Please enjoy this transcript of my interview with Sami Inkinen (@samiinkinen), a Finnish-born, Stanford-trained entrepreneur and the founder and CEO/president of Trulia and Virta Health. Virta is on a mission to reverse metabolic disease in one billion people using technology, AI, and nutrition. He is the founder of Fat Chance Row, which he created to raise awareness of the dangers of sugar and its connection to diabetes, rowing 2,750 miles from California to Hawaii with his wife—completely unsupported—while breaking a world record in the process.
The content of this episode is for informational purposes only. Neither Sami Inkinen nor Tim Ferriss is a medical professional, and nothing discussed here should be taken as medical advice or a substitute for consultation with a qualified healthcare provider.
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Tim Ferriss: I will start, I suppose, with something that I can potentially use immediately or some variant thereof. Do you still schedule your week, or at least workouts, each Sunday? And I’m reading here — this is from a blog post. Schedule everything, right? This is “Top Five Tips: Getting and Staying in Shape for People who are Busy.” “I spend 10 to 20 minutes every Sunday scheduling most of my workouts in detail similar to any other appointments in my calendar. Like with most unscheduled tasks and to-dos, they’ll fall between the cracks. On the other hand, with proper scheduling, you’ve managed to get in your workouts with 150+ annual travel days, changing cities, super early wake-ups and delayed flights,” et cetera.
So this is kind of a micro question that edges into the macro just around planning and scheduling, but do you still take time out each Sunday to go through these things?
Sami Inkinen: 100 percent. 100 percent. It’s every Sunday. I just find that structure allows flexibility and spontaneity. If you don’t have structure, nothing gets done, at least in my life. And not that my life is super special, but two pretty young kids, happily married, running a company, growing, that’s thousand employees, and then trying to be a kind of semi-athlete in the process, if I don’t schedule, it’s not going to happen. So I spend about 15 minutes at the end of each week, that Sunday, professionally list the three things that absolutely have to get done, and then I schedule a few things, including workouts, and it works very well.
Tim Ferriss: When do you do that on Sunday?
Sami Inkinen: Well, this could be a long conversation, but it’s either early morning before the kids wake up and Sunday gets going, or if I don’t have it done by Sunday afternoon, then it’s after 7:00 p.m. when everybody else quiets down and I take my own time.
Tim Ferriss: Virta, how many employees do you have right now?
Sami Inkinen: Yeah, Virta Health. So we have about 1,000 employees. And the caveat these days, of course, is don’t brag about employees because the more employees you have, less you’ve leveraged AI. But I guess mentioning 1,000 employees, it’s a real company and obviously growing fast, so it takes fair amount of effort. So about 1,000 people.
Tim Ferriss: Well, the good news is, like so many companies in the news these days, if you did end up over-hiring during COVID or something, you cannot say, “We made a mistake.” You can just say, “We’re using AI to improve efficiency,” when you have layoffs. But we won’t dwell on that. The question I had is, what type of training in your life right now are you currently scheduling each week?
Sami Inkinen: Well, we’re talking about training, so this is sort of physical training.
Tim Ferriss: Physical training. Mm-hmm.
Sami Inkinen: It’s really in two buckets. The primary focus is really endurance sports around cycling. So I do a lot of mountain bike racing as well as road bike racing, so that’s essentially endurance training. So I’d say 90 percent is cycling related, and that’s my core workout that essentially happens in the morning every day. 99 percent of the time, it’s one of the first things. It’s not the very, very first thing in the morning. So that’s one. We can go into morning routines and stuff like that in a second if that’s interesting. But I do a little bit of just core work pretty much first thing after waking up. So I don’t even have to schedule that. That’s sort of a non-negotiable. Before the brain even boots up, I’ve done my core work. But cardiovascular work is the main —
Tim Ferriss: Yeah, let’s not tease. Let’s just hop right into it. So what does the morning look like upon waking up, and what time are you getting up?
Sami Inkinen: Yeah. So, again, let’s separate into traveling and not traveling, traveling for work —
Tim Ferriss: Let’s do non-travel.
Sami Inkinen: Yeah, non-traveling. I wake up 5:00 a.m. latest. This morning, alarm was 4:45, so I wake up pretty early. And I have the amazing privilege and luxury that the second I roll off the bed, I jump into a lake or pond. And it’s not a long time, maybe like a minute, just cold water, a couple of strokes. But essentially it’s a freezing cold shower. And this is a mountain lake, so we are talking like 40-degree weather, pretty much straight off the bed. And after that, maybe just a minute or two of some air squats and jumps and core, literally core work. Nothing too special, so that’s some Supermans and leg raises and stuff like that. And I do it because, again, I race bicycles quite a bit, and I have some lower back issues, and core work, it just never gets done unless it’s the very, very first thing in the morning. And then I’ll throw in a couple of pushups there. So that’s 5 to 10 minutes. Straight off the bed, jump into the lake, dripping wet, little bit core, little bit jumps, a little bit this and that.
And I’m just a huge, not just a believer, but the practical experience I’ve had is mood follows movement and motion. So before I even ruminate or think anything, I’ve already been in a lake and done five or 10 minutes of core work and some jumping and get the heart rate up for a little bit, and that’s pretty much the first five, 10 minutes.
And then the other thing I try to do always right after is do something useful for other people. Do something useful for other people. And what is that in practice when I’m not traveling? It’s preparing coffee for my wife and emptying the dishwasher. And it may sound very simple, but that’s like 15 minutes after I’ve woken up, I haven’t had a second to think about or ruminate, “Oh, my back’s hurting,” or “Oh, my God, so much work,” or whatever that is. It’s like a 15-minute boot-up sequence, and it’s like life’s rocking. And then I’m ready to go and do the other things.
Tim Ferriss: Don’t worry, I won’t have you give the minute by minute for your entire day, but after you have done that, so you’ve made coffee for your wife, you’ve emptied the dishwasher, then what? Are you having your first intake of coffee? What does the next 30 to 60 minutes look like for you?
Sami Inkinen: Man, sounds like you’re mind reader. So I do drink coffee. That’s time for an espresso or a cup of coffee at that point. Everybody else is still sleeping in the house. I sit down, and basically I write down my sleep, how many hours I slept. And I have a little diary. It’s a spreadsheet online, 16 years of data now. And I also write three things I’m grateful for. So this is kind of little gratitude journal, super, super simple things. And I try to focus on the mundane, such as leaves in the aspen trees or warm temperature, just simple things, very, very simple things. So I do that and write down a few things.
And then I usually work for about an hour, so clean email and Slacks, or maybe I have like a 20-minute writing thing, so this is kind of my CEO job. So I try to do about hour of that. And then whenever my wife wakes up, then we have sort of a 15, 20-minute couples moment, drink coffee, and talk about life. It’s a really wonderful moment there. So that’s kind of the very morning.
And then my real workout usually happens between 6:30 and 8:30, the exercise. And then after that, get to office. Exception would be if I have any meetings that are across time zones, then it could be a 6:00 a.m. Zoom or something like that. But before that, I’ve always done my swimming in the lake and a little bit core and maybe a cup of espresso. That’s the routine. And pretty much repeated that for more than a decade. It’s nothing too special. People ask like, “What’s the science behind?” I say, “Listen, if it doesn’t feel good, it’s not right for you. If it feels good, repeat it.”
Tim Ferriss: So I suppose there are different types of fun, right? There’s type one, type 2, maybe type three fun, which is just embracing the suck. God, I can’t remember who sent this to me. It was a friend of mine — maybe you recall who this is because I’m sure I pinged you about it. But they were driving up some windy, incredibly steep road in the mountains, and they were taking a video from their car of some lunatic, who I think they called a lunatic, “Look at this fucking guy. He’s crazy,” on what you could envision, listeners or watchers, as incredibly long rollerblades. They’re basically skis with a single track of wheels on them and poles doing uphill, I suppose, Nordic skating, let’s just call it, going up this unending incline, and they’re like, “God, who is that lunatic?” And of course, who did it end up being? Ended up being Sami. So fun means different things, or feeling good means different things in different contexts.
But the reason, for people who are wondering, why am I digging into all these details? Number one, I like the details, and the details matter, but you have always impressed me with the number of important pillars that you’re able to methodically schedule into your life, and furthermore, within those pillars, how you’re able to operate at a very high level in multiple domains. So that’s why I’m asking about the specifics, because these things, much like workouts, tend not to happen accidentally. If you don’t schedule them, particularly with the number of moving pieces that you have, and frankly the number of moving pieces that any person probably has, things will not manifest magically.
And I’m curious, we talked about the single day, do you have any type of — I know for training you almost certainly do have weekly and monthly architectures, particularly with competitions. But from a work, could be work, could be physical perspective, do you have a consistent weekly architecture of any type where, say, you might batch certain types of tasks or meetings or otherwise on certain days or anything like that? Or is it pretty much Monday to Friday more or less the same daily routine?
Sami Inkinen: I do have a system. Well, a couple of things. First, I think it’s good to remind when myself or anyone’s like, “Oh, here’s the system,” and — the reality is life happens all the time, so let’s just remember that. You’re running a company, you have kids, crap hits the fan all the time, or at least frequently, so obviously you have to be flexible. So what I’m going to share next is the kind of beautiful, clean scenario where you can kind of live with your structure. But the reality is you’re running a company —
Tim Ferriss: The platonic ideal gets smashed a lot.
Sami Inkinen: Exactly. It’s 24/7, and the Sunday afternoon walk with your kids or with your spouse may not happen because you need to address a crisis. But let me start with — you mentioned like, “Oh, I’m kind of impressed how many things you can do.” Honestly, the biggest secret is saying no to 99 percent of the things that many people consider quote, unquote, normal. So what you care gets done. And sometimes people ask me like, “Wow, so many sacrifices. You’re trying to be an athlete and a CEO and a founder and trying to be a parent as well, and you even travel with your kids. You must have so many sacrifices.” I actually find that saying no is incredibly liberating in life. I’m way happier that I’m married to one person versus five. It’s awesome. There’s no way I could be a CEO of many companies. I love the kind of focus.
And so I actually find it personally in life, when you find something that kind of fills your cup and is satisfying and gratifying, just having the one or two things that I focus on and then go all in, rather than a sacrifice, it’s a happy place for me. So anyway, I would say that’s my biggest secret.
Tim Ferriss: I think a lot of people will hear what you’re saying and theoretically agree with it, and yet most people are unable to embrace that in practice, for whatever reason. And it doesn’t mean they’re not capable of doing it, but they don’t do it. Why do you think people have trouble saying no or the default is people are inclined to over-commit or that they do the 99 percent of things that are quote, unquote, normal that you say no to? Why do you think not more people do what you’re describing?
Sami Inkinen: Honestly, if I had a perfect answer, I’d probably write a book about it, but —
Tim Ferriss: With all your spare time. Yeah.
Sami Inkinen: Here’s my guess. I think one might just be a narrative. And I can’t tell you how many times someone has said, “Oh, my, you must be sacrificing so much to be able to do what you do.” And I’m sure you could say the same for an Olympic athlete, like, “Oh, my God, so many sacrifices.” But if you’re an Olympic athlete focused on your sport and your craft, sure, you can’t do 99 percent of things quote, unquote, normal people do, but it’s probably incredibly satisfying to be able to do that one thing for the five or 10 or 15 years of your life. So that’s why I meant maybe it’s a narrative that, oh, if I say no to all these, whatever that is, a movie night every night or some distraction, whatever, staying on social media and watching Netflix four hours a day, then, oh, it’s a sacrifice not to do that. So that’s my guess, one thing, that it’s a narrative in our minds, like, oh, you want to do all these consumption things that maybe take time away from the thing that could move your life or profession forward. So that could be one.
And then the other thing is I think this sort of life structure that if you don’t have a basic — we can go back to your original question, what’s your architecture, what’s your structure? If you’ve never taken the time to take a step back and say, “Hey, how am I allocating my time,” it’s very easy to let the universe or the entropy to take control of your time, whether that’s your inbox or text messages from others or phone calls. It’s actually very, very easy let the world run your life as opposed to you running your life.
Tim Ferriss: Well, let’s talk about the weekly architecture, and then I am going to come back to this particular question that I asked. But let’s take a breather on that, and would love to hear more about the weekly architecture or other architectures outside of the daily.
Sami Inkinen: Yeah. So, again, this is sort of in an optimal world, but I would say professionally I do try to group similar type of tasks into specific days. So just to give you an example, Monday is filled with a lot of group and leadership meetings and stuff like that, so there’s one kind of context switching, that it’s meetings in front of the whole company and in front of leadership team and so forth. So that’s Monday. Tuesday I try to have all my one-on-ones, again, one type of context switching. And as an introvert, that takes a lot of energy, by the way, as important as it is and sometimes very enjoyable, but the kind of one person after another, it’s pretty draining for me personally.
Tim Ferriss: How many direct reports do you have?
Sami Inkinen: Well, I should say this has changed all the time. There’s been 15, there’s been 10, and I had eight for a long time. But for the last couple of months, I’ve had two, only two, which is a very small number. And again, that could be another one-hour conversation. But when you’re building a grow company, you always have to ask yourself, “What’s most important for this year?” And there’s not really kind of a school book-perfect kind of approach. But anyways, it is two right now. So Tuesday is that. Wednesday I actually try to reserve for thinking and writing, thinking and writing. So the default is no meetings. And one example of writing that I do, I write a team letter for the whole company from the CEO. So I’ve now written 553 of them.
Tim Ferriss: Wow. So you do that every week.
Sami Inkinen: Every week, and there’s a one topic, and again, another topic we could dive into. But what I find is that it’s as the company has scaled, there are a few things that are very scalable, like whether my email hits five inboxes or thousand obviously doesn’t take any time away from me, but I can give context, explain what’s happening, what’s important, what’s happening in outside world, what’s happening inside the company, and then every employee feels hopefully some level of connection. So that’s one example.
There’s a couple of things that I’ve kind of repeated ever since day one, and now at thousand-employee scale is still very scalable. But that’s just one example. I could be preparing for board meeting or thinking about strategy, which sounds very high-flying, but I would say one thing that’s very, very easy as a CEO of a grow company is to fool yourself that you’re productive and useful by being busy. But if you miss a decision, something around a corner, no amount of knocking tasks off the to-do list is going to compensate that. It’s almost like managing your own brain and feelings. It’s hard not to have a tightly scheduled calendar, but in fact, having that time open for like, you can go for a walk and think about the problem.
So anyway, so that’s kind of my Wednesday. And then Thursday and Friday is a lot of internal client work and those kinds of things, but I usually — that’s not too structured. But that’s a little bit of a typical week.
Tim Ferriss: On Wednesday, when you’re doing the writing and thinking, what are some of the ways that you structure your thinking? There’s unstructured thinking, right? You go for a walk and kind of ponder and allow the void to invite hopefully some type of insight. But then there’s structured thinking. And I guess to the extent that I know you at all, I would say I’m inclined to think you probably have some prompts or structure or an approach to doing thinking. What does that look like, or how would you speak to that?
Sami Inkinen: Yeah, actually typically the way my brain works is the actual thinking and problem-solving happens 24/7, and I’ll give you a specific example. My workouts every morning, which is about an hour, hour and a half, unless it’s a very, very, very high intensity, that’s one of the best times where my thinking happens, and problem-solving and new ideas and creativity happens there. And then for the Wednesday, I actually just block an hour and say — it’s almost like the time to get the words and the thoughts and whatever that might be off my brain to a paper, or obviously in a cloud. So unless I have to do a very kind of left-brain, mathematical, deterministic problem-solving thing, literally like, “Okay, let’s look at how do we improve cross margin,” or something like that, the creative work does not happen at the desk for me.
And one thing that I noticed, this was especially during COVID, when COVID hit, I was listening a lot of podcasts and music and audiobooks on 100 percent of my workouts. It was maybe like a year. And I realized that the problem-solving and the creativity almost stopped. So now I have a rule that maximum of half of my workout I can listen to Tim Ferriss. Sorry. So if your download numbers are going down or listening numbers —
Tim Ferriss: Damn it, Sami. I need all the help I can get.
Sami Inkinen: So if the brain is in a consumption mode, you’re kind of just filling in the cup, and I’ve noticed the creative thoughts and the problem-solving that’s happening or background processing, it’s not happening. So anyways, this is tactical thing that I’ve noticed that too much audiobook or podcasts filling the brain, and it stops creating stuff. It’s very interesting. That’s at least my personal experience. So I’m very conscious of, on those moments when I’m exercising or walking or driving somewhere, that there’s kind of a cutoff point. No more listening. Just let your brain do its thing.
And then the Wednesday comes in, it’s more like, okay, now I kind of have the framework in my head, take an hour and a half to, I don’t know, write about next year’s priorities or the new product we’re going to launch. Or even these team letters that I write, I actually write them in my brain when I’m away from the desk, and then when I sit down, it just — it comes out.
Tim Ferriss: So that actually leads into my follow-up question — I can’t imagine I’m the only person wondering this — which is, when you’re doing these workouts, let’s just say it’s an hour and a half to two hours, the real workouts, in the morning, I would imagine quite a lot percolates and comes up, and if you’re doing that Monday, Tuesday, maybe also Saturday, Sunday, et cetera, by the time you get to Wednesday, if I have not taken some step to maybe verbally record some of that or make short notes in a notebook for cues for later, I would be doubtful that I would be able to recall the good ideas that I had earlier in the week. Do you just have a preternatural sort of inclination to be able to remember all that stuff, or do you take some type of shorthand after the workouts so that you can use those then on Wednesday as prompts? How does that work?
Sami Inkinen: Essentially I write emails to myself or store notes. It’s the same thing. So there’s tidbits along the week, and then I have it for Wednesday. And then half may be in the brain, and half is written somewhere so I don’t forget it all, but yeah.
Tim Ferriss: And you just send yourself an email after the workout with some type of note?
Sami Inkinen: Yeah. Yeah. Yeah.
Tim Ferriss: Mm-hmm. What is an example of what you might cover in a team/company email on a Wednesday, and how long is that? Because that is, like you mentioned earlier, one of the things you’ve repeated since day one. What would be an example that you can share? I mean, it could be hypothetical, but just what might you put into that, and how long is it?
Sami Inkinen: Half is standard structure. So there’s a quote from — again, we can go into details, but we’re in a business of reversing metabolic disease and helping people get healthy with nutrition. So we treat patients like real humans, hundreds of thousands. So half of it is this existing structure. There’s a quote from a patient, so we always kind of lead with, this is why we’re here, and here’s a positive feedback from a patient. Then there’s some business metrics, like how much we’ve grown, and what are the priorities, and just a reminder of this year’s key objectives. So half is like that.
And then the most important other half is topic of the week. So topic of the week is essentially my, as a CEO/founder, essay, and I think that’s what you were asking. I would say they’re roughly in two or three categories. One is what has happened in our external world, what’s the context there, and how does that affect us? One example, this is a real-world example that I’ve written quite a bit about, since we use nutrition as the core tool, but obviously our providers use all the tools in the toolkit, one of the things that has really changed in addressing obesity and metabolic disease over the last couple of years is the GLP-1 drugs, so these are the Ozempics of the world. And so I’ve had a number of letters discussing, how do these drugs potentially affect how we take care of our patients, and what’s the impact on our business? So that would be ity, and how is that affecting our strategy? So that’s one example.
The other category is career and personal advice to our team members, like how to make most out of your experience working at Virta and around that kind of stuff that we discussed now, like personal productivity and how do we make most out of — so that, I would say, is the second category. And then third is just internal, this is what happened, this is what it means for us. So honestly, I kind of like it. It’s my personal outlet, and sometimes I’ve said, “Hey, 530 plus essays, there’s a book in a making. All we need to do is upload it to ChatGPT and we have a book ready to be published.”
Tim Ferriss: I promised I would come back to a thread, which I realize is probably a misworded question. The question I asked was why people have trouble doing what you do, which is saying no to 99 percent of the things that normals do, or feel compelled to do, to your point about the narrative. And I realize that’s perhaps not the right question. The right question might be, what advice would you give to someone who is having trouble saying no, or focusing on just a few things? But I can make it much more specific, because I think the more we can imagine it, perhaps the easier it is to dig into this.
So, let’s say that you had a relatively new hire, who is on the younger side but a 10X engineer, or some equivalent of that. Someone who is clearly a superstar, but who has not established the type of architecture and routine that you have in your life. Let’s just say you sense that they are on the path to burnout, which is going to be bad for them, it’s going to be bad for the company, it’s going to be bad for the patients you serve, and you want to stage an intervention to help them correct course. I imagine you may have even had these conversations. What might that conversation or coaching look like?
Sami Inkinen: Yeah. Well, funny enough, this has been one of the topics of my team letters, one of the 530. So, I would separate it into two things, my advice. One would be this sort of planning. Literally, it would be very simple. Sit down for five minutes on a Sunday evening before the week starts, and write down what absolutely completely needs to get done next week, super-duper simple, professionally and personally, and schedule it into your calendar, literally. And if you have the flexibility, then block two hours in the mornings to get those two or three things done. And then when life happens, or work happens, everything else kind of comes after that. So, that to me would be the number one thing.
And then I would couple that, when Monday comes or Tuesday comes, it’s whether you work in an office or in a remote setting, do not let the universe control your time. So this means absolutely no notifications. Maybe if you have to get text messages for, I don’t know, family emergency or something, but take everything else out and you kind of create that sacred space where you can do that work, whether that’s writing, or coding, or cold calling 15 prospects or whatever that is. It’s super-duper simple, but it’s so easy to then sort of, again, Monday comes, Tuesday comes, and then the world takes over, and you’re like, “Oh, my God, it’s 4:00 p.m. I haven’t done the thing.” So I’d say that would be the one category.
And then the second part —
Tim Ferriss: Can I pause for one second?
Sami Inkinen: Yeah, sure.
Tim Ferriss: Okay. So before we get to the second, for some people listening, if they sit down for 10 minutes on Sunday to write down the things that must get done professionally and personally, they might have a list of 20 things in each category. So, are we talking about one thing, three things in each category? I know this seems like very persnickety, but this seems like a possible failure point for people, right?
Sami Inkinen: Yeah.
Tim Ferriss: So, what is your suggestion there?
Sami Inkinen: Yeah. So, it’s probably one or two things, but this, again, we could launch into another part, which is obviously you need an architecture of annual thinking, planning, like what does business need, for example. In fact, I just have a text file, ASCII file on my computer. I was like, “Here’s the four things to remember as a CEO now and 20 years from now. Here’s the three things for this year. And here’s the three things for this week.” I literally have a text file and I just update it every Sunday.
And a whole another topic, which I’m sure some people think I’m crazy, is I have a 15-year plan for myself, which I accidentally stumbled that it actually could be useful and I update it every year. And again, we can take that offline or take a bookmark how that came about. It’s been incredibly helpful. And again, I want to highlight, structure allows spontaneity and flexibility, but if you don’t have that architecture, then obviously on a Sunday evening it’s like, “Oh, should I write a book, or get a new job, or just do this project that my boss was asking?” So, if you don’t have that North Star, you could be kind of spinning like a compass.
Tim Ferriss: I did take you off track, because you were saying block these things out in the calendar like Sunday, five to 10 minutes, block those things out in your calendar if you can, two hours first thing in the morning. Do not let the universe dictate how you use your time, block out notifications. And then you said the second thing, and then that’s when I interrupted you.
Sami Inkinen: Yes. Second bucket, this is probably the most important as this relates to a burnout and you’re falling apart. And I’m going to knock here on my wood, my table, not too hard to create any noise, but I founded my first software company in April 2000. So now we’re here in 2026, so that’s 26 years, running, building, fast-growth companies. And I haven’t cracked yet. And again, caveat is it could happen tonight. But there’s a few things I’ve learned, and I think these are applicable to, especially any knowledge worker, where everything’s just coming to your brain, and it’s very easy to get stressed, and anxious, and crack. And I’ve written about this as well. Here’s my formula that has worked for me very well.
One, you have to take care of your sort of foundational metabolic health. What is it? It’s sleep, nutrition, exercises. That’s kind of one. If you are metabolically very, very unhealthy, it’s very, very likely that you’re going to crack under pressure. So that’s one. Second one is, it’s very helpful to have, especially for founder CEO types, but for anyone, have at least two or three identities, or outlets. For me, it’s parent/husband, one, CEO, two, and then want to be athlete. And so if one’s failing, hopefully at least two are the areas, outlets in my life where it’s like, “Oh, it’s going okay.” And by the way, it’s never that I’m rocking and winning and ringing the bell in all three at the same time. And it’s very helpful. It’s almost like a mental trick, like, “Oh, my God, work sucks, but at least my kids love me today.”
So having that outlet, and particularly founder types, younger ones, it’s often the opposite. They’re sort of proud of the fact that I only have one thing and I’m ready and willing to die for my company. Well, that’s all well and good when everything’s going well, but you have the first speed bump and then everything falls apart. So that’s the second thing, I would say.
Third one is have peers outside of your company that you can let your hair down and relax. For me, it’s a group of CEOs. Other CEOs was, “Oh, my God, can you believe? Can you believe these employees are bitching again?” But obviously you can’t say that in front of the company. Personally for me, it’s been YPO, the Young President’s Organization since, I guess, 2008. So now for me it’s not anymore the why the young, it’s just PO, because I’m old enough. So, I have that.
And then I think the fourth one I would say is everyone has their own tools, but just understanding how your mind work. It could be meditation, could be some other tools, but that’s been a process for myself, to just realize that if you are just attached to your thoughts, eventually they’re going to get you, and you can’t really think yourself out of the hole that you’ve thought yourself into. So unless you can take a step back and observe like, “Oh, my God, my brain’s having a life of its own.”
So that’s kind of the tool that I would not to crack. So foundational health, have different outlets, identities, have peers you can talk to, could be friends as well, and then some sort of understanding and way of taming your mind, if you will, or being able to see that the mind has the life of its own. That’s been helpful for me. And I will say, again, could happen tonight, but I haven’t touched any prescription drug for anything sort of mind related, and that toolkit has kept me head above the water so far for 25, 26 years.
Tim Ferriss: I have a very left turn question for you. Hopefully, it won’t be incredibly offensive. But I was just thinking, when you were like, “I would knock on wood, but I don’t want to make any noise,” and then you’re like, “I can let my hair down, no offense, sorry.” And you’re very polite, and I’ve only been to Finland once. And I was walking around. And of course, went to the obligatory saunas and so on, which I actually can tie into my story, but I was walking around and in the maybe two days that I was in Helsinki, I thought to myself, because I lived in Japan, I speak Japanese, I’m still close to my host family who I stayed with when I was 15 and I thought, “Finish people feel like white Japanese people.” That was my feeling there.
And the reason it ties into the sauna, different context, but if you go to Japan, it’s everything is very restrained, very polite. People don’t stare you in the eye when you’re walking down the street. And in Japan though, if the boss says, “We need to go out and drink, when you drink, okay. And if the boss says you have to drink, you have to drink. But you go out and you can get really loud, and you can get really boisterous. And you’re allowed to say things when you’ve had some alcohol that basically everyone agrees they’re going to forget the next day like it never happened.
Now, I can’t take it that far with Finland, but when I went to the saunas, one thing that I was very surprised by is that they sell huge stein glasses of beer that people bring into the saunas. And I was like, “Oh, this is where they let their hair down. Okay.” Am I totally off base? I don’t know if you’ve spent time in Japan, but culturally I felt like in my 48 or 72 hours of exposure, I was like, “Wow, this is actually, even Finish itself has some of the phonemes, some of the sounds of Japanese. I mean, it sounds like I’m really overreaching now, but — am I just an insane person, or do you feel like there’s something possibly there?
Sami Inkinen: I think there’s similarities. And you’re definitely the connoisseur of a Japanese culture versus me, having just been to Tokyo and a few other places a couple of times. But that kind of space and distance, and politeness that people — well, actually, there’s no distance in Tokyo obviously, but sort of emotionally there is a kind of distance in Finland and in Japan versus when I came to America 2003, moved to California, it’s like everyone’s on your face and everything’s freaking awesome. And it took a couple of years to, I was like, “Wait, wait, wait, wait, come on, give me space,” and everything’s not awesome.
And so yeah, maybe there are similarities. And then, yeah, alcohol I’m sure has been a mental health tool, not very effective at that in Finland for many, many decades. But sauna, I have to — well, first of all, there’s five and a half million people in Finland, and there are more than three million saunas. More than three million saunas.
Tim Ferriss: It’s a crazy number.
Sami Inkinen: So on average, you have one to two people per sauna in Finland. Babies used to be delivered in sauna in Finland, because it’s the clean, bacteria die in the heat.
Tim Ferriss: Sterilized.
Sami Inkinen: There’s warm water. I think my mom was delivered in sauna. I was in the hospital, just to be clear. So, sauna is beyond being part of the culture. It’s part of the DNA. And it’s culturally, it’s an amazing place, actually, not just kind of let loosen your head down, but you don’t have your uniform, you don’t have your titles, you don’t have your whatever, socioeconomics, singles, symbols, fancy watches, and kind of everyone comes together, whether that’s family, or your friends, or your community. And yes, sauna is definitely a place where a lot of things happen in Finland. And yeah, we could talk about saunas and it’s its role in a culture, but it’s —
Tim Ferriss: Well, let’s talk about it.
Sami Inkinen: — way beyond cold ponds and sauna.
Tim Ferriss: Yeah. Why is that? Why is it so prevalent in Finland? Because it seems like, and I’m sure you’ve seen this, but there’s certain studies in the world of psychedelics where it’s like they did brain imaging and one study that they’ve been slicing over and over again and torturing the data again and again to just produce more and more papers on this one study that was done so long ago. It seems like the same group of 140 fins has been dissected five million times in various announcements around saunas, but why is it so prevalent there versus other places? I don’t know the origin story.
Sami Inkinen: Yeah. And hopefully, there’s a historian who will check me on this, but it definitely goes back hundreds, let’s say, many hundreds of years, where it was sort of necessary. Finland, four seasons incredibly cold winters. So sauna was a place to basically heat and warm up in the winter. It was also a place where you could dehydrate food. So that’s kind of how it goes way back when. And obviously now, it’s not necessary to stay warm and it’s not necessary to dry your food, but I think that’s where it started.
And then in saunas where you duck into a side of a mountain, and then you burn wood on top of rocks, and then you extinguish the fire, and then you make sure that the smokes goes away, and the rocks stay hot for a long time and you go in. That was the original, it’s called, people still have that kind of saunas today, it’s called smoke sauna. So essentially you don’t have a way to get the smoke out other than open the door. So there’s no fireplace where the smoke just goes through a chimney. So that’s called smoke sauna.
It’s a special sauna experience. And obviously, it takes much more time to heat it and make it safe, because you don’t want to go there, where there’s smoke. But I think that’s kind of the history. And then somehow I’m missing the link how it became sort of like a culture, but now, nobody will build a house without a sauna. Literally, first is where it’s a sauna, and then let’s figure out if there’s space for a bathroom. That’s kind of the order in Finland.
Tim Ferriss: I went to this public sauna, it’s pretty fancy, and there’s a word, you could probably tell me what it is, it’s like löyly or something like that.
Sami Inkinen: Oh, löyly.
Tim Ferriss: There we go. So this is, what? The act of throwing water on the stones? Is that what that refers to? Or the sound that it makes? I don’t know what the name of the actual location means, but you can tell me in a second, but the reason I bring it up is I have never experienced so many varieties of sauna, and they had a smoke sauna room. And in my mind, looking at the menu of options before going in, I’m like, “Okay, I get it. It’s a hot room. How different could it be?” But the experiences, and the feeling in the body, and the way it penetrates your being is very different. I was shocked, because I’ve spent so much time in dry saunas in the US, and I’ve also done steam rooms and so on, but I did not expect there to be such a broad palette of experience in saunas.
Sami Inkinen: Yeah.
Tim Ferriss: So that place was amazing.
Sami Inkinen: Yeah. So, I guess Eskimos have a dozen or so words for snow, because they know every nuance and detail. And Finns have dozens of words for different things around sauna that you can’t even translate. Löyly is probably the most important. You judge the sauna and it’s quality based on löyly. And löyly is essentially it’s after you throw water into the rocks, the fireplace, the rocks, and then the steam comes up. It’s not the steam, it’s not the heat, it’s the, I guess you could say the spirit of the steam, but how it feels, how it lands. And let me tell you, there’s a million different variations how it happened. Is it too hot? Is it too sharp? Is it soft? Does it sort of linger around and how does it feel on your body? That is löyly. And you judge the quality of the sauna based on the löyly.
And there’s a whole science to it, kind of like how big is the space. To get the löyly right in a barrel sauna, which by the way I have at my house, is very, very hard, because it’s too small, the fireplace, you can’t get high enough, and you should be sitting kind of above the fireplace. So yeah, löyly is — if you know one word, löyly, and you want to impress Finns, you go to a salon and I say, “What a fantastic löyly.”
Tim Ferriss: I feel like I need to reach out to the Finnish Tourism Board to sponsor this episode, get people headed over to Finland. I really enjoyed it. It was a very short trip, but hopefully I’ll have a chance to get back.
Let’s talk about metabolic health, because certainly Virta, we can talk about Virta. And part of the impetus for this conversation was tons and tons of text messages back and forth, and some of them I’m sure we can’t talk about publicly necessarily because it’s internal data or whatever, but I would have say a conversation with Dominic D’Agostino, who some long-term listeners will know synthesizes novel exogenous, meaning supplemental ketones and so on.
I was, for instance, I give one example, facing a bit of an enigma in my own experience, which was, I’ve gone into ketosis, and I know that’s a very sloppy way of putting it, but let’s just say getting into ketosis, so eating a predominantly fat-based diet, or even doing it through fasting, getting to a point where I feel like my brain has switched over to ketones. And I was lamenting to Dominic that my devices were telling me I was not in ketosis. And I found this implausible, because after so many years of experimenting with it, I feel like I have a very good bead on when my cognition clicks over, and is actually operating at a much faster CPU capacity.
But my finger pricks with, say, a Precision Xtra device, or the Keto-Mojo, were telling me I was basically not ketosis. And very confusingly, even with a breath-based, I think it’s KetoAir or something like that, pretty primitive device, but even with that I was being given a negative. And you sent me a text showing your bar graph over the last 10 years or something of measurable ketone levels going down over time, even though presumably you’re increasingly and increasingly fat adapted. And I was like, “Of course Sami has this data.”
And then you have some fascinating, fascinating data I have certainly never seen anywhere else looking at different cohorts with various combinations of things, with or without, say, dietary ketosis. So that is part of the reason I wanted to have you on. You’re such a meticulous thinker around these things and data cruncher. But let’s maybe just define some terms before we get into things. What is metabolic health? And maybe you could tell your personal story, because my understanding is at some point you were sub 10 percent body fat, but your report card in terms of biomarkers and so on came back and you were pre-diabetic, is my recollection, but perhaps you could take that TED Talk I just gave and use it as a leaping off point for discussing, defining metabolic health and then talking about your own personal journey maybe as a starting point.
Sami Inkinen: And first the caveat, which is that I do have two master’s degrees, but I’m not a medical doctor and I don’t play one on the internet. And I’m sure in this conversation we’ll go into that area, so I just want to be clear: I’m not giving medical advice to anyone, and I’m not a medical doctor. But obviously, I have a lot of experience with the topic that you just asked.
But in terms of, I guess the personal story, so just rewind, not quite all the way back to Finland, but again, my background is not in medical field. I’m a physicist by training, and in fact, started my career in a nuclear power plant way back when in Finland when it was still fashionable. And I guess nuclear power plants coming back to fashion now, again. Which is just to show that like my background is in science and technology, not in healthcare. However, I’ve been essentially an athlete all my life, cross country skier, bi athlete, came to America, started doing triathlons.
Tim Ferriss: Well, you had to ski to school at one point, right?
Sami Inkinen: Yeah, sounds very idyllic. Maybe that was a punishment by my parents. So Nordic skiing to school in the first grade through sixth, so —
Tim Ferriss: Sounds terrible, actually.
Sami Inkinen: And biathlon came handy, so carrying a rifle so I could shoot the bears when they were attacking along the way, which may or may not be true. But yeah, I was an athlete and have been athlete all those years. And then after coming to America, started doing triathlons, and pretty high level athlete. Again, we’re not talking about the Olympic gold medals, but as an amateur, and did many, many Hawaii IRONMANs, I think seven of those world championship races. And even won the world championships in my age group as a triathlete 2012, I believe.
And I give that all as a background context, because my view on metabolic health and sort of chronic disease, type 2 diabetes and obesity, was, this is very embarrassing to admit, was the following, which is, it’s ridiculous, it’s very simple: people know exactly what to do, most people, most Americans, they just don’t do it.
And as a result, we have just obese people everywhere. Everyone has prediabetes or type 2 diabetes. And by the way, it’s more than 50 percent of American adults. Now the data is, I think, 93 percent, this is the published period of number, 93 percent of Americans are metabolically unhealthy in one way or another American adults. And it’s either you have a high blood pressure, or your lipids off, or you’re obese, or you have type 2 diabetes, or prediabetes. And my view, as judgmental as I was, was always, “Listen, ridiculous. You know what to do, but you’re not doing it. You’re eating too much, you’re just eating too much and you’re not exercising. You loser.” And that’s why I pay too many taxes, because healthcare is five trillion a year, of which almost all of it is metabolic health related. So that was my view.
And I’m very, very embarrassed to say that’s how I was thinking. Sort of judging people like, “You’re unhealthy for reasons that are 100 percent in your control.” And then I got the moment where I had to eat a lot of humble pie, and I discovered that despite being, I don’t know, 10 percent body fat or whatever, and exercising 15 hours a week, and performing well as a triathlete, I was pre-diabetic. All the numbers are often essentially on my way to type 2 diabetes, and I was like, “Shit, wait, I’m not one of those people with no willpower, I’m not one of those lazy people, I’m not one of those ‘middle of America,’ 300 pounds seatbelt extender. That’s not me. Seriously, what’s going on here?” And this was 2012, around the time my previous company Trulia went public, and I was like, well, first I have to figure this out for myself, because if I can’t avoid being metabolically unhealthy, nobody can. Well, guess what? Nobody can. That is the status quo in America today with so many people metabolically unhealthy.
And that got me very interested in this whole topic of, what is actually driving poor metabolic health? fortunately met with amazing scientists who helped me understand that, fundamentally, obesity, type 2 diabetes and the other conditions that result from poor metabolic health, it’s not a personal choice. People don’t wake up on a Monday morning and say, “I want to gain 200 pounds and develop type 2 diabetes. That sounds awesome. And sticking an insulin needle to my body for the next 10 years every day, awesome. Sign me up.” No, it is not lack of willpower. However, nutrition and food is the number one driver of poor metabolic health.
And if you know how to use nutrition, if you know how to use nutrition to actually improve and reverse your metabolic health, you can take an average, let’s just call it 300-pound middle of America truck driver or average person that we, people on the coast often look at like, “Oh, it’s your fault.” And systematically, reverse the condition nutritionally. And essentially, that’s what we’ve done at Virta Health now, with more than quarter million patients and scaling fast. But let me just pause there.
That’s kind of the how did the Nordic skier physicist from Sigma get interesting in metabolic health, and then we can take this down to different paths.
Tim Ferriss: Yeah, let’s hop in. I want to start with, well, as you might expect, question about diet. I want to know what, looking back, what the problem was with your diet, and also, this is of course a leading question, so feel free to discard it if it’s not a good question, but how large a role does high fructose corn syrup play broadly in the US in metabolic dysfunction, right? If that just were removed from the market, what impact would that have? But let’s begin with just your personal retrospective. Hindsight 2020, what was wrong with your diet? When you were actually 15 hours a week, roughly 10 percent body fat, performing well in competition. What was wrong with your diet?
Sami Inkinen: Number one question I get like, “Oh, was it your genetics? Because you were exercising so much.” Obviously genes play a part in everything, but I just want to remind that, given about 60 percent of American adults, six-zero, either have type 2 diabetes or prediabetes today. Clearly it’s not like our gene pool has changed. So it can’t really be genes. Or if 93 percent are American also metabolically unhealthy, it’s not like our genes have changed. So no, it’s not that same was the N equals one thing with very, very bad genes. This is happening to a lot of people. I would say one thing. The first one is there.
The second thing is that it is possible to be skinny and lean and metabolically unhealthy. Some kind of people of certain background, especially in Asia, it’s more common that you don’t gain 100 pounds, but you’re very metabolically unhealthy. Also, you can out exercise the calories and burn and not gain massive amount of fat, but you can still be elevated blood sugar, elevated insulin and be insulin resistant. And that’s basically what I was doing. It’s very, very hard. I can tell you that I was hungry for 15 years as an athlete. It’s like, “I’m always more hungry than I could. And if I eat to my appetite, I’m going to gain fat. I can’t do that as an athlete.”
So now I’m going to answer your question. So my N equals one, I’m absolutely convinced because I was able to fix and improve it is I was eating six meals a day of essentially incredibly high carbohydrate and incredibly high glycemic index foods and practically no fat for 10 plus years.
Tim Ferriss: So you weren’t eating Twinkies.
Sami Inkinen: No.
Tim Ferriss: We’re talking about things like white rice or what are we talking about?
Sami Inkinen: Rice, bread, apples, granola bars. I don’t know, ketchup, pasta. But anything that has a glucose molecule turns into blood sugar. Sure. If it’s an apple or if it’s lots of fiber, it comes very, very slowly. But if you’re eating 4,000 calories a day, of which 3,000 is carbs, do the math, 750 grams of carbs a day or more. And so you’re basically drip-feeding sugar into your veins constantly. Jamba Juice in the afternoon, once I get tired. I just remember it was my diet all the time. When you’re in your 20s and you can overdose. People say, “Dose makes the poison.” That’s true. You can tolerate for a long time, but once you get to your 30s, it gets very hard. So very convinced that that was it.
Tim Ferriss: What are some of the more surprising things that you have seen within Virta Health now that you have more than N equals one? And what do the interventions look like?
Sami Inkinen: Yeah. Well, let’s start from the front end of your question.
What’s the most surprising? The most surprising is that we’ve been able to be successful with literally anyone, anyone. I’ll give you one example. And why is that surprising?
Even overcoming my own concept of, “It’s all about willpower.” I had this like, but it’s like people aren’t maybe not as educated as I am. Maybe they’re kind of busy lives. Maybe they don’t have my willpower or the willpower of willpower Olympians.” So that’s been one of the most surprising.
We work with Native American tribes, 800 or so large employers. There’s truck drivers. We’ve analyzed outcomes based on what’s called ADI, Area Deprivation Index. So you take all zip codes in America, and you rank them by average income, exactly the same outcomes. Exactly the same outcomes. We looked at race, ethnicities, exactly the same outcomes. And these are large scale, tens of thousands, hundreds of thousands of patients.
So that’s one that’s been very surprising, which is to say, “If you fix the biology, you fix the outcomes.” This isn’t, “Oh, you didn’t even go to high school and you have a very busy life, so we need some sort of extra willpower training.”
No, you fix the biology, you fix the body and the outcome. So that’s number one.
Number two is the magnitude of improvements. So to give you a couple of examples, someone may have had type 2 diabetes for 15 years. They are on 100 units of insulin a day, sticking the insulin needle three times a day for 10 years. And we can reverse that state of type 2 diabetes in six to nine months, and then sustain it for long term.
13 percent average body weight loss, and this is like on an intent-to-treat basis, not thousands start and then you calculate results based on five successful ones. No, you calculate the average drugs from all the thousand. So 13 percent.
In our clinical trial that was about 30 pounds or so, average weight loss at one year and sustained, and mostly fat because we did DEXA scans as well.
I would say the third one is the broad-spectrum effects, and some of these are peer-reviewed. So we’ve been able to show not just blood sugar down and reversing type 2 diabetes, not just weight loss, but up to 75 percent reduction in liver disease. It used to be called fatty liver disease, but scientists changed it to liver disease. So it’s called MASH and MASLD. By the way, it costs $100 billion a year in America today.
There’s one FDA-approved drug today, one FDA approved drug today for MASH. It’s one type of liver disease. It costs 45,000 a year. No kidding. And it came out to market last year, first time, 2025, billion dollars in sales. We deliver similar results nutritionally.
Tim Ferriss: I think this is public. This is in our texts, but the paper just accepted through peer review treating Stage 4. There is no Stage 5, if I’m remembering correctly.
Metastatic pancreatic cancer. This is bad news. This is super, super bad news. I mean, if my memory serves, this is kind of like a Steve Jobs-type situation with — okay, but this is treating Stage 4 metastatic pancreatic cancer with three chemo drugs, that’s one arm, versus same drugs and on Virta, trying to get patients into ketosis remotely. Well, do you want to describe the results of that?
Sami Inkinen: Yeah. So this was a very well-controlled, it’s a randomized control trial for Stage 4 metastatic pancreatic cancer. We ran the trial with a number of academic oncology centers. So this wasn’t just us, a very well-controlled randomized controlled trial.
And before I talk about the results, just a reminder: pancreatic cancer is number two or number three killer, depending on the year of cancers in America. So it’s very deadly. It’s usually diagnosed too late, at Stage 4 metastatic stage. And the life expectancy is usually 12 to 18 months or 12 months. It’s very, very deadly cancer.
And so we had a trial where we had one arm where we randomized people. It was chemo, three drugs, and then another arm, as you mentioned. Same drugs, exactly the same therapy, plus the Virta nutrition therapy. And we were able to show just about 35 percent life extension on average in that arm, chemo plus Virta.
Again, it’s a very deadly disease. 35 percent is stunning, but of course we’re still counting months. It’s not that you go from 12 months to 12 years on average.
But I guess going back to your earlier question, that shows the power of metabolic health and poor metabolic health and what might be possible. What is absolutely possible is reversing type 2 diabetes, losing weight, preventing liver disease.
We didn’t even talk about kidney disease and other things. But the fact that we can drive outcomes even with some cancers, and I will say, “some cancers.” I can’t say, “Oh, nutrition can cure cancer.” Not quite.
But poor metabolic health and in our case, we didn’t really define the poor metabolic health in the beginning, but essentially it’s high glucose levels, high fasting insulin levels and what you then might call insulin resistance. Your body’s primarily burning sugar and you’re constantly hungry, you’re constantly craving. So even if you’re 100 pounds overweight, you’re hungry and you want to eat more of that stuff. That’s the typical state of poor metabolic health.
And then it manifests itself with type 2 diabetes, cardiovascular disease, fatty liver disease often, eventually chronic kidney disease and many other things.
And seems like many cancers thrive in that kind of environment, in that kind of poor metabolic health.
Tim Ferriss: Yeah. I don’t think that’s controversial. I mean, maybe look, says the non-doctor to the non-doctor, but I mean, certain cancers, not all, are very glycolytic, right?
Sami Inkinen: Mm-hmm.
Tim Ferriss: I mean, they’re really dependent on a steady fuel of sugar to simplify it. Dom, I think for people who want to hear more on that, also Dominic D’Agostino has spoken about it quite a bit in a couple of my conversations with him.
So what I want to ask you about, because we’ve teased it a little bit, the Virta nutrition therapy. I’m looking at the Virta quick guide right now. If you don’t mind, I’ll just kind of lay out some of it, right?
Sami Inkinen: Sure.
Tim Ferriss: Because for me, this is where probably the magic is embedded. And I want to learn more about how you guys get the compliance, the adherence that you do. Because that to me has always been this very elusive, I don’t want to say missing link, but challenging link with anything approaching what we might consider a ketogenic diet.
And I want you to also dispel if I’m making a false equivalence with the ketogenic diet, but you have curb your carbohydrates, aim to begin with around 30 grams per day just as needed.
And you have some very important stuff in here, right? Measure total carbs, not net carbs. This is where people try sometimes outsmart themselves, and then you give examples of what that can look like. And then building your plate, what does an actual meal plate look like? Non-starchy vegetables, moderate protein, added fat, salt and extras, et cetera.
So I’d love for you to describe what you have found to work when you are getting people started, and just what you’ve picked up over time in terms of the most helpful components. I was going to say ingredients, but not food ingredients. Ingredients for getting people to adhere to these diets, right?
Because my assumption, which may be incorrect is, “Okay, I, Tim Ferriss, I can go to Whole Foods and buy salmon and vegetables and this and that.” But a lot of people in economically depressed circumstances or areas or fill in the blank buy a lot of their what some people would consider unhealthy food because it’s very inexpensive and it’s readily available.
And having spent time around a number of Native American reservations, it’s like, “Man, there are food deserts in the United States.”
What have you found, what have you learned over the course? Because your data set is so incredible. I mean, it’s just like such a rich and amazing data set. What have you learned about helping with adherence and compliance, or modifying the diet itself?
Sami Inkinen: Yeah. Well, I will bracket, you said we have big dataset. We absolutely have the largest dataset of metabolic disease reversal in the world, millions of patient years of data and data points from each patient every single day. Not just qualitative information, but blood biomarkers.
Yeah, let me try to peel the onion to answer your question, because a lot goes into it. I guess just to take a step back, yes, we use nutrition, individualized nutrition as the core therapy to treat our patients. It is our own protocol.
I say “our own protocol” because any kind of generic label that you put into it, people go to Google and they Google and they can go wrong in 1,000 different ways. So anyway, so we use our own protocol.
But yes, to address and reverse insulin resistance, you do have to reduce your total carbohydrate intake. And we have dose response curves to know that the more and the better you do it, the better outcomes you typically see.
But that’s sort of number one thing I will say that yes, we use nutrition as a therapy to reverse metabolic disease. And I will say that as a physicist, using nutrition as a drug or as a therapy is harder than nuclear physics.
Why? For all the reasons you mentioned. Because every person makes a medical decision three to four times a day, that’s when you eat. It’s different today versus tomorrow, and then it’s different between individuals. So it is a very, very hard puzzle to solve. Fortunately, computers and software is very helpful about that. So that’s one, individualized nutrition.
Number two, what does it take, and how do we approach? Key piece, even if you know exactly what somebody should eat, is you need the support system. And I guess that’s my tech background with Trulia and other things that comes to play that everything we do, we do virtually.
So what we can do is we can monitor your biomarkers remotely. We give you tools to do that. We can track blood ketones, blood glucose, your weight, and other things. And then we have actual real medical doctors, not me, who are full-time employees who monitor you, and coaches who can then make adjustments.
Tim Ferriss: Is that collected through continuous —
Sami Inkinen: Collected devices —
Tim Ferriss: — monitors? Is it also blood draws, or is it mostly some type of continuous monitoring?
Sami Inkinen: It’s all of the above. Some patients get a CGM and some it’s a finger prick. But not everybody gets a CGM, depends on the situation. We do lab draws one to two times a year, so that obviously can’t happen daily.
Tim Ferriss: Yeah, I got it.
Sami Inkinen: Yeah, yeah.
Tim Ferriss: With the finger prick, that’s some type of Bluetooth-enabled thing that —
Sami Inkinen: Automatically.
Tim Ferriss: — automatically syncs the data.
Sami Inkinen: Exactly.
Tim Ferriss: So they’re not manually having to enter any values.
Sami Inkinen: No, exactly. It goes to the cloud and gets to us.
And I say that because if you say, “Oh, here’s how to eat. Here’s a brochure or a book or something,” it’s kind of like telling a car driver, “Just hold onto the steering wheel straight. It’s going to be awesome. Here’s brake and gas pedal.”
And you know what’s going to happen. The car is going to beautifully stay on the road until the first corner. It’s like, “Ooh, forgot to mention that we may need to adjust, turn left, turn right.”
And so it’s the same thing with nutrition, that unless you have this kind of a platform, there’s constant adjustments and constant adjustment. It’s kind of like a self-driving car. But then if you have the cameras, white line and yellow line align, and you kind of try to keep it in between.
So with the remote monitoring, we can try to keep you between the yellow and the white line. So that’s the second thing.
The third piece for adherence, we start talking about nutrition. The most important thing early is to understand the constraints that a person has. I’ll give you silly examples.
If we tell a vegan to have bacon and eggs for breakfast, you know what happens? They’re going to say, “F-U-C-K, I’m out.” Right?
Tim Ferriss: Yeah.
Sami Inkinen: There’s no way to convince a vegan to have bacon and eggs for breakfast, and vice versa. There’s other things, obviously if you are, we work with US Foods, large kind of actual food delivery, food service, is truck drivers. Their concept of a lunch is McDonald’s.
We can’t tell them, “Oh, here’s the list, go shop Whole Foods or Erewhon, and then go home and cook at home.” It’s like, “Okay, McDonald’s it is. We’re going to reverse your diabetes on McDonald’s diet.” And by the way, we do that.
Tim Ferriss: I don’t want that to get buried.
Sami Inkinen: Yeah.
Tim Ferriss: But what are some sample meals that people might get at a McDonald’s or something like that?
Sami Inkinen: Perfect. Yeah. So that’s the next step with food, and maybe I’ll give an example. It’s like, “Okay, now that we know you are a truck driver and you will never become a vegan, you can never become a vegan.” Obviously I’m tongue in cheek here, but most of them don’t.
Tim Ferriss: Yeah, I’m not a vegan either.
Sami Inkinen: Yeah, yeah, yeah.
Tim Ferriss: And I’m not sure if you’re probably not either, right?
Sami Inkinen: Yeah. And by the way, we have many, many successful vegan patients.
Tim Ferriss: Yeah, yeah, yeah.
Sami Inkinen: So I know, sorry if I started a diet war here, but — okay, example, you truck drive. Okay, so McDonald’s it is, it may not be the pinnacle of health. But we can reverse your metabolic disease with that. And let’s forget the organics, we’ll do that later if you can. Here’s what you do.
You go there, say, “All right, well, you want your burger, maybe you even add extra cheese. But please ask them to drop the bun and just have a lettuce wrap, get that.
“Then you go to the condiments. Yeah, mayo might be fine, but don’t take the ketchup because we can educate you and tell you that ketchup is colored sugar. You can’t have that.
“Yeah, you want your soda. You really want your soda, water is not enough? Okay, so go for the Diet Coke. Don’t take the soda with the sugar.”
Again, somebody’s listening like, “Oh, Diet Coke’s bad for you.” I totally agree. I’d rather drink water. But again, let’s not let perfection be the enemy of progress.
So that would be a McDonald’s kind of a session, and off you go.
Tim Ferriss: Yeah.
Sami Inkinen: So that’s the second step with food. And then the third one is really empowering the patients with — we talk about AI, like AI-based tools.
You go to a restaurant, or you’re trying to cook something. You can take a picture and we instantaneously say like, “Hey, what kind of adjustments should you make?” and tie that to your actual situation. So how do you change that?
And this happens every day, two, three, four times a day. And that’s the self-driving car analogy, that the car that goes straight is fantastic until you have a corner. And that’s 100 percent of the diets in America today. You can’t do one size fits all.
And then before you ask a follow-up question, this is mind-blowing for people, and ties to your earlier question as well.
The adherence of Virta patients, again, which are real Americans, not Samis, real Americans, is twice as high at one year as taking a GLP-1 drug.
We have 83 percent adherence retention of patients at one year, and look at any of the publicly available data. People stick to GLP-1s like 40 percent, maybe 50 percent, 30 to 50 percent. Why is that?
Number one reason is the user-perceived benefits. It’s like, “I can’t believe I feel this good. I can’t believe I’ve lost 35 pounds. I can’t believe I don’t need to stick the insulin needle to my body.”
And the stories that we hear from people is like, “I’m 65, I thought I don’t see my grandkids grow. Now I see, and I have so much energy that I’m gardening the first time in 20 years,” or whatever that is.
And you know this. When you’re feeling really, really bad, you’re sick and everything’s hurting, and then that suddenly goes away, that’s like life is freaking awesome.
Tim Ferriss: It is.
Sami Inkinen: And so I think the number one reason is the benefits are so strong versus a calorie-restricted diet where you’re like, “This sucks, but I’m going to look good on a beach at least for a week.”
Tim Ferriss: How do the experience of benefits l differ from GLP-1s? Just because we’re segueing directly from that, and certainly a lot of people listening will either directly themselves have experienced or know someone who has lost 35 pounds and feels more energy because the GLP-1s do make you slightly more ketotic.
For the people who are wondering why they might feel sharper, that’s actually one very plausible piece of the puzzle.
But how do the perceived benefits differ in a way? And maybe there’s more to explain it, I’m sure there is, the two times GLP-1 adherence at one year. I guess that’s what you said, right?
Sami Inkinen: Mm-hmm. Mm-hmm.
Tim Ferriss: So I’m just trying to identify where those two interventions diverge.
Sami Inkinen: Yeah, absolutely. First, I will say our Virta providers prescribe both oral and injectable GLP-1s when appropriate and/or necessary. And when our client, the plan sponsors like an employer, health plan have them in a plan design.
So I just wanted to mention that so that nobody thinks, “Oh, this is some sort of nutrition dogma.” No, there’s effective pharmaceuticals and especially GLP-1s in obesity and metabolic disease context are way better than the 1980s and ’90s diet pills. So it’s a real, real innovation.
Tim Ferriss: You guys don’t prescribe Fen-Phen to your patients?
Sami Inkinen: We don’t. We don’t. By the way, there are companies that do that to lower cost of GLP-1s, but absolutely we don’t do that.
Tim Ferriss: Yeah.
Sami Inkinen: I’ll start from very basics. The GLP-1s 100 percent affect your appetite. They change how much you eat, so you eat less, but they alone don’t change what you eat. So that’s a starting point.
Tim Ferriss: Sure.
Sami Inkinen: And if you don’t change what you eat, you’re not going to be perfectly or even optimally metabolically healthy. And so one example is you lower appetite, you eat less.
But the second you come off these drugs, all the data shows that your weight skyrockets. And more likely than not, you gain fat and you’ve lost pounds of muscle.
By the way, we’ve shown the patients who come to us on GLP-1s, and once they discontinue the drug for whatever reason, by personal choice or side effects, we’ve been able to sustain that weight loss. This is published in peer-reviewed data, 18 months out. And soon we will have even longer-term data. But 18 months, no weight regain. Why? Because we start changing what you eat while you’re on the drug, and if you do that.
But to sharpen the point to your question, obviously we know the side effects of healthy nutrition: none. Every drug has side effects. So that’s one thing. And these GLP-1s are tolerated much better than many, many other drugs. But there’s a lot of things, nausea and stomach issues.
And it’s interesting, we’ve surveyed the patients who are on GLP-1s in our care. 80 percent of them say, “I either want to severely reduce the dependence on these drugs, or get completely off of them.”
So this idea which is prevalent, at least in the press, “Americans just want to take a pill, and keep taking the pill for the rest of their lives.” Most people, if given the choice, if given the choice to be healthy without, they don’t want to be taking drugs.
So I guess hopefully that answers the question of what are the user-perceived benefits? Well, there’s no user side effects when you’re eating healthy food. But with the drug, you usually have that.
I’m not the expert to talk to how energy levels or excitement or mood and things like that change. I think lots of data will come out when millions of people on these GLP-1s for years, but yeah, eager to see what happens.
But there’s definitely a lot of things to be fully aware, like lean body mass in elderly populations, 65 and plus people who lose a lot of weight on GLP-1s, very alarming reports coming out.
Tim Ferriss: I want to get granular again with just a hypothetical example of a vegan, because you mentioned this. This word has come up a couple of times.
And in a way, in my mind, I’ve always envisioned that as a tougher nut to crack than McDonald’s, just because so many — how should I put this?
This is true across the board if you just walk through any grocery store, including Whole Foods. There are a lot of junk foods masquerading as health foods, which are full of ingredients that are terrible for you. Incredibly high glycemic, meaning they’re going to spike your blood sugar.
Maybe we could talk about glycemic index versus glycemic load. But suffice to say if you eat it and you check your blood sugar within 90 minutes, it’s going to be a lot higher. And this seems to be true of a lot of vegetarian or vegan food also.
So what would be an example of how a diet plan, or let’s just say a meal or a day of meals for a vegan, let’s just say, on the Virta program?
Sami Inkinen: Yeah. Yeah. Again, I will say everything has to be individualized. But to use average figures, we rarely have to massively change protein intake for our patients.
Maybe surprisingly to some people, the standard of American diet has a, give or take, maybe it’s a little bit on a low side, but more or less the right amount of protein. And by the way, that’s the most expensive macronutrient.
So sometimes people are like, “Oh, when you start treating your patients, it must be so much more expensive.” Well, actually protein is the most expensive. We rarely changed that a lot.
In vegan context, that’s probably the hardest thing to get right, to get sufficient amount of protein. And you really have to get at least 1.2 grams per kilo, kilo. One kilo is 2.2 pounds of protein proline or normal body weight mass. So if you’re 80-kilo person, which is 176 pounds, that would be a kind of lean person, 100 grams of protein a day is minimum you have to.
So that’s probably the hardest, and vegans know this very well. You have to look at nuts and tofu and may need to rely on soy, and are you willing to eat eggs? But that would be one.
So we figure out again with the patient like, “Okay, what are you willing to eat? Are you able to have dairy?” Some people are okay, some not. But that’s probably the hardest usually to make sure that people get adequate protein.
And protein is really essentially it’s the only macronutrient that doesn’t really store itself. So you have to get it couple of times, two to three times a day to maintain your body mass.
Then after that, it’s actually interesting. To get the sufficient calories if there’s a lot of crap vegan food, meaning sugar or cornflakes or whatever, then we start replacing those with healthy fats.
And this is also misconstrued like, “Oh, it must be so expensive because corn is subsidized, or corn syrup is subsidized. Hence, you can have unlimited amount of corn calories, cost nothing.”
Well, guess what? You can buy 9,000 calories, so one liter of high-quality olive oil from Costco for, what does it cost, two bucks? So it’s a misconception. The cheap subsidized sugar calories can actually be replaced at the same cost.
Now if you’re very, very overweight, you don’t want to be replacing those calories because guess what? You want your body to give the fat calories. And then around the kind of healthy vegan food, then we guide the patient towards leafier, less starchy, vegetable options. So you can eat very sumptuous vegan food. I think we even have, because this was a misconception in our very early days, so we’ve been pretty vocal.
We have bunch of patients who are vegan. If somebody Googles “Virta Health on vegan diet” or something, there’s a couple of our patients have openly shared what they eat, but it’s totally manageable. In fact, you just end up throwing out the window the crap vegan food, so I don’t know — sugar-frosted cornflakes would be a perfect example of that. Orange juice or something like that, which I love oranges, but orange juice is essentially soda.
Tim Ferriss: Tell me if I’m hearing this correctly. It sounds like, if you reduce the high glycemic junk that someone is consuming, you’re going to over time improve metabolic health, right? But is it fair to say that, for instance, the truck driver who’s eating the lettuce wrapped cheeseburgers and drinking Diet Coke, man, you do that for, depending on the size of the person and blah, blah, blah, blah, blah, obviously, if it’s a male, I don’t know, maybe in three to five days, that person’s probably clocking in at, who knows, 0.7 plus millimolars. I’m not sure how you say it.
Ketones, right? Beta-hydroxybutyrate, I would imagine, but in the vegan example, maybe you’re simply reducing the glycemic load, but maybe not getting deeply into ketosis, just because the question in my mind was related to the protein, right? How do you consume tofu, tempeh, et cetera, et cetera, et cetera while keeping your total carb count low? It doesn’t immediately seem possible to me, unless they’re willing to eat eggs, but if we take eggs off the table, then it seems like you can significantly improve metabolic health, but it may not be through the vehicle of what would technically be considered ketogenic. Is that fair to say?
Sami Inkinen: Yeah. That’s why We don’t really use the ketogenic —
Tim Ferriss: The K words?
Sami Inkinen: Again, for two main reasons. One, you Google it, and you get your version that you get the love or hate, and likely it’s wrong, and then two is it’s all on a spectrum or kind of a dose response curve, and we never want to let perfection be the enemy of progress. The less you have hunger and cravings and the better you feel, more sustainable and easier everything is, including just life. That’s what we teach to our patients, and you can kind of be anywhere in the dose response curve and be successful.
The further you are, we can pretty much predict not just your health outcomes here out, but even the healthcare cost savings, which is sort of insane, because drug companies do these trials. You take one pill, this is what happens. You take two pills, this, and then you kind of want to optimize where you want to be on a curve. Our therapy is no different, and we show this to people. We actually say, “It’s your choice, and you get here,” but the beauty is that we empower people so they can make their choice. Then, the beauty also is that you don’t have to be perfect, and you can still be very, very successful. Average diet is so bad, honestly, that it’s relatively easy to make your own progress.
Tim Ferriss: Yeah. The Standard American Diet, SAD.
Sami Inkinen: Yes.
Tim Ferriss: I just love that the acronym is SAD. It’s so good. Whoever came up with that, God bless you. What a great acronym. I want to get back to your training, so we’re going to get off of Virta in a moment, but I want to say, just for people who maybe have heard the last few conversations I’ve had with Dominic, I am deeply interested in ketosis, the ketogenic diet, and exogenous ketones, but I have seen, I think Virta is approaching this the right way with a greater degree of flexibility. I would also just point to, for instance, the slow carb diet and The 4-Hour Body. It is not a ketogenic diet, right? You’re consuming legumes, you’re consuming a lot of fiber in the form of beans or lentils, et cetera.
It is not ketogenic in any way, but it does reduce or eliminate processed food. It eliminates most starchy carbohydrates, except for one day a week, and the types of transformations that you can see metabolically are just remarkable. Granted, that is a book, so by nature of its format it is a kind of on size, hopefully, fits most, whereas Virta is much more adaptable and customized for the left right turns that you described, but I wanted to just underscore the fact that I am not a keto purist by any stretch of the imagination, and most of the time I am not in ketosis, although I do spend time in that range.
I want to hop from Virta to a question around training. So, just in brief, and I’m not sure this number even exists, but what is it an average non-athlete VO2 max, and what is your VO2 max?
Sami Inkinen: I’m freaking old by the way, I just turned — Do you know how old I am?
Tim Ferriss: I don’t know how old you are. You’ve got those impeccable Finnish genetics. I have no idea.
Sami Inkinen: Oh, my God. I turned 50 in December.
Tim Ferriss: Oh, nice. Congratulations.
Sami Inkinen: Yeah, so I’m very, very old. This is at least what my —
Tim Ferriss: You’re not that old.
Sami Inkinen: — two kids tell me, who are like 10 or something, but I think at this age in particular, or even like a 30-year-old fit male, VO2 max is measured relative to your body weight, so it’s how much oxygen you can consume, your body can utilize, so it’s milliliters per kilo per minute. I think it’s maybe 40.
Tim Ferriss: Would be on the average side?
Sami Inkinen: 40 maybe or 35 or 40 or 45. Yeah, my measure is more than 80 milliliters. It’s pretty high, very high. The caveat is it was measured a couple of years ago, so it’s probably a little bit lower today, because the VO2 max tends to go a little bit down as you age. You can still kind of increase the percentage of that, that you can produce for five or 10 or 15 or 20 minutes, but it’s kind of very, very high. I think the highest ever method recently, it’s more than 100, but if you’re 90, you’re kind of Olympic. 85 to 90 gets you to kind of Olympic podium in endurance sports, can catch, and again, that’s not the one and only measure. There’s a lot of other things, but if you’re above 90, you should not be doing podcasts. You should be in the Olympics.
Tim Ferriss: Well, good news, bad news. I’m going to stick with the podcasting. I’m definitely not above 90. The reason I’m bringing this up is that, in conversations with my doctors and people I really trust, as well as a number of podcast guests, like Dr. Tommy Wood, who is a neuroscientist and phenomenal athlete also, the topic of endurance training, as it factors in, I hesitate to use some of these labels, but endurance/aerobic training, as it factors in, you’ll see very quickly why I’m struggling with terms, factors into health span and longevity. It’s become a topic du jour in the last handful of years in particular.
The way it’s been presented to me is, and I’m particularly interested in this for its implications for cognitive health and potential volumetric changes in the hippocampus and so on with certain types of training, given that I have Alzheimer’s in my family, but the way I’m taught to think about it is that, let’s just say zone two is the base of the pyramid and then VO2 max is the height of the pyramid, and you’re trying to maximize the total surface area/size of that two-dimensional pyramid, and I will confess, I’m very ashamed to confess, I hate sitting on a stationary bike. I absolutely loathe it. I find it so boring.
I also just see these long term changes in the sort of kyphosis, like the hunchback postures of some long-term cyclists, and I want nothing to do with that. I have enough back issues as it is. So, my question for you is, when you’re trying to get a normy to do more endurance-like training, and I am on the path. I have some spinal issues with the lumbar and sacral kind of segments of the spine, which I won’t bore everybody with right now, but I’m hoping to get to a point where I can actually do sports I enjoy, like jiu-jitsu or other things which, at least for high intensity interval training, mimic something like the Norwegian four by four really well, right?
I could do a round of four minutes, take three minutes off, do another round of four minutes, and maybe it’s four minutes on, four minutes off or three minutes on, three minutes off, but close enough, right? If I’m doing it consistently, but as it stands right now, I can’t really do incline treadmill with, say, a ruck sack or something for zone two because of the hip extension and the issues that causes in the lower back, so despite my best efforts to avoid the stationary bike, I keep on ending up on this damn stationary bike. And road biking just scares me too much with the traffic, say, in a place like Austin. Everyone I know here who has done street, road biking for more than a handful of years has had some type of accident.
What would be your advice for someone who’s trying to get, literally, back in the saddle to do some training? How do you think about this type of training, as it fits into health span and so on? Because I’m not intrinsically someone who enjoys this particular type of training. I remember for The 4-Hour Body, I was in South Africa at the Sports Science Institute of South Africa, and they did a muscle biopsy of my thigh, my quadricep, my vastus lateralis, and they looked at all the enzymes. I can’t imitate a good quality, strong South African accent. It’s pretty good. It’s a great accent, but “years.” I can’t even say “years.” That’s how you ferret out the South Africans, or the North English.
But the point is he came back and he showed me these charts of enzymes like citrate synthase, which seem to be correlated to endurance capacity. Tertius, I think that was his name. He said, “Basically, this flat line is Homer Simpson, and here is your line, which is like infinitely below Homer Simpson,” so I don’t think I’m very well-built for this stuff. This was a long litany of complaints, but how would you suggest I think about this kind of training, right? Because it seems important. I’m not sure how to make it more interesting. I do find the interval stuff a little more compelling, and it keeps my attention more than the zone two, but it seems like you kind of want to do both. What are your thoughts? I’m just turning this into a therapy session.
Sami Inkinen: Sure. Asking the non-coach a coaching question. My favorite topic, pretending to be an expert.
Tim Ferriss: Yeah, but you’ve dealt with coaches.
Sami Inkinen: I will take it. I will take it. Yeah, so my approach, I’ve had a coach, and then, essentially, 95 percent of my life I’ve self coached myself, because I take it as an interesting puzzle to try to learn, and then surprise, surprise, as an entrepreneur I don’t really want to be told what to do, so I ended up self coaching. Based on that experience and with that caveat, first of all, on a high level, my approach, basically, in everything in business, metabolic health training is kind of nailed the basics, less marginal gains and crazy. I know it’s boring and doesn’t sell a lot of supplements and stuff, but it’s like nail the basics, less marginal gains and crazy.
When you do that, that’s when you actually get the 99 percent of the results. For training, specifically, also whatever you want to accomplish, and you’ve done a lot of sports and lifting, the very basics are very simple. It’s progressive overload and specificity. If you don’t have progressive overload, even if it’s just the walking or hiking or running, you aren’t going to get better. Initially, when you’ve done nothing, come off the couch, it’s like very easy progressive overload. It’s like do anything, and you get better, and then the other one is just the sort of specificity. If you want to be a sprinter, you can’t train like a marathon runner and vice versa.
If you want to squat a lot, bench press isn’t going to help a lot, so it’s literally those principles that I use, but to give specific advice to you, what you just said, to get the cardiovascular stimuli, you obviously have to get your muscles burning oxygen, using oxygen and then burning either fat or carbs and your heart rate up, so you need to do something for that. The reason cycling or any kind of a bike thing is so widely used, it doesn’t take space, and if it’s indoors, it’s very safe, and it’s low impact. It’s low impact. One thing I would say for the bike is, and Austin has a lot of good bike stores, shout out to Mellow Johnny’s and others.
Tim Ferriss: I have two indoor bikes upstairs.
Sami Inkinen: Exactly.
Tim Ferriss: One was set up by tech from Mellow Johnny’s, so I’ve got the bike.
Sami Inkinen: There you go. So, one is bike fit, so if there’s someone who’s like a PT and a bike fitter, and say, “Hey, I have these XYZ issues. Fit this bike to specifically work for me as much as I hate it,” so that’s one thing where you could get the handlebar crazy high or something like that, maybe even do a lot of standing. By the way, those are fun workouts to kind of, I don’t know, do a three-minute standing, three-minute seated, three-minute standing, whatever. So, that would be one thing to consider for the bike, that you get a fit that’s specifically for your back issues. It may not be the world’s most aerodynamic, but if it’s stationary bike, who cares? So, that’s one. The other thing, you don’t have a lot of snow around, but I know you occasionally go to places with snow. Nordic skiing and sort of skinning, obviously fantastic. Fantastic.
Tim Ferriss: Yes.
Sami Inkinen: Fantastic.
Tim Ferriss: Skinning, I love. I love skinning. If I’m outside, I’m not going to get hit by a car. If I could do skinning every day, I would, and my back actually loves it. So yes, I’m 100 percent behind skinning.
Sami Inkinen: Then, of course, often people who’ve kind of totally destroyed their knees and hips, it’s swimming, which I hate swimming personally, as a traveler. Well, elements of it are beautiful. You go underwater, and it’s kind of like meditation, but more than 20 minutes, and it’s like, “Please give me a break.”
Tim Ferriss: See, I will take the swimming. I’ll take the swimming over the cycling. I went and did some swimming yesterday, so I’m up for the swimming.
Sami Inkinen: Yeah. Then, if you live in a mountains, it’s very, very easy to get sort of zone one, zone two by just walking, even without actual weight, because you go up, up, and sort of speed walk. Then, maybe the last one I say, if you have the self-confidence to not feel too embarrassed, is Nordic walking. So, Nordic skiers do summertime. You either walk or run with them, but you basically have poles and you go uphill. You’ll probably get an extra 10 heartbeat and kind of higher level exercise.
Tim Ferriss: So, it’s kind of like jogging uphill with poles?
Sami Inkinen: Poles, poles. Yeah.
Tim Ferriss: Yeah.
Sami Inkinen: Obviously, you could just walk and then use them.
Tim Ferriss: Yeah. I could get into that. I use poles. Yeah, I could get into that.
Sami Inkinen: Then, to the sort of VO2 max, so building a better aerobic engine in like zone two does help your VO2 max two, and then of course, if you lower your body fat, body weight, the kind of denominator in the calculation improves, but specifically VO2 max training, you actually get the adaptation pretty quickly. I don’t do it all the time, crazy amount, because it can also burn you out. The two most common ways to really hit VO2 max is either you do sort of 30 seconds on and offs, like you go very hard, and then 30 second easy, but then essentially you kind of keep hitting the VO2 max oxygen consumption or sort of two to four minutes all out. They’re very, very hard, or two to three minutes all out, and then you take three minutes off and you do that whatever, four or five minutes, four or five times. Those are the most effective, I would say, and typical ways to specifically get your VO2 max up, but they can burn you out if you do too many of those.
And so, for me, personally, what I do typically closer to like a specific event or race, it may be like three weeks, where I do two of them a week, so just like six workouts. Then, I drop it to, I don’t know, one every two weeks or something. You can burn out and you can’t keep growing, and the VO2 max isn’t just going to infinitely keep going up. Bad news. And so, maybe that’s how I think about it. Find a sport where you can comfortably and enjoyably do an hour or so of cardio, whatever that is, and then this would be my advice. Think strategically when you do your VO2 block, and that could be just, I don’t know, three weeks or maybe it’s two weeks every quarter or something like that, and then the maintenance dose, again, I’m using dangerous terms here, because who knows what the optimal dose is? But constantly pushing the VO2 max, I think it’s just the injury risk, it burns you out, and it’s not going to do anything, because once you reach your VO2 max ceiling, you kind of are there, so there you go.
Tim Ferriss: Yeah, so a broader question I want to ask you about is what exercise dogma or sacred cows you have stress tested? Because I was looking at, this is a blog post that you wrote, this is a while ago, and I actually don’t have written down here the title, but it’s about hacking your running speed in four weeks. I’m tempted to read this whole thing, but I’ll just read some of it, right? So, my total running time averaged one hour, 50 minutes per week. It’s a four-step protocol for four weeks. So first, and I won’t read all of this, but develop muscle endurance by running 10 to 15 minutes every day, right? That might surprise people, because it’s like, “That’s more achievable than I would have expected.” You contrast that with the conventional approach of doing a long run once a week and increasing the distance each week, so I’m not going to steal the thunder.
We could comment on this as an example, but then broadly speaking, just kind of like unfounded sacred cows, because man, there are so many everywhere, not just an exercise, but everywhere. Number two, build your cardiovascular engine with all out, I think this is 10 by one-minute set, once a week, on a treadmill for regulating effort, right? And so, the total workout is less than 35 minutes, and you give links to scientific evidence. Number three, plyometrics for quick improvements in running efficiency. Even highly trained endurance runners seem to improve their running times in a few weeks of plyometrics, which is not that much, right? Roughly five-minute routine, three times a week, three times 12 explosive box jumps, three times 12 jumps for max height, right? Which is sometimes replaced with skipping into a hill. I don’t know what skipping into a hill is. Maybe you can explain that. This approach took 40 seconds or roughly 10 percent per mile off my best running speed in four weeks, leading up to a competition. Typically, a five percent improvement per year is a huge jump.
I mean, that’s kind of bananas. Then, you also added the note on, simultaneously gained about a pound or two of body weight, so my speed gain wasn’t due to change in body weight. This seems to, and I just confessed that I hate endurance stuff, so I’m really wading into the deep end of my ignorance pool here, but this seems to fly in the face of a lot of conventional recommendations, so I was hoping you can speak to anything that I mentioned, but also just broadly speaking, dogma in exercise because there’s so much crap, and there’s so many things that never really get stress tested in daily living, health, wellness, right? It’s like you hear all this crap all the time, where it’s like, “You only use 10 percent of your brain.” That’s not true. Evolution wouldn’t allow that to be the case, right? Drink to eight glasses of water a day. It’s like, “Well, yeah. It really kind of depends, right?” I mean, there’s so many recommendations you hear over and over again, so what have you uncovered in terms of dogmas?
Sami Inkinen: Well, first of all, that particular like, “Oh, my God. I need to get fast and running,” I wanted to do a triathlon, this is already a couple of years ago, actually, just about 10 years ago, wanted to do a triathlon, and I was training to row across the Pacific Ocean with my wife in a row boat, which is a whole other conversation we can have. I had stopped kind of running, and I was lifting weights, doing a lot of front squats. I was weighing 200 pounds, and like right now, I’m kind of in a cycling team, so my weight’s like 177 pounds. I was 23 pounds heavier.
Tim Ferriss: It’s a lot heavier.
Sami Inkinen: And I was like, “Whoa, how do I go from zero to hero? I want to be the Tim Ferriss of running. How do I hack this?”
Tim Ferriss: You don’t want to be the Tim Ferriss of running, I can tell you. That is my weak, Achilles heel.
Sami Inkinen: So how do I hack this? In that approach, basically, I wanted to slice and dice the running performance or at least the minimum, fancy, Silicon Valley term, first principles, but into contributing parts, like what are the one or two, three things you need to have? One, muscular endurance. You can be cardiovascularly fit, but go and run a downhill for 30 minutes or even 10 minutes. Your legs are noodles. You can’t continue running, so you need minimum dose for muscular endurance so that your legs don’t fall apart, and I think I was running for a triathlon that had a half a marathon, so 13 miles, 13 by one miles to run, so muscular endurance was one.
Then there was the efficiency you mentioned and so forth, but anyways, to go back to the actual, broader question, a couple of things for me. Especially for endurance sports, triathlon and for a marathon running and other things, one is like massive load and volume, and you kind of get more and more tired over like six weeks, eight weeks, maybe twelve weeks.
Then, you taper for two or three weeks, and you hope that after your last crazy week, in two or three weeks, you dig yourself out of the hole, and then you are super-fast on a race day. It’s like, literally, you’re on a knife’s edge all the time, and I completely changed that in the last four or five years I was really competing in triathlon, which is I want to be ready to race almost at the end of every week, meaning progressive overload but stay vibrant, and no matter how hard of a workout I do, say, on a Saturday or Sunday, by Wednesday I have to be ready to hit hard and feel like I can do almost like my best numbers. Personally, I found that more effective, avoided any kind of over-training, and I think when you’re lifting weights at the gym, this concept is much easier to crash.
It’s like, let’s say do your bench press, and for three weeks your reps or weight just keeps going down, everybody would be like, “What the F? Clearly I’m not either eating enough or I’m lifting too often,” but endurance athletes do exactly that. They kind of keep grinding, grinding, grinding. They get more tired. Then, they hope they get out of the hole, so that would be one thing that, basically, training in a way where you progressive overload, you hit your body, but then in sort of three to four days, you are back better, faster, stronger than ever, and then you keep repeating that. Personally, I found that, at least for myself, way safer, way more objective, and I always knew, “Oh. I’m getting stronger,” “oh. I’m getting more tired,” “All right. I’m going to take two days off, or maybe I have a full rest week,” so I would say that’s one thing.
The second thing, again, I’m not a running coach, a running expert per se, but especially if you have a multi-sport approach, it’s way better to train the cardiovascular engine on a low impact machine, so cycling. If you’re doing triathlon, I’ve done more than 10 full distance iron mans, and fastest was eight hours, 24 minutes, which is pretty fast for an amateur, especially before all the aerodynamic gains that people now have on bikes, so maybe I could take 10, 15 minutes off of that, but 824 is pretty fast. I run a 256 marathon off the bike. I think it was 256, two hours, 56 minutes after the swim and the bike. So, reasonably fast, but my longest run, to be able to run a marathon in a triathlon, was usually one hour, 20 minutes, which is like, I don’t know, nine or 10 miles, so just as an example, that would be the second thing.I don’t think you need specificity in that sense.
If you need to build a cardiovascular engine, do it in a way that doesn’t beat your body down, so like cycling versus running. I think that would be one thing, and then let’s leave the nutrition aside, but that’s like a war, like how much should you eat carbs versus this, and should you do carb loading and all that? Needless to say, I’m personally a huge believer that, as long as you sort of fuel the work while you do it, you don’t have to gain, because glycogen stores three grams of water, so if you have 600 grams, let’s just say 600 grams of carbs glycogen in your body, so that’s 2,400 calories, you have another 1,800 grams of water, so it’s 2.4 kilos, so that’s five or six pounds if you’re like fully loaded. I haven’t found, even for very long distance, you don’t need to gain five or six pounds. If you drip feed and fuel the actual work, you get to the same results. Controversial statement, but that’s my experience.
Tim Ferriss: I recommend people read the blog post also, and since you mentioned it and we’re probably not going to go for a six-hour conversation, I can’t not mention the rowing 2,400 plus miles with your wife. I think that was 43 days plus? 43 days, three hours, something like that, which sounds like, I mean, it really sounds like a divorce camp to me, and we could spend another three hours just talking about this insane decision to row for that. It was way more. Yeah, 2,750 miles roughly from California to Hawaii. I mean, the flight itself is pretty long from Hawaii, but my question is around, you Domestic peace or —
Sami Inkinen: Violence, violence.
Tim Ferriss: Yeah, minimizing violence. I was looking at this piece in USA Today, and it says that you had a written and signed formal document that not only described how you would treat each other in the journey, but even how you would respond to specific complaints and gripes. It’s like the only thing more Sami than rowing almost 3,000 miles is having this document. I wanted to hear about this document, and if it was as helpful as you hoped it would be and also anything else that you guys figured out in terms of not killing each other over that period of time being stuck on a boat.
Sami Inkinen: Yeah. Well, for listeners, just the context is, indeed, it’s 2,400 nautical miles from Monterey, California to Hawaii, Waikiki Beach, the shortest distance, but weather wasn’t really our friend. So we ended up doing 2,750 nautical miles. And I think it was 45 days and three hours, but who’s counting? But essentially a month and a half, almost seven weeks of rowing with my wife and completely unsupported.
I just want to be clear, no helicopters, no follow boats. There weren’t submarines around us and helicopters dropping bonbons. So it was just two of us. First of all, there’s so many life lessons and if you, Tim, are fortunate to find a woman of your life, that’s definitely a way to test the relationship’s longevity. And if you survive it both and come out together, and I will say this, we had been married for four years. We had known each other for six years. Having gone through that experience and hopping off the boat on a platform on Waikiki Beach and hugging my wife, that still is the sweetest moment in my life.
Hugging her and knowing there’s only one person on this planet who knows exactly what we went through and it’s my freaking wife. And the fact that we got it through together, no amount of hardship is going to break this, including having kids. But anyways, so it certainly was life transforming experience many ways.
The document, it served two purposes. One, in a kind of preparation phase I maybe mistakenly wanted to make sure that my wife is 100 percent in. So I was like, “This is what it’s going to take. This isn’t show up in two weeks and start rowing. It’s going to be a halftime job for six months to even get physically ready and kind of train and know how to jump into survival suit. It’s a halftime job.” So part of the document was like, “I’m signing into this. I’m not going to give up.” Which sounds like husband is asking wife to do that, but yes, that’s me.
And then the other half was about behaviors on the boat and the most important piece of the document that served us very, very well is the following. Any and every decision once it’s made is water under the bridge because we had to make a lot of decisions around safety and navigation and do we go this and all of that. Lots of decisions every day, like what do we do today? And you would never know if that was the right decision because the weather changes. And it’s one thing to do that at home and then you go to work and you forget it, but you’re basically stuck in a small stinky box for 45 days. There’s unlimited opportunities to get back to it and kind of bicker about it. That was incredibly helpful and served us very well.
The one thing I will say, and then you can ask other questions, we had a lot of time, obviously 45 days, three hours. We slept about six, seven hours a day. So there’s 18 hours a day to talk, listen, be together, can’t escape, can’t go to the bathroom, can’t lock the door, go to the bedroom, you cannot. And so some of it was silent, some of it was we had to fill the airwaves and we had all kinds of questions to each other. And one of the questions my wife had to me was, I think we were running out of questions. She said, “Listen, of all our friends, if it wasn’t me, who would you marry?” And as a diligent engineer, I stepped into that trap and answered it going through friend by friend, landing on the very specific one. But anyways, that is a question no married or unmarried person should ever answer, but I answered.
Tim Ferriss: When you were done with your very thoughtful engineer’s response to that question, how did she respond? And later was she like, “Yeah, I just for whatever reason wanted to throw a Molotov cocktail into the boat and see what would happen.” I mean, what happened afterwards?
Sami Inkinen: I remember it vividly sadly. It was, “I can’t believe that’s the last one I don’t think.” And, yeah, I have to explain myself out of it. But, yeah, it was a life transforming trip during which I made several big life decisions, one of which we made together, which was to start a family, which also is a complicated, obviously big decision to have kids. And entering the boat, we were both convinced that life’s too good to be mess, to be destroyed with children. And we literally changed our minds within the hour at the same time independently, which is quite something.
Tim Ferriss: So you decided to start a family, meaning you made the decision to start a family on the boat, or you actually started trying to have a family on the boat?
Sami Inkinen: Both, actually. So I think we were about seven or 10 days into the trip. It was very, very stormy early. And I had had enough white space ruminate about life and it was like a lightning strike. I still cannot explain this feeling of like, I was in my 30s, what is there to do? I could start five more companies and I don’t know, put my name on the side of a hospital, which I don’t want. What’s the meaning? Essentially it’s an existential crisis. What can a human do? So what’s worthy of the life? And obviously there’s a number of things, but the lightning that hit me was, wow, can you imagine raising a child? That’s incredible. And I turned to my wife and said, “Listen, this is kind of weird because we’ve talked about this and we don’t want, but I just feel we should start a family.” And her immediate response was, “Well, I’ve been thinking about exactly the same for the last 24 hours, exactly the same last 24 hours.” And then and there it was, “This is it. It’s going to happen.”
And my wife happens to be even more decisive than I am. So we had an Iridium satellite phone. This is time way before Starlink, which works, but you can send like a text message barely, and she texted to her girlfriend who obviously wasn’t rowing and said, “Hey, I’m going to give you some data. Can you start tracking my ovulation cycle so you can tell us, text us back when is the exact timing?” And we should have tried on the boat, and I will say that was the least romantic moment for both of us. And the fun part of this story is there’s a little bit of a mystery, but we got off the boat just about 10 years and nine months ago now and my oldest daughter is 10 years old. So there’s a little bit of a mystery what happened and where it happened, but it’s very close.
Tim Ferriss: When you had that lightning strike, and you both very coincidentally or not had that lightning strike at roughly the same time, if you tried to explain it, do you think it was just the incredible isolation of the two of you? Was it your wife saying, “Oh, my God, I love Sami, but I need at least one other person to talk to?” If you had to try to explain it, even if it’s grasping for straws, what do you think led to that lightning strike?
Sami Inkinen: My guess is it was the clarity of thought when there were no distractions, like the clarity of thought. And I think there’s even a theory of the brain or the mind is kind of Bayesian, like you have priors, you have so many priors and you’re always stuck in your rigid thinking and obviously there’s science that you can kind of loosen those priors with psychedelics and other things and then you kind of see things clearly.
I honestly think that there was the ability to think cleanly and clearly and that’s kind of what contributed to it. And what I found in life is ultimately the human experience is 100 percent subjective and if you’re not in touch outside of that, it’s just computers and algorithms, but it’s 100 percent subjective. And when you really tune into the subjective experience, oftentimes the biggest decisions in life are based on that, like who do you marry?
By the way, I had a spreadsheet for that too, but then I realized, met my wife, I threw the spreadsheet out the window and that was it. Same thing about having children, like the truly meaningful decisions, they are ultimately subjective in nature. And when you’re truly in kind of touch, how does it land? How does it feel? The answer kind of comes there. And I feel in the middle of the rowboat, no email, no nothing, no job, no task, no to dos, all to space. It was much easier to be in touch with that kind of experience and feeling. So that’s the story I tell, but may or may not be true.
Tim Ferriss: Makes sense to me, especially after a period of time of being on the boat, right? Once you have the routine aspects more or less on autopilot. Of course you have the decisions about angle and direction and so on. But I want to come back to something you said, which was, sure, I could start five more companies or have your name on side of a hospital. I know as you mentioned, that’s not of interest.
It seems like you did not, this is from Forbes, so who knows, but did not own a car until you were 36, talks about basically how minimalist or some might even say, “Austere you have been for certainly a period of time.” And you’re talking about renting cars from Thrifty. It had the cheapest cars, had not bought a watch in 15 years, exercise clothes are all swag from various endurance competitions, which is funny because I sometimes get shit for wearing all the free swag that I have. Most of what I wear is free stuff that I’ve gotten.
I’ve never been accused of having a great fashion sense. And the rest of his casual wardrobe is 10 copies of the same t-shirts and jeans. Literally this shirt that I have, I basically have crew and v-neck. It’s the same brand. It’s the same shirt. It’s just different colors. So my question is, is that a Sami thing? Is it a Finnish thing? And where have you found the most value in — let me rephrase that. What are some examples of where you have found great value in overcoming that type of frugality, where spending money has actually produced a real improvement in your quality of life?
Sami Inkinen: Yeah, interesting. Feels like a two-part question. Maybe the start is, I think I mentioned earlier that I find people say, “Sacrifice,” or you have to say, “No,” to so many things. I actually find saying, “No,” and focusing on the essential incredibly liberating and it’s kind of my happy place.
And so for some of these crap around and too much choice, what color t-shirt or what kind of clothes do I put on? I just find it very liberal. I love the fact that things are as simple as they are and sure life is way more complicated now than say 15 years ago, but I actually like not to clutter my life with money or anything else. Let’s put it that way and keep things very simple. And I’ll briefly give the example of the car story. So yes, I’ve had my driver license ever since it was possible in Finland.
It was 18, so 18. But actually I didn’t buy my first car. My wife bought it. Maybe I was 36 first because I had been renting Thrifty car from San Francisco Airport for eight years. Why that? It’s a funny story, but it illustrates my point. Well, first of all, I didn’t have any credit in America, and I needed a car after I came out to Stanford. For work reasons I could go to Thrifty and rent it. This was like 19 bucks a day, no credit, I could rent it. And then I realized this is amazing because I travel so much for work. I don’t need to wash the car. I don’t need to change the oils. It got broken into twice in San Francisco. I could just drive the 19 bucks a day car to airport and drive out with a new car.
I was like, “This is so convenient. No worries.” Ford Escape, that was my car of choice. And then one weekend I came home years, years later, and my wife’s like, “This is it. You need to own a car. You’re an adult. You can’t be renting all the time.” And she bought me the same Ford Escape that I had been renting for seven years. So that was it. So that’s kind of where it’s I think mainly coming from that the simplicity and convenience, focus on the things that matter. Sure, I have fancy bicycles to ride fast.
Tim Ferriss: What was the color? I want to know if you threw some flourish in there. Was it white or black or was it like electric blue with a racing stripe?
Sami Inkinen: Unfortunately didn’t have flames on the side, but it was blue, the one that she bought.
Tim Ferriss: Oh, I get that. I got it.
Sami Inkinen: Yeah, yeah, it was —
Tim Ferriss: No spoiler on the back? Yeah.
Sami Inkinen: No spoiler on the back. So there’s that. Yeah, so my approach to money is very, very simple. The less I have to think about the happier I am, and the fact that earlier success have enough for house and food and leftovers is wonderful. But if I have to be thinking about the leftovers at all, something’s wrong. So simplicity is very, very — but yeah, buying time is very helpful. There’s some things that just it’s good to have service and helpers around. I would say that’s a good investment.
And then the one and only thing where I would say, “Yeah, I do like sort of living environment to have a house that you can enjoy, not for the sake of it, but to have the kind of little things and conveniences you have, whether that’s to be able to exercise or roll into a lake…”
Tim Ferriss: Have a [inaudible].
Sami Inkinen: “…roll into a lake from your house.” So I would say that, but yeah, the less I have to think about money, happier I am. It’s just focus on life and the life’s happening, forget the money, life’s happening, go and make it happen.
Tim Ferriss: Do you have any books that you recommend or gift to people more than others?
Sami Inkinen: That is a good question. I’m not a big book gifter other than recommend for my like Virta team and sadly they are professionally, and they are all too kind of well known and common that they would add a lot of value. There’s the —
Tim Ferriss: Well, what are they?
Sami Inkinen: Score [Takes] Care of Itself, High Output Management —
Tim Ferriss: What was the first one?
Sami Inkinen: The Score [Takes] Care of Itself The 49ers coaches, Walsh’s book and High Output Management. Actually the High Growth Handbook by Elad Gil is much, much, much new. And I know you’ve interviewed Elad. So it’s in a professional setting. I do read a lot. If you want to plug for a book that I’ve really, really enjoyed over the last year, very inspiring, shows what’s possible in life and a little bit of leaves this kind of universe, leaves you wondering like what’s really true in a universe and whatnot is Trejo by Danny Trejo. Absolutely mind-blowing book.
Tim Ferriss: Yeah. Machete, he’s appeared in a bunch of Robert Rodriguez films, Robert’s right here —
Sami Inkinen: Oh, my God.
Tim Ferriss: — in Austin.
Sami Inkinen: That story.
Tim Ferriss: How on Earth did you end up picking up that book?
Sami Inkinen: Well, in our family, I read a lot, but there’s one person who reads more, that’s my wife. So I’d say half of my book recommendations come from her because she screens 10 books for everyone that I read so is a good filter. And I cried several times. I laughed several times, and I was incredibly inspired and came out reading that book, belief in humanity and just it was amazing.
Tim Ferriss: If you had given me a million guesses for what you were going to say, I never would have guessed Trejo by Danny Trejo, so T-R-E-J-O, right? If I’m getting that.
Sami Inkinen: Yes, yes.
Tim Ferriss: Right. Yeah. Okay. Wow. Okay. You’re full of surprises, Sami. I like it.
Sami Inkinen: Also, if you are ever contemplating having a family, that book also gives humility as you think about how much can you affect your kids’ life, and I’m not going to give a spoiler alert, but it’s highly recommend.
Tim Ferriss: I’ll get it. I’ll get it on Kindle today. I mean, we have covered a lot. I have a few questions I’d love to ask as we start to wind down, but is there anything else that you would like to cover, make sure that we discuss or anywhere you’d like to point my audience? I mean, I’m going to link to everything in the show notes. Of course, they can find Virta Health, V-I-R-T-A, Virtahealth.com on the website and we’ll include everything where people can find it easily. But is there anything else that you would like us to cover?
Sami Inkinen: I think you covered things very, very well. I would say, “My professional duty is to be an evangelizer,” and say, this very sad metabolic health mess that we find ourselves in America and globally and this savvy, the common sense thing that, oh, the diseases that we talked about, type 2 diabetes, obesity, cardiovascular, is they’re chronic and progressive, and the best we can do is to manage them with an every increasing load of medications is fundamentally not true.
And whether that’s Virta or something else, I just want to be very clear that there’s hope in the horizon and the hope is largely in the form of nutrition, but not in a traditional way that you need to restrict and suffer. So that’s sort of my professional duty to bring hope and say, if you’re living with type 2 diabetes, and by the way, people who are living with type 2 diabetes, usually they’re family members, their relatives, and you’ve seen people lose eyes and limbs and lives because of type 2 diabetes. To me, mostly completely unnecessary for the last three, four decades, that that disease, among with other metabolic health conditions, is fundamentally reversible and you don’t hear that from your doctor today, sadly.
And it’s not doctors’ fault, they’re well-meaning, but you go to medical school, you get literally zero, 0.5 hours of a nutrition training and nobody tells that conditions like type 2 diabetes can be reversed systematically, not miraculously. And so hopefully I can be a messenger of hope that these conditions are reversible, especially after I already disclosed that I used to live thinking it’s your fault, it’s your fault, you are just lazy, you don’t have the willpower, but that’s not true. Nobody gets these things because they’re lazy or they decide. It’s because of our food environment and the food environment kind of slowly but surely poisons us. But if you know a few little tricks and changes, you can actually turn back the clock. So that’s my PSA.
Tim Ferriss: And I want to say to folks, if you’re a large employer, who are the actual customers of Virta Health? Who should actually go check out the website?
Sami Inkinen: Yeah, thank you. That’s so nice. Anyone who pays healthcare costs in America could be and should be a customer. If you pay healthcare costs, you are paying for the party or people staying sick and others profiting from the sickness. So this includes self-insured employers and we work with like 800 of them. So essentially all Fortune 1000 employers, self-insurer and thousands of others. So all self-insured employers, obviously health insurance companies when they take risk on their patients. And this includes the private Medicare Advantage, private Medicaid, managed Medicaid organizations, state employee groups. I think we work with 13 out of 50 states today already. So state employee groups and then some government entities, there’s VA, there’s DOD and others. Any payer who pays healthcare costs could be our customer. And our pitch to them is, guess what? We’ll help you make money. Yes, indeed, we’ll help you make money.
And the side benefit is we also save lives. And I say that because the love language of American capitalism is dollars. And so when you can help someone else to make money, you’re going to be very, very successful, and I love it.
Tim Ferriss: Virta has done something that I wasn’t sure could be done. I mean, you have, as you already mentioned, I mean the world’s largest data set of this type of metabolic health and disease reversal and the way that you’ve been able to refine and engineer and iterate and further polish a program for individualized care and sort of mass scale adherence really makes, it’s mind-boggling to me. It’s really, really incredibly impressive.
And I don’t want to say, “I know how much work goes into it,” but I think I have an idea of just how challenging that is because I think of myself as someone who kind of specializes in behavioral change. And to your point, you can do a lot of really innovative things once you free yourself from the tyranny of the perfect, right? Not letting perfection be the enemy of progress. That is the mistake of a one size fits all approach like you need to be on the ketogenic diet and you need to hit this minimal concentration of blood, blah, blah, blah, blah, blah. It’s just not going to work on a mass scale. It just doesn’t work.
But when you have different ways to help people improve five, 10, 20 percent, 50 percent. The way that moves the needle over time, this is not the right way to put it, but it defies conventional explanation in the way that as you already put it, a lot of doctors have been taught in their minimal exposure to say, “Nutrition.” So the science that you’re doing, and I’ll say it as it’s on me, but really what you’re doing with the controls and with the trials, but also with the cohort analysis and everything else you’re doing internally, like the science you’re doing is incredibly, incredibly valuable. And I don’t just mean that in dollar science, it’s valuable to humanity.
So I really applaud you for building Virta and I just felt like we needed to have this conversation because A, you’re just such a freak of nature, and I wanted to talk to you about all the things we’ve talked about, but also because what you’ve built is something that I wasn’t sure it could be built. And with the many text messages and seeing a lot of stuff that just blew my mind, I wanted to have you on, so I’m glad and grateful that you took the time.
Sami Inkinen: Yeah. Thank you so much. And honestly, I appreciate those kind words. It’s 11 years in the making and never take it for granted, bigger company, bigger problems, but trying hard every day.
Tim Ferriss: Well, I’m going to pick up Trejo, which is not what I expected to be my immediate next step after having this conversation, but for everybody listening, we will link to everything in the show notes. You can find Sami, certainly you can find Virta first and foremost at Virtahealth.com, V-I-R-T-A. You can find Sami Inkiken. Good luck with the spelling, S-A-M-I I-N-K-I-N-E-N on all of the places, samiinkinen.com, on Instagram, X, et cetera. I’m not sure how active you are on those, but check out the blog posts for sure. And we’ll link to everything as I mentioned in the show notes at tim.blog/podcast. Just search for Sami S-A-M-I. I can promise you he’s the only one who’s going to pop up.
And until next time, just be a bit kinder than is necessary to others, but also to yourself and take those 20 minutes on Sunday, plan it out, get those things in the calendar. Otherwise, it’s going to get crowded out by the universe and then woe is you, woe is us. So take care of that. And, Sami, again, thank you so much for the time.
Sami Inkinen: Thank you very much.
Tim Ferriss: All right, folks, until next time. Thanks for tuning in.
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Comment Rules: Remember what Fonzie was like? Cool. That's how we're gonna be — cool. Critical is fine, but if you're rude, we'll delete your stuff. Please do not put your URL in the comment text and please use your PERSONAL name or initials and not your business name, as the latter comes off like spam. Have fun and thanks for adding to the conversation! (Thanks to Brian Oberkirch for the inspiration.)