. Mitch, you're taking us out with number three.

Mitch: So the last one is actually a tip for my partner, Jonathan, and it's kind of this same thing. If you have difficulty sleeping and it has something to do with not being able to turn your brain off or not being able to just let go of the anxieties of the day, the thing that he does every night as part of his sleeper team that he's come up with is he has a series of positive affirmations and mantras that he tells himself.

At the start, again, I think there's a touch of toxic masculinity where I'm just like, "You're doing what? You're positive self-talking before bed?" I don't know. I need to be better about that. But he has seen a significant . . .

Scot: Go ahead and incorporate that into your self-talking.

Mitch: Right. I've got to bring that in to me, right? But he's found a lot of real benefit from it. And I've been trying it out recently where it's just . . . If you are someone who's struggling with any sort of negative self-talk or any sort of . . . if you go to bed and you replay the bad moments that happened through the day, if that's you, this has been really helpful.

And it sounds cheesy and it feels ridiculous. You're looking in the mirror telling yourself something, but it works for him. And since I've been doing it, I've been finding myself able to go to sleep faster.

Thunder: Mitch, I think that's awesome because I think we're good at being hard on ourselves about different things and replaying those in our mind, but we're not good at the opposite, patting ourselves on the back when we need to.

Scot: This turned out to be a far more entertaining show than I could have expected.

Mitch: Not the snooze fest?

Scot: Yeah, not the snooze fest I thought it was going to be. I was like, "What are we going to talk about?" But I think we've learned a lot about each other.

Troy: And I'm so glad you shared, Scot. I'm so intrigued by your sleep techniques. Anyway, it's definitely been entertaining.

Scot: Yes. It's been a good show. So I think the takeaway is that the Core Four . . . Sleep is one of them. And a lot of times, if you get your activity, and your nutrition, and your mental health right, the sleep will take care of itself. But sometimes it doesn't. Sometimes maybe the sleep is the first thing that you need to tackle.

The Core Four don't live in isolation. They all impact each other. And like Mitch explained to us, how sleep impacts those other three for him is absolutely huge.

So hopefully you got some good tips here. Hopefully you have a better understanding of the importance of sleep, and thanks for listening.

We are going to talk about next week, in our "Back to Basics: Core Four" series, mental health. So that'll be next.

If you have a technique that you would like to share, you can get a hold of us. It's so easy.

Troy: Yeah. You can reach out to us, hello@thescoperadio.com. We're on Facebook, facebook.com/whocaresmenshealth. Call our listener line, 601-55SCOPE. I would love to hear who is going to try Scot's elevation of the knee technique tonight when they can't sleep and tell us if it worked. I'm going to try it, Scot. If I can't sleep, I'm trying it, and I'm going to give feedback.

Scot: All right. I look forward to that.

Thunder: I'm going to try the color technique.

Mitch: Oh, yeah.

Troy: The color technique. I'm going to start with color and then I'm going to move on to knees. That's my strategy.

Scot: I'm glad I had an influence on you guys today.

Troy: You did.

Scot: As always, it's awesome. Thanks for listening and thanks for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: All right. Welcome to the "Who Cares About Men's Health? Sideshow" today. We've got our mountain medicine expert on the show. Going to talk to him about the first aid winter kit that you should have in your car. Especially if you live in Utah or areas like Utah, where you might go on a car drive across the state of Wyoming in the wintertime, and if something happens it might be hours before somebody is able to help you. So what should you carry with you to stay safe? This is "Who Cares About Men's Health?" My name is Scot. I bring the BS and the MD to my BS, Dr. Troy Madsen.

Troy: That's me, Scot.

Scot: And producer Mitch is in the mix.

Mitch: Hey there.

Scot: And we've got Graham BZ, who practices mountain medicine here at University of Utah Health. Welcome, Graham.

Dr. BZ: Thank you so much. Thanks for having me.

Scot: On the podcast, I want to get a story from you if we could. So on the podcast, we talk about something called the core four, and that's to be healthy now and in the future, that if you concentrate on your nutrition, your activity, your emotional health, your sleep, and then the plus one more is you've got to know what your genetics are, that that'll go a long way to keep you healthy, prevent disease, and just, you know, make life a little bit nicer.

Any of those things are things that you struggle with, Graham? We like to talk about that on the show to just kind of normalize it a little bit. I, you know, sometimes struggle with my activity and my nutrition. I know Mitch does as well. I don't know about Troy. Troy is a super . . . I mean, he runs marathons and stuff, so he's fine. But Mitch and I are listening, if you have any stories you'd like to share. I mean, how's your health in terms of those things?

Dr. BZ: I always say, first of all, for my mental health, I never compare myself to Troy because it's always so depressing.

Troy: Oh, right. Yeah. You're doing much better than I am, I know that.

Dr. BZ: But I struggle with all of those things as well. I think I could use . . . using, you know, shift work as an excuse for making it hard to motivate, to get up in the morning and be active before I do anything. Or, you know, getting home at 2:00 in the morning and forcing myself . . . trying to prevent myself from just eating an entire pint of ice cream when I get home when I want to prevent stress.

I think I definitely struggle with that. The biggest thing for me is having some sort of routine, whether it's, you know, whatever time of the day it is I've . . . When I build my schedule, I'm a big to-do list person. I'm a big calendar person. And I actually put whatever I need to do on my calendar. And so whether it's my workout or activity for the day, it's got its own designated time slot.

When I was better at focusing on my diet and my nutrition, I would actually plan my meal out the next day. I would kind of think about, "All right, this is what I have in the fridge. This is what I'm eating for each lunch, of each meal." When I had that kind of planned ahead of time, it was much easier to follow that routine and stick to it rather than just trying to do it in the moment, where I'm like, "Oh, I'm pretty hungry, maybe I'll just grab a handful of chips or have that candy bar instead of getting a meal."

And so, for me, I definitely struggle with it. It's something I wish I was better at, but when I do succeed, it's when I'm really intentional and really plan it out.

Scot: I think that's a great point. I think, you know, for some people that does work really, really well. And I think we tend to believe that stuff like exercise or what you're going to eat, when you're going to eat, it just kind of happens, right? But it really in our busy lives doesn't. And if you want to avoid eating that pint of ice cream, you've got to be full on something. So if you've planned out, "Hey, this is what I'm going to have for my meal. I know if I bring a meal to work that makes all the difference when I get home. I'm not, you know, in the sweets and stuff." So good lesson there.

Dr. BZ: Well, I wish I could practice what I preach all the time, but.

Scot: Yeah. Well, it's all a work in progress, right?

Dr. BZ: Yeah, yeah.

Scot: I think that's the thing we're all learning on this podcast.

Troy: Yeah, it is. Yeah. And it's so refreshing to hear that from you to, Graham, because I struggle with the exact same thing. And obviously, we both do shift work, we get home late or early, depending how you look at it, you know, 3:00 in the morning or whatever. And yeah, I agree. I'm the same way. I've got my calendar. I have to plan things out. I have to think ahead and be like, "Okay, this is what I'm doing then." I think for anyone who's doing shift work, that's a big challenge. So it's great to hear you're doing that and making it happen.

Scot: All right. What is in your survival kit in your car? Now we're talking about a winter survival kit. If you're going to do any traveling over the, you know, the wintertime and you live in kind of a remote area, like here in Utah, you can drive a lot of places where you might not be near a town. Or if you have to travel like I do to another state and you have to drive across a state like Wyoming, if a storm hit and you had to spend the night in your car or a couple of nights, what kind of survival kit would you have? Graham, do you have one in your car, and what do you recommend?

Dr. BZ: I do. And I'm so glad you're asking me this because my wife makes so much fun of me for my kit that I keep in my car.

Scot: Maybe this is something just guys like, I don't know.

Troy: Yes, exactly.

Dr. BZ: There's probably something to that. You know, I've actually . . . So I also commute out to a hospital in Wyoming for work as well. And I've had one particular close call where being stuck would have been awful. And so my kit, I keep kind of continuously adding to that kit over time. But I think with any medical kit, you want to think about, you know, what you're using it for, the environment you're going to be in, and how far you are from definitive care or rescue. So, you know, how long are you planning to use these materials to survive?

Thankfully, in a car, you know, 24 hours is probably pushing it in terms of how long you need to be. If you're on a highway, I should say commuting to Wyoming, something like that and you're stuck in a storm. So your kit can be sized down for that. If you're going further out into the wilderness, then plan for more time.

I have a couple of things. So one, I have something for just kind of self-rescue, like you should do with any activity because the best way to get yourself out of something is to be able to get yourself out and not rely on someone else for help. So now in my car, I've got some traction devices that I can use to place under the wheels if I were to get stuck in deep snow or sand or mud. I have a -- I'm trying to think of the term for it -- a tow rope, basically, that's a very heavy-duty, synthetic rope that I can attach to a point in my vehicle and hook it up to somebody else's if I needed to pull someone else out or vice versa. And I also have my own jack, a spare tire, all those things.

So whatever you can do to help yourself, I think is super important.

Troy: And what do you mean by traction devices? Are you talking like tire chains or like cables or something like that? Or what exactly do you have there?

Dr. BZ: So no. So you should always have those things, especially if you don't have four-wheel drive. So I have four-wheel drive and winter tires. I actually hate putting chains on and cables, but I think those are great things to have, especially on a road like that.

There's a bunch of different commercial devices you can get that are kind of deployable tracks that you can put down onto loose snow or something. I think Trax, T-R-A-X is one company, and just as an example. Not that I'm endorsing them over another. But they're basically these traction pads you can put down to help your wheels get traction and get out of a rut, especially, you know, I think a lot of people, myself included in the past, when you get in deeper snow, you try to get yourself out and you end up spinning your tires and digging yourself down. And then the more you do that, the harder it is to get those tires out. So these traction devices, you can place down and give your tires some grip to help you get out of those ruts.

Troy: Oh, nice. And you can get those down far enough where your tire can actually get a little traction on it. Once it's on there, then it's going to start moving forward on that traction?

Dr. BZ: Exactly. And that brings up another thing I have, which is a snow shovel. Not the one you . . . I mean, if you wanted to, you could carry the one you bring in your house, but that's going to be pretty cumbersome in your car. So I actually have an avalanche snow shovel that you put in an avalanche pack for back-country skiing or snowboarding. Because sometimes you dig your car so deep that you're actually kind of high pointing it and the chassis of the car is actually in the snow. And so you have to have a shovel to help dig around those tires so you can dig that, you know, spot for that tracking device or at least dig a trough out for your car to drive out of.

Troy: And have you ever used this stuff? Have you ever had to use it?

Dr. BZ: I have actually. I'm embarrassed to say how many times.

Scot: What? Really? Because I'm sitting here this whole time thinking . . . I'm the one that wanted to do the topic and I'm thinking the whole time, "Oh, I'd never use any of that stuff." And you're like you've used it multiple times.

Dr. BZ: Well, I should say again . . . So getting yourself out of things is the best thing to do. The very best thing to do is make good choices, and I have definitely not made good choices.

Troy: Prevention.

Dr. BZ: Yeah, prevention is key in all these situations. When you miscalculate, that's where these devices can be very helpful.

Troy: See I can definitely think of times I wish I had these things. Like, especially the traction devices, I never even thought about that. I guess I should have known they're out there. But that seems like an incredibly useful thing, because I've definitely been stuck in the snow and just been like, "How am I going to get out of this?" So that's good to know.

Scot: Yeah, they're useful for sand too. If you ever decide you want to go out into the desert or whatever with your four-wheel drive vehicles, a lot of people use them for sand as well. There must-haves.

Dr. BZ: There's some really big, burly ones that people love to put on the side of their adventure vans that are not, you know, practical to put in the back of most cars, but they also make some much smaller ones that fold up or roll that are still very effective that I just . . . I basically have all the stuff just stuffed around my spare tire. They kind of divide up my spare tire in the back of my car, and it fits very well.

Scot: It's cool. So you've got your tools to get you out of the situation. What other kit do you have and what's in it?

Dr. BZ: Yeah, so I've got . . . I always carry . . . I have probably too much water. I have like 10 gallons of water, but I always carry spare water.

Troy: You've 10 gallons of water in your car?

Dr. BZ: Well, that's just the . . . Yeah, I do.

Troy: That's awesome. I'm impressed.

Dr. BZ: And that, you know, moves out of my car sometimes. And whenever I'm going to Wyoming, that's in there. It's just one of those big, kind of blue squares.

I actually have a sleeping bag that I keep in my car. I've got some extra pair of gloves. And so I basically have a bin that I move in and out of my car when I'm going, you know, anywhere, like going to work or going on a bigger trip. And so it's got an extra sleeping bag, an extra beanie, extra pair of gloves, an extra jacket. I think I've got like six or seven like meal bars in there as well. I've got waterproof matches and kind of one of those match kits. And always have duct tape. Wherever you go you need duct tape.

I've got a headlamp and a flashlight because you always want to make yourself visible as well. They make some really great kind of emergency lights as well, the triple one that's like a flashlight and a flasher. And you can kind of put that on the back of your car if you are going to sleep in your car so you stay visible for plows and things like that. So I've got one of those. I've got a knife as well. I feel like pretty much every vehicle I have or backpack I have has two headlamps and two knives just because I go a little overboard on that.

Troy: I was going to say you never know when you need two knives.

Dr. BZ: See, if you've got two knives, you've only got one knife, it's the same with headlamps.

Scot: What? I don't understand that saying.

Troy: The second knife breaks or what?

Dr. BZ: Yeah, it breaks or you lose it, or yeah, I like to have some redundancy in the safety stuff.

Troy: See, I'm just thinking of the movie, "The Grey" with Liam Neeson, when he was fighting wolves and he had two knives. It made perfect sense. He had a knife in each hand, so I guess . . .

Dr. BZ: Well, exactly. Yeah, you never know when the pack of wolves are going to come out.

Troy: Yeah, you never know. But yeah. See, I am feeling so inadequate right now. In my car I have a roll of duct tape.

Dr. BZ: That's good.

Troy: I have a blanket. I do have a spare tire and a jack.

Scot: Maybe a couple of French fries down the side of one of the seats.

Troy: Yeah, I think there's some Cheetos under the driver's seat, maybe some peanuts or something. I might have a screwdriver and some zip ties, like if I could do something, you know, to fix my car, if I actually knew how to fix it. So I am feeling very inadequate. But this is like incredibly helpful to hear this because, yeah, I like the idea, like you said, Graham, you've just got your kind of your bin, it has everything in it. Obviously, you're not dragging this stuff around town all the time, but if you're going on a long drive, you just grab it and you throw it in and you've got everything you need.

Dr. BZ: Yeah. And again, you can see . . . My wife makes fun of me because mine's a little overkill. I will say, so zip ties are great. The other thing that works really well for any sort of securing or kind of jury rigging some together are Voile ski straps, if you're familiar with those. They're very heavy duty, kind of stretchable straps that have saved me in a lot of different environments. And so I've got a couple of those in the bin as well, and a multi-tool like you said.

Scot: Mitch, how's your survival kit shaping up in your car? How are you doing?

Mitch: It's pretty miserable. I'm the opposite of Graham in my relationship. Jonathan has maybe seven different first aid kits and survival kits in each of our vehicles and everything. I just have some tools. Like, I drove junk cars for so long in my life, I have a mobile thing to fill up my tires. I have a full tool kit. I have spare spark plugs, spare battery jumpers, etc. But nothing if my car were to break down into like the wilderness. I think I maybe have a Red Bull in a glove box, but.

Troy: Well, since we're talking about Wyoming, I have to tell you my favorite, not favorite, but just, yeah, a survival experience in Wyoming. I pulled off an exit. I was driving through Wyoming. I was super tired. So I took a nap, but I left my lights on. And it was just an exit out in the middle of nowhere in Wyoming. And so my car died and there's no one there. And so I just I had jumper cables. So I do have jumper cables in my car. So I got out and I'm just walking along the highway just thumbing and holding up jumper cables, thinking like some nice person will just see I need my car jumped. Like, no, they're going to think like some creep is out here walking along, getting ready you to strangle me if I pull over. So fortunately, I found like this old, rundown gas station like a couple of miles down the road, middle of nowhere. So I found the guy there and the guy's like, "Yeah, if you give me 40 bucks, I'll go jump your car." So.

Scot: Oh, that's real neighborly.

Troy: Yeah. It was super nice. I'm sure it's not the first time it's happened there, but anyway, yeah, I can't imagine. And do you carry like . . . Speaking of your car dying, since then I've thought, on long trips, you can get those kind of small things to jump your car battery that are rechargeable. Do you carry one of those as well?

Dr. BZ: I do. Again, out of experience. So I had a similar experience, and actually, Troy, you're familiar with this. So I was driving back from a shift at about 4:00 a.m. on Highway 80. And I got a flat tire between the two exits between my house and Troy's house. And so I was probably about four miles from home. So I pull over, I fix my tire, and I get into the car to drive, and I had left my headlights on and my battery was dead and I did not have one of those devices.

Troy: Oh, no.

Dr. BZ: Yeah. So I ended up . . . Thank God, I had my headlamps. And at the University of Utah, we wear black scrubs, so I'm running down Highway 80 trying to get home. And so I have my headlamp over my head, and I'm flashing it so someone can see me. And I have to run the four miles home to wake my wife up, who wasn't answering her phone, to have her take me to my car. So since then I use one of those devices. The one I use is called Jump-N-Carry, and I take it on all my van trips. We have a VW van that it definitely lives in the back of that. And I also have one, like a smaller version in my car as well, just so I don't get stuck in that situation also.

Scot: So if I'm hearing this right, it sounds like that in my car if I'm going to be driving out, you know, maybe this might be actually a trip out in the back country, I'm driving to go somewhere, I'm doing a little expeditioning or whatever, or just a, you know, across the lonely state of Wyoming on a highway in the wintertime, it sounds like there's a few categories of things I want to have. Thing number one is things to get me out of the situation I might be in, which you talked about. Thing number two is if you can't get out of that situation, warm clothes, sleeping bag, gloves, hats, boots, that sort of thing. I suppose that's also helpful if you have to walk and get help, because, I mean, how many of us would have adequate clothes to go on a prolonged walk in Wyoming, in the wintertime? And then it sounds like number three is food and water. Does that cover kind of the major things?

Dr. BZ: That's definitely how you want to think about it. Again, you don't have to have all the stuff in your car at all times. You should just think about the trip you're doing and how much time, you know, worst-case scenario you think you'd need to be self-sufficient or what you need to get yourself to a safe spot or to a place where you can contact folks.

Troy: And I'm going to ask this real quick here, Graham. I remember there was this horrible story like a couple of years ago. A guy was going out to interview somewhere out in like the west desert and took a wrong turn and his car got stuck and he went to try and find help and died out there somewhere. So I guess that brings up the question, and I've thought about it a lot since then. Are you better off if that does happen and you are in a situation where you get stuck, do you just stay in your car, or do you go out trying to find help?

Dr. BZ: So most of the time we advise, if you're lost like that, you stay with your vehicle, you stay where you are, because people are going to have a better sense of the general area where you're going to be. If you leave that space, if you leave that area, you know, vehicle, that's much easier to spot from, you know, a search helicopter, a search plane, it's going to be much harder to find you. So the best advice is to stay with your vehicle in that case. Unless you know exactly where you're going and you have a very good sense that you can . . . you know, if you passed a gas station four miles ago and you know you can get there, that's one thing. But if you're just completely lost and, you know, more than a reasonable distance from any infrastructure like that, just stay with your car.

Troy: And it sounds like with the kit you've got, you know, 10 gallons of water, you've got protein bars, you've got sleeping bags, you can just set up camp there and live there for a week and you're good.

Dr. BZ: Yeah. Honestly, it'd be a great break. Yeah, [inaudible 00:17:54].

Scot: Oh, my God.

Troy: So if you don't show up for a shift next week, I'll know what happened.

Dr. BZ: Yeah, exactly.

Troy: Graham goy lost? I guess he's okay.

Scot: I was going to say Graham's living better in the event of an emergency in his car than I live in my house. What do you bring to read to kill time? Since, I mean, you're going to be so cozy and well-fed and well watered.

Dr. BZ: Yeah. You have a spare book. You're listening to all your podcasts on your phone. You have an extra battery for that.

Troy: Just listen to 90 episodes of "Who Cares About Men's Health?" You know? What more could you need?

Dr. BZ: Exactly.

Scot: If the exposure doesn't kill you, the podcast will.

Troy: That will be the end.

Scot: All right, Graham, thank you so much for geeking out a little bit about what's in your first aid survival kit or your in-car survival kit. That's been a lot of fun. And thanks for sharing your health story as well. And thanks for caring about men's health. It's been great having you on the show.

Dr. BZ: It's been a ton of fun. Thanks for having me.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

We started the Who Cares About Men’s Health podcast with the premise that if men focus on activity, nutrition, sleep, and emotional health, they would feel better now and in the future. Plus, men would also reduce the chances of developing diabetes, heart disease, and many other conditions, all of which are impacted by lifestyle choices.

Today, we revisit the Core 4 Plus One More and what it means to be healthy. Since some of you haven’t listened before, we’ve included links to previous shows so you can learn more. In today's episode, Troy, Scot, and Mitch talk about the Core Four 4, how they've implemented them, and what they’ve learned from doing the podcast during the past two years. If you are starting your health journey, this is a good episode for you.

What does it mean to be healthy? We take a different approach to health than other places on the Internet. Contrary to fitness magazines, health isn't an all-or-nothing thing. You don't have to be a health and fitness fanatic. The pursuit of health doesn’t need to dominate your life. We believe health is the currency that lets you enjoy your relationships today and in the future.

• Episode 1: The Turning Point
• Episode 3: Finding Your Motivation
• Episode 18: Mitch’s Personal Health Journey

To feel better today and in the future, you should concentrate on four areas: activity, nutrition, sleep, and emotional health. Lots of research shows that focusing on those four things will go a long way toward helping you function, feel better, and protect you from disease. The plus one more? You should be aware of any genetic-related health issues in your family and address those.

While some might enjoy weight training and spending time in the gym, it’s not for everyone. We intentionally choose the word activity over the term exercise. Exercise sounds like you need to join a gym. Exercise sounds like something that's detached from your life. Activity, on the other hand, is less formal and part of your life. Just do something that makes you break a sweat for 30 minutes a day. It might be running. For others, a brisk walk with the dog, playing basketball with the kids in the driveway, hiking, even raking leaves and shovelling snow is an activity that helps you stay healthy.

Find the activity that you enjoy doing every day and be consistent. Small, constant effort makes the difference. If you don’t enjoy what you’re doing, you’re not going to want to continue doing it.

• Episode 24: The Secret to Successful Strength Training
• Episode 54: Getting Active Again
• Episode 158: Kettlebell Curious
• Episode 168: Getting a Bodybuilder Physique Is More Involved Than You Think

What you eat impacts your physical and emotional health. That doesn't mean you have to eat perfectly. However, you should try to avoid processed foods and refined sugars. Eat more fruit, vegetables, nuts, and seeds. If changing your diet seems overwhelming, simply change one thing. Drink one less soda a day. Eliminate one fast food meal a week. Eat one extra serving of veggies. Small changes add up over time.

• Episode 12: The Importance of Good Nutrition
• Episode 20: Time Your Meals to Lose Weight
• Episode 42: Get to Know Your Macros - Protein
• Episode 46: Carbs Aren’t Bad
• Episode 49: Surprise! It’s Hidden Sugar
• Episode 51: Don't Fear the Fat

Many underestimate the importance of getting good sleep. The average adult needs 7 to 9 hours of sleep. Research has shown that lack of sleep impacts your health in multiple ways.

• Episode 11: How to Beat Your Insomnia
• Episode 38: The 4 Rules of Rest

Mental health is the state of your thoughts and emotions, and it impacts everything. If we're not functioning well emotionally, it can affect sleep, nutrition, and activity. If your emotional state is supportive of meeting your goals, that’s good. If our emotions are a barrier to doing the things we want to do in life or impacting our relationships, we need to do something. Sometimes seeking professional health is the answer. You’re not weak for talking about it. If you broke your arm, you’d go to a doctor. If you only listen to one episode about mental health, listen to Episode 39. The tools for your mental health toolbox are easy for anyone to use, and they do make a difference. If you need more help, check out Episode 45 to learn how antidepressants can help.

• Episode 7: What is Mental Health Anyway?
• Episode 19: Seven Steps to be a Better Listener
• Episode 39: Three Tools for Your Mental Health Toolbox
• Episode 45: Do I Need an Antidepressant?
• Episode 47: Therapy Isn’t Just for a Crisis

If you smoke, quitting has almost immediate health benefits. Excessive drinking can also have a significant impact on health. Quitting can be challenging, so if you're not ready yet, pick a few easier health changes first. For both smoking and drinking, you might need professional help. If drugs are an issue, you'll almost certainly need to seek professional help. In all three cases, these changes can have the most significant impact on your health.

• Episode 21: Opioids, Treatment, and Hope
• Episode 26: Trying to Quit for 7th Time
• Episode 53: The Line Between Unwinding and Drinking Too Much
• Episode 57: The Real Problem Isn't Drinking Too Much

Some people are at higher risk for certain types of cancers, cholesterol, blood pressure, diabetes, heart disease, and mental health issues. If you know where you're at higher risk, you need to focus more on those areas.

Guys love to take a "wait-and-see approach to health." But if you have an issue that has been around for a while, it's not likely going away on its own. Whether it's an old injury that prevents you from being active, a chronic cough, or any ongoing issue, you should have it checked out.

• Episode 5: Putting a Physical Therapist on Your Health Care Team
• Episode 48: Recovering from a Sprained Ankle
• Episode 59: Erectile Disfunction and Your Health
• Episode 67: Ask a Sports Medicine Doc

If you’re struggling with your health, just pick one of the four, make one small change, and be consistent.

• Be patient. Change takes time.
• Be independent. Health is very personal, and you can do it your way. Don't judge yourself compared to others.
• Be kind to yourself when you slip up.
• Congratulate yourself for all the small wins.
• Reach out. You can contact us anytime.