Live Long and Well with Dr. Bobby

Dr. Bobby Dubois

Let's explore how you can Live Long and Well with six evidence based pillars:  exercise, good sleep, proper nutrition, mind-body activities, exposure to heat/cold, and social relationships.  I am a physician scientist, Ironman Triathlete, and have a passion for helping others achieve their best self.

  1. 5d ago ·  Video

    Long-Term Health Requires More Than Motivation

    Get the free newsletters and 1 page action guides Motivation is great for starting, but it is unreliable for the long haul and health is a decades-long project. We wrestle with the real problem most of us face: continuing to exercise, eat well, sleep better, manage weight, and control blood pressure and cholesterol after the novelty fades, the scale stalls, or life gets chaotic. Along the way, we also reflect on how “inspiring” stories can backfire, and why the right message is not “be more disciplined,” but “build better fuel.” We break down four practical fuels that help healthy habits last. First, make progress visible with a calendar goal or clear feedback, like step counts, weight trends, or home blood pressure monitoring. Second, don’t go it alone: accountability, social support, group identity, and even smart competition can improve exercise adherence, and sometimes the missing piece is expert help, like CBT-I for chronic insomnia. Third, we talk about wake-up calls and what research suggests happens when people see personalized cardiovascular risk information like coronary calcium scoring. Fourth, we connect behavior change to what matters most: travel, family, independence, purpose, and even causes bigger than yourself. The most important twist is what happens over time. The fuel that works today may stop working next year, so we talk about rotating strategies without shame and building structure that reduces the need for willpower, from automatic habits to simple cues like placing medication by your toothbrush. If this helps, subscribe, share it with a friend who is trying to stay consistent, and leave a review on Apple or Spotify. Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  2. Oct 22 ·  Video

    How Do We Keep Fear and Anxiety from Diminishing Our Lives?

    Sign up for my 1 page action guides and newsletter Fear and anxiety are part of being human. But sometimes they interfere with activities we enjoy, cause us to worry about things that may never happen, or leave us feeling ashamed of being afraid. During a recent endurance race, I experienced intense panic while swimming in extremely cold water. I felt embarrassed that, despite decades of competing in triathlons, I couldn't control my fear. When I shared the experience with a friend, he offered a different perspective: He admired my willingness to continue racing, knowing that the fear might return. I saw weakness. He saw courage. That conversation led me to explore how common anxiety really is, why shame can make it more burdensome, and what clinical research tells us about reducing its impact. In this episode Anxiety is remarkably common. One large U.S. survey found that 44% of adults reported anxiety or measurable symptoms, although far fewer met diagnostic criteria for an anxiety disorder.Fear can create three burdens: The distress itself, avoidance of meaningful activities, and shame about being afraid.Some fears are highly treatable. Exposure-based cognitive behavioral therapy (CBT) has strong evidence for specific phobias, including fear of heights.Other anxiety may persist. Acceptance and Commitment Therapy (ACT), structured mindfulness, and other treatments can help reduce symptoms or their impact.Shame is not inevitable. Psychological interventions may reduce the additional suffering caused by harsh self-judgment.We also explore breathwork, EMDR, my own experience with morning anxiety, and the surprising effect of my beloved cup of coffee. Three questions to consider Inspired by the Serenity Prayer: Is this a fear or anxiety I could meaningfully reduce with treatment?If some anxiety remains, how can I prevent it from limiting what I do or enjoy?Can I stop adding shame and self-criticism to an already uncomfortable experience?Key research and references How common is anxiety? Kavelaars et al., 2023 — The Burden of Anxiety Among a Nationally Representative US Adult Population. A large survey found that 44% reported anxiety or had measurable symptoms. Anxiety was associated with poorer health-related quality of life.Kessler et al., 2005 — Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders. Approximately 18% met diagnostic criteria for an anxiety disorder over 12 months in an older national survey.Fisher et al., 2021 — Men's Anxiety: A Systematic Review. Examines anxiety, masculine norms, disclosure, and barriers to seeking help.Shame and anxiety Cândea & Szentagotai-Tătar, 2018 — Shame-proneness, Guilt-proneness and Anxiety Symptoms. Meta-analysis examining the association between shame and anxiety.Clement et al., 2015 — Impact of Mental Health-Related Stigma on Help-Seeking. Systematic review examining how stigma may discourage people from seeking assistance.Goffnett et al., 2020 — Interventions to Reduce Shame. Systematic review finding promising reductions in shame with several psychological interventions.Treating fears and anxiety Wolitzky-Taylor et al., 2008 — Psychological Approaches in the Treatment of Specific Phobias. Meta-analysis supporting exposure-based treatment.Freeman et al., 2018 — Automated Virtual Reality Treatment for Fear of Heights. Randomized trial demonstrating substantial improvement in height-related fear.Haller et al., 2021 — Acceptance- and Mindfulness-Based Interventions for Anxiety Disorders. Systematic review and meta-analysis of randomized trials.Hoge et al., 2023 — Mindfulness-Based Stress Reduction vs Escitalopram. Randomized trial finding structured mindfulness training noninferior to escitalopram on the primary anxiety measure.Fincham et al., 2023 — Effect of Breathwork on Stress and Mental Health. Meta-analysis finding modest benefits, with methodological limitations.Valiente-Gómez et al., 2017 — EMDR Beyond PTSD. Systematic review examining applications of EMDR to other conditions, including anxiety.Liu et al., 2024 — Caffeine and Anxiety. Meta-analysis finding that caffeine generally increases anxiety, particularly at higher doses.The takeaway Anxiety doesn't have to be disabling to diminish our lives. And experiencing fear doesn't mean we lack courage. Some fears can be substantially reduced. Others can become more manageable. And even when anxiety persists, we may be able to lessen the shame we attach to it. If fear or anxiety is interfering with your enjoyment of life, consider discussing it with someone you trust or a healthcare professional. Effective treatments are available. Living long and well isn't just about preventing disease or adding years to our lives. It's also about finding more joy in the years we have. This podcast provides educational information and is not a substitute for individualized medical or mental health care. Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  3. Oct 13 ·  Video

    Chocolate: Sweet Promises or Bitter Truths? #81

    We love chocolate—and we would probably love it even more if we could call it a health food. In fact, 65% of North Americans in one survey said they would rather give up social media for a month than give up chocolate. But does chocolate actually deserve its healthy reputation? In this episode, I dig into what the human evidence really shows. Cocoa flavanols do appear to improve blood-vessel function and modestly lower blood pressure. But when researchers moved beyond these surrogate measures and asked whether cocoa actually prevents heart attacks and strokes, the results became much less convincing. We also look at whether chocolate protects the brain, improves mood, enhances athletic performance, or disrupts sleep—and why an “85% cacao” label doesn't necessarily mean you're getting a large dose of beneficial flavanols. One of my favorite studies divided 258 people into four groups: mindful chocolate eating, ordinary chocolate eating, mindful cracker eating, and ordinary cracker eating. The mindful-chocolate group experienced the greatest improvement in positive mood. Perhaps chocolate makes us happy partly because we like chocolate—and because taking the time to savor something pleasurable matters.  What you'll learn  Why cocoa flavanols are the most promising part of chocolate  Why darker chocolate doesn't necessarily mean more flavanols  How cocoa can improve vascular function without necessarily preventing cardiovascular events  What the 21,442-person COSMOS trial found  Why cocoa extract hasn't been shown to prevent cognitive decline  How chocolate's caffeine and theobromine may affect sleep  Why chocolate doesn't appear to improve athletic performance  Why calories and potential weight gain are probably chocolate's most important downside  Why cocoa butter's saturated fat may be less concerning than it sounds  And why you probably don't need to feel guilty about enjoying chocolate in reasonable amounts Key studies and references Cardiovascular health: Sun et al. — Cocoa flavanols and endothelial function — Meta-analysis of 15 studies/18 intervention arms found cocoa flavanols improved flow-mediated dilation by about 1.17 percentage points, although heterogeneity and risk-of-bias concerns were substantial.  COSMOS cardiovascular trial — More than 21,000 older adults were randomized to cocoa extract providing 500 mg of flavanols daily or placebo. The primary cardiovascular endpoint was not significantly reduced (HR 0.90; P=.11), although cardiovascular death, a secondary endpoint, was lower.  Brain health: COSMOS-Mind cognitive trial — 2,262 older adults were followed for three years. Daily cocoa extract containing 500 mg of flavanols produced no significant improvement in global cognition.  COSMOS-Clinic cognitive trial — Detailed neuropsychological testing in 573 participants similarly found no meaningful cognitive benefit from cocoa extract over two years.  Chocolate and happiness: Meier et al. — The sweet life: mindful chocolate consumption and mood — 258 participants were randomized to mindful or ordinary consumption of either chocolate or crackers. Mindfully eating chocolate produced the greatest increase in positive mood, with food liking partially explaining the effect.  Chocolate and sleep: Drake et al. — Caffeine 0, 3, or 6 hours before bedtime — Caffeine significantly disrupted sleep even when taken six hours before bedtime. The study used 400 mg—far more than a typical serving of chocolate—so it establishes the caffeine principle rather than proving that evening chocolate itself disrupts sleep.  The bottom line Chocolate isn't a superfood—but it isn't something most of us need to fear either. Its flavanols have some genuine biological effects, but we don't have convincing evidence that eating chocolate prevents heart attacks, strokes, or dementia. Its clearest practical downside is simpler: chocolate is calorie dense, and for some people, eating substantial dark chocolate late in the day may interfere with sleep. There's a concept often associated with Voltaire: “The perfect is the enemy of the good.” Chocolate isn't perfect. But it's delicious, pleasurable, and reasonable amounts are unlikely to cause meaningful harm for most healthy people. So if you enjoy chocolate, enjoy it. Watch the calories, pay attention to your sleep—and take the time to savor it. Chocolate may not help us live long, but it can certainly help us live well. Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  4. Oct 1 ·  Video

    Why do i need a vacation...after my vacation?

    Sign up for my Newsletter and 1 page action list You unpack your bag, drop onto the couch, and wonder why you feel worse than when you left. That “vacation after the vacation” crash is not just bad luck or a weak willpower problem. We walk through a more useful explanation: travel quietly rewires your daily inputs all at once, from sleep timing and bedroom temperature to meal schedules, movement, quiet time, and even bathroom routines. We dig into what the evidence says about travel and health, starting with physiology. Research suggests ordinary domestic travel can shift markers like morning cortisol, hinting that your body is genuinely responding to the disruption. Then we tackle the big question people argue about: does travel stress “lower immunity” and cause colds? Viral challenge studies point to chronic stress as the bigger risk, while vacation-style acute stress may not be the main culprit. A simpler explanation often wins: exposure. Airports, planes, restaurants, and family gatherings put you near more people, which increases the odds of encountering a contagious person. Airplane myths get a close read too. Recirculated cabin air does not appear to be the smoking gun many assume, but dry cabin humidity can irritate airways and may slow mucociliary clearance, your nose and throat’s cleanup system. We also cover practical prevention options like hand hygiene, keeping hands off your face, and deciding whether an N95 mask is worth the hassle for you. From there, we focus on the most reliable travel saboteur: sleep disruption. Large wearable data show sleep loss can begin the night before departure, and even when total sleep rebounds, sleep stages like REM and slow-wave sleep can take longer to normalize. We finish with the unglamorous but real topic of travel constipation and the simplest fixes, then land on a travel philosophy that actually works: do not optimize your vacation into a copy of home, just protect the few routines that matter most. Subscribe, share this with your favorite travel buddy, and leave a review on Apple or Spotify. What is the one habit you refuse to give up when you travel? Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  5. Sep 22 ·  Video

    Should This Health Headline Change Your Life? Five Questions to Ask First

    📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com Every day brings another health headline: Coffee may prevent dementia. Alcohol raises cancer risk. A Mediterranean diet reduces diabetes. A supplement lowers heart disease. A new treatment cuts risk by 30%. But should any of those headlines actually change what you do? In this episode of Live Long and Well, I share five questions I use when reading a new medical study. They can help you separate an interesting finding from something important enough to change your diet, take a supplement, request a test, or start a treatment. The Five Questions Can I trust the evidence? Was this an observational study, a randomized trial, an animal experiment, or something else?How big is the effect—really? A “30% reduction in risk” may sound enormous, but what was the starting risk? We explore why absolute risk can tell a very different story than relative risk.Does it apply to me? Who was studied? Were they people like you? And did researchers actually study the intervention you’re considering?What’s the downside? Benefits are only one side of the decision. Consider side effects, cost, inconvenience, time, anxiety—and the potential downside of doing nothing.What should I do? Sometimes the answer is act now. Sometimes it is discuss it with your physician, watch and wait, or simply keep scrolling.Examples We Explore Why eating fish and taking a fish-oil capsule are not necessarily the same thingHow mammography and the shingles vaccine illustrate the difference between relative and absolute riskWhy a Mediterranean lifestyle trial was much more than simply “eat more olive oil”Why bicycle helmets are an easy decision despite a low risk on any single rideWhy aspirin can be highly valuable for one person and inappropriate for anotherThe aspirin example brings all five questions together: the same medication can produce a dramatically different absolute benefit depending on your starting cardiovascular risk. Key Studies and References Episode #22 Health headlines: helpful, harmful, or just confusing? Bicycle helmets Olivier J, Creighton P. Bicycle injuries and helmet use: a systematic review and meta-analysis. International Journal of Epidemiology. https://pubmed.ncbi.nlm.nih.gov/27450862/ Fish oil — VITAL Trial Manson JE, et al. Marine n−3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer. New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/30415637/ Fish oil — ASCEND Trial ASCEND Study Collaborative Group. Effects of n−3 Fatty Acid Supplements in Diabetes Mellitus. New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/30146931/ Mammography, ages 40–49 USPSTF systematic review of randomized screening trials. https://www.ncbi.nlm.nih.gov/books/NBK343823/ Shingles vaccine — Shingrix Lal H, et al. Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults. New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/25916341/ Alcohol and cancer Bagnardi V, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. British Journal of Cancer. https://pubmed.ncbi.nlm.nih.gov/25422909/ Mediterranean lifestyle and diabetes — PREDIMED-Plus Konieczna J, et al. Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes. Annals of Internal Medicine. https://pubmed.ncbi.nlm.nih.gov/40854218/ Aspirin — primary vs secondary prevention Antithrombotic Trialists’ Collaboration. Aspirin in the primary and secondary prevention of vascular disease. The Lancet. https://pubmed.ncbi.nlm.nih.gov/19482214/ Aspirin in healthy older adults — ASPREE McNeil JJ, et al. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/30221597/ USPSTF aspirin recommendation https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication Download the Action Guide Use the Five-Question Filter the next time a health headline catches your attention: Download the one-page graphic action guide The bottom line The headline is only the beginning of the story. Before changing what you do, ask better questions. 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  6. Sep 10 ·  Video

    Concierge Medicine: Better Care, or Just More Care?

    Concierge medicine promises something many patients desperately want: more time with their doctor, easier access, and appointments when they actually need them. But as concierge practices rapidly expand—and corporations, non-physicians, and heavily marketed longevity programs enter the field—the concierge label no longer guarantees excellent primary care. In this episode, I’m joined by two board-certified internal medicine physicians with firsthand experience in this changing model. Dr. Spyros Smith has practiced concierge medicine for many years, while Dr. Hayan Yacoub is transitioning from a large, busy internal medicine practice to establish Yacoub Signature Medicine, with an interest in evidence-based longevity care. We discuss why traditional primary care can feel so frustrating. A typical physician may care for approximately 2,000 patients, offer visits lasting only 15–18 minutes, and have limited availability for urgent concerns. By comparison, a concierge physician may care for only 300–500 patients and provide longer appointments, same-day visits, and access by phone, text, or email. But more access does not automatically mean better outcomes. We explore research discussed in the episode suggesting that concierge care may cost substantially more because of additional testing and services, without a demonstrated difference in five-year mortality. We also examine the rapid growth of corporate ownership, the rise of expensive testing, supplements, hormones, and protocols, and the pressure physicians may face to approve prescriptions, scans, or referrals simply to meet paying patients’ expectations. Before joining a concierge practice, ask what the annual fee actually includes, who will care for you during and after office hours, what additional costs you may face, and how the practice approaches routine testing, specialist referrals, medications, and imaging. Takeaways: Concierge medicine can provide valuable time, access, and continuity—especially for people who are unhappy with their current primary care experience. However, the term “concierge” does not guarantee evidence-based or higher-quality medicine. Understand exactly what you are paying for, evaluate the physician’s training and philosophy, and remember: buyer beware. Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  7. Sep 1 ·  Video

    Night Owl or Morning Lark: Are You Living With—or Against—Your Body Clock?

    Sign up for Dr. Bobby's 1-page action "Prescriptions" We follow the daylight saving time debate into a deeper question: whether your chronotype makes you a night owl or a morning lark, and how that fit with real life changes your sleep, performance, and health. I share what the evidence says about social jet lag, why synchrony matters more than labels, and how to decide whether to change your schedule or try to shift your body clock.  • what chronotype means and how it shows up in daily energy, appetite, and sleep  • why social jet lag happens and how to measure it with weekend vs weekday timing  • what studies suggest about cognitive performance when timing matches your chronotype  • how exercise performance can depend on morningness or eveningness  • observational links between evening types, cardiometabolic risk, metabolic syndrome, and mental health  • how light therapy, meal timing, exercise timing, and caffeine timing can shift the clock  • practical steps to reduce a mismatch, including consistent wake times and gradual changes  If you like this episode, please provide a review on Apple or Spotify or wherever you listen.  If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at Dr. Bobby Livelongandwell.com.  Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

  8. Aug 20 ·  Video

    When Abnormal Does Not Mean Sick

    Sign up for my newsletter and 1-page action plans  That red number in your lab portal can hit like a verdict. We know the feeling: your mind jumps from one “abnormal” result to the worst-case story, even if you feel the same as you did yesterday. But medicine has changed, and “abnormal” often reflects how much we measure, how we define normal ranges, and how quickly a borderline finding can turn into a lifelong label. We walk through why it’s become so hard to stay “normal” on paper without ever getting sick. First, we simply test more, and when you run enough labs or scans, something is bound to look off. We dig into classic examples like back MRIs that look abnormal in many pain-free people, plus thyroid cancer screening that found far more “cancer” without reducing mortality. We also talk about genetic testing, including APOE status for dementia risk, and the key question most people forget to ask before ordering a test: what will I do with this information? Next, we tackle moving goalposts, when guidelines shift for blood pressure and LDL cholesterol. Earlier detection can save lives, but it can also turn huge portions of the population into patients overnight. Finally, we discuss the rise of new labels for common symptoms and why the suffering can be real even when the diagnosis is not clearly evidence-based. Our practical takeaway is a four-question framework you can use with your doctor: Is it real? Is it relevant? Is it risky to me? Is it resolvable? If this helped, subscribe, share it with a friend who is staring at a red result, and leave a review on Apple or Spotify. Send us Fan Mail Support the show 📥 Tap to join my free newsletter & get the 1-page episode checklists: drbobbylivelongandwell.com

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Let's explore how you can Live Long and Well with six evidence based pillars:  exercise, good sleep, proper nutrition, mind-body activities, exposure to heat/cold, and social relationships.  I am a physician scientist, Ironman Triathlete, and have a passion for helping others achieve their best self.

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