Ray's Take

I got a leg cramp in the middle of the night last week, and it sucked. Hurt really bad - like 9/10 pain scale. I had to get out of bed and stand up to stretch my hamstring, which led the other leg to cramp. It was insane.

Since then, i've been afraid of cramps in the middle of the night (which don't happen often, but when they do more often happen in shins than hammys).

I believe I cured myself as soreness is basically gone, so wanted to tell you what I leanred and how I did it.

Who I am

I am bla

Background

Nighttime leg cramps (and cramps in general) are due to:

• Strenuous exercise
• Dehydration
• Electrolyte imbalance
• *This is for otherwise healthy people (medications and other medical conditions can also cause cramps)

Did I lift and play tennis last week? Yes, but I always do

Was I dehydrated? Maybe, but I am always drinking water. I do have a glass of wine or two and alcohol can cause increased dehydration (but I always do).

So did I have an electrolyte imbalance? Decided to look into this

Electrolyte imbalance for cramps

The electrolytes that matter for cramps are:

• Magnesium
• Potassium
• Calcium
• Sodium

Let's not worry about sodium (salt) - most ppl get plenty.

This is what I found for the others:

I then did a quick calc on how much of each I was getting from a typical day of eating

Potassium supplementation is kind of dangerous so I didn't want to mess with that, and calcium I'm not worried about as get more from a a multi-vitamin already.

I realized I could deficient in Magnesium.

I was taking a supplement called ZMA, but was only taking one capsule per night (for sleep) which contains ~150 mg Magnesium Aspartate and Magnesium Oxide. This wasn't enough in itself, but after doing some research, I found that mag supplements aren't fully absorbed by the body, especially not Magnesium Oxide.

Here is a breakdown:

Source - Peter Attia MD

Based on Peter's research, I decide to take Mg-glycinate, which I already had at home, 100 mgs per pill, 4x a day.

So far it's working.

More on Magnesium soon...

Ray's Take

I don't really think too much about skin care. I think good skin is more about simply eating well, staying fit, and being healthy, but I also know its much more complicated than that for most people.

So that being said, here is what I use:

AM

Erno Laszlo Detox Cleansing Oil
Erno Laszlo Sea Mud Bar

Take a tiny bit of oil and massage on dry face for 10-20 sec. Leave on.

Take a small piece of the bar and lather up with wet hands - i don't use much at all.

Take soapy hands and massage face for 10-20 seconds and rinse off.

I don't rub hard or for too long. I'm just moving the oil/soap around gently. I also use a very little amount. I had a sample size bar and it lasted me literally 2 years.

The oil + bar is a new workflow for me but i've used the bar alone for years. So far, I like it. I see visible improvements in clarity and less blemishes using the oil+bar method.

Note - when you first start, the bar may bring out acne that is hiding underneath your skin.

If you want to try this, I'd recommend this sample set. It's $25 and will last you a long time.

Midday

Neutrogena Sunscreen

Sun screen - I really think this is important. Most people don't use enough. You can use any brand you want. At least 30 spf and make sure non-comedogenic meaning it won't give you acne.

The trick is to have it everywhere. I have it in every bathroom, in my car, and in my tennis bag. If sun will hit my face I will just use some on face and neck.

Sunscreen is effectively my moisturizer too.

PM

Acne.org Cleanser
Acne.org Benzyl peroxide

I shower at night, and have the cleanser in there. I lather in my hands, and gently spread all over face - like10 seconds.

I shave with this as the "shaving cream" which works great. (Do this last after you've been in the shower for awhile)

After I shower, I dry face and use a tiny amount of the benzyl peroxide. Again, I only use a tiny amount. One bottle can last me for years.

I've used this forever. The cleanser is good and I tried to fully quit benzyl peroxide many times, but find that I will get acne (at 39 years old) if I fully quit.

TLDR: What you need to know

• List of the supplements Ray takes in 2024
• Creatine
• BCAAs
• ZMA
• Whey protein

Ray's Take

Here are the supplements I take and why. Science/data coming soon.

Creatine monohydrate

Recommendation strength: 9/10 if you do strength workouts

Brand: Optimum Nutrition

Why?
Def improves strength on lifting.

How do you know?
When I stopped taking it strength went down by 5-10%. It was noticeable.

How long have you used this?
Last 15-20 years, consistently

How do you take it?
Add to blender bottle with BCAAs (see below). I don't measure.

When do you take it?
Doesn't matter when you take it vs when you work out. Instructions say have after but I have it with BCAA drink (below) around noon before I work out.

BCAAs

Recommendation strength: 9/10

Brand: Xtend

Why?
Takes away hunger. 100% recommended if you want to do intermittent fasting.
(And yes i know it might count as "breaking" fast but this drink is 10 cals with 5g protein and no carbs or fat...so relax).

Even if not intermittent fasting, its a great drink for if you are hungry anytime. Prevents unnecessary snacks and kills hunger.

How do you know?
If I do not drink this midday, I will feel hungry around 1 or 2pm. If i have it, I will not be hungry until 4 or later.

How long have you used this?
10 years.

How do you take it?
One scoop in blender bottle with ice and creatine.

When do you take it?
Around noon. Trigger is when I feel very slightly hungry or I just remember to have it.

ZMA aka Zinc Magnesium Aspartate

Recommendation strength: 7/10

Brand: Optimum Nutrition

Why?
It has mag which is important and many people are deficient, and zinc which can improve immune function.

I perceive it helps me sleep deeper. I experience more vivid dreams (which I enjoy. It's not scary, its fun). I also. have not gotten sick much since I started taking this. These are both anecdotal but both supported by other user reviews.

How do I know?
Less a/b testing on this. I started 10 years ago and liked it and never stopped.

How long have you taken this?
10 years+.

How do you take it?
One pill before I sleep.

Whey protein

Recommendation strength: 9/10 if you can't get at least 0.5g grams of protein per lb of body weight per day. 10/10 if you like sweets for protein fluff.

Brand: Optimum nutrition

Why?
To get protein (very hard to get enough which is 0.75-1g per lb) without protein powder.

More importantly, to make protein fluff which tastes amazing, is low calorie, and makes you really full.

How do you know?
I eat fluff every day and i love it every day. Actually not sure how much protein I need to maintain muscle. I've had about the same physique for the last 12 years. I don't count protein daily. Would estimate 100g per day or so.

How long have you taken this?
10+ years.

How do you take it?
Protein fluff every night as a 9pm dessert.

Other

List of other occasional supplements:

• NAC if i drink. 1/2 pill before drinking - yes i think it works. Don't take full pill bc it disrupts sleep

• Propel powder kiwi strawberry. Have every day in blender bottle. Really like the taste.

• Stevia, liquid. Add to protein fluff

• PB powder. Add to protein fluff sometimes. It's good with keto bread too but I recommend the no sugar added sweetened version for that. Flavor of this is worse if eating vs using in a fluff.

Love

Your mission is to fill your love tank. The more your love tank is filled, the higher odds of reaching your objective.

What is love?

Love means you do an activity or eat a food that you truly enjoy.

Doing this activity also helps you make progress toward your objective.

Both conditions must be met for true love.
Enjoy + progress => love

But I love ice cream and pizza. Does that count?

I love ice cream (gelato) too.

However, it's not true love. It's more like a guilty pleasure.

Why is it not a true love? Bc I know having it every day will make me fat. It is anti-objective of "look great" and "six pack" and "prevent disease."

Bc I know its bad for me, I don't truly love it.

Does this mean I never have gelato?
No, I do have gelato....when I'm on vacation in Italy. And i'll have a lot. But will I have it on a regular Tuesday? No

Do you have to learn to love something?

Yes and no.

When you try a new activity, you should like it, at least a little, immediately.

The great thing is, if you're making progress by doing or having it, you'll enjoy it even more. You'll also get better at doing it (this goes for cooking, and exercising). This automatically turns into love.

Did you learn to love it? Kind of, yes? If you enjoy something and it helps you "look jacked" "prevent disease" "feel better" why the hell would you not love it, and do it all the time?

Of note, If you just flat out don't like something, it's better to drop it and avoid pain. There are a million things that can help you make progress, that you will enjoy more.

What does it mean to fill up my love tank?

Filling up your love tank actually means what % of foods you eat are foods you love (like + prorgress). The higher the %, the better.

This does not mean it is required to have many foods you love. Let's say you have precisely 1 meal you love, for example, salmon with vegetables and salsa. If you can have this every single meal, and enjoy it....then just have it every single meal. Your food love tank is full. You will accomplish your objective.

It is GOOD to do the same thing over and over again.

The same goes for exercise. I've done the same movements for 10 years and don't see myself ever changing anything.

That said, most people need at least a little variety...

How do I fill up my love tank

Try new things that you think will help you make progress toward your goals. If you like them and they work, keep doing them.

How do you find out about new things?
1 - Me. I'm gonna tell you a ton of shit I love, and things you might love.
2 - Anywhere else. You can get inspiration from everywhere - every time I eat restaurant food (usually unhealthy), I'm thinking about how I can re-create in a healthy way that I would love. And i'm usually successful.

How do I know if its gonna help me make progress?
Max simple:
I'll tell you what will probably work. You just try it and see if you like it. Like it -> repeat.

Max smart:
For food: Food is just about calories and macros really. If the food you're about to have is high lean protein, high fiber (veg), and moderate fat/carbs. It's probably going to help you make progress. Just be able to mentally estimate the macros, check food label, or calculate with a food tracker. I always know in the back of my mind around how many calories something has and will make a mental calculation of if its "worth it." A simple framework is just to turn up lean protein and fiber, and turn down everything else.

For exercise: Any exercise is always good. Just make progress, and don't get injured.

For medications: Know your numbers, take the meds, see if numbers improve with no side effects.

For supplements: Know why, take the supplement, see if it actually improves the thing it says it was going to improve.

One more example

I love wine. Red wine. There are no health benefits to alcohol.

However, I do have 2 glasses of red wine, almost every single night.

Why?
1 - it does not go against any of my objectives "six pack" "prevent disease" "feel young"
2 - I understand whats in red wine - each glass has 4g net carbs and 150 calories -> I can accommodate that by having less other shit that is less worth it to me. This is my "thing"
3 - I understand how much is too much. If I drink more than 2 glasses, I will be hungover the next day. This is anti-"feel young" so I rarely do this.
4 - There is a question of why I love red wine. Maybe after grinding work for 10 hours, it's fun to have a glass to "feel young." It definitely makes me relaxed, and let my brain loosen up (which often gives me way better ideas than just drinking coffee and force thinking). I very much enjoy the taste too.

Should you drink red wine? No - i wouldn't recommend it. Again alcohol has no health benefits.

But you should find your own version of red wine for yourself, based on what you love.

Next step

I'll give you something I think you'll like. Right now.

Chicken thighs with cauliflower workflow. Make it tonight. See if you like it.

Ray's Take

Welcome. So happy you made it here :)

You want to start taking control of your health program. What now?

There's 2 ways in which humans can make changes.
- Big and sudden - IE throw all the bad shit away in your house and completely start over
- Small and gradual - IE cut out 1 type of food

A business analogy is, you could fire the entire management (big and sudden), or you could reprioritize certain strategic initiatives (small and gradual).

If you are the type of person that needs to go with "Big and sudden," you'll know. And you should do that. You can't fire yourself, but essentially you are bringing in a whole new way of doing things (which will not be easy).

But I'd say most people making it here will fall into the 2nd category. You are a motivated person that has achieved success in your life. You know the process of learning what to do, executing, and getting results. You just haven't focused on the strategic initiative of optimizing your health.

Let's go through what to do step by step..

1 - Design your objective

This can be as easy as two words:
- "Get jacked"
- "Not die"
- "Feel younger"
- "Look hot"
- "Less fat"
- "Prevent diabetes"
- "Less depressed"
- "More energy"

You should know your objective already. Pick one. Write it down.
(Yea yea, you're prob not gonna stop right now and write anything, so write it in your head, until the end of this article).

There is probably benefit to writing your full "why," but thats a personal choice. If there are deeper reasons you are focusing on your health now, journaling them could be cathartic, motivating, and clarifying. I'd recommend it. But I also know many people don't know what they want other than "get jacked."

Just do what works for you.

2 - Assess your current state

Background

You have a program already. It's what you do every day.

We need to improve our program to fulfill our objective. To do this, we need to measurable "key results" that signify we are working toward accomplishing our objective.

Yea its like an OKR. And yea OKRs are annoying, but if done right, they work.

Assessments

To pick key results that make sense, we need to know our starting point.

I would recommend to do as many assessments as possible:
- Blood tests (link)
- DEXA scan (link)
- Strength
- VO2 max
- Nutrition

You should 100% get the proper blood tests to evaluate heart disease and diabetes risk. And you should 100% get a DEXA scan to know body fat %, lean mass, and bone density. Schedule ASAP.

Both of those assessments will give you valuable information AND increase motivation.

For the sake of this article, you can't have that info right now. So let's focus on nutrition and exercise, two things that drive every single objective anyways.

Nutrition assessment

Nutrition is tricky to quantify. It's hard to be objective and measurable because there is no single "best" diet and its complicated how what you eat affects what you care about. All we know is it matters, a lot.

It's also annoying AF to track all your food. To make things more complicated, if you aren't weighing your food, your tracking is wrong anyways.

Thus, we'll try to make nutrition as objective and measurable in a way that fits into real life.

• Level 0 - I eat whatever I want. I don't think about nutrition. I am not happy with my current status, and I'm not moving in the right direction.

• Level 1 - I try to eat healthy sometimes. I don't know much about nutrition. I am not happy with my current status, and I'm not moving in the right direction.

• Level 2 - I think i'm eating healthy. I superficially know something about nutrition. I am not happy with my current status, and I'm not moving in the right direction.

• Level 3 - I'm focused on eating healthy. I know some fundamental principles about nutrition. I am not happy with my current status, but think I'm moving in the right direction.

• Level 4- I know I'm eating healthy. I am sure about fundamentals principles of nutrition. I am not happy with current status, but know I'm moving in the right direction.

• Level 5 - I know I'm eating healthy and don't need to think about it (its automatic). I am knowledgeable about nutrition . I'm either happy with current status or on autopilot to get there.

What level are you?

3 - Nutrition -> Key result

The goal is to just get to 3 as efficiently as possible. This is when you know something about nutrition, and are making measurable progress. If you are already at 3 or higher, I don't think you need to change anything. Just keep measuring your progress via blood, DEXA, scale, etc.

After you get to 3, just keep on gaining knowledge about nutrition and you'll auto get to level 4.

If you get to level 4, just keep assessing if you are happy with what you are eating and measuring progress. If yes and yes, you'll auto get to level 5.

If you get to level 5, you made it.

Nutrition - START

I'll give you some knowledge I'm very sure about.
1 - Eat more veggies and lean protein
2 - Eat less refined carbs and added sugar

We can argue about carbs, fat, keto vs low fat, fruit, dairy, gluten free, bla bla forever.

However, I'm very sure that veggies and lean protein are good. Have more of those.
--->Here are starter recipes, orders, etc.

I am very sure refined carbs (white bread, chips, pretzels, candy, anything else that is processed in a package with high carbs, low fiber) are bad. Eat less of those.

If you want to lose fat, add one extra step- don't eat if you aren't hungry. Specifically, this means two things:
- Don't snack mindlessly (don't even have a "healthy snack." Go for water, tea, coffee, or something else with 0 calories. It's vital to build habit to not snack)
- If you are eating a meal, once you are satisfied, stop

For this week, use our app to check in what you are eating, and how you are feeling. This doesn't mean to track every single one of your foods (though you can if you want to). Just write down your thoughts, plans, questions, and even include photos to show types of foods and portion sizes.

Exercise assessment

Strength

Have you lifted weights in the last month?
If yes, your strength is whatever you did last time.
If no, we'll have to start over. Just assume you are low/medium strength (we'll quantify later).

VO2 max

You can get an estimation of this from Apple Watch or other wearables (if you have). And yea this isn't as accurate as the official test, but it works on a relative basis (comparing you, to yourself).

If you don't trust it or don't have it, you can also do a validated test -> see how far you can run in 12 minutes. It's called the Cooper test and you can do it RIGHT NOW. If you do this, there is a high chance you will succeed, so you should do it.

Ray's Take

Your program, is what you do.

Every single person has a program. It's what you do, every day.

You can't not have a program.
- You ate today - what you ate is part of your program
- You exercised (or not) today - what you did (or didn't do) is part of your program
- You slept last night - how you prepared to sleep, and how you slept is part of your program
- You talked to yourself today - how you communicated to yourself is part of your program
- You may or may not have taken medications/supplements today - what you took is part of your program

Life is more complicated than this, but your program essentially comes down to:
Program = What you eat + How you move + How you sleep + How you talk (to yourself) + What medications/supplements/drugs you take

Your goal

Have a sustainable program that makes progress toward your health objectives.

Stupid ideas

I'm not focused on my nutrition or exercise right now.
That's great. Your program is currently on autopilot. But you still do what you're doing, so you still are on a program. I'd argue that autopilot is the truest form of your program. It's the essential condition for long term adherence to your program.

I do things differently every day
That's great. Your program includes variance. My program follows similar principles every day, but by no means do I eat the exact same thing, in the exact same amounts, every single day (even though maybe you should).

I don't want a program
Too bad. You have one. You can ignore it. But you have one.

Design

How do you design your program?

It always starts with you. What is your program today?
(link to why cookie cutter programs never work)

With that starting point, assuming you want to improve in some area (heart disease prevention, reverse pre-diabetes, lose 10 lbs, get under 12% body fat, etc) you need to introduce updates to your program.

If you like them, you measure if those updates are moving you closer to your goal.

If they are, then you keep doing that new activity...forever.

In summary, you design your program by adding a new practice to your life, seeing if you like it (immediate), and seeing if it is working (weeks to months).

Note - I typically find that if you don't like something in the beginning, its probably unlikely to stick. Of course you can be "bad" at something IE starting a new sport or activity, or cooking, but you need to initially find some joy in doing it, or else its really unlikely to last long term.

Knowledge

What should I add?

You are the founder of your own health. You have to figure it out. You do this by deciding which new practices even have a chance of fitting into your life, and then you do them.

I've worked on 10 products that tried to get people to "change their behavior" in a way that they didn't really want to change and guess what.....they never fucking worked. We're not gonna make the same mistake here.

We're gonna give you knowledge coming from
- scientific research IE new randomized trial
- scientific fact IE 1g protein has 4 calories. 1g fat has 9 calories. 1g water has 0 calories.
- my personal experience IE "I cut out bread, rice, and pasta and lost 10 lbs"
- community experience IE "someone substituted every sandwich to the salad on doordash and lost 10 lbs"
I will give you my take on if I think its likely to work and if I would try it myself.

Then, you decide if you want to try it.

How many new things should I try?
As many as you want.

If you feel motivated to throw out all the shit food in your pantry, and start a completely clean nutrition program, my hat is off to you.

If you just want to order doordash, but in a healthier way for lunch, that works too.

Remember, this is your program, so its your timeline, and there is no deadline.

You'll always have a program.

Note - I've found people are who they are, and they're gonna do what they're gonna do. If you're not really motivated to change anything about your program right now. Don't. I'm not gonna try to convince you. Just wait until it's a better time (maybe its never).

That being said, the right time to start was yesterday, and you don't have to start huge. Just decide i'm going to eat more protein fiber and water. Then for lunch, have a salad with chicken breast/thigh. Boom done. Did you like it?

Action

How do I action new knowledge?

Two ways:
1 - just do it (default)
2 -get our app, and "check in" the knowledge you just acquired, and found just slightly interesting enough you might want to try it at some point. Then, just do it whenever you want.

Let me give you a couple examples for 2 above

Diagnostic test:
- I watch a vid showing the importance of getting apoB tested for cholesterol
- I think its valuable to my objective of preventing heart disease
- I check in "get apob test"
- Next time I go to the doctor, I tell him I want the apoB test in addition to regular cholesterol panel

Nutrition:
- I watch a vid explaining how amazing cauliflower is. It is 92% water. It has fiber. A whole pound has ~110 calories. I can eat as much cauliflower as I want.
- I think its valuable to my objective of preventing pre-diabetes and getting to 12% body fat.
- I check in "eat cauliflower"

- Next time I'm at trader joe's, I buy a cauliflower, cook it at home, and eat it

Not that complicated.

Why "check in" ?

Yea, i know its annoying to download another app. And yea you'll have to scroll away from youtube, IG, or tiktok to do it. But is it worth it? That's up to you. You're the boss.

I think that writing things down are good bc you can access what you thought before (yes you forget things) and there is some higher likelihood you'll actually try the new practice if you write it down (this isn't worth looking up scientific evidence on bc....who cares. It's fast, easy, and up to you. If it works for you, great. If not, don't).

What I do know, from helping 1000s of people lose weight, is that by far the most important factor to improving health, is feeling like you are doing a good job (yes this is surprising and yes have data on this). Practically speaking, this means if you are even thinking about your health, and thinking you are actioning practices that will help you reach your objectives, you are way more likely to reach your objective.

The way I recommend doing this, is checking in knowledge from what you learn, and what you did. Write down every exercise session with reps/sets for strength, beats per min and total time for cardio). Calorie counting over long term is too tedious, but you can certainly jot down notes on what you ate if it was different and you are testing something.

So if you made it here, check this in.

Ray's Take

Knowledge, sustainability and progress are the pillars of the the RW philosophy.

Knowledge

You have to know what matters, why it matters, and how to improve. Based on those, care about it enough to set a goal and change your behavior by taking the actions necessary to improve.

Then move on to....

Sustainability

You use the knowledge on how to improve toward your goal and try doing it.

In doing it, for our pursposes having to do with health, nutrition and exercise, do you:
- not like it? (for any reason)
- feel like you are sacrificing or missing out on anything? (would rather be doing or eating something else)
- not feel good (hungry, sore, injured, etc)
If any of the above are even close to "yes," your current program is an auto-fail. Keep in mind, when first starting, what you are trying is most likely to fail, and that's OK. Our program has so many strategies to help you get to full, authentic sustainability.

Progress

So lets say you have a nutrition and exercise program that you can honestly say you are happy with. That's table stakes.

However, we must assess if we are making progress toward our ideal goals. Examples:
- Are you reducing body fat and getting closer to "abs?"
- Are you increasing strength based on what you have written down?
- Are you lowering cholesterol (apob) and in effect lowering heart disease risk and increasing longevity?
- Are you getting more high quality hours of sleep?

Do you actually have to assess the above?
YES. If you learn anything from this article, you must assess, for real.

To know your body fat, you must get a dexa scan (you can just look in the mirror in between).

To know your apoB, you must get a blood test.

To know your strength, you must write down every workout.

To know your sleep, you must assess with a wearable or clinically validated PRO (patient reported outcome survey).

Reaching true success mode - routine goal fit

If what you are doing (routine) is truly sustainable, and you are making measurable progress toward your goal...just don't change anything.

Like product market fit for startups, you just need to find your routine, that you can do sustainably, that moves you closer to your goal. At this point, just don't change anything. It doesn't matter how long it takes to reach your goal. In fact, slow and steady is the best.

If you do not have a routine you can do sustainably or that routine is not moving you closer to your goal, you must iterate on your routine. You must achieve sustainability and progress.

It's the only thing that matters.

My sustainable nutrition plan
My sustainable strength plan

TLDR: What you need to know

• Finding the most simple routine that you can do every single day (nutrition) or week (exercise) will boost your chance of success, exponentially.
• Variety is not your friend. Do the same thing that is working over and over again.
• If you feel any dissatisfaction with your routine, you have to change it and keep searching. It wont' work.
• You must feel satisfied, not missing out, and feeling in control for your routine to stick long term (which is 100% required).

Ray's Take

Variety is not your friend.

Let's assume your goal is to improve your overall health, and look better.

For most people, this means they'll need to update their nutrition habits, and update their exercise plan.

In my experience, from seeing 1000s of people try the above, those that succeed almost always find something that works, and do it every single day (at least every single weekday).

What does this mean?
- Find a meal you like, and have it every single day
- Find a strength exercise lift, and improve it every single week
- Find a zone 2 workout routine, and do it almost every single day
- Find a zone 5 workout routine, and do it every single week

In other words, keep it simple. Find something you like, and then do it every single day or week.

Monitor your progress - are you looking 0.01% better every day? 0.1% every week? If yes, don't change anything. Keep it simple. Don't overthink. Just keep doing it.

Let me give some examples.

1 - "Robert" was a 45 year old man, that wanted to lose 50 lbs. He skipped breakfast (coffee only), had avocado toast (with keto bread from costco), every single day, and lost 80 lbs. (He ate a normal dinner and also wanted to eat out 1-2x a week).

2 - Me, for the last 10 years:
- I have organized my strength workouts basically in the same pattern -> chest, squat, break, chest, dead, break and repeat . I write down what I do, every single day.
- I have had the same nutrition routine -> coffee in the am, BCAA drink at noon, small lunch (right now its just a quest bar), dinner which is just rotation of protein with vegetable (but is always max volume and low cal, protein fluff before bed. [More on what I actually eat]

Has it worked?

Yes, I know I'm a tool for posting all these shirtless pics, but hey its easier to understand a pic than reading data.

Here is recent data from my data driven blood test and my last dexa scan.
- Blood - cholesterol (apoB) is in ideal range. Metabolic numbers are in good range
- Body fat - 11% total, 7% abdominal, low visceral
- Bone density - 99th% - I'm confused at how normal is z-score above 0, 99th% is 2.5, and I am 4.8 (i might need to check this again)

My most recent bench on 1/25/24 is 6 sets of 225 in neutral or wide grip [link].

What does this mean for you?

1 - decide if you are serious about optimizing your health and looking better.

2 - educate yourself on why the key metrics we outline matter (ApoB, glucose/HbA1c, body fat, bone density, lean muscle mass, muscle strength, VO2 max). Even if some of the concepts are nerdy, I find the more you understand, the more you care. Being smart is also fun.

3 - develop the most simple routine for yourself, that you can do every single day (nutrition) or week (exercise).

4 - try it.

5 - assess honestly. This point is particularly important. If there is any part of you that is "sacrificing" or "dieting" or "feeling unsatisfied" or worst of all "hungry," your routine won't work. You need to switch it up somehow to make it so you feel "100% satisfied."

(This is how I've felt the last 10 years. I love how I eat, I eat what I want, I do not feel like I'm missing out on anything. If my friends shake a fry or chip in my face, I just chuckle or ignore, thinking to myself yea i'd rather look like me than you.)

TLDR: What you need to know

• The way to accomplish any goal, is by improving 0.01% every single day.
• Motivation does not persist. The only way to improve every day, for long enough to reach your goal is through education.
• Education means knowing why something matters, how to do it, and then discovering for yourself that this new way is actually better for you.
• This lifestyle switch, is what the Ray Wu MD program is all about.

Ray's Take

Succeeding in feeling more youthful, living longer, having better cholesterol, getting stronger, or getting a 6 pack all follows the same process and has the same issue.

Whats the process?
- Know where you are starting
- Know your ideal goal
- Improve by 0.01% every day

Lets use getting a 6 pack as an example.

Know where you are starting
This is easy. You can just look in the mirror. Bonus points for taking a photo of yourself in the mirror (and please send all of these to us!).

Know your ideal goal
This is easy. I want a 6 pack.

Improve by 0.01% per day
This is also "easy." I put quotes around this bc its easy, but only if you know what i mean.

If your ideal goal is to get a 6 pack, your daily goal is to reduce your body fat, every single day.

That means that as I wake up this morning, my goal is to have a lower body fat when I go to sleep tonight than I do now. This is the significance of 0.01%. It's not a real number or metric that you have to shoot for. It literally signifies that I did the things today, to make my body fat lower than it was when I woke up. If you do this every single day, you will get a 6 pack - 100% chance. It doesn't matter if you improved your actual body fat by 0.00001% or 0.1%. As long as you are improving, you will reach your goal.

So why is this challenging?
It can take longer than we want. Most people stop improving every day before they reach their goal.

Why would they stop?
- They don't know what to do (lack of education)
- They lose motivation (it's too hard to do what they need to do)

Most people already know their goals. They want to be healthier, live longer, and look better. The core of our program, is to enable people to improve 0.01% every single day, in the areas they care about, through education.

For getting a 6 pack, the education lies in how to eat sustainably while losing fat.

For areas like heart disease and lower cholesterol, the education lies in understanding why high ApoB matters, and how taking a medication lowers ApoB, and thus your risk of heart disease.

In the 6 pack case, you eat right every day to improve 0.01% daily.

In the heart disease case, you take your medication every day to improve by 0.01% daily.

In both cases, you put this on autopilot.
*This is really important and why we recommend [finding something you like, and doing it over and over. No need to change]

You eventually reach your goal.

Notes

Knowledge over motivation
Our experience tells us that motivation is impossible to keep "high" for a long period of time.

Our anecdote to this is education. For losing fat, we want to teach you what to eat, so it is really easy, tasty, and filling to eat less calories than you burn. Thus it requires little motivation to improve body fat 0.01% per day.

If you have to actually "try" by eating foods you don't think taste good, while being hungry, and feeling like you are missing out, you'll never succeed. This is why typical calorie counting, point counting, restrictive diets always fail. People can be motivated to lose the weight, but they gain it back nearly 100% of the time.

We think differently.

We teach you about the why you are doing something, how to do it, and then leave it up to you to find out for yourself that this new way is actually better for you, forever.

This turns into a lifestyle change, which allows you to sustain your 0.01% improvement every day.

Then you wake up one day, and you have reached your goal. At this point, you can keep going, or maintain.

It's that simple.

TLDR

• You are the founder of your own health program
• As founder, you first must define your health objectives
• Next, get a baseline for where you are today
• Your mission is to find things that you love, and help you reach your goals
• These things must fit into your unique, busy, lifestyle. Then just repeat

Ray's Take

Welcome. So happy you made it here :)

Let's start with a fact. You are the founder of your own health program. This is by definition, not by choice.

You're thinking your product needs to be better. And now you have a choice.

Do you want to improve it?

In startup, the goal is to make a product your customers love. As founder of your own health program, your goal is to make a program you yourself love.

But what does love mean? It means doing things you like that also help you make progress.

How do you do this?
- try something new
- If you like it, repeat it.
- If this helps you make progress toward your objective, you'll start to love it.

---> Add it into your "love list"

Your mission is to add as many things to your "love list" as you can. The more things you add, and the more often you do them, the more successful you will be....sustainably.

Who am I

This is where I come in. I'm Ray (why you should trust me.)

Tool photo I know, but included to demonstrate I practice what I preach.

I'm 39, an Ivy League trained engineer, MD, MBA, Mckinsey consultant, YC founder (with an exit), home cook, and practitioner of trying to reach optimal health. I've been focused my whole life on preventing disease, performing my best, and looking my best -> maximizing youthfulness. Perhaps most importantly, I love everything about my health program....

My mission, is to share all the knowledge I've gained (and will continue to gain) with you from the latest scientific research, scientific facts, my personal experience, and what others in the community are executing with success.

I will tell you what obviously works, what I would do, (what I actually do, and how/why I love it).

Then you, as the founder of your own health program, can try things that you think you might like.

What you like may not be the exact same as me, but I'm sure you will find what's right for you. These things you like will turn into things you love. Repeating what you love will become automatic and progress will flow, effortlessly.

This article will give you a concise prescription of how I would start developing your health program.

There is a lot of information, so don't feel pressure to go through it all in one sitting. There are also links to more articles, videos, and guides. I will never stop adding more information :)

Keep in mind, we are in this for the long term. We are not getting ready for a trip to Vegas day club. Today is the starting point, but there is no deadline.

Let's get started...

Define your objective

First step - clearly understand why you are re-focusing on your health program.

This can be as easy as two words:
- "Get jacked"
- "Not die"
- "Feel younger"
- "Look hot"
- "Less fat"
- "Prevent diabetes"
- "Less depressed"
- "More energy"

You should know your objective already. Pick one. Write it down.
(Yea yea, you're prob not gonna stop right now and write anything, so write it in your head, until the end of this article. We also have an app you should download, but you can get it when you feel like it's worth it. I'd recommend now.)

There is probably benefit to writing your full "why," but thats a personal choice. If there are deeper reasons you are focusing on your health now, journaling them could be cathartic, motivating, and clarifying. I'd recommend it. But I also know many people don't know what they want other than "get jacked."

Just do what works for you.

How to succeed

Background

You have your first objective already. (Did you write it down?)

There are 5 buckets of activities you can do, to optimize (or ruin) your chances of getting there.

They include:
- What you eat (Nutrition)
- How you move (Exercise)
- How you recover (Sleep)
- What you take (Medications/supplements)
- How you talk to yourself (Mindset)

You should recognize that you have a program already. It's what you do every day in each of the 5 buckets.

To fulfill our objective(s), we need to make updates to our existing program.

To do this, we need measurable "key results" that signify we are working toward accomplishing our objective.

Yea its like an OKR (Objective and Key Results). And yea, OKRs are annoying, but if done right, they work.

The measurable "thing" is called an assessment.

Process of improvement

Simple:
- Get baseline assessment (one time)
- Gain knowledge (daily)
- Execute (daily)
- Measure to make sure we are making progress (weekly, monthly, yearly)

You don't need to measure every single day. It makes no sense. What you should do every day is learn something about yourself or for yourself. For example, I like spaghetti squash and 1lb is only 120 cals, I did bench press 5 sets 8 reps of 225 lbs, I should eat 150g protein per day to maximize muscle growth, etc.

This knowledge should feed into what you execute, every day. If you like it, repeat it.

Then, just measure if you are making progress on a weekly or monthly basis. Some things don't even need measuring more than yearly.

Love, revisited

I want to re-emphasize this concept of love. It is the most important concept.

Again, loving something means you like it, and it helps you make progress. Progress is key.

When you first try something, you're not sure you're gonna like it.

If you don't, then kill it. Forcing yourself to like something you don't like usually doesn't work.

If you like it, repeat it. If you repeat it and find that its working, and you still like it, you'll start to love it.

The more often you do things you love, the faster your progress will be.

I should mention you'll also get better at doing things you love. I am WAY better at making cauliflower today, than I was 10 years ago, and I fucking love it now. I am also better at bench press than I was 20 years ago.

I'm going to tell you a bunch of things I love, and you can try them. You can also discover other things you may love yourself.

Your mission is to fill up your love list...to the max.

My love list is overflowing. There are SO MANY foods and activities I love everything in my health program. This is why i've gained and maintained my objectives , "look great," "prevent disease," "six-pack," "feel young," over the last decade....without trying.

Action Items

1 - get our app
2 - "Check in" your health objectives
3 - "Check in" your current assessments you can get immediately (weight, selfie, and any recent blood work or medical tests).

After this, start looking into the other categories. I'd start with nutrition first.

• It's the most important category
• You are going to eat anyways
• You can start executing, today

There are 4 types of endurance

• muscle endurance
• anaerobic endurance (high intensity)
• VO2 max endurance (high intensity)
• prolonged endurance (lower intensity)

Each has unique benefits, and training protocols.

Muscle endurance

• What it is: how long a muscle can keep doing work at around 50% 1RM.
• Exercise examples: Push-ups, pull-ups, air squats, wall sits, planks
• Benefits: Your muscles have more endurance! This is a win in itself for many movements in every day life. Can gain muscle hypertrophy from the 6-30 rep range.
• What your body needs to improve: Increase ability to remove waste. Increase ability to buffer acid.
• How it does this: Increasing capillaries to muscles being worked, locally.
• How to train: Do the exercise you care about, as many times per week as you want. These are low strain low injury risk so there is no limit to volume
• How to progress: Do one more set, one more rep, less time in between, variations in exercise, every week.
• Training examples: 5 sets of max push-ups, 2 times a week. Add any other exercises you like.

Anaerobic endurance

• What it is: how hard can you go from 20 sec to a minute. This is high intensity bc you will reach your max heart rate when you train it.
• Exercise examples: Sprints, bike, swim, rower, cycle.
• Benefits: Your body is able to do the highest intensity work, harder and faster.
• What your body needs to improve: Increase ability to remove waste. Increase ability to buffer acid.
• How it does this: Increasing capillaries to muscles being worked.
• How to train: Do the exercise, and then take a break. Repeat.
• How to progress: Go faster, do more work, do more sets, take less break in between sets.
• Training example: Pick an exercise you like, and do it for 6 total minutes a week. IE if you like sprinting at the beach (me), do six 30 second sprints, 2x a week.

VO2 max endurance

• What it is: how hard can you go for 4 min to 10 min. This is high intensity bc you will reach your max heart rate when you train it.
• Exercise examples: Running, biking, swimming, rowing, cycle.
• Benefits: This is your peak oxygen consumption AKA VO2 max. VO2 max is strongly associated with longevity.
• What your body needs to improve: Increase muscle glycogen reserves. Increase oxygen delivery. Improve ability to remove waste systemically.
  
• How it does this: Increasing capillaries to muscles being worked.
• How to train: Pick an exercise you like. Do it as hard as you can one time for 4-10 min every week.
• How to progress: Go faster, do more work, do it more times.
• Training example: Run one mile as fast as you can, every week. Done.

Prolonged endurance ("Cardio"_

• What it is: performing an exercise for 30 min or longer.
• Exercise examples: Running, biking, swimming, rowing, cycling.
• Benefits: This is what we typically think of as cardio or endurance work. You are increasing the quality of your mitochondria (only way to use fat for energy), as well as increasing capillaries (vasculature) all over your body. Both of these are highly correlated with disease prevention, longevity, and general health. This is also a good thing to do on "off" or "recovery" goals
• What your body needs to improve: Increase muscle glycogen reserves.Improve breathing. Improve ability to use fat for energy.
• How it does this: Increases physiology of muscles, mitochondria efficiency, size, and quality.
• How to train: Pick an exercise you like. Do it for 30-60 min zone 3 or 60 min or longer zone 2 every week.
• How to progress: See if you can do more work or go further during every week.
• Training example: Choose an exercise you like, and do it for however long you want, at the intensity you want. This could be jogging or biking at zone 2, 2x a week for an hour.

The best part is, you can decide which kind you like best, and it will

Ray's take:

We know Zone 2 is great for our metabolic and cardiovascular health.

However, Zone 2 is just distracting enough that is hard to do work (like work, work) at the same time.

I find zone 2 is also way easier running or playing tennis (vs biking). It's not easy for me to get my heart rate up to 125 on peloton bike without smoking my legs.

So I had a thought - Is Zone 1 enough?

Who I am:

I'm Ray, a doctor that is obsessed with helping you found your own health program, to reach your health objectives.

Zone 1 vs Zone 2:

Review:

Cardiovascular exercise is any activity that increases your heart rate and blood circulation throughout your body. It improves the efficiency of your cardiovascular system in absorbing and transporting oxygen, which prevents disease.

It is typically accepted that you start working cardio at 50% of your maximum heart rate, which is Zone 1.

Maximum heart rate is estimated at 220 - your age.

For example, I'm 39, so my max heart rate is 220-39 = 181. My zone 1 and zone 2 heart rates:

You should know yours.

Now let's take a look at the benefits of each:

Source: Exercise and cardiovascular health: A state-of-the-art review

My conclusion

Both Zone 1 and Zone 2 training have health benefits, and fit my life and health program.

Zone 1

I like Zone 1 because it allows me to do work while exercising. Getting heart rate to 90 is quite easy while using my Peloton bike on "just ride."

I have a "spin tray" which is like a desk that fits on the Peloton handles, so I can do calls, review video, do research, and even write articles (like this one, right now!) . Zone 1 still provides metabolic benefits....so why not?

I also like Zone 1 if i'm sore, such as days after squats or deadlift (which I also am, right now).

Zone 2

Zone 2 training has a higher impact on aerobic capacity, fat oxidation, and cardiovascular improvements. However, it does demand a level of effort that makes doing work more challenging.

It's still a fantastic option for multitasking in a different sense—like listening to a podcast or audiobook—which can still make the time fly by (or reduce pain). This is great when you need a break or want to learn something new.

My favorite Zone 2 exercise is playing tennis - this is pure fun, no pain. I love it.

TLDR: Do both Zone 1 and Zone 2, in a way that fits your life

Sources:

San-Millán I, Brooks GA. Assessment of Metabolic Flexibility by Means of Measuring Blood Lactate, Fat, and Carbohydrate Oxidation Responses to Exercise in Professional Endurance Athletes and Less-Fit Individuals. Sports Med. 2018 Feb;48(2):467-479. doi: 10.1007/s40279-017-0751-x. PMID: 28623613..

Podcast from Peter Attia: Iñigo San Millán, Ph.D.: Zone 2 Training and Metabolic Health

Pics

Me smiling doing Zone 1 while writing this article.

Yes I'm actually writing this article, right now.

This was the workout I did while writing this article.

Ray's Take

Squats are the best lower body exercise, by far.
- Compound movement (requires over 200 muscles to perform).
- Kinetic chain is basically the entire lower body and core. Some work on upper back and shoulders to balance if you are using a bar
- The exercise you can do for a long time and keep improving (and see benefits from improving)

You have to learn to do it right:
- Like deadlift, it's a more complicated movement than you might think, bc many joints and muscles need to work together to do the movement correctly.
- As with deadlift, if you have poor technique, it means part of your kinetic chain did not do its job, and is not getting strong. Can cause injury if you don't have proper technique.

Squat vs deadlift:
- Both work similar muscles (and are both awesome)
- Squat works quads more (front upper leg more)
- Squat is slightly better for strengthening legs in general (and deadlift better for back)
YOU SHOULD DO BOTH

Recommendation:
- Start with 5-10 sets of 8 reps per week. (Can be all on one day or on two or three days).
- Beginners should start with weight that seems pretty easy.
- Everyone must track their workouts and progress.

Ray's Take

Exercise is the most powerful drug.

Yes. It's true. You've probably heard this before, but it's worth gaining knowledge of the actual evidence. I'm sure it'll make you motivated to start an exercise program, or stepping up your existing program.

VO2 max

To analyze, we are referring to a massive study of 122,007 people with average age of 53. Follow-up was average 8.4 years.

We all know smoking is bad, really bad. If you smoke, you were 41% more likely to die.
None of us want diabetes. If you had diabetes, you were 40% more likely to die.
None of us want heart disease. If you had heart disease, you were 29% more likely to die.
None of us want kidney disease. If you had end stage kidney disease, you were 2.78 times more likely to die.

Here's the evidence.
If you had low VO2 max, you were 3.9x more likely to die than if you had high VO2 max. That's crazy.

Just taking low VO2 max (bottom 25%) to medium levels (25-75%) you cut your risk of dying by ~2-3x. This is WAY MORE powerful than quitting smoking, or not having heart disease!

The higher your VO2 max, the less likely you are to die

This graph shows "there is no upper limit" to the benefit of improving your cardiovascular fitness (VO2 max). Survival probability on the Y-axis means how likely you were going to not die, over time which is on the X-axis. You want the graph to stay as close to 1.0 aka 100% as possible.

As you can see, there is a massive difference in survival (not die) rate going from low to below average. It's very cool that there is even a benefit going from high to elite. This means:
- Every single person should improve their VO2 max, with no "upper limit" of benefit for living longer
- If you are in the low category range (don't exercise), it is particularly important for you to start exercising

If you want to know where you land, here are the cutoffs for VO2 max:

If you have an Apple Watch, it gives you an approximation, though there are more accurate ways to measure.

Strength

To analyze, we are using a large study of 4449 people who were 50 or older, average age of 53. Follow-up ~10 years.

If you had low muscle strength (LMS), you were 2.34x more likely to die.
If you had low muscle mass (LMM), you were 1.47x more likely to die.
*Don't worry about ALM - that means appendicular lean mass aka muscles on your arms and legs
**1.47 comes from ALM/BMI meaning muscle mass per total body mass. ALM

Interesting points here:
- Strength is more important than muscle mass
- If you are strong, but have less muscle, its ok.
-If you have a lot of muscle but a lot of body weight, its actually not protective.
- If you are strong, you probably have more muscle too.

Stupid ideas

I already have high strength and muscle mass so I'm good
Without training, strength declines at least 1% per year. Probably closer to 2% and up to 4%. The compounding effect of this is crazy. 10 years at 2% loss per year and you'll be left with 81.7% of your strength. A massive decline.

I am already pretty fit and my Apple Watch says my VO2 max is above average so I'm good
VO2 max declines 10% per decade. You have to train to reduce this loss with age.

What I would do

Start or step up your strength and VO2 max program, immediately.

Ray's Take

Bench press is the best upper body exercise. It's the exercise I do the most. It's my favorite.

- Compound movement
- Works chest, shoulders, triceps, forearms, hands, core
- The best exercise for upper body
- An exercise you can do for a long time and keep improving (and see benefits from improving)
- Not hard to learn
- Can do with bar or dumbbells

Recommendation:
- Start with 5-10 sets of 8 per week. (Can be all on one day or on two or three days).
- Beginners should start with weight that seems pretty easy.
- Everyone must track their workouts and progress.

Stupid Ideas

Stupid idea: I lift whatever I feel like
Cmon man. You have to plan for progress. Write down what you lift today, and then beat it the next time you lift. I recommend increasing by 5 lbs every session until you fail. After you fail, try the same weight again. If you fail 2x, then lower by 10% and try the process again. If that fails, then you should shift to a new rep range and restart the process (IE if you were doing sets of 10 reps, do sets of 5 reps or vice versa). Just start with a weight that is doable.

Stupid idea: Do bench every day
You should not do this. Muscles grow as they recover. This won't kill you but its pointless bc you won't be able to improve your numbers without letting your muscles recover. And you have to improve your numbers to build strength (and build muscle).

Technique

Start:
- Choose a weight that will be easy. I suggest 45 lb bar only.

Steps:
- Lay on bench
- Put your hands directly over shoulder - start with this grip width (or just slightly wider)
---> I usually use the bar rings to make sure my hands are the right distance apart
- Make sure the bar is at the right height which means your arms are not fully extended when you reach up, so you can lift the bar off the rack and put it overhead
- Tighten your body, especially squeeze your butt muscle
- Lift the bar off the rack
- Slowly bring down to your chest, at the level of your nipples
- Touch the bar to your chest
- Push up to overhead

Pro tip:
RECORD IT WITH VIDEO FROM SIDE AND FRONT ANGLE

More advanced techniqu

Three tips to lift more:
- Press lats (upper back / shoulders) as hard as you can into the bench
- Squeeze butt as hard as you can
- Squeze bar as hard as you can

Ray's Take

Deadlifts are one of the best exercises you can do:
- Compound movement
- Kinetic chain is basically the entire body -> from feet through lower leg, upper leg, hips, core, back, shoulders, arms, forearms, hands)
- The best exercise for back muscles, zero doubt 100%
- The exercise you can move the most weight
- The exercise you can do for a long time and keep improving (and see benefits from improving)

You have to learn to do it right:
- It's a more complicated movement than you might think, bc many joints and muscles need to work together to do the movement correctly.
- If you have poor technique, it means part of your kinetic chain did not do its job, and is not getting strong. Worse yet, it can cause injury.
- If you can learn how to do it, and improve, you'll be stronger at everything else in life. It also often cures back pain paradoxically.

Deadlift vs squat:
- Can move more weight with deadlift
- Gets more upper body
- Gets more back
- Uses more hamstring
YOU SHOULD DO BOTH

Recommendation:
- Start with 5-10 sets of 8 reps per week. (Can be all on one day or on two or three days).
- Beginners should start with weight that seems pretty easy.
- Everyone must track their workouts and progress.

Stupid Ideas

Stupid idea: I don't want to deadlift (with no good reason)
RW response: Deadlift is one of the best exercises for you, period. I'd rate it #1. It is a compound movement, meaning it works multiple large muscle groups. Deadlift in particular is probably the best, bc its the exercise you can lift the most weight, which allows you to progress and get stronger and stronger with just this one exercise.

Stupid idea: Lifting too much weight, too soon
RW response: Please please please learn the right technique. Lower the weight until you can do it perfectly. Then do 3 sets of 8-10 and add 10 lbs next time. Do this....forever. It doesn't matter if you start with 65 lbs. That's actually better bc you can improve longer before you hit a plateau.

Stupid idea: I don't want to gain size
RW response: It's really hard to gain size. I can deadlift over 2x my weight and I don't think I've gained size in 10 years. It's also hard to gain size as you get older. You want stronger muscles and bigger muscles as you get older. In addition, if you really want to optimize for strength and not size, just aim for 4-5 reps. Bodybuilding requires at least 6 more like 8-10 reps per set to gain size.

Stupid idea: I want to gain size (but I don't want to do deadlift)
RW response: Deadlift is literally the best exercise, along with squat, for building size. When you do compound movements, with high intensity, your body produces testosterone, which increases strength and size. Deadlift is the best way to do this bc you can do more reps with more weight.

Stupid idea: I don't want to hurt my back.
RW response: You won't, if you learn the right technique.

How to deadlift

Start:
- Choose a weight that will be easy. I suggest 65 lbs which is the bar with a 10 lb plate on both sides. Use a full sized plate so the bar is off the ground.

Steps:
- Start with feet slightly closer then shoulder width apart
- Toes are straight forward or slightly pointing outward
- Hands wider than feet.
- Grip overhand grip with both hands. Can later switch to one overhand and one underhand (this is what I do on heavy weights).
-Turn chest toward forward wall and butt facing toward behind wall. This straightens back. Back should be perfectly straight IE neutral.
- Tense your entire body (IE all force should go to moving the bar with no extra slack meaning the first movement you make will move the bar up)
- Push through your feet and pull the bar up.
- Keep back flat the entire time
- Stop when your knees are fully extended
- Drop the weight in a controlled manner along the same path as you lifted (keep back straight the entire time)
- Repeat

Pro tip:
RECORD IT WITH VIDEO FROM SIDE AND FRONT ANGLE

TLDR: What you need to know

• If you want to get "ripped" (aka see more of your muscles, and having less body fat), the biggest mistake people make is working out, and then feeling like they've "earned" or "deserve" any extra amount of food. An alternate to this is they feel like they "need" a protein recovery shake.
• Instead, if you want to get ripped, you have to work out and then not eat any extra food.
• The reason is to get ripped, you have to lose fat, which means you need to lose weight. The only way to lose weight is by eating less calories than you burn.
• Lifting weights really doesn't burn that many calories, so you should not eat any extra.
• Lifting heavy and then having "the same" diet will lead to visible results.

Ray's Take

People tell me all the time that they want to get "ripped." How do you do it?

The answer is really simple, you have to lose body fat. That's it.

Your muscles are already ripped, you just need to remove the fat on top of your muscles to see them more clearly and be "ripped."

Here is me:

On the left, I was in college and 165 lbs - I didn't think I was "bad" but not one person ever said i was "ripped" or "huge."

On the right, I had graduated college, medical school, and business school and was 150 lbs - Many people said I looked "huge".....even though I was 15 lbs LIGHTER than in college. I didn't do DEXA, but I almost guarantee I had LESS muscle than in college. But people still felt I was "huge." Think about that.

The takeaway is that to look "ripped" or "huge," the solution for most people is to simply lose fat.

How do you do this?

Simple - Exercise and don't eat too much. For me, I like lifting heavy. You can do zone 2 (cardio) or zone 5 (high intensity) if you like and it will work too***

"Don't eat too much" means you have to be in a calorie deficit. Fancy people call this "calorie restriction" (CR).

We have many strategies to utilize CR that do not feel like restriction at all (see this, this, and this), but for now, lets just say if you want to get ripped, you should exercise and NOT eat anything extra.

Feel like you "earned" or "deserve" a burger, slice of pizza, ice cream, or even a protein shake is a mistake.

Don't do it. Just do your exercise, and follow the same nutrition plan you were previously on. If you are in a calorie deficit, you will see results soon.

***Lifting heavy is the best way to maintain or even build a small amount of muscle. If you only do cardio and you will lose muscle, which is bad.

Cool thought experiment for normal people - Protein shakes

I used to go to Barry's Bootcamp on Sunday afternoons and had a couple observations.

1. Virtually no one that goes to Barry's is actually ripped
2. Barry's is really hard! It is a very good workout!

For this thought experiment, let's assume everyone that goes to Barry's actually wants to be "ripped."

Why was this?
Simple - no one who goes to Barry's ever loses enough fat to have their muscles show.

Why not?
Simple - they were eating too much.

Who is to blame?
The person of course, but Barry's doesn't help.

You see, after each class, Barry's makes available a protein shake bar, where you can get a protein smoothie after your very hard workout.

I saw so many people ordering these things, which depending on the order, would have 600 calories or more.

This is insane. Let's think about this.

You just went as hard as you can at Barry's, which for guys lets say you were able to burn 500 calories in 50 min (this is a lot). Women even less.

After the class, you had a protein shake that was 600 calories.

The actual biology is a bit more complex, but lets just say that over the last hour (workout + shake slurping), you consumed more calories than burned.

Was the workout good for your VO2 max, mitochondrial health, cardiovascular health, and longevity?
Yes

Did you just help yourself get more ripped?
No

For getting ripped, I could argue that taking a nap or an easy walk without the shake would have been more effective bc you would have been in a calorie deficit napping or walking.

Let me be clear, I'm not saying don't have a protein shake. Protein is very important and you should get 0.5-1g per lb of body weight (which is hard). But if you have one, just stick with one scoop of whey protein in water or unsweetened almond milk. That's about 120 calories with 30-35g protein. Barry's + that would be ideal.

TLDR: What you need to know

• Zone 5 workouts are when you are working really hard, and your heart rate is 90% of max. You can think of this as training "VO2 max" and can do it from running, biking, swimming, or rowing. Improving VO2 max is highly beneficial for longevity, so we highly recommend it for everyone on the Ray Wu MD program.
• VO2 max is the maximum amount of oxygen your body can use at any given time.
• Higher VO2 max is directly correlated with longer lifespan.
• Finding out your VO2 max is best done through treadmill tests, but can now also be determined from an Apple Watch.
• You can improve VO2 max with a simple workout, 1x a week.
• Literally everyone in all age categories should increase their VO2 max through zone 5 workouts. It's never too late to start.

Ray's Take

Out of all the metrics we think are important, VO2 max is my the one I rank lowest in.

However, the data is clear. VO2 max matters.

Why? Higher VO2 max lowers your risk of dying. And in fact, training VO2 max is more effective than literally any medication you can take for increasing your lifespan.

Training VO2 max doesn't take too much time, but is purposely difficult when doing it.

Let's both make it a goal to increase our VO2 max this year!

How to train VO2 max

It's really pretty simple:
- Go as hard as you can for 4 minutes while running, biking, swimming, or rowing.
- Rest for 4 minutes.
- Repeat 3-5 times

Do this 1x a week.

Cool knowledge for normal people

Data from this study published in JAMA shows that
- Increasing your VO2 max from the bottom 25% to 25%-50% reduces your risk of dying over the next 10 years by 2x.
- Increasing your VO2 max from the bottom 25% to 50%-75% reduces your risk of dying over the next 10 years by 2.75x.
- Increasing your VO2 max from the bottom 25% to 75%-95% reduces your risk of dying over the next 10 years by 3.9x.

• Increasing your VO2 max from the 25%-50% to 50-75% reduces your risk of dying over the next 10 years by 1.4x.
• Increasing your VO2 max from the 25%-50% to 75-95% reduces your risk of dying over the next 10 years by 2x.

There is nearly no other medication or intervention in which you can impact your risk of dying by this much. And it is totally doable with 30 min of training, 1x a week!

Classification of VO2 max

TLDR: What you need to know

• Zone 2 workouts are when your heart rate is 60% of max, for a prolonged period of time. You can think of this as "cardio" from fast walking, jogging, biking, swimming, etc. This is a foundation of any health program because it is relatively easy, and so good for your health. We highly recommend it for everyone on the Ray Wu MD program.
• Zone 2 has so many health benefits, with the most important being that it is the foundation for good metabolic health.
• Zone 2 helps metabolic health by optimizing your mitochondria, the energy producers in your cells.
• When you optimize your mitochondria, your body gets better at using fat for energy.
• Literally everyone in all age categories should do zone 2 workouts. It's never too late to start.

Ray's Take

For most of my life, I was never the biggest fan of "cardio" which i used to think of as running.

I hated running. When I was in medical school, the only reason i would run is to burn calories so I could eat or drink more than usual.

Today, I realize how dumb I was back then.

Cardio, which we'll start calling "zone 2," we'll define as a exercising to the point where you can talk to someone else. However, it would be annoying for you and your conversation partner as you would breathing hard and speaking strangely.

In this state, your heart rate would be 60-70% of your max, which is largely determined by your age (roughly 220 - age).

Why was I wrong?

First, the reason to do zone 2 is not to burn calories. Rather, when doing zone 2, you are training your mitochondria (your cell's energy producers) to use fat for energy. This is is so important for metabolic health. One of the saddest things is that most people with a lot of body fat cannot use it for energy because their mitochondria are unhealthy. People who train zone 2 do not suffer from this problem.

Second, you are promoting something called "non-insulin mediated glucose uptake." Suffice it to say that this makes your body more insulin sensitive, which is the opposite of diabetes, and exactly what you want.

Third, doing zone 2, can increase heart rate variability (HRV), which is a good thing. When your body is adaptive, less stressed from having more parasympathetic response (rest and digest) vs sympathetic response (fight or flight), you have increased HRV. This is a good thing.

Fourth, and maybe most obviously, zone 2 is the easiest, lowest stress way to exercise, and exercise in general improves cardiovascular health.

Last, doing zone 2 isn't really that hard, and its therapeutic benefits are immediate. When I'm doing zone 2, I'm sweating, I'm feeling productive, I can even do work on my phone, listen to a podcast, or watch a game. So why not?

I'm literally optimizing my mitochondria and boosting my metabolism while being able to do what I was going to do anyways.

It's a no brainer for me, and should be for you too!

How can you do zone 2?
Literally any way you want:
- run outside
- run on a treadmill
- bike outside
- bike inside (I use a peloton bike on "just ride")
- swim
- row
- walk briskly

The only thing you should do is monitor your heart rate so you can see your improvement. The more you do, the higher your heart rate can be while still feeling good and "being able to talk to someone."

I do this through an apple watch but there are many other options.

How much zone 2 should you do?
There is no max. We recommend at least 2 hours a week for everyone on the Ray Wu MD program.

I personally use a Peloton bike for 2-3 hours per wk while maintaining 155-120 beats per minute.

My saving grace / unfair advantage? I love tennis, and have played my entire life. I play roughly 4x a week, and maintain an hour of 125 bpm. This gives me a "free and fun" 4 extra hours of zone 2 per week.

How much zone 2 should you do?

Literally as much as you have time for.

It's almost impossible to do too much.

Does zone 2 make me look better?

Honestly, yes. It will.

How? Zone 2 does burn calories and burning calories will help you lose weight and fat.

However, doing zone 2 is NOT for the calorie burn. It is for improving your cardiometabolic health.

Please do not reward yourself with pizza, ice cream, or a burger because you did zone 2.

It is way easier to not work out, not eat those bad foods, and have the same calorie equation.

Zone 2 will also not improve your strength or increase muscle much. For that, you need to work on building strength.

How do I start?

Easy - just start.

Run, jog, walk, bike, swim.

Go as fast as you can while being able to talk.

Go as long as you feel like (minimum 20 min).

Note - if you make it to 30-40 min, you'll feel better and things will get easier. This is known as the "runners high."

Cool knowledge for normal people

Mitochondria

Mitochondria are in all human cells. They are responsible for producing Adenosine triphosphate (ATP), the main energy source of the cell.

How mitochondria turn fat into energy

Mitochondria take fatty acids, and turn them into energy through a process called beta-oxidation.

When you do zone 2, you are working at the hardest level you can, while getting all of the energy to do so from fat. This causes your mitochondria to get better at "burning fat."

Optional info for nerding out

Beta oxidation from Wikipedia

Podcast from Peter Attia: Iñigo San Millán, Ph.D.: Zone 2 Training and Metabolic Health

TLDR: What you need to know

• No matter where you are starting, your goal is always to improve your strength on the core lifts you are focusing on. Usually, this will be bench, squat, deadlift, and chin-ups.
• Rule 1 is your must challenge yourself every single workout. To do this, you must avoid F-arounditis.
• Rule 2 is you can't get injured
• The balance between rule 1 and rule 2 is the art of getting stronger, and varies depending on your current strength level.

Ray's Take

Whenever anyone starts working with us, one of the first questions we ask is "What is your goal?"

100% the time the answer includes looking better, living longer, or feeling more youthful. To achieve any of those things at any age, you must start strength training. Here is an article on why.

I'd go as far as saying, if i know your weight, and your current numbers for bench, squat, deadlift, and how many chin-ups you can do, I have a very good idea of what you look like (without ever having to see you).

In other words, your relative strength (amount of weight you can move vs your body weight) determines how you look.

So let's list out the goals at each level starting with beginners and ending at elite. Then I'll give my simple plan that lets you advance the entire way.

Beginners

Goal: Learn the proper technique at light weights.

Learning the right technique for bench (with bar), squat (with bar), deadlift (with bar) and chin-ups is essential, as if you do not have the right technique, you WILL get injured. My recommendation to learn:

• 1) Watch videos on how to do the lifts, which should include things to keep in mind.
• 2) Go to the gym and try doing the exercises yourself with a light weight (just the bar works for most people) and video it. (Yes video it. Do not worry about others watching or judging you. This feeling is in your own head, and in any case who cares what other people think).
• 3) Watch the video and see what doesn't look right. Members on the Ray Wu MD program can send the video to one of our coaches for feedback.
• 4) Add weight so you can very comfortably do 8 reps of that lift (this will feel light).
• 5) Video it.
• For chin-ups, use a chin-up assist method if you can't do a body weight chin-up. If you can, there is minimal risk to injury so just do as many chin-ups as you can (chin-up grip and pull-up are both fine).

For those that do not want want to do the core lifts, I would recommend that you reconsider. There really should be a good reason why you cannot (usually injury related, or no access to equipment).

Alternate exercises:
- Chest press (dumbbell)
- Incline chest press (dumbbell)
- Chest fly (machine)
- Chest press (machine)
- Shoulder press (dumbbell)
- Single handed or double handed rows (dumbbell)
- Lat pull down (machine)
- Seated row (machine)
- Squats (dumbbell)
- Lunges (dumbbells)
- Thruster (dumbbells)
- Can replace all of the above with Kettlebells

All of the above are compound exercises that can be effective, if you make consistent progress on weight and reps.

Simple workout plan

After you have learned the correct technique, I recommend a very simple program to start, such as the following to improve your strength, methodically:
- work upper body (bench press) 2x a week
- work legs/back (squat and dead lift) 2x a week or 1x per week each per exercise
- do chin-ups up to every time you work out
- have rest days at least 2 days a week

This means you would have a schedule such as the following:
- Monday: Bench and chin-ups
- Tuesday: Squat
- Wednesday: Rest
- Thursday: Bench and chin-ups
- Friday: Deadlift
- Saturday: Rest
- Sunday: Rest
NOTE: You can do cardio or VO2 max training on rest days if you would like

If you can only go to the gym two days a week, then this works
- Day 1: Bench, squat, and chin-ups
- Day 2: Bench, deadlift, and chin-ups

You can mix and match however you'd like. You can also add in any alternate exercises from above.

For your workout days, make sure you warm up properly. This means starting with a very light amount of weight, and doing 5-10 reps for 3 sets. These are called warm-up sets.

After you are warmed up, you are ready for "work-sets." As a beginner, my recommendation is to start with a weight that you are very confident you can do 10-12 reps. Then do 5 sets of 8 reps. The key here is to start lighter than you think, bc we are going to increase that weight by 5 lbs every time you have a chest day, and 10 lbs every time you do squats or deadlifts.

NOTE - it is super important to write down your workouts, and methodically progress (read this on why)

Intermediate level metrics

Reaching an intermediate level should be a fairly straight-forward path with the simple workout routine above.

Strength Goals: Intermediate
Bench press: body weight x 1.2
Chin-ups or pull-ups: body weight x 1.2 or 8 reps with body weight.
Squat: body weight x 1.6
Deadlift: body weight x 2

For clarity, this means that if you are 150 lbs, you should be able to bench 150x1.2 = 180 lbs. Also of note, you do not have to do a one rep max. You can use a calculator such as this

To set expectations, this could take two years of consistent training and there shouldn't be a big injury risk if your technique is solid.

Advanced level metrics

The method to reach these levels is the exact same as before, but it will be slower progress, taking 5-10 years.

Bench press: body weight x 1.5
Chin-ups or pull-ups: body weight x 1.5 or 15 reps with body weight.
Squat: body weight x 2
Deadlift: body weight x 2.5

A 185-lb male that has been training consistently for 5-10 years should therefore be expected to:

Bench press 275-280 lbs.
Do a chin-up with 90-95 lbs hanging from his waist.
Squat 370 lbs.
Deadlift 460-465 lbs.

This is a serious accomplishment, and once reaching these levels, progress will be quite slow.

I really can't bench, squat, and deadlift

When people say this, my first question is why not?

Unacceptable answers include:
- I don't want to get bulky (even for women)
- I don't want to have big muscles
- I don't want to get injured
- I don't like it

Trust me, you won't get bulky from this and you won't get big muscles unless you are on steroids or eat a TON. Not getting injured is a legitimate concern, but that just means we need to start light and learn the right technique which is 100% doable. If you just don't want to do it, then most likely you suffer from F-arounditis and don't want to face that reality.

Acceptable answers typically include legitimate injuries. In this case, we would work with you to make a program that follows the same principles as the above simple workout, but that your body can tolerate.

For example, if you break your leg or tear your achilles tendon, you clearly will not be able to bench or squat for a long time. In this case, we would add exercises such as:
- Incline chest press
- Shoulder press
- Rows
- Other compound exercises from above that do not rely on lower body strength or stability.

It's important to note that the same principles hold. You must write down your workouts, and you must challenge yourself to improve without getting injured.

Conclusion

By far the best way to gain strength and muscle is by focusing on core lifts, and increasing the weight methodically over a long period of time.

If you cannot do bench, squat, dead, or chins, we have provided alternate compound exercises.

There are too many benefits of increasing strength (look better, live longer, stronger bones, etc, etc). It's never too late to start!