Under the Influence (with Jo Piazza) - Get Outside! The Indoor Epidemic Is Real and It’s Wrecking Our Brains

00:00:00.000 Hey all, Jo here and you are listening to Under the Influence. Today's episode is yet another

00:00:11.580 reminder that we all really need to get off our phones and back into real life, particularly

00:00:18.140 real life outside. Today I'm talking to Dr. John LaPuma about what he is calling the indoor

00:00:25.480 epidemic. We're spending something like 93% of our lives inside, under artificial light,

00:00:31.520 breathing recycled air, and glued to screens. And apparently, it is quietly rewiring our bodies

00:00:38.000 and our brains in ways we haven't fully reckoned with yet. And John thinks this is a real problem,

00:00:44.940 an actual epidemic. Today we're talking about what getting outside actually does for us,

00:00:50.960 that it's like a prescription better than almost any pills we could take. We get into what it does

00:00:56.860 to our sleep, our mood, our creativity, and why something as simple as stepping outside for a few

00:01:03.620 intentional minutes a day might be the closest thing that we have to a burnout intervention.

00:01:10.040 There is a lot in here that feels so wildly obvious and then also kind of revolutionary

00:01:16.700 because we have to change the ways we're living. It's not working for any of us,

00:01:21.540 and it's certainly not going to work for our kids. I loved everything that John had to say

00:01:27.020 in this episode. And look, maybe I'm going to start recording this podcast outside.

00:01:32.400 Right? Kind of fun. Who's with me? Let's all go outside. Let's all go outside and make a podcast,

00:01:37.260 guys. Here's my chat with Dr. John. All right. Hi, John. How you doing? I'm great, Joe. Great

00:01:49.460 to be with you. Great to be with you today. I just want to dive right in. What is the indoor

00:01:55.600 epidemic that you say we are in the midst of right now? The indoor epidemic is the way that

00:02:05.160 Our biology has been confined, along with the rest of our bodies,

00:02:10.320 indoors 93% of the time.

00:02:13.220 And that's caused really dramatic changes in how we live our lives 1.00

00:02:17.900 and in our health.

00:02:19.880 It's making us older and sicker and tired.

00:02:22.960 We evolved over 200,000 years, and we evolved mostly outside.

00:02:27.860 So in one or two generations, we've moved back inside,

00:02:30.700 and we've never left.

00:02:32.320 it. So the toxins inside and the chronic inflammation they provide, plus the disruption

00:02:38.680 in our circadian rhythm, those things together have created kind of a low ebb inflammatory and

00:02:46.420 sick state among many people manifested by anxiety and depression and many medical problems as well,

00:02:53.620 including insulin resistance and immune problems. What we haven't done is try to fix it or explain

00:02:59.700 why it's there. And that's what I did in this book. All of this terrifies me and also makes

00:03:05.860 so much freaking sense, right? Of course. Like we have all become indoor cats and you say that

00:03:12.700 we've become an indoor species even. And I can see it. I can see it in rising anxiety. I can see

00:03:20.640 it in rising depression levels. You recommend an outdoor prescription. What does that mean?

00:03:28.000 Well, the Outdoor Rx is a very simple and mostly free, by the way, way to fix our biology.

00:03:38.100 Much of this disruption comes because we don't pay attention to the signals that our brains

00:03:43.680 evolve to have and actually require light, air, and movement.

00:03:49.100 We pay attention to pixels.

00:03:52.000 That's what grabs our attention.

00:03:53.960 Ultra-processed food grabs our attention.

00:03:55.860 Anything going past really quickly grabs our attention, but light, air, and movement are

00:04:01.120 actually what our brain requires.

00:04:03.020 And what I mean by that is that light outside is 25 to 50 times brighter than the light

00:04:07.900 inside.

00:04:09.100 That bright light is what your brain needs, actually metabolizes to set your circadian

00:04:15.540 rhythm for the day, to tell you that you're alert and set your mood and your energy and

00:04:20.040 your focus and your metabolism.

00:04:21.800 So the Outdoor Rx is a simple way to use the time that you're already spending outside, which is about 7% of our waking hours for most people, that's the 7, and turn those incidental minutes where you walk to the car, you walk to the office, or you walk to school, or you walk across the lawn, you pick up a DoorDash, those are all incidental minutes, you happen to be outside, into intentional minutes.

00:04:50.860 So if you do that, you can turn those incidental minutes outside into medicine, which can help to improve your mood, your focus, your memory, your immune problems, your insulin resistance, your insomnia.

00:05:11.660 Sleep actually is one of the easiest things to fix with this.

00:05:15.140 And, you know, in my 30 years of practice, I found that the question that we ask the least is where people spend their time.

00:05:23.520 And yet it's probably the most important question that we haven't been asking and need to.

00:05:29.080 Because once you change that, once you change even a little bit, and I think the minimum effective dose, the research that I did shows that the minimum effective dose is 17 minutes a day.

00:05:39.820 Once you change that, you can turn those minutes into medicine remarkably quickly and feel so much better in sleep, in immune problems, in mood, in memory, focus.

00:05:54.460 I mean, I love hearing that because I am a terrible sleeper.

00:05:57.840 So anything that I can do to improve my sleep, why is it better for sleep?

00:06:01.680 Well, you know, most people, actually not quite most, 40% of people go to sleep with a lamp or a TV on.

00:06:10.660 So if you wake up in the middle of the night, you get all that bright blue light.

00:06:14.820 Those wavelengths give you that signal to wake up, and it's very hard to get back to sleep.

00:06:20.380 And we never get the outdoor signal.

00:06:24.060 Very few of us get the outdoor wavelength signal first thing in the morning that we need to wake up to begin with.

00:06:31.220 Most of us wake up, and what do we do?

00:06:33.220 We look at our device.

00:06:36.360 Those wavelengths, yeah, they're not biologically active.

00:06:39.820 They don't help you wake up.

00:06:42.480 But outdoor light in specific minutes, in specific dosages, in specific places does

00:06:49.540 help you wake up.

00:06:50.580 And not only that, it sets your melatonin for release that evening, 14 hours later.

00:06:56.840 It tells the pineal gland, which is where melatonin is made and stored, that you're

00:07:03.360 going to release it 14 hours later, you're going to have a good quality sleep.

00:07:06.760 if you get the right light early in the morning for long enough.

00:07:12.240 And you want to do it early in the morning

00:07:13.640 because that's when your retinal receptors

00:07:15.940 to the bright light from the sun are most sensitive

00:07:19.420 within the first 60 minutes of waking.

00:07:22.000 Oh, wow. Okay.

00:07:22.820 So it is a really good thing for us to get up,

00:07:27.060 go outside first thing in the morning.

00:07:29.500 Should we do it even before we have our coffee?

00:07:34.120 Yes. Light first, coffee second.

00:07:36.760 light first coffee second why is that you can do them simultaneously if you like

00:07:41.360 i like that i like i take my mug i take i'm i mean i'm i'm a crazy reckless person who doesn't

00:07:47.340 even put coffee in a to-go container i just take a mug right to school drop-off in the morning i

00:07:52.460 love that i think that's all good and if you're good right it's all good yeah especially if you

00:08:00.360 can get out before school drop-off and have 10 minutes to yourself you know the people who have

00:08:05.300 the least time are the people who we depend on most in our society, and moms are right

00:08:10.640 up there, caretakers, caregivers right up there.

00:08:14.800 And they are seldom outside, you are seldom outside, your listeners, many of them who

00:08:19.180 are parents, or particularly young parents, are seldom outside without responsibility.

00:08:25.380 Yeah, true.

00:08:26.520 So, you know, I wrote about, in my book, I wrote about a woman named Sarah who was a

00:08:29.860 caregiver for her mom, one of my patients who, her mom had early dementia.

00:08:34.920 And she was really reliant on Sarah.

00:08:37.460 And Sarah is an early middle-aged, very responsible, lovely woman who just didn't want to leave her mom alone and knew that if she wasn't there, you might fall.

00:08:48.240 And so she just was constantly there.

00:08:50.580 And like a lot of caregivers, she began to burn out.

00:08:53.620 And she would have about 15 minutes in between, you know, getting her settled and then having a little time for herself before she had to get to the next call because she was also working.

00:09:03.340 And I asked her to take that 15 minutes.

00:09:06.220 I write about this in Indoor Epidemic.

00:09:07.880 I asked her to take that 15 minutes. 0.99

00:09:09.680 She lived in a multi-level apartment building and go into the courtyard.

00:09:14.200 The courtyard is not especially beautiful.

00:09:16.720 It had a couple of trees and some strawberry, but it was a courtyard.

00:09:21.140 And I asked her to leave her device in the apartment, which she couldn't do.

00:09:26.060 So she took it, but she did put it on airplane.

00:09:28.540 And I asked her just to watch the different leaves move in the trees and to pick out different colors of green in that 15 minutes and try not to look at her device and just appreciate what it was to be outside for a moment away from her responsibility.

00:09:46.680 And at first she thought I was nuts because she just, I'd never heard that advice from a doctor, but she was getting all kinds of benefits from that.

00:09:54.320 She was getting the microbially rich air, the chemicals in the air from those trees that are beneficial for people and their immune systems.

00:10:01.360 She was getting away from the constant responsibility or prefrontal cortex going, oh, I have to do this, I have to do this, I have to do this.

00:10:12.220 That sounds familiar to a lot of people.

00:10:14.400 And she was also beginning to shift her adrenervic, her nervous system from adrenervic and sympathetic to parasympathetic, from fight and flight to rest and digest.

00:10:30.220 And after trying this for, you know, maybe four or five times a week for three weeks, she suddenly found she had left more patience with her mom.

00:10:40.000 that she herself, for some reason, was sleeping better,

00:10:43.640 even though it wasn't early morning light.

00:10:46.220 She was resetting her brain.

00:10:48.720 She was restoring her focus.

00:10:51.900 And that's what happens when you do any of the 250 things in the book

00:10:57.740 to try to give your brain a rest

00:11:01.520 and use natural forces to improve your own medical systems.

00:11:08.100 And so it's a simple example.

00:11:09.540 but it worked. And she was able to achieve some equanimity and feel less burned out and go back

00:11:17.460 and do a better job and eventually got some help because she realized that she couldn't do it really

00:11:22.020 alone, which is the truth for so many of us. Right. Right. Of course. Yeah. You know, last week

00:11:28.480 I was the author in residence at the Northern California Writers Retreat. And, you know,

00:11:34.180 it's in carmel valley the weather is beautiful and i did a lot of my writing especially my early

00:11:41.100 morning writing outside and i gotta tell you it made all of the difference in my creativity i

00:11:49.060 really think that it did i also you know i've become something of an amateur bird watcher which

00:11:54.660 means i have the merlin app and i look up all of the birds yeah but just listening to the birds

00:12:00.900 and then looking for new birds in the trees

00:12:02.700 and the noticing that you just mentioned.

00:12:05.640 Yes.

00:12:06.560 It made me feel a lot more present.

00:12:09.220 And then I think it really sparked a lot of my creativity in my writing.

00:12:13.180 Yeah, it does.

00:12:14.220 And you know why?

00:12:15.280 I'll tell you why.

00:12:17.340 This is true, by the way, for any creative.

00:12:20.840 Anybody who has creative impulses knows that some of their best work comes

00:12:26.380 not when they're going like, write this.

00:12:28.040 Like, I'm in front of the iMac right now.

00:12:30.020 So if I look below, I'm seeing the words underneath here, but that is not when your best work

00:12:37.280 comes and you're focusing hard on your work when you're trying to get, as you know, write

00:12:42.040 also.

00:12:42.520 And so I edit sentences and formulate paragraphs and I'm going, but that's not where the creative

00:12:47.720 impulses are.

00:12:49.100 The creative impulses that are most beneficial come when you are distracted, when your brain

00:12:55.860 is distracted from that intense precortical focus that is linear. Because creativity often

00:13:04.780 is based in sensory elements. And how do we understand nature? We understand it with our

00:13:13.760 senses. Birding is cool because you get to identify birds by their song and their color

00:13:20.980 and their flight pattern and their wing tips and their beaks. I love birding too, by the way.

00:13:26.800 But you are still bathed in different air,

00:13:34.320 which, by the way, is five times healthier

00:13:36.140 than almost any indoor air,

00:13:38.520 except if you live next to a smokestack.

00:13:41.520 Almost always outdoor air,

00:13:43.160 and because it's so much more quantitative,

00:13:45.680 it's so much larger, you dilute all those glutens.

00:13:48.900 And indoors, they're concentrated.

00:13:52.300 Outdoor air is cleaner.

00:13:54.640 Outdoor air moves.

00:13:55.860 You feel the air against your cheek or against your skin elsewhere, and you use your parasympathetic

00:14:03.640 system.

00:14:04.740 You can use your senses by touching outside, by listening outside, by seeing outside,

00:14:13.820 by smelling outside, by tasting outside.

00:14:17.840 And that, Stanford did a study showing that there was a 60% greater input with walking

00:14:24.740 outside than there was in focusing on a project inside. And with greater creative

00:14:34.360 input and output, you get better ideas. So what you experienced is what every creative

00:14:43.940 should experience. Take your medium, whatever it is, paint, sculpture, writing, woodworking,

00:14:51.780 outside. One of my favorite is gardening. And, you know, gardening is basically a serotonin

00:14:59.000 intervention. It's also incredibly sensory. I have a small organic farm. We grow lots of

00:15:04.120 different things, dozens. But what it does biologically is change, allow your brain to

00:15:12.040 release serotonin and act in the same way as many antidepressants do. There's a bacterium in the

00:15:19.820 soil called Mycobacteria vaccii that triggers that release of serotonin in your brain when you

00:15:28.100 garden. I think everyone should have their hands in healthy soil once a week because it changes

00:15:34.140 your microbiome on your skin to protect it. And it allows you to feel happier.

00:15:41.820 I love that. I love that for all of us. You just inspired me. After we get off this call,

00:15:45.320 I'm going to walk down to the garden shop with my girls and plant some spring flowers in front

00:15:50.540 of our house. That is so awesome. And you know what? A lot of people are, don't, I love gardening

00:15:57.260 and there are 71 million of us like you and I who are gardeners, but, and I don't sell these. I,

00:16:03.420 but I've made them up. I give them away at tops that I give. This is a coaster that has in it

00:16:09.060 my face and a qr code and um basil parsley and chive seeds so for people who are gardeners

00:16:18.260 and there's a qr code where you can scan it and it tells you how to plant it oh my god i love that

00:16:23.300 i want some send me send me some okay i will all right done send me your dress and i will all right

00:16:29.840 great so these are magic because for people who want to kill everything and i was once one of

00:16:36.820 those people. If you get organic, healthy potting soil in a pot and plant one of these and put half

00:16:44.240 an inch of organic, healthy potting soil on top and water it, this is something you can't overwater

00:16:50.220 like most houseplants, which you can. And you get basil, parsley, and chive, which are some of the

00:16:55.780 most anti-inflammatory herbs that there are. In fact, gram for gram, seeds, herbs, and spices

00:17:04.060 are some of the most anti-inflammatory foods

00:17:07.400 that we know of.

00:17:08.720 So you get A, things for your salad,

00:17:13.320 and B, the joy of nurturing something,

00:17:15.780 and C, your hands in healthy soil

00:17:18.500 to release serotonin in your brain,

00:17:21.140 and to improve your microbiome on your skin

00:17:24.580 and in your lungs and even in your GI tract

00:17:27.180 because as you touch the soil,

00:17:30.040 little parts of it are aerosolized.

00:17:32.300 Wow. All right. Great. Well, I know what I'm doing this afternoon. Let's take a really quick break. And when we get back, I want to talk about what this indoor epidemic is doing to kids right now.

00:17:49.700 Okay, we're back. I've already made my plan to get the girls out in the dirt this afternoon. What is the indoor epidemic doing to our children? 1.00

00:17:59.520 Well, let's see. Let's start.

00:18:01.520 69% increase in antidepressants over the last six years.

00:18:06.280 90% of children in Singapore are myopic.

00:18:10.240 They're nearsighted. 0.99

00:18:11.140 And in California, where I live, it's 40%.

00:18:13.940 And nationwide, it's less than that, but still rising rapidly.

00:18:18.300 Myopia is nearsightedness, and it's not a big deal.

00:18:20.880 You wear glasses, you get eye drops, you're done.

00:18:23.440 But about 5% of myopia is high myopia.

00:18:27.020 And that high market turns into eye damage by the time you're 30 or 35.

00:18:33.400 That's significant and sometimes long-lasting.

00:18:36.260 That's one out of 20 kids, and we don't need to risk that.

00:18:39.620 So in Singapore, there are public health campaigns for kids to spend two hours a day outside with their parents off their devices, because that's why this happens.

00:18:49.960 Because when your device is this far from your face, your eye physically elongates.

00:19:01.960 Children are getting longer eyes.

00:19:05.320 It's reshaping their eyes when they have what's called near work on phones, on tablets, on other devices.

00:19:15.780 What can parents do instead?

00:19:18.280 Well, you need to go outside and play with your kids.

00:19:23.020 And it's just a...

00:19:28.060 The data shows that kids do...

00:19:31.140 The amount of time that a kid spends on his or her screen

00:19:33.760 is often directly related to how much time the parent spends.

00:19:38.980 So it's really important

00:19:41.700 because just two hours daily cuts myopia risk by 45%.

00:19:47.140 And being outside in a meadow and with free play improves social skills as well.

00:19:54.300 And that's so important that people don't recognize or remember that nature is really

00:20:00.720 social.

00:20:01.520 And when kids play, they often play together.

00:20:05.120 And that's actually a really good thing because you learn all kinds of ways to communicate

00:20:09.680 with other people that you're not so alone in the world and that your reality is not

00:20:14.320 just what's in front of you.

00:20:15.380 your world's not getting bigger.

00:20:18.020 You think it's getting bigger

00:20:19.100 because you have a screen in front of you

00:20:20.740 and you see things from Thailand

00:20:22.720 and from Alabama and from the West Indies.

00:20:26.820 And all of a sudden the world seems full of anime.

00:20:30.700 It's actually making your worldview smaller.

00:20:33.900 It's narrowing your focus.

00:20:35.340 And even worse, and you know this

00:20:37.660 because you keep up on this, 1.00

00:20:40.800 Meta was just found liable for hooking kids

00:20:44.100 addicting them to social media. They use the same mechanisms that slot machines use. It's called

00:20:50.800 variable reward systems, where you give a kid a positive psychological boost, and then you take

00:20:59.200 it away, and the kid has fear of missing out, and so they scroll more. You know, scrolling is

00:21:04.920 basically junk food for the brain. And that needs to be reversed. And that's what the jury

00:21:14.380 in New Mexico showed. That's what the jury in California showed. And there are memos at that

00:21:21.080 trial that show that social media is actually trying to hook kids, to actually get them away

00:21:26.120 from their friends so that they can spend more time scrolling, which is bad for them in every

00:21:35.300 kind of digitally overloaded way that you can think of. It makes their worldview more narrow

00:21:39.900 and responsible at least in part for that big surge in antidepressant prescriptions. It certainly

00:21:46.540 makes myopia more common, more prevalent, and more likely. It reduces their socialization function

00:21:53.740 and ability to socialize, and it makes their worldview smaller and they become less imaginative,

00:22:01.600 less creative, less part of a society than they could be. So for them, it's kind of the same

00:22:10.580 thing as it is for adults, daytime before screen time. And so this is a really doable solution.

00:22:19.120 And I want to point out again, it's free.

00:22:22.740 Nobody profits when you go outside, right?

00:22:25.660 That's why nobody's marketing the outdoors as a health intervention.

00:22:30.900 Right.

00:22:31.620 Right.

00:22:32.120 Right at your fingertips.

00:22:33.660 And all you have to do as a parent, although I know that it's stressful and it's often

00:22:38.580 easier to hand a kid a device, is to go outside with them and do something like you did when

00:22:45.600 you were birding, or what I did for Sarah. Show different colors outside. Listen for different

00:22:52.080 sounds outside. Touch different textures outside. They're not what you expect, and they're not to

00:22:57.920 be afraid of. Still, like a quarter of people in the country are afraid of spiders, and you don't

00:23:03.120 have to be. Most spiders are actually good and won't hurt you, especially if you don't hurt them.

00:23:08.820 So daytime before screen time, let's model going outside, fly a kite, get a Frisbee.

00:23:16.520 There are 250 ideas of what to do outside when you are outside in this book.

00:23:21.400 I actually wrote it kind of like a workbook.

00:23:23.720 I didn't call it a workbook per se because I wanted to be able to give the science behind it.

00:23:30.380 There are 2,200 studies in this book and there are 20 pages of references again.

00:23:35.580 But at the end of each chapter, there are four or five fill-in-the-blank pages where

00:23:41.380 you can interact with the ideas given and try them.

00:23:45.960 You know, one simple practice, you don't like it, try another.

00:23:52.120 And parents can take control of this.

00:23:55.380 And so can educators, by the way.

00:23:56.800 The kid that's looking out the window at school should not be punished.

00:24:01.420 that kid is trying to reset his or her brain trying to get other types of uh input to rest

00:24:12.420 his or her brain which has been too focused on too many things in class for too long to do

00:24:19.420 productive work so the kid is actually was looking out that window at school actually

00:24:26.600 just needs to be accommodated and not told why aren't you paying attention because the kid

00:24:33.400 actually is paying attention but needs a brain reset to do so right that makes that makes so

00:24:43.360 so much sense i mean what are some of the things that you recommend for parents to do an outdoor

00:24:52.600 reset when you don't have two hours to go play outdoors in the day? What are some of the things

00:24:58.160 that you recommend in the book? Well, as I said, the minimum effective dose is 17 minutes a day.

00:25:05.040 But where you spend that time, who you spend it with, how you spend it, and it is almost as

00:25:13.600 individual as you are. I like the idea of getting morning light outside as a way to start your day.

00:25:20.400 It not only sets your melatonin level, but it gives you brain cleaning that night so that you engage what's called the glymphatic system, which is the system that was discovered in 2013 and Nobel was given in 2017, that actually physically cleans your brain at night.

00:25:39.560 And for adults, we care about the fact that it cleans out the beta amyloid and tau in our brains, which are the proteins that accumulate during Alzheimer's disease.

00:25:48.900 So, but for kids, especially,

00:25:52.180 we care that it helps to repair muscles

00:25:54.200 that were injured during the day,

00:25:56.380 that it helps them build bone,

00:25:59.420 and it helps them consolidate memory.

00:26:01.460 That's how, that's the time that you get at night

00:26:05.540 called deep sleep, where all this happens.

00:26:08.360 But the first deep sleep only happens

00:26:10.380 in the first half of sleep.

00:26:11.740 So unless you get morning light,

00:26:13.700 you don't get enough deep sleep.

00:26:15.500 And this gets worse when you get older.

00:26:16.960 kids get actually a lot of deep sleep because they're so young, but they get optimal deep sleep

00:26:22.840 if they get morning light. So I like for everybody, kids and adults, daytime before screen time. And

00:26:29.640 for you and I, light first, coffee second, or have your coffee outside. Okay. I like that.

00:26:35.420 I like that. And, you know, for that matter, lunch outside or a walk to the garden center,

00:26:45.540 if you can. Or walk almost anywhere else that's green. Because green and blue spaces, intentional

00:26:52.260 time in green and blue spaces, is what resets your brain. It's easier for your brain to digest

00:26:59.140 those, to see those shapes, to watch the way the wind moves, to smell different non-chemical smells

00:27:07.860 from inside that we get inured to because we're inside all the time. We don't even realize that

00:27:12.720 they've built up and than it is for us to stay inside.

00:27:18.380 And actually, when we stay inside, when possible, we should open the windows because in sealed

00:27:24.680 environments, CO2 builds up and there can be even a big cognitive drop of 15% or so

00:27:32.000 once you get about 1,000 parts per million of carbon dioxide.

00:27:36.040 And some schools and businesses have installed CO2 meters so that they can track CO2.

00:27:42.100 and when it gets too high, open the windows.

00:27:44.980 In school conferences, I like to ask people to open the window

00:27:48.240 to upgrade the IQ of the room,

00:27:50.180 which sometimes gets a wink or a laugh,

00:27:53.880 but it's actually true.

00:27:55.700 You need fresh air as an input to get rid of some of what's inside,

00:28:01.820 including the carbon dioxide that we're exhaling,

00:28:04.340 to perform optimally.

00:28:09.600 Fascinating.

00:28:10.120 yeah all right you're making me one i want to open every window in my house now

00:28:14.700 and then i'm going to the garden store okay let's take one more quick break and when we get back i

00:28:19.680 want to talk about digital obesity which you talk about in your book and how it's and how it's driving

00:28:26.600 burnout. Okay, we are back. What is digital obesity? Like too much sugar burns out your

00:28:42.720 metabolism. Too many pixels burn out your brain. We're just overwhelmed by pixels. We spend five,

00:28:50.660 six, seven hours a night on a day on a device. Scrolling is like junk food for the brain.

00:28:58.240 And we are overwhelmed by pixels and we have become digitally obese about them. We've become

00:29:06.940 digitally obese with pixels so much so that we need a refresh and we often can't escape. And

00:29:14.380 Because scrolling is built for us as basically an addictive form, kind of like ultra-processed

00:29:21.020 food is, it's very easy to gorge on and not feel satisfied, right?

00:29:26.920 What does that lead to?

00:29:28.040 It leads to obesity.

00:29:29.520 But the good news is that you can break that.

00:29:33.740 And the way to break it is where specific doses of light and air and movement, especially

00:29:41.900 green movement outside, green movement spaces. You've asked about burnout. I think digital

00:29:47.340 obesity is burnout. It's not a character flaw. It's not because you're not tough enough.

00:29:55.720 Burnout is not an inherent personal problem. It's an environmental problem. The environment

00:30:03.460 is causing burnout. It's not the person is weak and can't handle the environment. It's that the

00:30:11.640 environment is toxic. And that environment is one that is in schools. It's in offices. It's

00:30:20.380 in businesses of all kinds where we're basically forced to work constantly on screens. Now we're

00:30:29.740 on screens now. We want to be productive. I love being productive and having achievement and

00:30:35.200 having to write indoor epidemic. I had my butt in the chair a lot. And this is my eighth book.

00:30:41.640 So I know what it's like to sit in a chair and write a book and have a screen.

00:30:48.060 So I'm not saying never do that.

00:30:50.280 In fact, you should do it.

00:30:51.580 And technology is great for accomplishing work.

00:30:54.440 It just isn't everything.

00:30:57.260 And the mistake we've made is thinking that it is everything.

00:31:02.560 And outdoor light, air, and movement is nothing.

00:31:05.400 when specific exercises outside combined with some inside actually reduce all-cause mortality

00:31:12.500 by 19%. Inside exercise does not do that by itself. You have to have inside and outside,

00:31:20.620 and walking, by the way, is the most powerful. We've tried to, when we're burned out, we sometimes

00:31:27.120 think, okay, I'm not getting enough nutrition. I'm going to supplement. I'm going to get energy

00:31:32.440 from energy drinks, from every kind of new supplement I can find. But you can't out-supplement

00:31:40.080 in an indoor life. You have to change that environment a little bit. And it's not even

00:31:46.460 very much. We're already spending the time that we need outside. We're just not doing it very

00:31:51.560 intentionally. When we spend time intentionally in blue or green spaces, in any of the ways that

00:31:58.520 I describe in the book, that add up to a minimum of 17 a day. That's where, by the way, the data

00:32:04.360 shows that memory improves, that mood improves, that focus begins to improve, that blood pressure

00:32:11.380 begins to drop, that sleep problems tend to improve. That minimum effective dose, particularly

00:32:17.340 when done in the early morning, but even also in the evening, if we watch the sunset, those are red

00:32:23.900 and amber waves. And what do those colors do? Those colors are the only wavelengths of light

00:32:30.920 that do not suppress melatonin. You want melatonin at night because you want to be

00:32:36.880 able to go to sleep so you can get up and be prepared the next morning. Instead of staying

00:32:40.600 restless, which often people who are burned out do, they stay restless. And what do they do?

00:32:45.420 Before they go to bed, they're looking at their device. But bright brew light an hour before bed

00:32:51.580 suppresses melatonin by 80% and you're not going to get good quality sleep. So you need to develop,

00:32:57.920 when you're burned out, a sleep ritual that is yours. And I describe like 10 different types

00:33:05.060 of sleep rituals in the book. But one of them that I like is chamomile tea, finding an analog

00:33:11.780 book. I just happen to have this one. But you need a physical book instead of a digital book

00:33:19.740 and page through it or a magazine page through it it's different than on a screen and it relaxes

00:33:27.000 your eyes it takes away some of the tension just like distance takes away the tension people who

00:33:32.620 are burned out need to stand at a window and look at the distance for a minute an hour what do i

00:33:39.900 mean by distance i mean try to get a sky view try to try to see the sky if you can't see the sky

00:33:46.700 try to see a building top really far away.

00:33:50.980 If you can't get outside,

00:33:54.500 or if you're in a city,

00:33:55.960 go to a fire escape and look out

00:33:57.440 or a threshold or any window.

00:34:01.000 You want to see as far away as you can.

00:34:02.720 Why do you want to do this?

00:34:03.560 Because it relaxes your muscles around your temples

00:34:06.920 and your ciliary muscles,

00:34:08.920 which scrunch in your eyes

00:34:10.440 and make them feel really tight

00:34:12.180 and make you have a headache and mild fatigue.

00:34:16.640 That distance, your eyes need distance

00:34:18.960 like your lungs need air, by the way.

00:34:21.160 That distance is relaxing for your eyes.

00:34:23.680 It allows you to reset so that you can focus

00:34:25.940 and feel less burned out.

00:34:28.260 You know, burnout has lots of different layers,

00:34:30.740 but this is a simple solution

00:34:32.960 that almost everyone is missing.

00:34:35.780 And I want to point out again, it's free,

00:34:38.880 but also a prescription, deliberate.

00:34:42.900 Where and when and how you do this

00:34:45.060 matters. And that's what the details are. You know, I recently moved my computer

00:34:53.040 so that I'm facing a window while I work. And I swear, that's also made all the difference.

00:35:01.660 And well, it should. I have, you can't see it because I'm seated, but I have

00:35:07.320 four windows, actually six in front of me. And I planted all of what's in front of me. So

00:35:14.540 there's that. I can see it move. But we're not, we're lucky to have that view. Not everyone has

00:35:21.700 that view. And so getting up and looking out at a window, wherever it is, even if you're in a

00:35:29.160 cubicle office without any windows, or a cubicle classroom, God forbid, without any windows.

00:35:35.820 During breaks, you try to go to a window, try to go to a doorway and see outside. It will reset

00:35:44.280 your focus so that you can pay attention better in school, at work, wherever you are.

00:35:51.180 And it's so easy and it's also free.

00:35:53.460 That's right.

00:35:54.140 And we haven't really even covered movement or the sky or the stars or the ground.

00:36:00.920 We mentioned gardening briefly, but there are a lot of details about why it's important

00:36:05.560 to have time in those areas too and how bountiful they are, how social they are and how

00:36:14.260 interesting and fun they are, with the practical examples that I give and the kind of workbook

00:36:20.100 ideas at the end of each chapter. Well, talk to me a little bit about the stars. Why is it good

00:36:27.000 for us to go out and stare up at the sky? There are a lot of reasons. And the sky during the day

00:36:35.300 is a really comforting color. It's usually blue or a shade of blue. And that natural color is

00:36:41.520 relaxing to our brain and something that it easily understands and metabolizes. The sky at night,

00:36:48.100 and you might like this as you are interested in birding, has especially, you know, the

00:36:53.040 conformations of stars and the way that stars have patterns is interesting. And it takes you

00:37:02.180 out of the pixel environment, takes you off the scrolling, the doom scrolling, so that you

00:37:10.300 see, you do your biology response in several ways. One, you're using your senses because you're

00:37:17.900 outside. And that means, as we said, touch and hear and see and smell and taste. And that's very

00:37:26.620 different than using your cognitive brain where you're trying to figure stuff out or have lists

00:37:30.560 of things to do. Relaxing and complementary to that function. And then lastly, enables your

00:37:39.180 It often invokes the phenomenon of awe because the sky is awesome, literally.

00:37:47.540 It's larger than anything on earth and gives you a perspective, not just a perspective

00:37:54.660 that your problems are small compared to the universe, but even more amazingly, I think,

00:38:01.580 It changes the way that your brain works so that the hormones that are released in your

00:38:09.320 brain function to improve focus and improve memory, which doesn't happen when you don't

00:38:19.420 have that kind of awesome appreciation of a natural phenomenon.

00:38:25.200 So there are many details about the sea and the sky and the stars.

00:38:29.360 the C is also interestingly underneath. We did a project with children who were getting vaccines,

00:38:36.560 flu vaccines. And because one of the, my colleague's daughter was deathly afraid of

00:38:46.040 shots. And so we wanted to design a trial to help them help other children who were deathly afraid

00:38:52.000 shots and and so we gave them um an oculus that showed the beach um and showed the sky and and

00:39:04.440 the ocean and you could go under the ocean in this um app in vr app and swim with fish and then when

00:39:13.860 you came out you could look at the sky and you could look at the beach and it was a free app

00:39:19.640 um and the we used the oculus that was a actually a very cheap version at the time it cost literally

00:39:26.500 twenty dollars and and we did a control trial of children in a flu clinic flu vaccine clinic

00:39:34.280 that showed dramatic differences in kid enjoyment of the experience in a parent enjoyment and

00:39:44.160 experience and in nurse enjoyment of this experience, they felt that the clinic went

00:39:51.720 much smoother. We presented these data in Rome at a pediatric meeting and changed policy here

00:40:01.320 in Santa Barbara so that now any children who get shots and are fearful are offered this Oculus.

00:40:09.280 In fact, Oculus donated a dozen headsets of nature simulation.

00:40:16.980 So, you know, is that brain distraction?

00:40:20.200 Is it something else because it's only two-dimensional and not three-dimensional?

00:40:25.160 I don't know.

00:40:26.600 And it isn't the same as going outside.

00:40:29.100 But it's a virtually free intervention that made flu shots dozens of times easier,

00:40:36.460 made everybody happy and didn't cost any more time in clinic and changed practice.

00:40:43.880 So, and that was with these awesome creations of swimming with fish and looking at the stars.

00:40:53.540 Even, and this is now five years ago, and I know the technology has improved even more

00:40:59.900 since then. So there are dozens of imaginative ways to do this. And I was just able to pull

00:41:08.020 together many different literatures to try to synthesize my own training as an internist and

00:41:16.300 as a chef and now as a farmer for the last 15 years, to try to put together this idea that

00:41:24.820 we are not our environment, that we've been treating, medicalizing. And what's really an

00:41:31.300 environmental deficiency, and our environmental deficiency is that we're not outdoors in the

00:41:37.900 needed metabolic, biological ways that our brain, our metabolism, and the rest of our bodies require.

00:41:45.740 But when we do go outdoors directly and purposely, intentionally in blue and green spaces,

00:41:53.840 we can turn minutes into medicine.

00:41:57.380 Well, you inspired me, obviously.

00:41:58.960 So I'm just going to end this interview now

00:42:00.400 and go to the garden store.

00:42:02.100 John, will you tell our listeners

00:42:03.580 where they can find you

00:42:05.480 and where they can find your wonderful book,

00:42:08.300 The Indoor Epidemic?

00:42:09.880 Sure. 1.00

00:42:10.420 If you want to know where to start,

00:42:11.940 I wrote a free seven-day outdoor reset

00:42:14.020 that everybody can have at IndoorEpidemic.com.

00:42:17.760 And it's simple.

00:42:18.920 It's a one-page simple summary

00:42:20.980 of many of the top points in the book.

00:42:23.600 and try them if it works for you.

00:42:25.440 There are 250 more in the book.

00:42:26.980 You can get that at IndoorEpidemic.com

00:42:29.260 or wherever books are sold.

00:42:31.740 Wonderful.

00:42:32.360 Well, go have a great rest of your day outdoors, John.

00:42:35.300 Will do.

00:42:35.840 Thanks, Joe.

00:42:53.600 Thank you.

00:43:23.600 Thank you.

Under the Influence (with Jo Piazza) - April 16, 2026

Get Outside! The Indoor Epidemic Is Real and It’s Wrecking Our Brains

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