Know Your Physio

Interoception: The One Word That Changed My Health Forever | Part 1

• Andrés Preschel • Episode 136

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Quitting Adderall was the hardest thing I’ve ever done—and one of the most transformational. In this episode, I open up like never before about my journey from being a highly medicated, underweight teen with low self-worth to becoming a high-performance health coach grounded in neuroscience, data, and deep empathy. We talk about the emotional and physiological toll of stimulants, and how I began to rebuild my brain and body from the inside out through exercise, sleep, nutrition, and self-awareness.

Joined by Carlos and Miguel Bertonatti on Beyond Biohacking Brothers, we dive deep into the three most important health metrics I believe everyone should track for longevity and performance: VO₂ max, heart rate variability (HRV), and body composition. I explain how these markers work together, why most people are too stressed to truly optimize them, and how sleep is the real secret weapon for recovery and high performance.

This conversation isn’t just about quitting Adderall—it’s about becoming your own Chief Medical Officer and learning how to feel again. Whether you're struggling with ADHD, burnout, or just trying to reconnect with your physiology in a world that constantly pulls you away from it, this episode will show you what’s possible when you stop numbing and start listening.

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Topics:

[00:00:00] Quitting Adderall and its impact.

[00:03:34] Adderall and childhood struggles.

[00:08:00] Overcoming gym intimidation.

[00:11:02] Overcoming academic challenges and identity.

[00:12:58] Aligning inner and outer worlds.

[00:19:05] Lifestyle medicine and disease prevention.

[00:21:20] High performers and lifestyle intervention.

[00:25:24] Human KPIs for longevity.

[00:25:56] Body composition metrics for longevity.

[00:29:10] Sleep as a health calibrator.

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Andrés Preschel:
Yeah, but by the way, quitting Adderall was the most difficult thing I've ever done. When you stop taking it, your brain feels like mush. It was the worst thing that ever happened, but the best thing that ever happened in the sense that I gained so much wisdom and strength from that experience, and now I can put myself in the shoes of people that I want to help. Most people aren't gathering objective data about their body on a regular basis with medical-grade tools and devices and technology, so they don't know any better.

Carlos Bertonatti: empowering people to understand their biology at a deeper level.

Andrés Preschel: Most people have such high levels of baseline stress, of chronic stress, that when they do the training required to elicit increases in VO2 max, they get exhausted, they get burnt out.

Carlos Bertonatti: I'll tell you this, for all you guys that think that this is hocus pocus stuff, this stuff works.

Andrés Preschel: I've never mentioned this on a podcast before, and you're really bringing up a lot of emotion right now, but bro, I remember I went to UN. Don't cry right now. I'm not gonna cry on you, don't worry. I'll cry on you. No, please do, please. I'm not gonna cry.

Carlos Bertonatti: Hey guys, welcome to another episode of Beyond Biohacking Brothers, where we discuss all things health optimization, longevity, biohacking, and beyond. As usual, I'm joined by my brother Miguel, and today we have the privilege of speaking with another pioneer in biohacking, Andres Prischel. And, I'd like to add, one of the best looking and youngest faces in biohacking. And Venezuelan.

Andrés Preschel: Carrying the blood, carrying the legend.

Carlos Bertonatti: We're very proud of our own. Andres is a leading expert in the field of health optimization and longevity. As a serial entrepreneur and one of the most sought after consultants for longevity, high performance, and biohacking protocols, he's worked with some of the top minds in the space to bring the most cutting edge tools and knowledge to the forefront. And he's here to share some of the incredible insights with us today. So Andres, thank you so much for coming, man. We're so excited. we've been with you at certain conferences and we've heard you speak and we're like man this dude is awesome so you know we just kind of want to honor your work and talk a little bit about you know um everything that you do and all the people that you've worked i mean at such a young age man i just want to say that i honor that and i'm proud of you man because you've done a great job and in establishing yourself in this industry, and to your credit, for good reason. So just kind of tell us a little bit about how you got into this, man. What drove you down the path of biohacking and longevity and that path that you have embarked on?

Andrés Preschel: Yeah, for sure. I mean, first of all, thank you for having me. I mean, this is so exciting. I haven't been this excited to do a podcast in, I can't even remember how long. The energy that we have together is magnetic. It's the culture, it's just seeing.

Miguel Bertonatti: And we embody the bow hacking word itself.

Andrés Preschel: You gotta live what you preach, you know what I mean?

Miguel Bertonatti: At the end of the day, it's very relevant. Fun fact, he's one of the best shaved people I've ever seen, but I'm in better shape.

Andrés Preschel: At the end of the show, if you stick around until the end, we're all going to take our shirts off.

Carlos Bertonatti: Narcissism is a problem in our industry.

Miguel Bertonatti: There's a bit of an issue, but… We work really hard for this, man. Yeah, it's fair, it's fair.

Andrés Preschel: You're like an Austin Martin and I'm like a Ferrari, how about that? I'm not even going to debate you on that. We got time, we're limited on time.

Carlos Bertonatti: Alright, alright, cool, cool. So what drove you down this path, man?

Andrés Preschel: So look, I started biohacking technically before biohacking even existed just as a word, as a theme. And I was just a guy that thought I had a broken brain. I spent a decade of my life taking Adderall just to acclimate to this broken modern school system and to support my self-esteem as a young guy. How you do in school is very much tied to your self-esteem when you're a young person. Well, we share that. I'm the same way. Yeah Adderall same thing. How many milligrams were you taking? 60 milligrams. Oh god me too bro.

Miguel Bertonatti: I would take 60 milligrams and drink a half a bottle of whiskey to go to bed because I turn off my brain.

Andrés Preschel: I was a pothead in high school most people wouldn't expect to hear that from me but that's that's what I needed to self-regulate I didn't know any better.

Carlos Bertonatti: You're one of the few people that I've met that actually were prescribed 60 milligrams which by the way for the average listener I mean, just 10 milligrams today will keep me up an entire day.

Andrés Preschel: Yeah, it's cocaine. Yeah, it's cocaine. And you give that to a 17-year-old kid. I was 8 years old when I started. Oh, wow. That's a crime. I took it until 17.

Carlos Bertonatti: So you're modulating your brain. That's why you're so messed up. That guy should go to prison. Who gave you that? Don't even tell me.

Andrés Preschel: Well, I'll tell you something. My parents are medical doctors. I've always admired them for what they do. Wow, look at that. They are the biggest fans of my brother and I and the best parents we could ever have.

SPEAKER_04: Yeah, beautiful.

Andrés Preschel: And they just, they did their research and they didn't, there's just, there wasn't, the information, like it is, it just wasn't out there. It wasn't pervasive. You know, we're doing this podcast to bring information out there so that our kids don't have to take that shit. Correct. You know? My parents, my mom did her due diligence. She looked at all the research, considered so many different things. I did cognitive behavioral therapy. I did Adderall. I did Vyvanse. You name it. And my parents really did the best and at home we had access to extremely healthy foods. But when you're on amphetamines, you don't want to eat anything. I survived off of insurer shakes. And there were days where I probably had just one shake, like 300 calories. I was skeletal. I was almost anorexic. I would wear a long sleeve shirt to school every single day, even in the summer months here in Miami. And nobody knew the way I looked. It wasn't until one time, I remember I went to my friend's house just to hang out after school. We were on a trampoline and I took my shirt off and everyone was having a good time. I take my shirt off, everybody stopped and just looked at me and they're like, dude, like what, what the fuck's going on with you man? So bone, I'm bone. Yeah. Yeah. Skin and bone. And then I remember, you know, as this kind of progressed, you know, certain people in my life started expressing a sensible level of concern. At that point in time, it was my ex-girlfriend and her family. And then my brother, my brother was like, dude, like, dude, you look like a Holocaust survivor. What the fuck? This is really bad. And anyway, that's just how things were. And like I said, like I was just trying to acclimate to the school system and get by. But even with the maximum prescribed dose, I was still a mediocre student. And I thought I was like this, I just had a broken brain. All of this kind of happened by accident. Like how I started to fix myself, it kind of happened by accident. Even though people were motivating me and like, obviously, you know, getting into college and like living life my own was like, was like right there. Nothing really clicked and I didn't really know what to do.

Carlos Bertonatti: When I was in my- And you went to school for exercise physiology, yeah?

Andrés Preschel: Eventually, yeah, yeah. So this was all in high school is when I started to realize how bad this was and that I needed to fix myself. But I didn't really know how. There was, there weren't any answers out there. So what happened was, I signed up the summer before my junior year of high school, which is the most difficult year, as you know. I signed up for a summer scholars program at the University of Miami. As a high school student, you go to a college campus and you just gain credit for classes over the summer, so you beef up your resume. Originally, I had signed up for a class on viruses. I thought that was really cool, whatever. For whatever reason, I guess by the luck of the draw, They didn't end up running that class, and they shifted everyone from the viruses class into neuroscience. And so I was there on a college campus on a summer break, so I wasn't on the medication, because it was summertime. And I was learning about neuroscience with unlimited access to all of the things that I had deprived myself of that elicit neuroplasticity. So exercise, unlimited access to the gym and the dining hall, so the food and nutrition, social life. I was able to sleep. And in those two, three months that I was doing this program, for the first time in my life, I felt confident. And I started gaining muscle. And I soaked this up like a sponge. I gained muscle so quickly because I had been so deprived. People thought I was taking steroids. I have never taken anything like that in my life.

Miguel Bertonatti: And did you know what you were doing in the gym? Because when I started, I had no idea.

Andrés Preschel: I was lifting curls for bicep curls. Funny I've never mentioned this on a podcast before and you're really bringing up a lot of emotion right now But bro, I remember I went to you right now. I'm not gonna cry on you. Don't cry Remember this Parker you can do anything Anyone has been to a gym is gonna understand exactly what this means how it feels as soon as I say it I got into the gym and there's this massive space right this massive open space. Everyone's doing the thing and And the only place that I felt comfortable in was that little corner where the machines are, as far away from the free weights as possible. Because all the guys that were doing free weights were like these jacked guys, like they know how to move the weight around. I just did the little machines, I just went to failure, whatever. And even with that, bro, it was enough stimulus to get me to grow. Look at that. So I became obsessed. As soon as that happened, I was like, oh my God, I need to exercise more, I need to eat more, I need to sleep. Were you still taking Adderall at this time? No, he wasn't. No, no, no, I was still taking it. But you were on summer break. I was on a summer break, but I was getting prepared to take it for the most intense year of school.

Miguel Bertonatti: Which is pervasive in school and for studying. There's an epidemic with that.

Andrés Preschel: They use it, everybody's selling Adderall. By the way, and I'll say, and I'm very proud to say this, I was one of very few students that could have gotten more time on my exams on like the ACT SAT And I said no Why did I say no and by the way, I have so many people that I know that that printed fake slips to extend their time Yeah, like if you have an ADD ADHD, they give you extra time. I didn't have I I could have gotten I didn't do because I knew if I can look forward into my life like I didn't want to I didn't want to rely on that to feel good about myself. And as I was learning all this stuff, I was like, nah, like I have to focus on these habits and do this. I don't know how I gained that wisdom, but I was like, I need to do more of this.

Carlos Bertonatti: That's so funny. I did the same thing too. I was allotted extra time and I didn't take it. Yeah, I didn't take it. I didn't want to take it.

Miguel Bertonatti: I didn't want to feel like that was the reason why I was successful. I took the teacher, I cheated, I acted down syndrome. Change the answers, please. Bro, C's were an A plus for me, okay? That's how it was for me too. D's were like a B for me. I barely made it through school. It was a nightmare school for me. I had a tutor until I was like 17. I'm like, I can't continue having a tutor. I'm freaking self-reported here.

Andrés Preschel: I wouldn't believe how involved my mom was to help me do my projects. And dude, you wouldn't believe it. The only thing that really helped me as a student was I took a lot of AP classes and I was like a cool nerd. I took a lot. It was like very competitive with my friends. How many AP classes can you take? I ended up getting really good awards as an AP student, but as far as getting homework done, I'd go home, I'd play video games, and I'd go fishing. I did not do any homework. What I was relying on to get by in school and get into a good university was my standardized exam scores and my activities outside of school, community service, et cetera. Anyway, all that is to say that I decided to double down on this during the most difficult year of schooling, and I went from being a mediocre student to achieving the 99th percentile for the ACT without extra time, and I ended up getting the highest award as an AP student. I got the AP Scholar with Distinction, and I got all these awards all of a sudden. Like, dude, that was not me. That was not me. Seriously, it was not me.

Carlos Bertonatti: It's funny, because that kind of changed your identity, where like, hey, I am capable of doing this, right?

Andrés Preschel: Yeah, but by the way, quitting Adderall was the most difficult thing I've ever done. Oh, no.

Carlos Bertonatti: The symptomatology is insane.

Andrés Preschel: I begged my mom to help me quit. I remember that before, because she used to keep the pills in the kitchen, before she took them from the kitchen, I grabbed some and I hid them in my room. I would take them just to feel good. It was nuts, bro.

Miguel Bertonatti: It's funny because it took me, I was on Adderall for almost 15 years. I forgot the name exactly of the shoes, but they gave me, I used to work at a body shop, and they made me some shoes, pajazuela, como pajero. Something like that, because you would ask me, bring me a wrench and I would bring you, I don't know, a shovel. Like my brain, you stop taking it and your brain feels like mush. And thinking just makes you sleepy. The reason why it's so addictive is because the withdrawal effect is so hard that you fall back so easily.

Andrés Preschel: If I hadn't had that summer and learning exactly what I was learning in that environment, I would not be having this podcast with you guys right now. I would be a depressed doctor or something like that.

Miguel Bertonatti: And unfortunately, the story is sad for a lot of people that are still hooked on it.

Andrés Preschel: I know 50 year olds that are still taking it. I mean, look, it was the worst thing that ever happened. We'll switch gears in just a second, but it was the worst thing that ever happened, but the best thing that ever happened in the sense that I gained so much wisdom and strength from that experience and now I can put myself in the shoes of people that I want to help because yes, I went to school and I studied all the underlying mechanisms of exercise physiology, psychology, nutrition, neuroscience, but my number one form of credibility, and I say this all the time, is the empathy because I was so disconnected from my body and it created these massive issues. Now when I work with people, I can feel that pain and I help them get back in touch and I help them close the gap. Basically, so that they can align the world beyond and the world within. Because our modern environment, our modern world evolves exponentially. Our physiology evolves linearly. And just like me, I was in school basically in a modern environment trying to acclimate to it, but becoming more and more detached from my physiology, from my body, to be someone that I wasn't. And so I had to honor, because I do have a genetic predisposition for ADD. I have lower baseline levels of dopamine. But when it comes to the things that I actually enjoy, and I'm sure you guys are the same, you're like hyper-focused. That's all you want to do. So basically I leveraged, and I got to understand and leverage those mechanisms, and I doubled down. And it just so happens that because I have a relevant story and pain point, That's what I wanted to study. So I applied my scientific mindset that I gained from my parents and the way that they approached their work as medical doctors. I mean, every single night at dinner with my family, my dad is an eye surgeon and I was a dentist. My dad helps people see every single day. My mom helps people smile, feel confident. So imagine the combination of these two things, all of a sudden as a young kid in an environment where I get to see the difference that applied science has on someone's life and well-being. So I was like, I want to do that. So I was a pre-med student at UM. I didn't really know what I wanted to study. Yes, I had changed and upgraded myself a lot. And I still suffered a lot in school in the sense that there was just a lot of stuff I didn't agree with. But I was getting better at just getting by school. What changed my entire trajectory up until that point was I switched majors three times just to try to find something that I actually enjoyed within the pre-med realm. It wasn't until I showed up to a physiology nutrition class, professor walks in, and I didn't realize it was the professor. It was this guy in a button-down shirt, handsome, chiseled guy, amped up to teach us. And that was my professor, Dr. Wes Smith. He was a triathlete, he was an entrepreneur, and he was a professor, had his PhD. That's so cool. And within minutes of him speaking, you could feel the energy.

Miguel Bertonatti: That he's doing it not even for the money, he's doing it because he wants to teach young.

Andrés Preschel: He teaches more classes than any student at the university. He loves what he does, and he's brilliant. But it's not just that he's brilliant, that he knows a lot, it's that he lives what he preaches. And when I saw that, I was like, as soon as he walked in the class, I could feel the energy, I was like, I want to be like that guy. Remote Physiological Monitoring. Before COVID, obviously with COVID, we had to shift a lot of medical related stuff to, you know, from the comfort of your home, right? Like that was the silver lining of COVID in the medical realm, among others. It's like, we can't have patients going into the hospital and overwhelming the hospital system. So how can we monitor patients remotely and then have them come in when it's absolutely necessary or help them be proactive based on that data? So the internship that I was doing with Dr. Wes Smith was an internship where he had a health platform that he had developed. and we would get UM employees sign up on this platform, and we would monitor their blood pressure, some biometrics, their weight, and based on that data that I was gathering, I would help incentivize very specific lifestyle changes that I could hold them accountable with with the data on top of coaching, apply what I was learning in my nutrition and physiology classes, and help them see sustainable change. This was before Woo, before Aura, before any of that was even an idea. What happened was I had that experience, and then as COVID started to take place, I had the chance to collaborate and join forces with a doctor that I was shadowing, Dr. Moises Roycental, who's a Harvard doctor, twice my age, and he is an interventional radiologist. So basically, like, he puts stents in arteries and helps people.

Carlos Bertonatti: No, no, no, that's a serious, it's a serious specialty.

Andrés Preschel: And he's one of the best in the world.

Carlos Bertonatti: specialty so imagine just to kind of paint the picture and so they basically go in there they and they have to do it at a timely at a timely manner where they go in the arteries and they have to open it so that they have a little balloon it opens up this like metal it's one of the hardest specialties in medicine oh dude yeah this guy's

Andrés Preschel: through the stage live every single day. It's unbelievable. And you're exposed to a lot of radiation as well. So it's like, it takes a lot of guts and a lot of courage to do that, to play that kind of role. Anyway, so imagine it's this perfect storm where I was like trying to figure out what to do. This one guy inspired me with every one of his classes. I was learning something about my body that I felt was essential knowledge. Everybody needed to know. Cause after every single class I felt better and more empowered. And like, I knew myself better. And I was like, I need, this needs to be like, like, know, widespread knowledge. I can't believe I have to go to this specialty because I have this experience and pay this tuition to learn this about my body. Everybody needs to know this. Anyway, it was that kind of storm and then the shadowing experience with this doctor because I was pre-med, one day this doctor goes, hey, you know, I've been experimenting with intermittent fasting. And I've been losing some weight and I'm reverting my fatty liver. And I know you have a passion for this stuff. We're still getting to know each other. I know you have a passion for this stuff generally. I want to give a speech to my employees, which were all overweight at the time, at my office about what they can do to lose weight and feel better. And I was like, yeah, sure, I'll join you. So we're here in his office one day. And he starts giving this presentation and taking people through what he's doing. And I would kind of like jump in and like add, you know, my two cents about the underlying physiology, how the fasting was helping and all that. And I got to a point where he kind of like respectfully said, hey man, like take it away. Like tell us like what's going on here. Like how does this actually work? Basically, I ended up giving a lecture to his employees and he was so impressed that he took me aside and he's like, hey man, I didn't realize that this was something that you're so passionate about, lifestyle medicine, disease prevention. Why don't we join forces and start a company, like a lifestyle medicine company, and help my patients to have something that works synergistically with the procedures that I offer for weight loss and for- Which is incredible because it's kind of like a follow-up of optimization after they fix the problem.

Carlos Bertonatti: Yeah, it's almost novel in the traditional medicine.

Andrés Preschel: It was very novel at the time, for sure. It was to improve the long-term success rate of everything from stent procedures to gastric procedures, bariatric embolization, where you embolize the artery that produces ghrelin, so you have less Hunger hormone less, hunger you eat less. But the long-term success of that specific procedure wasn't there because with people's bad habits, collateral arteries were developed around that zone and the ghrelin would come back. So there had to be a lifestyle intervention for this novel procedure for it to actually work. Our lifestyle program was so successful that we ended up taking candidates for that procedure, putting them just on the lifestyle program, and they were able to keep the weight off longer than the people that had the procedure. So we ended up writing a book together, doing video courses in Espanol, by the way, todo en Espanol. It was a very niche project.

Carlos Bertonatti: And a super underserved community, for sure.

Andrés Preschel: Yeah, exactly. And to imagine, I'm still in school, I'm a young guy, I'm bringing my life experience and my passion for scientific writing into this, combined with the internship experience. It was like, if you've ever read the book Outliers, I just happened to be at the right place at the right time, learning the right thing. And then COVID happened. And now all of a sudden, I'm like a subject matter expert in remote physiological monitoring. Like, what is that? So anyway, eventually I started my master's in nutrition and physiology. Unfortunately, because of COVID, the classes stopped running and I couldn't finish that degree, even though I was in a fully funded scholarship, I was a graduate assistant. But to close out the story, because I know you have a ton of questions and I want to jump into these questions. All I'm going to say is my mentor, Dr. Wes Smith, told me, hey, man, focus on your business. You're doing something incredible. Focus on your business, and eventually you can return to academia. I said, great. I was doing Hambre Hormonas, which is the name of the company with Dr. Marcel Royzental. It went extremely well. But then I sort of pivoted because I saw what I saw with these older folks. I saw where bad habits eventually take people, and I wanted to focus on the younger demographic. to help them prevent this disease to begin with, you know, from the forefront. And people that I identified with a little more… And then eventually that shifted into, okay, let's take younger people, younger demographic that I can identify with, but let's take it a step further. Let's focus on high performers. Because I want to work with people that are as self-aware and as obsessive as I am. And that's just kind of like what led into this. And with content creation, with the podcast, and working with incredible people, one thing led to another, and now I'm here with you guys.

Carlos Bertonatti: Yeah, that's awesome, man. And it leads to the next thing that I wanted to talk to. First of all, congratulations, I'm proud of you.

Andrés Preschel: Thank you. And last thing I'm going to add, I'm currently doing my master's in biomedical neuroscience, returning to the inception of all of this. That's amazing.

Miguel Bertonatti: You went from not being able to freaking pass to becoming the biggest nerd, man. I'm a huge nerd. Most people wouldn't know that. I feel like, damn, I never, I never, I was never able to overcome. But then again, here we are, kicking ass.

Carlos Bertonatti: So yes, I did it my own way. So one of the things that I love about when you speak to people, first of all, you're super relatable. You're superhuman. And I do believe what you say about one of your superhuman powers is empathy. I really do believe that. And that comes forth every time that you speak and every time that we've hung out. And so kudos to you. And you always like, every time you speak, I think, you know, you speak of the importance of understanding, like you're very empowering and empowering people to understand their biology at a deeper level. And, you know, we call it, you know, become your own CMO, your own chief medical officer, right? So, you know, we share that in common. So what are the, in your perspective, what are your core biological systems or markers that you believe everyone should focus on or at least learn about when it comes to longevity, anti-aging and high performance? Because again, it's not about you not dying. It's about you being the best version of yourself. So what are those key markers that you look for? At MHI, we're focused on longevity. And as we age, we begin to lose our bone density, our stem cell production, and detoxification abilities, among many other things. And that's why we're excited to introduce you to the Juven Microimpact platform.

Miguel Bertonatti: The Juvent platform provides low-magnitude mechanical stimulation for increased stem cell production, bone density, and enhanced lymphatic drainage. Juvent has been used by some of the most technological institutes in the world. This non-invasive, easy-to-use technology supports your body's natural healing and regenerative processes.

Carlos Bertonatti: Make sure to visit the MHR Recommends section on our website to learn more and get your exclusive discount today. Or simply give us a call and we'll point you in the right direction.

Miguel Bertonatti: For now, stay healthy and God bless.

Andrés Preschel: It's a great question. So my favorite word that isn't in the dictionary, my favorite word that exists is interoception. It's a physiological word for a deep bodily awareness. That's the biggest thing I remember on your website. I love it. Then that's the main takeaway of the website. I'm so glad that it portrayed that. It's a deep bodily awareness and I like to use data to build the backbone of that intuition and interoception So like I don't believe in wearing your whoop all the time and you have to look at your sleep to make a decision Like I haven't worn my whoop in months, but I know that if I go to sleep tonight I'm gonna get a hundred percent sleep score.

Miguel Bertonatti: Yeah, cuz I know my body I know how it feels I know what I need to do you already know you're already in tune how you feel and that lets you learn because when you get 30 minutes of REM sleep, you feel that. You feel the mental fog. When you get 30 minutes of deep sleep, you feel the aches in your body.

Andrés Preschel: It takes lining up the subjective feelings with objective data. You start to see the matchmaking taking place and now you build what becomes intuition. But most people can't only rely on intuition if they've never seen the objective data. And most people aren't gathering objective data about their body on a regular basis with medical-grade tools and devices and technology, so they don't know any better. And I don't blame them. And we live in a modern environment that makes you very detached from that ability, so you have to fight back against it with the right tools and technologies. So, the three most relevant, call them KPIs is what I call them. I love that, it's true.

Miguel Bertonatti: Human KPIs.

Andrés Preschel: Human KPIs. I'm going to start using that.

Miguel Bertonatti: What are the major KPIs you need to focus on, my brother?

Andrés Preschel: You need to optimize your human KPIs. Yeah, I like that. I think for my population, but really for anybody, I recommend looking at three. The three most relevant are going to be VO2max, which I'll get into in a second. It's the most highly correlated metric with longevity, VO2max. HRV, heart rate variability, which is a measure of your autonomic nervous system function, your vagal tone, basically how adaptable you are and how you can shift your stress.

Miguel Bertonatti: Which one did he say?

Andrés Preschel: Sorry, which one? VO2max, HRV, heart rate variability.

Miguel Bertonatti: I got an Adderall moment there.

Andrés Preschel: And the last one is just a series of like body composition metrics and not for like the superficial aesthetic kind of approach, even though it is relevant, you know, you want to look good, you want to feel good, but I want to make sure that we're optimizing for muscle because it's the organ of longevity. So not just like reducing body fat by losing weight, but also like maximizing your fat-free massiveness.

Miguel Bertonatti: It's funny, when people say weight loss, I'm like, I weighed 10 pounds less. I'm like, stop focusing on weight. It should be the body fat that you should be after.

Andrés Preschel: And the fat-free mass index. Yeah, exactly. So let's break those down, right? And how are these actually relevant for both peak performance and for longevity? And actually all work hand-in-hand together. I love describing how they work hand in hand because people realize that this isn't like you're going to go out of your way to do this one thing. It's like all lifestyle that is realistic and can be made realistic and attainable for just about anybody. And when you leverage your knowledge of objective data and your biometrics, you can be super precise about how you approach this. So I'll get into that in a second. So VO2 max, right? VO2 max is a measure of maximum oxygen consumption.

Miguel Bertonatti: Can do in a minute.

Andrés Preschel: If you look at the Fick equation for VO2max, VO2max is equal to cardiac output, which is basically your stroke volume multiplied by your heart rate. Stroke volume is how much blood leaves the heart with every heartbeat. And then you multiply that. Yeah, exactly. And then you multiply that cardiac output, so how much blood is leaving the heart every minute, multiply that by AVO2 difference, the difference in oxygen saturation between your atrial and venous blood. So how much oxygen do the tissues absorb of the total blood volume pumped out by the heart? What's your total oxygen consumption per minute? So, what's the number one way to elicit an increase in VO2 max? Increasing stroke volume. So you have to increase the size of the left ventricle, the heart's main pump chamber, and the contractility of that left ventricle, like how hard it pumps. And how hard is that?

Miguel Bertonatti: and how hard can it bounce back. You guys are totally related. And how it can retract, not only the pump, but how it can expand, so fill up again.

Andrés Preschel: Exactly, so it's ability to fill up and then to pump blood out effectively, and then when that's pumped out, your tissues, you want to be able to extract oxygen. So then we can get into all things like CO2 tolerance, for example, and there's so many great ways to increase that, almost like cheat codes to increase CO2 tolerance, amazing. So anyway, if you look at that, everybody now wants So everyone listening is probably like, all right, tell me, how do I increase VO2 max? Right, everyone's getting excited. But hey, before you get to the edge of your seat, understand that it requires very intense training and you want to have your body primed for that kind of activity by mastering the art of recovery and sleep. because you want to have, number one, the energy naturally and endogenously without relying on caffeine or stimulants to get by, and then you want to be able to capitalize on that adaptive response, on that hormetic stressor. Most people have such high levels of baseline stress, of chronic stress, that when they do the training required to elicit increases in VO2 max— They'll be exhausted. They get exhausted, they get burnt out, or they need a ton of caffeine, and now they fuck up their sleep, and it becomes this vicious cycle where they're just throwing things on and literally losing, it's a catabolic response to the body, they lose muscle. So if we set the foundations for your body to fix and heal itself through incredible sleep quality, which you're right.

Miguel Bertonatti: I wanted to add to that just so people understand. So when you're in that high level of stress, and especially the CEOs that are like, Type A, they always wanna add more on. Yeah, yeah. So that is releasing more cortisol, your adrenal glands are completely depleted, so your ability to digest food and burn it and metabolically process things correctly is out the window. Exactly. Your ability to build muscle, to actually recalibrate your brain waves back to homeostasis, you're always on that fight or flight mode, so there's no time to recover. You make a disease environment, a disease-prone environment.

Carlos Bertonatti: And you said something super key. I mean, like, everybody's like you said, everybody's like, tell me how to improve my VO2 max. I mean, one of the best ways is focus on your sleep, right? Like, I always call sleep the greatest calibrator and the greatest consolidator, right? Calibrate your life, but it also consolidates your efforts from the previous day and it prepares you for the stress of the next day.

Andrés Preschel: Yeah, you replenish neurotransmitters, hormones, you get a flow of cerebral spinal fluid to clear out the brain's gunk.

Miguel Bertonatti: The lymphatic fluid is basically the fluid that basically flushes out all the cerebral debris that we accumulate because our cells poop.

Andrés Preschel: It's funny because I actually did this for my my project in neuroscience last quarter, it was all about the glymphatic system and how it's such a recent development. We just learned about it. But that's huge. You need to get into deep sleep in order for that cerebral spinal fluid to come into the brain and filter everything out. If you're not getting deep sleep, which is 99% of people, you're just gonna feel brain fog and low energy and low mood all the time.