Worth: Health & Wellness Issue

DRONES FOR

DID WE MISS THE RECESSION?

THE BEST HEALTH AND WELLNESS SPAS

Better Live Longer

THE NEW SCIENCE

OF LONGEVITY

Dr. Peter Attia on longevity, Dr. Gabrielle Lyon on building muscle, and Layne Norton, Ph.D. on nutrition

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You Can’t Take It with You

BY JOSH KAMPEL

People have been obsessed with the idea of the “Fountain of Youth” for centuries. The search for this mythical destination has been a part of folklore for thousands of years and has captured the imagination of people throughout history. The obsession is rooted in the human desire for eternal youth and longevity.

While there might not be a magical spring that can restore youth and vitality, advances in medical science and technology have made it possible for people to live longer and in many cases, healthier lives. However, while life expectancy has increased globally, many people are not necessarily living better.

Conversations have shifted from lifespan to healthspan, which looks at quality not just length of life. It captures the amount of time a person lives

in good health, free from chronic illnesses and disabilities. This issue of Worth contemplates how we should be thinking about both longevity and healthspan to live a long and fulfilling life, both physically and mentally. Unfortunately, there is no single solution to extend one’s length and quality of life. While there are companies looking to develop commercial solutions that leverage pharmaceuticals or cellular therapies, we do know that there are lifestyle choices and practices that can help us live longer, more productive lives.

From better eating habits to stress management, and getting more sleep, many of us know what we should be doing, but find it difficult to change our behavior. Many of us work in high-stress environments and aren’t always able to make the best choices for our own mental and physical health.

As we know, stress is linked to a wide range of health problems, including cardiovascular disease, depression, and anxiety. Finding ways to manage stress in your life should be a priority.

Getting enough sleep can help to reduce the risk of chronic diseases and improve mental health. People who get adequate sleep are more productive, have better cognitive function, and are less likely to experience depression and anxiety.

Social connections have also been linked to a longer life, better mental health, and a reduced risk of chronic diseases. Whether it’s spending time with family and friends or participating in community activities, social connections are essential for both longevity and healthspan.

If you take anything away from this issue, I hope it is that you can make conscious choices that will have a positive impact on your length and quality of life. Many of us emphasize financial success; while that is important, we need to learn how to balance our priorities.

You truly can’t take it with you, so make sure you invest in yourself and focus on achieving a long, healthy, and fulfilling life.

— Josh Kampel CEO, CLARIM MEDIA josh.kampel@worth.com

Filling your long, healthy life with meaningful connections is vital.

Plan for Your Healthspan

BY DAN COSTA

went to a doctor myself. Call it luck, more likely laziness, but I simply didn’t have the need. The incident in the jungle showed me the second half of my life would need a little more attention if there would, indeed, be a whole second half. I needed a doctor.

nutrition are the real secret to his success. Eti Ben Simon’s work at the UC Berkeley Center for Human Sleep Science shares her insights on how to sleep better. Dr. Beth Pegg Frates explains how the degrading of social connections may have been one of the most insidious effects of the COVID lockdown.

When I turned 40, I vacationed in Dominica, a relatively tourist-free island in the Caribbean. It has beaches to sit on, reefs to snorkel, and wild jungle trails to explore. One hike led down a steep hillside over rocks slick with rain that never stops to a stunning 200-foot waterfall. The trek down was treacherous, but it was the climb back up that broke me. By the time I made it to even ground, my heart was pounding, my lungs felt filled with water, and my vision started to cloud over. It was at that moment I realized I was no longer young. Also, I was going to die, possibly right here, right now, on the forest floor.

Of course, I did not die. However, I did hold up our hiking group for 15 minutes while I caught my breath. I also had to admit to my partner that she was in much better shape than me. It was embarrassing but revealing. Although I was diligent about taking my son to the pediatrician, it had been many years since I

At the time, I was working as a tech journalist, so I wanted a high-tech doctor. One Medical was a start-up out of San Francisco promising a new kind of healthcare—online scheduling, offices across the country, and they even had an app! I browsed through the available general practitioners and picked one (mostly) at random.

In our first meeting, he explained the five pillars of health: Not smoking, exercise, nutrition, sleep, and stress management. After the pandemic, he added the importance of maintaining social connections. At every visit, those are the general areas he checks on. He is still my doctor today. When it came time for Worth to create a Health and Wellness issue, doing a story on those six pillars seemed like a great place to start. Worth found an expert in each of the six categories to share the latest research. Lane Norton certainly looks like a fitness expert, and he is a worldchampion bodybuilder, but his insights into energy balance and

Doing this issue also gave me the opportunity to talk to Dr. Peter Attia, Author of the upcoming book Outlive: the Science and Art of Living Longer. I’m a long-time listener of Attia’s podcast The Drive, where he talks to medical colleagues about topics like “The Metabolic Effects of Fructose” and “Understanding apoB, LDL-C, Lp(a), and insulin as risk factors for cardiovascular disease.” It is amazing.

Within these pages, you will find the best medical advice in the world. At the same time, living longer and better isn’t about medical advice. As Attia explains, “So much of what it takes to live a longer and better life does not actually require a physician.” Medical interventions are essential, but the actual practice of living better is on the individual. Knowing what the six pillars of health are is one thing, but holding them up is another. And that, ultimately, is on you and me.

— Dan Costa EDITORIAL DIRECTOR dan.costa@worth.com

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Josh Kampel

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EDITOR AT LARGE CONTRIBUTORS

Dan Costa

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Jason Ashlock, Cait Bazemore, Sean Captain, Kirsten Cluthe, Bob Diamond & Larry Kantor, Ruthie Kornblatt-Stier

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Our Mission Is Building Worth Beyond Wealth

Worth helps our influential, successful community better invest their time and money. We believe business is a lever for social and economic progress. From practical financial advice to exclusive profiles of industry leaders, Worth inspires our readers to lead more purpose-driven lives. Through our conferences, digital channels, and quarterly print publication, we connect the people and companies that are building the future. We showcase products and services that are indulgent, luxurious, and sustainable.

A Heritage of A Modern Approach.

Your wealth, your life, and your goals are unique. Whether you’re looking to protect and grow your assets for future generations, succeed in your business ventures, or prepare for the unexpected, Wilmington Trust is here to help guide you through life’s transitions. To learn more about how we can help you achieve your goals, visit wilmingtontrust.com.

Wilmington Trust is proud to celebrate 120 years of helping generations of families and businesses thrive.

Freelance writer and editor, Ruthie Kornblatt-Stier, hails from the woods of western Massachusetts. After studying English and Literature at Barnard College of Columbia University where she was awarded the Stains-Berle Memorial Prize, she settled in New York City full-time to pursue writing in all its forms. Ruthie has a passion for telling investigative stories about female entrepreneurs, sustainable technologies, art, culture, and more. In addition to her work as a journalist, Ruthie has worked as an animation screenwriter, communications consultant, and teacher.

Meredith Salisbury has a passion for helping people understand and improve their health through the lens of genomics and life science. As a journalist, she has spent more than two decades writing about genomic technologies, ethical issues, policy debates, and more. She also co-founded and ran the Consumer Genetics Conference for five years.

Sean Captain has two decades of experience in many facets of journalism, including breaking news, longform, short features, and consumer reviews, tips, and buying advice. He has covered the tech industry and personal tech since the 2000s, but has also written on politics, art, entertainment, and health. His work has appeared in Fast Company, the New York Times, the Wall Street Journal, Wired, Vox, Popular Science, cnet, Tom’s Guide, PC World, Gizmodo, and elsewhere.

Sean has been remaking his own health in the past year, embodying the six pillars he describes in this issue, with a special enthusiasm for nutrition and high-intensity training. He moves around a lot, having lived in Munich, San Francisco, Boston, New York City, and Los Angeles, among others. Sean currently enjoys the mountain vistas and offbeat culture of Asheville, NC, but retains his New York area code.

Ruthie Kornblatt-Stier

Meredith Salisbury

Sean Captain

North Atlantic views, Caribbean hues.

Why the Fine Art Market Soared Last Year

Fine-art market sales set new records this year as collectors embark on “a flight to quality.”

BY TERRY SULLIVAN

Fears of inflation, global recession, the COVID pandemic, and a brutal land war in Europe dominated international headlines in 2022. Nevertheless, last year was a record-setting year for the fine-art market.

Of the three largest international auction houses—Christie’s, Sotheby’s, and Phillip—it was Christie’s that reached the highest mark by selling $8.4 billion in art, which according to the auction house, was up 17 percent from 2021 and is the largest annual total in the history of the fine-art market. But it’s not the only record Christie’s set. Last year, it also auctioned off the most valuable 20th-century work of art—“Shot Sage Blue Marilyn,” by Andy Warhol, which fetched $195 million. Christie’s said it was also the second-highest price any artwork has ever achieved at an auction.

On the face of it, Sotheby’s seemed to do well, too—$7.7 billion in sales.

However, this figure included roughly $1 billion in real estate and car auctions, which meant sales from fine art and collectibles were $6.8 billion, down 7 percent for 2022. But Phillips, the smallest of the three houses, did well, up for the year to $1.3 billion from $1.2 billion.

While the record year may have baffled some, others found the competition to own blue-chip works of art made perfect sense. Charles F. Stewart, Sotheby’s CEO, told Barron’s: “The flight to quality in 2022 led to sustained demand for blue-chip masterpieces…” In other words, buyers were, in fact, worried over those headline fears, and choose to buy “quality” or fine-art works that were safe bets, and not risky.

Several single-owner sales helped push Christie’s sales to its record-setting $8.4 billion. By far, the most notable of these auctions was the landmark sale of Paul G. Allen’s collection, the co-founder of

Microsoft, which sold for $1.62 billion in November, setting a new record for a single-owner collection. Unlike some collections, which tended to focus on one particular era, Paul G. Allen’s collection included a variety of works, from French Impressionists to American Modernists, as well as artists from other periods, including the Early Renaissance.

Christie’s noted that another surprising outcome from this par-

ticular sale was that it included five paintings that sold for more than $100 million, including “Models, Ensemble (Small Version),” a gorgeous figurative painting of three nudes by Georges Seurat, which fetched $149.2 million, and “La Montagne Sainte-Victoire,” a landscape by Paul Cézanne, in his signature style, which sold for $137.8 million. There were other very prominent painters in the collection, as well, not just Post Impressionists, including Early Renaissance painter Sandro Botticelli, American realist Andrew Wyeth, English Romantic painter J. M. W. Turner, Austrian symbolist painter Gustav Klimt, and American modernist painter, Georgia O’Keeffe. It even sold the astonishing “Large Interior, W11 (after Watteau),” a painting from 1981-83, by the renowned British realist Lucian Freud.

The Paul G. Allen auction eclipsed the previous record sale of Harry and Linda Macklowe, which went for $922 million just a few months earlier, in May 2022. There were other prominent single-owner collection sales in 2022, including the sale of the Ann and Gordon Getty collection and the Hubert De Givenchy sale.

Although these sales figures are impressive, there were other intriguing trends in the fine-art market in 2022. The industry embraced online sales, which meant both online auctions and auction bids were up. Plus, many of those looking to buy fine art were from Asia. But perhaps the most encouraging trend to gain momentum in 2022 was that previously underappreciated artists, both past and present, were getting noticed and generating significant sales. For instance, Christie’s, in its yearly report, noted there were “strong prices for works by female artists,” including Bridget Riley and Yayoi Kusama. Contemporary female painters, like Elizabeth Peyton and Lisa Yuskavage, also did well.

SHOT SAGE BLUE MARILYN, ANDY WARHOL

There was a renewed, even heightened interest in Black artists in 2022, sparked by the sale of “The Sugar Shack,” an iconic painting from Ernie Barnes, which he completed in 1976. The picture had a conservative estimate of $200,000 but sold at Christie’s for a whopping $15.3 million.

In Bank of America’s fall 2022 report on the fine-art market, when asked about the impact of the sale of Ernie Barnes, the report said, “we can expect to see more Ernie Barnes paintings coming to market… A result like this recalibrates the market for an entire genre and genera-

tion of Black artists beyond Barnes alone. Collectors are looking back in history to discover older or recently deceased artists previously overlooked by the market and institutions—including artists such as Jacob Lawrence, Romare Bearden, Charles White, Faith Ringgold, and Hedda Sterne.”

Lastly, interest in sales for NFTs, which seemed on track to remake the fine-art market in 2021, particularly with the sale of Beeple’s “Everydays: The First 5000 Days,” which sold for $69.3 million Christie’s that same year, went

down dramatically. In part, this was due to continued turmoil in the cryptocurrency world, such as the collapse of FTX and other companies.

This past December, Bloomberg reported NFT sales had dropped to a 16-month low, stating, “almost a year after the nonfungible token (NFT) frenzy crested, demand for the digital certificates of ownership has evaporated. Sales have dropped to the lowest level since July 2021.” We’ll be sure to keep an eye out on the NFT market to see if it can emerge from what’s looking like a long, and particularly frigid crypto winter.

“LA MONTAGNE SAINTE-VICTOIRE” BY PAUL CÉZANNE. CHRISTIE’S IMAGES LTD. 2023.

Climate Change Threatens Everyone’s Health

But its impact will be brutal for some communities in particular.

BY RUTHIE KORNBLATT-STIER

Climate change is altering our bodies and changing our lives every day. But as with all public health crises, the health impacts of climate change are not evenly felt. Those who already suffer the brunt of systemic inequalities are also those who face the most severe consequences of climate change.

One of the most serious effects on our health is the sharp uptick in droughts and drought conditions worldwide. Access to drinking water is only the tip of the iceberg regarding the health risks associated with shortages. Increasingly severe and prolonged drought periods impact sanitation, nutrition, and air quality. They can also lead to more disease. West Nile Virus, carried by mosquitoes breeding in stagnant water, is the leading mosquito-borne disease in the continental United States. Also, drought conditions can increase dangerous fungi in soils that cause “Valley Fever.” This dangerous fungal disease is a growing problem in Arizona and California.

Like dry conditions, wet conditions such as flooding, hurricanes, and cyclones that impact sewage systems and water sources can intensify the risk for diseases such as norovirus, hepatitis, malaria, and dengue. In the book Changing Planet, Changing Health: How the Climate Crisis Threatens Our Health and What We Can Do About It, Paul Epstein and Dan Ferber explain that the strong winds from hurricanes, cyclones, and other extreme storms

can carry infectious agents over thousands of miles, introducing pathogens to regions ill-equipped to handle them. For example, in 2022, flooding from Hurricane Ian led to an influx of deadly bacterial infections from Vibrio vulnificus, or the “flesh-eating” bacteria, with over 65 cases and 11 deaths reported in Florida.

Research from the Fourth National Climate Assessment indicates that climate change and warming temperatures contribute to increased levels of particulate matter and ozone—elements of harmful air pollution such as smog. These amplified levels of particulate matter and ozone contribute to a wave of new and uncertain health outcomes related to increased morbidity and mortality. In particular, wildfire smoke—capable of traveling thousands of miles and yet another consequence of worsening droughts—and other pollutants can penetrate deep into our respiratory and circulation systems, triggering problems related to inflammation such as asthma, depleted immunity, respiratory conditions, diabetes, and hypertension.

The effects of air pollution are not limited to the here and now, putting the health of future generations at risk. In a recent study conducted by the University of Aberdeen in the United Kingdom and Hasselt University in Belgium, researchers found that “unborn babies have air pollution particles in their developing lungs and other vital organs as early

as the first trimester.” What’s more, the Organization for Economic Cooperation and Development found that the healthcare costs related to air pollution will rise from $21 billion in 2015 to over $175 billion by 2060.

Though the various health risks associated with climate change are scary and overwhelming, those with adequate healthcare and resources can combat them successfully. Vulnerable populations and those who lack financial resources are not so lucky. Marginalized groups and communities, such as people of color and those in low-income zip codes, face inflated risks due to systemic inequalities such as racism and discrimination.

Dr. Robbie M. Parks, Ph.D., a professor at Columbia University, explains that “It’s not just about exposure. It’s also about your preparedness and resilience. The United States is a microcosm for the world. The story is how unequal the health detriments of climate change are for vulnerable populations—in terms of increased exposure and how these communities lack the resources to recover from and combat environmental insults.”

According to a 2021 Environmental Protection Agency (EPA) report, minorities are the most likely to live in areas that suffer the brunt of climate change—areas with the highest projected escalation of climate-related morbidity and mortality. The EPA found that due to pernicious historical policies such as redlining, Black individuals are over 41 percent more likely to live in areas with the highest projected increases in premature death due to extreme heat and poor air quality.

Likewise, Hispanic individuals are 21 percent more likely to live in the hottest parts of cities, and yet a third of Hispanic households lack access to air conditioning, leaving them susceptible to extreme heat exposure and its health-related impacts. As Hispanics and Latinos make up almost half of all agricultural workers and a third of construction workers

in the United States, a 2016 report by the National Resources Defense Council found that “U.S. Latinos are about three times more likely to die on the job from heat-related causes than non-Hispanic whites.”

An often-overlooked minority group that faces some of the most profound health risks from climate change are Asian and Pacific Islanders. In a 2020 study, researchers found that most major EPA violations in the Pacific Islands are as-

sociated with pollution from U.S. Military Sites. In Guam, the Anderson Air Force Base—a site placed on the National Priority List in 1992 due to hazardous substances—sits in an aquifer that provides drinking water to over 70 percent of the island’s residents. According to census bureau data, almost a quarter of Guam residents live below the poverty line. They have no say in their generational exposure to fuel compounds, lead, and heavy metals, and they also

lack the resources needed to protect themselves from harmful pollutants.

Beyond ethnic and racial minorities, all low-income communities are more likely to have their health be disproportionately affected by climate change. “This kind of inequality is a moral, ethical component of climate change that is easy to understand but is often overlooked,” says Dr. Parks. A 2017 report by the Substance Abuse and Mental Health Services Administration found that people with low socioeconomic status are more likely to be exposed to environmental hazards and have a limited capacity to prepare themselves for extreme climate events. Similarly, the Shriver Center on Poverty Law found in 2020 that 70 percent of the United States’ most hazardous waste sites are located within one mile of U.S. Department of Housing and Urban Developmentassisted housing facilities.

The ironic crux of the climate crisis’s disproportionate and damaging health impacts on vulnerable populations is that those who suffer the most contribute to climate change the least. In 2021, researchers found that “people in the global top 1 percent of income cause twice as much consumption-based CO2 emissions as those in the bottom 50.”

Those with access to financial resources and the capacity to create systemic change must not take that responsibility lightly. “It’s a classic balance between individual and collective action,” comments Dr. Parks. “High net individuals have one of the greatest capacities to decrease their carbon footprints.”

As custodians of wealth, our small, individual decisions to protect our environment, such as impact investing, choosing to fly commercially, or driving an electric car, carry far more weight than we know. To protect our health and to effect positive, systemic change for the populations who need it the most, we must take action to ensure the health of our planet.

Everyone has a different answer to the question, “would you want to be immortal?” But no matter how long you would like to live, we can all agree on one thing—remaining autonomous for as long as possible. Many feel that a long life is only appealing if you are able to run with your kids, pick up your grandkids, and remain physically active.

So, how can we reach the finish line and still be able to sprint across it? It comes down to four factors: skeletal muscle, cardiovascular health, a balanced diet, and an emphasis on protein intake. That’s it. That’s the “silver bullet.”

Dr. Gabrielle Lyon, a functional medicine practitioner and boardcertified family medicine physician, is a pioneer in this space. As the founder of the Institute for Muscle-Centric Medicine, she works to shift “the focus away from reactively quantifying and treating disease to proactively quantifying and optimizing your health by focusing on the biggest organ in your body: skeletal muscle.” She is famously known for her take, “we aren’t over fat; we are just under-muscled.” Because we have, “an unhealthy muscle problem which is leading to diseases and chronic aging.”

Worth talked to Dr. Lyon about the connection between muscular health and longevity.

MCornerstone of Longevity

BY GABRIELLE DORÉ

How exactly does muscle affect our ability to live longer and stave off disease? “The more muscle mass, the more survivability against diseases,” Dr. Lyon explained. But muscle mass must be maintained to have these effects. It’s a use-itor-lose-it part of our biology due to sarcopenia. Sarcopenia, as defined by the National Institute on Aging, is “a decline in muscle mass, strength, and function.” Studies have shown that for both men and women, our strength and muscle mass steadily increase from birth to around 30-35 years old. After which, “muscle power and performance decline slowly and linearly at first, and then faster after age 65 for women and 70 for men”

Pumping iron, weight-lifting, strength training— call it what you want, but it is key to living longer, according to Dr. Gabrielle Lyon.

DR. LYON PHOTO BY JAI MAYHEW PHOTOGRAPHY

(Baltimore Longitudinal Study of Aging). Weight training is essential to mitigate these effects as we age. When you “stimulate skeletal muscle,” stated Dr. Lyon, “ [you] maintain mobility, mental clarity, hormonal balance, and improve mood.”

The National Institute on Aging explains that “a big culprit for losing our physical abilities as we grow older is the age-related loss of muscle mass and strength…in addition to making everyday tasks difficult, mobility limitations are also linked to higher rates of falls, chronic disease, nursing home admission, and mortality.” Dr. Lyon emphasized that we should be “focusing on building muscles rather than losing fat. [Muscle] will help you build your body armor to protect you throughout life.”

According to Lyon, “it’s time we switch the paradigm of thinking to ‘muscle-centric’ because obesity starts with unhealthy muscle first, and adiposity is just the symptom.”

Adiposity is the result of a health problem, not the starting point. It is the same with other chronic diseases “such as type 2 diabetes, heart disease, and fatty liver.” According to Dr. Howard J. Luks, an orthopedic sports medicine surgeon, in his article, Muscle Mass, Strength, and Longevity, he writes “losing active [muscle] tissue can have dramatic consequences. Muscles help us control our glucose levels, use glucose as fuel, and have a role in insulin resistance.” So, instead of thinking of fat as the root cause of health problems, we must understand that it’s no more than the middleman. The actual chain of command is unhealthy muscle tissue, adiposity, then disease.

But to build healthy muscle tissue, you need protein. “Protein is necessary for nearly every function in the body and every structure,” explained Lyon. “There are 20 different amino acids. We need the nine essentials— histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine—to support many processes that happen

within our body. Each amino acid has more than one role; they function as a metabolic signal and are necessary building blocks.”

Not all proteins are made equal.

“There are high-quality and lowerquality proteins, based on the essential amino acid profile,” Lyon explains. Furthermore, “Proteins from animal sources (i.e. eggs, milk, meat, fish, and poultry),” per the Journal of Sports Science and Medicine, “provide the highest quality rating of food sources.” Echoing Dr. Lyon’s previous statement, it’s “due to their ‘completeness’ of proteins.”

Now, what does this mean for those who eat plant-based? Is it possible to consume all the amino acids required to build and maintain skeletal muscle while on a plant-based diet? Lyons says, “It is possible. Is it easy? No.”

It’s not that protein isn’t present in a plant-based diet; it’s just more calorically taxing—requiring you to pay more attention to how you build a balanced diet. Getting sufficient Leucine, for example, can be a challenge without animal protein. That said, there are high-quality vegan protein powders that can fill this gap.

As we age, there’s a pretty clear difference between men’s and women’s processes. Women go through menopause which wreaks havoc on their system. Lyon explains that during menopause, “sex hormones decrease, insulin resistance increases, blood flow decreases, your protein signaling decreases.” To combat this, “women have to focus on their protein intake. Ideally 1 gram of protein per pound of ideal body weight, and they must challenge themselves in the gym [with] things like sprint intervals and lifting weights that are challenging. If you are a beginner, I always recommend investing in a trainer to ensure your stability, mobility, and form are solid prior to adding any additional load.”

Dr. Lyon recommends that women 65 and older focus more on muscular endurance training, which means high rep and low weight. However, “peri and menopausal women studies have shown lifting heavier load may be ben-

eficial. I believe your workout should challenge you and not be easy, and I want to encourage you not to make excuses but to get in the gym, put in work, and see that hard work pay off.”

But what about cardio? If you’ve ever been to a strength trainingfocused gym, I can almost guarantee you’ve heard the cardio vs. strength training debate. So, I posed the question to Dr. Lyon, is one better than the other? “It shouldn’t be cardio vs. strength training; there is room for a combination of both,” she explained. “Cardiovascular exercise is beneficial for your brain, heart, and lungs and has been shown to reduce the risk of heart disease. Strength training promotes building and protecting skeletal muscle which plays many roles beyond locomotion.” In essence, you need both.

If your focus is fat loss, “Strength is the key to the quality because resistance exercise will help protect and build skeletal muscle while losing fat versus losing both fat and muscle through solely cardiovascular training,” Dr. Lyon explained.

To build a standardized weekly workout plan, Dr. Lyon detailed it as follows:

Women:

Monday: Pull and legs

Tuesday: Low-impact cardio

Wednesday: Push & legs

Thursday: High-impact cardio

Friday: Pull and legs

Men:

Monday: Push

Tuesday: Low-impact cardio

Wednesday: Pull

Thursday: Legs

Friday: High-impact cardio

Building muscle is essential for a long, high-quality life. It provides you with the autonomy we all desire well into our later years. Women especially need to emphasize lifting heavy and focusing on their protein intake due to the hormonal changes that occur during menopause. This isn’t about bulking up; this is about building longevity.

America’s Healthcare Debt Is Deepening

BY RUTHIE KORNBLATT-STIER

The United States’ profusion of healthcare facilities, technologies, and therapies are unavailable to most of the world. Yet, for most Americans who need medical care, our country’s unparalleled resources quickly become a curse. It’s no secret that the U.S. healthcare system often leaves its patients with unwieldy out-of-pocket costs. And for those who lack the proper financial funds, these costs can quickly spiral into medical debt. But what is the true extent of medical debt in the U.S.? How does it affect both individuals and communities? And how can those fortunate enough not to suffer from medical debt work to ameliorate the problem for those who do?

The more likely one is to need medical care, the more likely one is to suffer from medical debt. Unlike other kinds of debt, accrued from things like purchasing a house, buying a car, or even going to college, medical debt is not incurred voluntarily. Those in higher income brackets are better able to pay off unexpected bills whereas, for people with limited financial resources, even the smallest, unforeseen medical expense can be unmanageable. Thus, rates of medical debt are at their highest in lowerincome zip codes, disproportionately affecting areas that often are already suffering from the brunt of systemic oppression.

The costs of healthcare have skyrocketed over the past fifteen years.

According to a 2018 report by the Health Care Cost Institute, the cost of medical care increased by 16 percent from 2012 to 2016—an unduly excessive growth in comparison to the inflation rate of 4.5 percent for the same

period. In cities such as New York and Tampa, medical care prices surged by almost 22 percent. In a 2021 annual employer survey, the Henry J. Kaiser Family Foundation (KFF) found that the average annual insurance deductible for single workers is $1,669, four times the average deductible cost in 2006. The combined weight of escalated medical prices and rapidly rising insurance rates have exploded into a debt crisis for everyday Americans.

A study by JAMA, released in 2021 and published by the American Medical Association found that almost 18 percent of Americans owed $140 billion in medical debt to debt collectors—a number that does not include data from the pandemic and is nevertheless almost double the $81 billion that JAMA estimated Americans owed in 2016. Another study done by KFF, investigating different federal data from the 2020 Survey of Income and Program Participation, gauged that Americans owed more than $195 billion in medical debt as of 2019.

The Burden of Medical Debt

One of the most pernicious effects of medical debt is the cyclical nature in which it simultaneously entraps patients while preventing them from receiving the care they need. For fear of being unable to pay for care due to inflated deductibles or other factors, individuals are discouraged from seeking preventative treatments— treatments that could help avert emergency situations. When emergencies do arise, however, this lack of preventative care often snowballs into the extreme costs and ensuing debt that patients were attempting to avoid in the first place. George Halvorson Kaiser Permanente’s former chief executive explained in an investigation done by Kaiser Health News (KHN) that “people are getting bankrupted when they get care, even if they have insurance.”

In addition to deterring people from seeking the care and treatments they need, the U.S. healthcare system also actively denies care to those who have already incurred medical debt. According to KHN’s study, 1 in 7 people with medical debt say that they have been denied access to care because of unpaid bills. The study also revealed that major health systems such as Northwell Health, Trinity Health, Mayo Clinic, and Kaiser Permanente will take legal action against patients who are unable to pay. In fact, Over two-thirds of hospitals have policies that allow them to sue patients or even garnish their wages.

U.S. citizens have access to unparalleled medical care, but the cost means millions will never receive it.

Source: Peterson-KFF Health System Tracker

The burden of medical debt is felt not only in the lives of individuals but also across communities, deepening systemic inequalities. According to the KFF analysis, Hispanic adults are 35 percent more likely, and Black adults are 50 percent more likely to struggle with outstanding healthcare costs than white adults. Women also report more medical debt than men due to expenses related to childbirth in combination with lower average incomes. Additionally, adults under the age of 30 are almost twice as likely to suffer from medical debt than those ages 65 and older. In exacerbating and reinforcing longstanding, pervasive social inequalities, medical debt is, at its core, a discriminatory practice.

Despite the insidious nature of medical debt, efforts in the past number of years to curb rates have shown both improvements in healthcare access and economic benefits. The 2013 expansion of Medicaid under the Affordable Care Act proved to be one of the most effective combatants of medical debt in the U.S. In fact, the Medicaid expansion was so effective that as of 2020, rates of medical debt in the eleven states that declined participation were over 30 percent higher than in the states that did participate. As population wellness is a concern closely aligned with the

Medical Debt by Demographic

nation’s economic well-being, a KFF investigation of numerous studies found that Medicaid not only benefited patients but also had “overwhelmingly positive effects of expansion on [healthcare] providers.” The same detailed analysis discovered that the financial impact of Medicaid expansion on states additionally had “positive effects, including budget savings, revenue gains, and overall economic growth.”

In addition to the 2013 Medicaid expansion, from startups to nonprofits, there are a number of independent businesses and organizations working to both forgive medical debt and make the process of paying for healthcare more transparent. Ribbon Health, a startup and API data platform, works to aggregate data in order to help patients find high-quality, affordable care. Turquoise Health, a similar venture, has collected over one billion records of pricing data from over 4,000 hospitals. On its website, it also provides an easy and convenient search engine for patients to investigate what costs might look like at their local hospitals. On the nonprofit end, RIP Medical Debt is an impressive 501 charity that simply buys medical debt from the debt collection market and then promptly forgives it. As of August 2022, the group has relieved 3.6 million people of $6.7 billion of medical debt.

The ever-climbing rates of medical debt—that even conservative estimates consider alarming— reveal that the cost of healthcare in the United States is out of control. Despite the evident benefits of debt forgiveness, cost transparency, and expanded Medicaid coverage, the underlying issue of cost remains, leaving the future of medical debt a concerning problem.

Source: Peterson-KFF Health System Tracker

Lake Nona Impact Forum: Home of Health Innovation

BY GABRIELLE DORÉ

Unlike many cities, Lake Nona has a specific birthday. It began in 1996 in Orlando, FL, when the owner of Tavistock Group, Joe Lewis, bought roughly 4,000 acres with one goal: to create a community that inspires human potential and encourages health and wellness. Today, Lake Nona is a 17-square-mile, 11,000-acre community with more than 22,000 residents.

Anchored by a health and life sciences district known as Medical City, Lake Nona has become a home for many of the world’s foremost companies. Its corporate residents include the Chopra Foundation, Johnson & Johnson, HCA Healthcare, the U.S. Tennis Association, KPMG, the University of Central Florida, Nemours Children’s Hospital, the Department of Veterans Affairs, and Verizon’s 5G Innovation Hub, among others.

Lake Nona is a community first, but it is also a living lab environment. They don’t just talk about innovation and change; they offer a place where big dreams can become a reality today. Autonomous shuttles carry community residents and visitors to and from work, retail centers, and medically integrated, hightech fitness facilities. And the focus on well-being isn’t just physical well-being; mental health is also a priority. “If you want to get out and meet people, get involved with anything from running clubs to art after dark, yoga, concerts in the park, community art —it’s all here in Lake Nona,” says Gloria Caulfield, the Founder and Executive Director of the Lake Nona Impact Forum.

As Lake Nona continues to develop, its creators want to attract the industry’s brightest thought leaders for in-depth conversations on how to build the well-being ecosystem of the future. Part of that conversation occurs at the annual, invitation-only Lake Nona Impact Forum, which gathers 300 of the world’s top CEOs, healthcare innovators, and thought leaders for three days of collaborative discussion about what’s next for the industry.

At the 2023 Lake Nona Impact Forum, there will be a continued focus on mental and brain health. “We evolve the conversation every single year,” explains Caulfield. “The first handful of years was destigmatizing mental health. But now, we’re really focused squarely on innovation.”

This year, Deepak Chopra, a fixture in the Lake Nona community, will lead a discussion on mental health and psychedelics. “I think that’s what’s so cool about the Lake Nona Impact Forum,” Caulfield says. “It’s not just physicians and the clinical, traditional side of medicine. It’s also exploring all of these different alternatives to medicine and preventative solutions to see how all of the pieces really fit together and impacts global health.”

Climate Change will also be Lake Nona Impact Forum’s agenda this year. One session, in particular, will focus on the decarbonization of healthcare within the U.S. Among global healthcare systems, the U.S. is the third largest emitter.

This year’s forum begins on March 8, International Women’s Day. It will feature a host of female scientists, inventors, and business leaders throughout the event, including CVS Health President and Chief Executive Officer Karen Lynch; Harvard T.H. Chan School of Public Health Assistant Professor of Immunology and Infectious Disease Dr. Kizzmekia Corbett, whose NIH team co-designed the leading COVID-19 vaccine mRNA-1273; Academy Awardwinning actor Geena Davis; Organamet Bio CEO Doris Taylor; and Chelsea Clinton, DPhil, MPH—just to name a few. Caulfield says, “It’s going to be exciting to amplify the successful and audacious careers of some of the great women leaders in the world.”

Many Impact Forum speakers have joined the Lake Nona community full-time. These include Deepak Chopra’s Chopra MindBody Zone, a new flagship location for Fountain Life co-founded by Tony Robbins, and NFL quarterback Russell Wilson’s Limitless Minds.

Beyond the abundance of high-profile celebrities, CEOs, and global leaders, the Lake Nona Impact Forum is designed to provide attendees with access and insight. “We want the event to be intimate,” Caufield says. “Like you’re sitting in someone’s living room engaged in conversation with them.”

The 2023 Lake Nona Impact Forum will take place March 8th-10th. More information can be found at lakenonaimpactforum.org.

Speaking with Founder & Executive Director Gloria Caulfield, Worth learns how the Lake Nona Impact Forum highlights a community collectively focused on health and wellness.

TRAVEL

INTRODUCING TRAVEL /

We’ve teamed up with our friends at WONDERLUST to bring the wonder of the world to you with our expanded travel coverage. wonderlusttravel.com

Discover: Fouquet’s New York

BY BOB GUCCIONE JR.

Walking down Greenwich Street in Manhattan, I noticed something was very different. Where there was once a barren wasteland of decomposing warehouses and tenement buildings, there is now an exquisite 97-room luxury hotel: Fouquet’s New York. The Groupe Barrière owners have a pedigree, being fourth-generation hoteliers with world-class properties in St. Barth’s, Cannes, Paris (on the Champs-Elysées), and the French alpine skiing destination of Courchevel, among others. The interior design, with a strong art deco theme, is immaculate. Management says it honors the area’s industrialism and Parisian elegance. The effect, whatever the dichotomous inspiration, is stunning. There’s a duplex penthouse suite called “Le Grand Appartement Terrasse,” along with two restaurants: Fouquet’s New York, based on the owner’s famous Parisian brasserie Fouquet’s, and Par Ici Café, with a vegetarian menu. The Titsou bar is fashioned after a Paris Speakeasy. This hotel is going to be a winner.

PHOTO BY MATTHIEU SALVAING

How to Become Italian

If you have Italian heritage, you may be eligible for Italian citizenship

CAROLINE CHIRICHELLA

In March 2022, Jennifer Sontag moved to Terrasini, Sicily. She launched Italian Citizenship Concierge, a bespoke agency that helps people searching for Italian citizenship through jure sanguinis—Latin for “right of blood” and the principle of nationality law by descent. Italy is favorable towards bestowing citizenship this way.

Jennifer feels that her move to Italy was about more than getting a new passport— nice passport though it is. Really, it was about starting a new life. So, here’s everything you need to know to obtain dual citizenship. (Yes, you can keep your current one.)

How can someone know if they’re eligible?

The easiest path is if you have Italian ancestry. There are some hitches. You can take a quiz on our website to determine eligibility.

Italy did not become a country until 1861, so it is essential to know if your ancestor was alive at that time or after. It’s also important to know when your ancestor naturalized in a country other than Italy. It needs to be after the next of kin was born and after 1912.

Already it’s confusing!

The first step is to locate the ancestral records and citizenship status. Once the research is complete, we start ordering documents from the various state and local agencies where vital and civil records are held. Once collected, we prepare them for presentation in Italy for Citizenship Recognition.

We provide all of the research, document collection and preparation, and assistance applying through a fast-track process in Italy.

Do the words “fast track” even exist in Italian?

Yes and no! It’s what we Americans consider as fast in comparison. It’s not fast or easy, but we do the heavy lifting.

We want our clients to have fun along the way. We make all the arrangements, from housing contracts to meeting on your behalf at the various agencies, but we also plan day trips and dinner parties with a mix of locals.

What do you say to someone thinking about applying?

What are you waiting for?

May the Fores Be with You

Swing easy at Worth’s favorite golf resorts for 2023.

BY ROBERT YEN

The best resorts have manicured fairways, challenging designs, courses to fit every skill level, beautiful settings, and plenty to do off the course. From the rolling terrain overlooking the Pacific at Kapaua to the fairways in the cradle of American golf at Pinehurst, there is a top-end American golf resort for everyone. Worth has played them all. The courses are listed geographically from East to West.

Harbour Town, HILTON HEAD ISLAND, SC

Designed by Pete Dye and Jack Nicklaus, this is probably the most famous of Hilton Head’s 23 championship courses. Harbour Town Golf Links hosts the RBC Heritage Golf tournament on the PGA Tour. The course focuses on finessed and careful shot-making instead of pure power. The par-71 course includes 7,099 yards of flat terrain. The highlight of the course is the infamous 18th hole, a 458yard shot directly toward the lighthouse. Even better, The Inn and Club at Harbour Town is a luxurious treat.

PRO TIPS: Rent a boat to cruise around Calibogue Sound or relax on the white sandy beaches.

Reynolds Lake

OCONEE, GREENSBORO, GA

Set along the waterfront about an hour’s drive from Atlanta, Reynolds Lake Oconee has all the amenities one would expect from a five-star resort. It has access to five challenging courses: The Landing, The Preserve, The National, the Oconee, and Great Waters. Ninetynine holes wind through wooded areas, rolling hills, dramatic elevation changes, inlets, and tree-lined doglegs, each with spectacular vistas. The golf is second to none.

PRO TIPS: For a break from golf, rent a boat and spend the afternoon touring Lake Oconee and the megamansions dotting its 350 miles of shoreline.

The Greenbrier

WHITE SULPHUR SPRINGS, WV

Situated amid the breathtaking Allegheny Mountains of West Virginia, the resort is a National Historic Landmark that’s been welcoming guests since 1778. Three of its four courses are close to or more than a century old. The resort, which sits on 6,500 acres, is anchored by the

Greenbrier Hotel, a grand structure built in 1780, updated over the past two centuries. Its massive white columns rise six stories against a white façade. It has 677 rooms and 33 suites, and outdoor activities include rafting, a hunt club, game preserve, and skeet shooting.

PRO TIPS: The Greenbrier has bowling allies and a casino.

The American Club Resort at Destination Kohler, KOHLER, WI

Along the rugged, windswept Lake Michigan shore sits one of the most famous championship courses in the U.S., The Straits Course of Whistling Straits. A companion course, The Irish, is an inland grassand-dune layout. Accommodations abound at the resort, including the five-star American Club; the Inn on Woodlake with its beach, hiking trails, and shopping venues; or the Kohler Cabin Collection of large private cabins.

PRO TIPS: Test your short game on a unique and entertaining 10-hole, par-3 course known as The Baths of Blackwolf Run.

Pinehurst

PINEHURST, SC

The largest golf resort in America, its first course dates to 1897. Each of its nine courses is known by the order in which they were constructed. The most celebrated is Pinehurst #2, the site of more golf championships than any course in the country. Accommodations feature beautifully updated rooms at the century-old Holly Inn, the Four-Diamond, 230-room Carolina Hotel, or the historic Manor Inn built in 1923.

PRO TIPS: Drink at the Deuce, on the veranda overlooking the 18th hole on #2.

The Broadmoor COLORADO SPRINGS, CO

The Grand Dame of Western Golf, the Broadmoor, opened its first course in 1918. In a unique twist in golf course design, the East Course was designed by not just one but two of America’s most distinguished designers, Donald Ross (holes 1-6 and 16-18) and Robert Trent Jones, Sr. (7-15). The West course opened in 1965 and features narrower fairways and 7,016 yards from the back tees. If you can only do one, play The East.

The Broadmoor Hotel is a classic luxury. Built in the 1940s, the resort boasts a diverse collection of rooms, suites, and cottages to estate houses and brownstones. It has all the amenities, so it’s ideal for nongolfing companions. And it may be one of the most romantic resorts in the U.S.

PRO TIPS: Sunday brunch!

Troon North SCOTTSDALE, AZ

The crown jewel of desert golf, Troon North’s two championship courses, Pinnacle and Monument, set the standard by which all golf in the Sonoran Desert is measured. Built in the shadows of Pinnacle Peak with verdant fairways carved through ravines and around giant granite boulders, Troon North is visually stunning. It is just 15 minutes from downtown Scottsdale and 40 minutes from Sky Harbor Airport. On-site is the Four Seasons Resort, deluxe but casual Southwestern hospitality. For those who prefer the nightlife of Scottsdale and its great dining experiences, there are dozens of top-notch hotels and resorts nearby.

PRO TIPS: If you have to choose, play The Monument. Peak season (January through April) can be pricey. Book for September-October, or May when daytime temperatures are high but rates are lower.

Pebble Beach Golf Resort

CARMEL, CA

Perhaps the most famous American golf resort, Pebble Beach consists of 4 championship courses. Pebble Beach Golf Links, Spyglass Hill, The Links at Spanish Bay, and Del Monte Golf Course. There’s also a fun short course known as The Hay, and a 20,000-square-foot putting course. It’s been the site of 6 U.S. Open championships and is scheduled to stage its first U.S. Women’s Open in 2023. The courses provide a diverse mix of golf, from seaside to sand dunes to forested fairways. If the ruggedness of Bandon Dunes is “golf as it was meant to be,” Pebble Beach is golf as refined and elegant as it can be. With luxury accommodations and dozens of fine restaurants, shopping arcades, wine shops, spa treatments, and year-round outdoor activities, the resort offers something for everyone.

PRO TIPS: Rumors swirl that tee times are impossible unless booked months in advance. But if you stop by the pro shop, ask about a tee time for one. I did and got one the following day at 9:00. And if you don’t have time to play but want to see the course, ask if you can take a cart. They believe once you see the course, you’ll come back to play it!

Bandon Dunes Golf Resort

BANDON, OR

Bandon Dunes is one of America’s finest, most immersive, comprehensive golf experiences, with six distinct courses. Built among the dunes along Oregon’s rugged coast, any of their courses are, as their saying goes: “golf as it was meant to be.”

Despite the relatively recent vintage of the courses, they’re meant to be played the way golf was played five centuries ago. The courses are walked. Here, there are no concrete paths, no electric

carts, and no beverage carts. Just the sound of the wind and the voice of a skilled and knowing caddy from the resort’s renowned training program.

The usual resort-style amenities are non-existent—no tennis courts or Olympic-sized pools. But as golf experiences go, there are none better. From the resort accommodations, guests call for a shuttle, and within minutes, one will take you to any of the many dining options, pro shops, practice areas, or courses.

For a diversion from golf, the Oregon Dunes National Recreation Area is a short drive away, known for its wind-sculpted sand dunes towering 500 feet. There’s also Coquille River Lighthouse.

PRO TIPS: After your round, relive the shots of the day at McKee’s Pub overlooking the first hole on Bandon Dunes.

Kapalua Golf Resort LAHINA, HI

The first week of January, the first PGA tournament of the year is at Kapalua’s Plantation Course. (Editors’ Note: Isn’t it time to retire the “Plantation” from Course names?) The 78-degree temperature under windless blue skies and endless vistas of the Pacific remind us that paradise exists even in winter. The course stretches to nearly 7,600 yards but can be played as short as 5,100 yards. (For variety, book a tee time at the Bay Course, Kapalua’s other championship venue.) Just up the road, there are stunning accommodations at the Ritz Carlton, which offers snorkeling at nearby Kapalua Bay (named America’s best beach in 2018), and numerous other activities like ziplining, ATV tours, horse riding, hiking, and lei-making or hula lessons.

PRO TIPS: For the asking, the team setting you up on the golf carts will give you Kapalua logo towels to clean your clubs on the course. Take a few extras for your buddies shoveling snow back home. The course knows you’ll keep them, and it’s pretty smart marketing.

PHOTO VIA BANDON DUNES GOLF RESORT

Tampa Rising

For a many years, Tampa was Florida’s lesser-known destination. Not anymore.

BY RICHARD BRADLEY

Sitting at a conference table while her dog, a rescue named Desa, naps happily at her feet, Tampa mayor Jane Castor is explaining why she ran for office back in 2018 and 2019. Like the city she leads, Castor is not easy to define. Tall and plain-spoken, she grew up in Tampa and played basketball and volleyball at the University of Tampa. After college, she served as a city cop for three decades, including six years as Tampa’s chief of police. Once a Republican—she switched, she says, because the Tea Party movement was “just too conservative” for her—she’s now a Democrat who maintains that being mayor is a non-partisan job. She is also the first gay woman to be mayor of Tampa, which is a complicated convergence of identity and politics given the culturally divisive reign of the state’s strongman governor, Ron DeSantis.

“I’ve been here for 62 years now, almost 63,” Castor says. In deciding to run for mayor, “my thought was that the city’s going to change more in the next decade than it has in my entire life. So to be a part of that change, to be able to guide it in a thoughtful and intentional way, was just an honor of a lifetime.”

If there’s a little bit of campaign rhetoric in the line; she’s a good politician, and she ran for reelection this year. (When I asked her a few months ago if she’d like to announce her campaign in the pages of Worth, Castor says bluntly, “No,” then hastened to soften the remark. “Well, everybody knows that I’m running.”)

She was right on both counts: Everybody knew she’s running, and Tampa, the largest city in the greater metropolitan area of Tampa Bay, which includes St. Petersburg and Clearwater, is changing—fast. (Tampa, locals will point out for clarity, is populated by humans; Tampa Bay is a body of water containing fish, sharks, and other sea creatures.) The city is enjoying a post-COVID population influx, as Americans from colder climates and higher tax states have flocked there. (It’s a cliché, but ask an Uber driver—time and again, you’ll hear

that they arrived within the past couple of years.) Tourism to Tampa, which dropped substantially during the pandemic, is surging in its aftermath. When businesspeople and travel planners, and politicians talk about rising American cities, they often mention places like Charleston, Phoenix and Nashville. In the last few years, Tampa has become part of that admiring conversation.

It wasn’t always this way. Tampa has long been a secondary city, even within its state. It doesn’t have the business community, vibrant art scene, or international flavor of Miami. It lacks the theme parks of Orlando (though it does contain the rollercoaster-centric Busch Gardens, and Tampa tourism officials are quick to point out that Walt Disney World is an easy 65-mile drive away). It has some fine restaurants, but no one would visit Tampa for its

culinary scene. And it’s on Florida’s west coast, which, perhaps because it’s farther away for travelers from the Northeast, typically attracts less media buzz than the cities and beach towns of Florida’s Atlantic coast. East Coast Florida has South Beach and West Palm and Delray; West Coast Clearwater has the Church of Scientology headquarters.

Tampa does have wonderful neighborhoods; Ybor City, the home of the cigar business that sparked Tampa’s growth in the late 19th century, has a charming Cuban feel, along with Spanish and Italian influences. Hyde Park is what you might call Tampa’s old-money neighborhood, but old money in Florida is a relative term, and the area feels far more welcoming than, say, Boston’s Beacon Hill or San Francisco’s Pacific Heights. Driving through Tampa sometimes feels like driving through L.A.—it’s everywhere and nowhere simultaneously, all sprawl and no center.

For a couple of reasons, that’s changing. One is an ambitious downtown development project known as Water Street. Funded by a partnership between Jeff Vinik, the owner of the Tampa Bay Lightning, and Bill Gates’ Cascade Ventures, the 56-acre, $3.5 billion project is replacing a largely vacant area adjacent to the waterfront. Tampa had 56 acres of mostly undeveloped land flanking its waterfront—with apartment buildings, retail, office space, and hotels, all intended to be pedestrian-centric and wellnessoriented. Recent months saw the opening of The Tampa Edition hotel, which the city describes as its first five-star hotel. The opening of an Edition would mark a typical day in Miami. In Tampa, it’s a watershed event that Vinik marked by buying a penthouse apartment within the building. At $8 million, it was the most expensive apartment in Tampa’s history. Water Street is attracting young people and filling downtown with new energy. It

“I can say that individuals, families, and businesses still value Tampa Bay for what it is, and that is a very friendly, welcoming, inclusive place.”

is, according to Santiago Corrada, president and CEO of Visit Tampa Bay, “a game-changer.”

Another factor in Tampa’s rise is the success of its professional sports teams. The Buccaneers both hosted and won the Super Bowl in 2021. The Lightning won the Stanley Cup in 2020 and 2021. The Rays, though they play in St. Petersburg’s Tropicana Field, a domed stadium widely considered one of baseball’s dreariest ballparks, consistently field an exciting team that outperforms its meager payroll. “It’s amazing, the exposure you get from sports,” Corrada says. Winning teams bring national TV, conferences, businesspeople, tourists, and maybe most important, a bit of mojo—some local pride.

Like any city, Tampa has its challenges. Its public transportation is nearly nonexistent; Castor jokes that “public transportation in the South

is two people in an SUV.” It faces rapidly rising housing prices. The Rays are threatening to pick up and leave when their lease expires in 2027.

Climate change and rising sea levels are a huge threat; Hurricane Ian missed Tampa last fall but would have caused massive devastation had it not taken a late turn to the south. And then there’s DeSantis, whose polarizing rhetoric and culture war-driven policies strike at the heart of Tampa’s inclusive identity while doing little to address—and perhaps exacerbating—problems such as a chronic, statewide teacher shortage. Indeed, DeSantis’ recently proposed budget mandates that Tampa spend a court-mandated transportation tax refund on roads and bridges but explicitly forbids the city from spending the money on public transportation. That doesn’t help.

Castor has no interest in picking a fight with a powerful and popular governor; it’s hard to see how that would help her city. “No one’s ignorant about what’s going on in our state,” she says. “I can say that individuals, families, and businesses still value Tampa Bay for what it is, and that is a very friendly, welcoming, inclusive place.”

That friendliness is a common refrain around Tampa, and it’s certainly something I experienced during a recent visit to the city—maybe it’s the weather, the water, or the quality of life in general, but folks in Tampa just don’t have that edge you find in cities like New York or Philadelphia or Chicago. When people visit Tampa, Castor says, “consistently what you hear is that this is the friendliest city they’ve ever been to. Friendliest, welcoming and clean—that’s what we get.”

Who would want more?

Live Better by Building on the Six Pillars of Health

Getting healthy requires tending to six interconnected components of well-being: nutrition, exercise, sleep, stress, substance use, and personal connections.

BY SEAN CAPTAIN ILLUSTRATIONS BY MUTI

“Everything Everywhere All at Once” is not only an Oscar-favorite movie. It’s an excellent description of how our personal health works. Sleep reduces stress, which lowers the risk of diabetes. The company we keep affects how much we drink. And vigorous exercise improves nearly every aspect of health. All our activities are interconnected and work together to determine our overall health.

In the early 2000s, health researchers began recognizing the now-obvious truth that the choices we make and actions we take determine how well and how long we live. A key eyeopener was a study titled simply, “Actual Causes of Death in the United States, 2000.” It showed that half of all deaths—including from heart disease, cancer, and strokes—were due to lifestyle choices, especially around diet, exercise, and smoking. Around 2010, the American College of Lifestyle Medicine (ACLM) translated these and other findings into

six interconnected pillars that support a healthy body and mind: nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances, and social connection.

“The idea is, what can we do with our day-today life that can impact our disease, either progression or prevention? And that’s where these six pillars come in,” says Beth Frates, MD who is Director of Lifestyle Medicine and Wellness in the Department of Surgery at Massachusetts General Hospital and President of the ACLM.

To better understand these six pillars, we spoke with six leading experts in their fields: Layne Norton, Ph.D. (nutrition), Francis Neric, MS, MBA (exercise), Eti Ben Simon, Ph.D. (sleep), Josh Briley, Ph.D. (stress), Professor Ken Leonard, Ph.D. (substances), and Dr. Frates (social connection). They explain the latest science about why we get sick and suggest concrete, achievable actions to become healthier.

Take Charge of Nutrition

Managing calories is like managing money. As long as you stay within your budget, you have flexibility on how you spend, says nutrition expert Layne Norton, PhD, founder of the health and wellness company Biolayne. Norton allows himself a measured amount of ice cream most days. But Norton is a mountain of lean muscle who works out for two to three hours daily. When it comes to losing weight (the most-popular nutrition goal, he says), most of us don’t have a good sense of our budget. “When we do studies on nutrition, we find that the majority of people underestimate their calorie intake by about 30 to 50 percent,” he says.

Tedious as it may sound, it can be very enlightening to do some calorie counting (there are handy apps for that) and even spend a week weighing the food you eat to understand how big the portions really are. “I’ll tell people, the most I ever learned about nutrition was the first week I ever tracked anything,” says Norton, (Calorie counts on labels aren’t terribly accurate, he says, but they give a relative indication of your consumption.)

While being aware of what you put in your body is important, balance is key. A helpful, healthy habit can quickly turn into an obsession or symptom of disordered eating. So, if you choose to calorie count, do so with care, and be sure to reach out to your doctor if you notice an unusual level of fixation starting to occur.

There are food choices that not only control calories but also boost overall health. Norton can’t say enough about fiber, and not just because it helps you poop. Fiber also binds to and removes LDL cholesterol—the major risk factor for atherosclerotic cardiovascular disease—as well as carcinogens and other toxins. Plus, fiber is really filling: You’ll feel satiated with fewer calories. Norton recommends consuming at least 15 grams of fiber per 1000 calories you eat. (For reference, a slice of whole wheat bread has about 2 grams, and a cup of broccoli has about 5.)

Protein is another satiating food—very filling for the number of calories you get. Protein intake, combined with resistance training, is especially important as we age to stave off a loss of skeletal muscle mass and strength called sarcopenia. “As far as animal sources of proteins go, focus on lean proteins, except for maybe some fatty fish,” says Norton. You can get sufficient protein as a vegetarian or vegan, although it requires more work. “Certainly on a percalorie, per-gram of protein basis, it’s hard to argue that animal protein is not higher quality in terms of bioavailability, digestibility, and its effects on muscle protein synthesis,” he says. To get enough protein without too many calories, vegetarians or vegans should include protein isolates (extracts from whole foods), such as whey (for vegetarians), soy (a moderate amount won’t affect hormones), or combined pea and corn protein, he says. Norton recommends eating at least 1.6 grams of protein for every kilogram of body weight but says there’s no downside to eating more.

One food type Norton cautions against is saturated fats due to their tendency to increase LDL cholesterol. But Norton doesn’t believe in prohibiting foods outright. Even the occasional donut is OK, he says, going back to the budgeting analogy. “[If] I’m gonna have a donut, I recognize it’s not as satiating, but I’m desiring an experience,” he says. “And I understand that means I’m going to have to reallocate funds somewhere else, meaning maybe you’re not gonna get the pasta tonight. Maybe you’re gonna have a salad.”

Up Your Exercise

Weight loss is also one of the main goals of exercise, but there are limits, says Francis Neric, associate vice president of certification and credentialing at the U.S. Registry of Exercise Professionals. “Eighty percent of weight loss is from diet, and 20 percent of the weight loss is from exercise,” he says. “So, the exercise, what it does is keeps you motivated, and it keeps you accountable.” It also builds muscle mass, which is what the majority of people want. For some, that means bulking up, but it doesn’t have to.

“For female clients who do a lot of resistance training [like weightlifting], they aren’t looking like Arnold Schwarzenegger,” says Neric. “They’re actually becoming much more defined, and they’re able to perform at a high level.” Building strength is key to remaining independent in our later years, giving people stability to avoid falls, and staving off sarcopenia and osteoporosis. (Special gear and exercises can also strengthen proprioception, the awareness of our body’s position and movement.)

There are many ways to exercise. “[For] somebody who is generally healthy, the biggest bang for your buck is high-intensity interval training,” says Neric. HIIT “gives you a little bit of benefit for aerobic endurance. It also increases your muscle strength.” But you may want to specialize. If strength is your main goal, you should go lighter on the aerobics, he says. If you want to be a great runner, go easy on the resistance training. The minimum requirements are different, too. For aerobics, it’s

five times per week, says Neric. For resistance training, it’s at least twice. That said, the American College of Sports Medicine recommends that everyone gets at least 5 days per week of moderate-intensity activity or 3 days per week of vigorous activity—for at least 30 minutes in either case.

While there are sophisticated ways to gauge your performance, such as VO2 max (the volume of oxygen the body absorbs and uses during exercise), there are good ballpark assessments, like the talk test. “When you’re working out at a high enough intensity, you can only spurt out a few words together,” says Neric. “If you can have a full-blown conversation, you’re not exercising hard enough.” For resistance training, he advocates the 2 for 2 rule: You can increase the weight after you can perform two more repetitions in your last set for two weeks in a row.

You don’t have to figure all this out on your own. Whether working one-on-one or with a group (which is great for solidarity), a professional trainer can guide you through your goals—and make sure you don’t hurt yourself. Selecting a trainer is a lot like finding a therapist, says Neric. “It’s just like being able to find somebody who understands who you are and is meeting your needs and meets you where you are,” he says. A trainer helps you set realistic goals (you won’t lose 30 pounds in a month), and they won’t overpromise. Also, beware of people who overwhelm you with technical jargon, says Neric.

He advises taking a close look at education and certifications. “I’m not gonna call out any organizations, but there are some where you can just go have an open book test, or you just pay for a credential,” he says. It’s important instead to look for people with credentials from accredited programs—ones that are certified in the U.S. by the National Commission for Certifying Agencies (NCCA) or internationally by meeting the International Standards Organization (ISO) 17024 requirements. (You can look up a trainer’s certifications at usreps.org)

Exercise only works in conjunction with nutrition, says Neric. “When [you] were in high school, you could eat whatever you wanted as long as you exercised. As you get older, especially when you hit 30 and 40, that’s not the same,” says Neric. “You can’t outwork a bad diet.”

Optimize Your Sleep

While your body needs a good workout, it also needs a good lie-down. But sleep isn’t passive. “It’s during sleep, and especially during deep sleep, when hundreds of thousands of brain cells all of a sudden decide to sing together in this amazing feat of coordination,” says Matt Walker, founder of the UC Berkeley Center for Human Sleep Science and author of the book Why We Sleep, in his eponymous podcast. If you don’t allow your brain sufficient sleep (seven to nine hours for a young, healthy adult, and up to 11 for teens), things deteriorate quickly, says Walker’s colleague, research scientist Eti Ben Simon. The effects are clear when people sleep for just six hours, then perform tests of vigilance and alertness.

“They would report not feeling sleepy,” she says. “But then when you look at their performance, they’re still doing worse relative to themselves on seven hours of sleep.” To test yourself, try a brief online Psychomotor Vigilance Test (PVT)—like one hosted by Sleep Disorders Center Florida.

Research by Ben Simon and Walker shows that poor sleep also impairs our ability to regulate emotions, increasing the risk of stress, irritability, and depression. After just one sleepless night, “you see that the region of the brain that is in charge of processing emotions, the amygdala, can be up to 60 percent more active,” says Ben Simon. If you pull an all-nighter, go easy on yourself—and others—the next day. Conversely, anxiety hurts sleep by keeping the body in the fight-or-flight mode, causing frequent awakenings and diminished deep sleep (the most important stage for regulating emotions).

Sleeping better requires paying attention to substances. Ben Simon advises cutting caffeine off by noon. Even then, up to a quarter of it still sloshes about your bloodstream at midnight. Alcohol blocks REM, the main dreaming stage of sleep, which helps us process emotions and consolidate memories. Ben Simon suggests ending drinking at least six hours before sleep. In lieu of that, taking a nap the next day can provide some REMcatchup. (She’s generally a proponent of naps but cautions that ones lasting more than 20 minutes are followed by 10-15 minutes of grogginess.) THC, the psychoactive component of cannabis, also disrupts REM sleep. Low doses of CBD, the other key ingredient in pot, rev you up. But higher doses (over 50mg) may help sleep, though there isn’t enough data to prove that.

Sleeping pills such as Zolpidem (Ambien) or benzodiazepines like Clonazepam (Klonopin), simply sedate the mind (as does alcohol). “There is a lot of...electrical dance that’s happening during sleep, and that’s not always mimicked by sleeping pills,” says Ben Simon. Supplements of melatonin, a hormone that initiates the sleep process, can help people over 60, whose natural melatonin levels can drop by up to 50 percent. (She recommends a gradual-release version, such as the melatoninmimicking drug Ramelteon.) But studies don’t show benefits in younger people. Learning new behaviors through psychological treatment, especially cognitive behavioral therapy, is the best remedy for long-term sleep problems such as insomnia.

A good bedtime routine helps everyone. Start by turning the lights down about an hour before bedtime, as darkness triggers melatonin release. Screens aren’t necessarily bad if you filter out the melatonin-blocking blue light component by shifting them to a warm tone, enabling dark mode (white text on black), or wearing blue light-blocking glasses. Otherwise, screens are OK, “as long as you’re not reading anything too suspenseful or arousing,” she says, such as aggravating social media. Ben Simon also advocates relaxing activities, such as meditating, stretching, or journaling. Light exercise like yoga is fine if doesn’t warm you up. (The body needs to cool about two to three degrees Fahrenheit before sleep.) Eating can also warm you up, but a snack to stave off hunger is fine. “It’s kind of the Goldilocks region of not too hot and not too cold, not too full and not too hungry,” she says.

Reduce Stress

Stress is a killer. A 2012 study in the UK found that people with high levels of stress had a 21 percent increased risk of death from all causes, with a 22 percent higher risk for cardiovascular disease and a 9 percent higher risk for cancer. (And none of these 68,222 people suffered from a diagnosed mental illness like anxiety or depression.)

This is just one of many studies showing that stress can kill you.

When stress is high, you go into fight or flight mode as if in mortal danger. “Your body pumps more resources to the extremities than to the torso, so digestion is affected, heart rate goes up, cortisone production is increased because your body needs those sugars to escape the bear that’s trying to kill you,” says clinical psychologist Josh Briley, a spokesman for the American Institute of Stress. Blood vessels constrict, raising blood pressure, and the extra glucose in your system raises the risk of developing diabetes. The recognized symptoms of stress hint at how widespread the damage to the body is. In addition to blushing, sweating, or grinding teeth, the unpleasantries may include muscle pain and spasms, frequent colds, and other infections, seeming allergic reactions, constipation, and excessive farting. People under stress also tend to wreck other components of health by smoking, eating poorly, and not exercising.

Stress isn’t always bad, though. “Stress can improve your performance,” says Briley. “[It] can help you think more clearly.” It’s natural, for instance, to feel stressed before you speak in front of a crowd, and that stress can focus the mind. But it’s unhealthy to feel stressed afterward, he says, especially if you criticize yourself with worries that you didn’t speak well, that you were boring, that people didn’t like you.

Such negative thinking prolongs and exacerbates stress and can lead to anxiety disorder and depression. Signs of danger, says Briley, include snapping at your partner or children, pulling away from friends and family, constantly griping or venting around others, and having poor sleep and diet. “That’s when it’s time to seek professional help,” he says. Briley doesn’t advocate a particular type of therapy. “More important than trying to find a cognitive behavioral therapist, or somebody who’s trained in EMDR or something like that, is finding somebody that you feel comfortable opening up to,” he says.

But some of the best treatments are DIY, and things you should be doing already for optimal health. “One of the best ways to deal with pentup energy from stress is to exercise,” says Briley. An intense cardio workout is best if your body can handle it. Briley used to run three to five miles a day. “I just poured all of it into that workout, and I was exhausted. But I wasn’t keyed up and stressed anymore,” he says. If that’s too much for you, though, the key thing is to get some regular exercise, says Briley, such as walking. In addition, “sleep is very restorative to your mind and body,” he says. “And so that increases your resilience to handle stress and all those situations.”

Maintaining solid relationships helps you gain others’ perspective to appreciate if you are overreacting and understand that you are not alone. “If you’re stressed out about something, and you think, ‘Man, I’m the only one worried about this,’ you run the risk of crossing from stress into anxiety,” says Briley. A changed mindset allows you to focus on how to solve a problem rather than magnifying it into a catastrophe or blaming yourself. “You can say that was a stupid thing to do; you can say, I screwed that up,” he says. “But don’t personalize it and make it a trait about yourself.”

Eliminate or Minimize Harmful Substances

There are many addictive and harmful substances, but the harm and potential for abuse vary wildly. There’s no case for smoking a drug—be it tobacco, cannabis, or anything else. “The substance that causes the most deaths and the most expensive in our society is tobacco—hands down,” says Professor Ken Leonard, director of the University at Buffalo Clinical and Research Institute on Addictions. He means smoking tobacco, which the CDC estimates causes more than 480,000 deaths (or about one in five) in the U.S. each year. But the second-greatest cause of harm (killing 140,000 people) is alcohol—something that most of us can use safely, with moderation. So substances fall into two groups: Those you might be able to use safely and those that are never a good idea. The latter includes some drugs that doctors prescribe. “The people who research pain suggest that opiates do not have real good effectiveness in the long term,” says Leonard. “But [patients] continue to need opiates...and doctors are reluctant to take them off.”

The possibly safe group is pretty tiny, including alcohol, perhaps cannabis (if you don’t smoke it), and maybe hallucinogens like magic mushrooms—at least in a clinical setting to treat ailments like depression. For cannabis that you eat, “I don’t think we’re near understanding what’s a safe level,” says Leonard, including the risks of THC vs CBD. Research on mushrooms is also scant, he says, but notes that people tend

only to take them occasionally, “and that would seem to mitigate a lot of the potential health problems, as long as they’re taking them in a protected environment,” he says. “I don’t think I’d want to walk around New York City after taking some mushrooms.”

Alcohol is much better understood. The National Institute on Alcohol Abuse and Alcoholism has some straightforward measures for excessive use. For women: more than three drinks on any day or more than seven drinks per week. For men, it’s four and 14 drinks. But alcoholism is more than a numbers game. The AUDIT test, which you can take online at auditscreen.org, asks about other factors, including whether you can ever stop drinking, if you drink in the morning, or if you have felt guilt or remorse after drinking. “You begin to think that there’s a problem when it begins to be an organizing principle in people’s life,” says Leonard. Are you really looking forward to that next drink? Are you drinking every day? Do you need a drink to prepare yourself before you go out? The same questions could hold true for cannabis, as well.

Some people may need professional help to curb addiction. The most effective therapies are motivational interviewing and cognitive behavioral therapy (including a version called relapse prevention). Opiate addictions, however, always require the medication buprenorphine (aka naloxone or Suboxone). There are also some medications for severe alcoholism: disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia).

Luckily, many people can deal with substance abuse on their own, says Leonard. Mindfulness practices like meditation, selfhelp tools, like the book Sober for Good, and (as in so many other cases) exercise are all excellent remedies. “I think moderate to high intensity is probably better at generating that positive feeling,” says Leonard. But if all you are up for is a walk, that still helps. Your relationships also play a key role. “Take a good hard look at your friends,” he says. “And if they’re just drinking buddies, and that’s all you do with them, then you need to expand your friend network and find friends that you can do interesting and joyful things with that don’t involve alcohol or cannabis or other drugs.”

Foster Social Connections

Companionship shores up the other pillars of health. It provides solidarity and encouragement in exercise groups. It provides a reality check and understanding for people with runaway anxiety, and it can provide healthy activities as alternatives to getting drunk or high. “The Connection Prescription,” a 2017 summary of research studies, pulled together oodles of findings on the possible health benefits of social connection. One study indicated that low social interaction was as harmful as smoking 15 cigarettes per day. Another showed that people with diabetes in a peer support group had better blood glucose control. And another found that social connection may increase the lifespan of women with breast cancer. “We knew that there was something protective about being connected to people,” says Dr. Beth Pegg Frates, who was one of the authors, noting that such research dates back to the 1970s. How can socializing potentially affect so many aspects of our health?

Some studies found that support groups for people with illnesses help them manage fears and develop strategies to feel better. But one physiological mechanism may be the “love hormone” oxytocin. It’s central to childbirth—stimulating labor, milk production, and bonding between mother and child. But oxytocin is produced by all types of intimacy, from lovemaking to petting your dog. And it’s an essential product of social interaction. Oxytocin lights up several parts of the

brain, improving mood and memory. It has sedating and anti-anxiety effects that can lower heart rate, blood pressure, and levels of cortisol (the primary stress hormone), dampening the amygdala response that revs up emotions. Some research indicates that it can lower blood glucose levels, too.

Several studies show that being married helps people live longer. “I don’t want people to read this and then say, ‘Oh, I’m not married, or I don’t have a partner, or I just had a fallout, and I no longer have a relationship, so I’m doomed,’” says Frates, explaining that close friendships or connections to family members can also be powerful.

It’s best to find what psychologist and author Robert Brooks, Ph.D. calls a “charismatic adult.” That’s someone “who really knows you, understands you. And after you’re with them, you feel energized,” she says. “You are not afraid of discussing any topic with this charismatic adult.” Sometimes you are also the charismatic adult for that person, but not always. You may fill the role for other people instead.

Deep relationships take time to form and effort to maintain. Life changes like moving or falling out with friends can force us to start anew. But even without a deep connection, any level of human contact is a health booster—even making chitchat with and saying thank you to a grocery-store checker or a barista. “Having just a little interaction, a little gratitude...these little acts of kindness can be very valuable and ultimately add up,” says Frates. Learning people’s names at stores or restaurants and exchanging pleasantries provides a basic level of friendship. Classes, including exercise classes, are another way to foster connections, even if they don’t yield deep friendships. “I like the idea of volunteering, and I like the idea of soup kitchens,” says Frates. “I like the idea of food pantries and coming back with the same group that’s serving. And then you have a mission.”

Frates recommends reaching out to a friend or loved one at least once a day, even if for just a few minutes. “You want to have interactions that make you feel alive, that make you feel creative, that make you feel even curious to learn more,” she says. “These would be positive social connections.”

BENDING THE LONGEVITY

Once an open water swimmer, Attia crossed the Catalina Channel in 10 hours 34 minutes 51 seconds at the age of 32 .

CURVE

Peter Attia’s new book Outlive: The Science and Art of Longevity is a personal handbook for living a healthier, better life.

BY DAN COSTA

When Peter Attia was in high school, he wanted to be a professional boxer and studied “the sweet science of bruising” with an obsessive focus. These days he is less of a bruiser, but the obsessive study of science remains. Trained as a surgeon, Dr. Peter Attia is now one of the world’s foremost experts on longevity and the author of Outlive: The Science and Art of Longevity, a manual for how to live a longer, better life.

Dr. Attia earned his medical degree from the Stanford University School of Medicine and spent five years at the Johns Hopkins Hospital in general surgery. Today, he is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to help patients lengthen their lifespan and simultaneously improve their healthspan.

Attia is also the host of a weekly podcast, The Drive, in which he has very deep conversations with medical practitioners about the latest scientific research. Subscribers should expect to take notes. They should also expect regular diversions into archery and Formula One racing, two non-medical passions of Attia.

Worth spoke to Attia via Zoom at his home in Austin, Texas. (This interview has been edited for length and clarity.)

Costa: The concept of longevity has occupied your research. I think we have a growing appreciation that it is about more than just living longer. How do you look at longevity?

Attia: For me, the simplest definition, and the one that I anchor to, is around the longevity curve. This is a function that describes the relationship between lifespan and healthspan. Lifespan is obviously easy to define because it’s a binary outcome. Are you respiring or not, are you alive or dead?

People just intuitively get healthspan, but I don’t know that they think enough about what it means. Certainly, the medical diagnosis of healthspan leaves something to be desired because it speaks to freedom from disability and disease. I don’t think that’s a high enough bar. We ask our patients to think of a far more sophisticated and personalized view of their healthspan. What matters to you in three buckets— the physical bucket…the cognitive bucket, and the emotional bucket. All of those things speak to quality of life. I think that today, people are thinking at least as much, if not more, about healthspan than lifespan.

One of the examples you often give on your podcast is the ability to pick up your grandchild at age 50, age 60, ideally at age 70. Why do you think that’s an important example?

It’s a very personal example that I think resonates with a lot of people. For me, there’s probably nothing that gives me more joy than playing with my kids and doing things with them that are physical—shooting bows and arrows, riding go-karts, that kind of stuff. I’m pretty fortunate that even though I’m 50, I still have two young kids. My youngest two are five and eight. And everything about playing with them is low, physical, and requires strength, balance, and coordination. To be able to pick a kid up out of a crib, something you and

I could do today without thinking about it, becomes really hard when you’re in the eighth decade of your life. To be able to get on the floor and play with kids becomes insanely hard at that age, and then to be able to get up off the floor.

I had a patient once who said something, and I really loved it. He said his goal for the end of his life is to never have to have his kids come to him. He wants to be able to go to them. He meant geographically. He’s like, “I want to be able to travel so that they don’t have to come visit grandpa, great grandpa, I can go to them.” And I said, “Yeah, that’s perfect. But let’s take that one step further. They shouldn’t have to come to you in the rocking chair, you should be able to go to them. If they’re playing sports, you should be able to walk over to them while they do that and engage with them.” So, in some ways, picking a kid up out of a crib is one of many ways we can make it more visceral, something that matters a lot to the quality of our life.

The book is called Outlive: The Science and Art of Longevity. What do you hope that readers will be able to take away from it?

I think so much of what it takes to live a longer and better life does not actually require a physician. In fact, very little that those of us who went to medical school learned in medical school pertains to what it takes to live a longer and better life. That’s unfortunate and probably a very sad thing to say, but it is true. Everything that we learn in medical school is geared towards this system that in the book I talk about as Medicine 2.0. It has done heroic things but has not been set up for this [longevity] thing. Outliving requires a new system, Medicine 3.0. And fortunately, much of that can be done with a manual. That’s what

this book is. This is a manual to help you think about how to eat, how to exercise, how to manage emotional health, and how to optimize sleep.

One of the things that I’ve always respected about you is your willingness to change your mind based on new data. As you were researching the book, was there anything that changed your thinking?

A lot, especially when you consider how long this book was in the making. This book started in 2016. From an editorial perspective, it came to a close in 2022. So, a little over six years of writing and rewriting. It would be hard for me to just tell you one thing, but I think the most profound change in my belief system, in the presence of new data, has been around the work in nutrition. My beliefs in nutrition have changed significantly. Six years ago, I believed that energy balance was not the most important parameter of food. Today, I think the data has been overwhelmingly convincing that energy balance is the first, second, and third-order term of health when it comes to food. Of course, other things matter. The quality of food matters, the balance of fatty acids matters. The nutrition chapter in this book is long for a reason. But the emphasis is orthogonal to where I started six years ago.

If you were to bottom line it, what is your current nutritional viewpoint: exercise and don’t eat too much?

It’s certainly more nuanced than that. When I’m looking at a person, I’m trying to understand three things immediately: are you over-nourished, or are you under-nourished? Are you under-muscled, or are you adequately muscled? And are you metabolically healthy or not? The answers to those three questions determine a nutrition and exercise strategy.

Within the nutrition arm of that, it’s basically going to come down to whether you need to increase, decrease, or maintain energy bal-

“I think that today, people are thinking at least as much, if not more, about healthspan than lifespan.”

ance. And what you need to do with respect to protein. That becomes a far more important question. Then, are you low carb? Are you low fat? Are you paleo? Are you vegan? All those questions become completely irrelevant in the context of the most important questions that pertain to overall energy balance—for example, things like visceral fat levels, muscle mass, and metabolic health.

You’re a surgeon by training and a medical doctor, you’ve also done some work for McKinsey. You have a very data-driven and systems-oriented approach to your work. If you could wave a wand and fix one thing about the U.S. healthcare system, what would it be?

Again, here’s a funny example of where my opinion has changed a lot. When I was at McKinsey, I would have had a different answer to this question because I would have been thinking about it through very specific silos that need improvement. I don’t know that there’s a single one that could fix anything in the U.S. healthcare system. It is that complicated. But I will say that a hybrid of the U.S. system and a single-payer system is probably an important first step.

If you move just to a pure singlepayer system, you’re going to increase coverage, that’s going to be fantastic. It’s an absolute abomination that there are people in this country that are going bankrupt because of under or lack of coverage altogether. In fact, I believe that healthcare is either the first or second leading driver of personal bankruptcy in the United States. That’s unacceptable. In the U.S., we have people using emergency rooms and things like that for primary care because they don’t have actual doctors. A single-payer system would fix that.

But a pure single-payer system is an abomination in and of itself. Just ask anybody who lives in the UK or Canada how badly that system

works. So, you do have to be able to layer on a second-tier system.

I’ll give you a very glib example. This is a true story about a friend who used to spend a reasonable amount of time in Saudi Arabia. He’s an ex-pat from the U.S. I was talking to him one day, and he mentioned that, unsurprisingly, he leaves Riyadh for four months during the summer because it’s unbearably hot.

I said, “Man, how hot is it when you come back to your apartment in October?” And he goes, “Oh, no, it’s like 66 degrees.” And I’m like, “how do you know that? That’s Fahrenheit? What

do you mean?” And he goes, “Oh, I leave the air conditioning on the whole summer.” And I was like, “you leave the air conditioning on for four months at 66 degrees? That must cost an insane amount of money.”

He goes, “No, no, the energy is subsidized. So it costs me like $20 for the whole summer.” And that’s part of the problem with the U.S. healthcare system. It is a total uncoupling of cost and risk.

Speaking of the U.S. healthcare system, Worth has a lot of high net worth individuals in our readership.

Chris Hemsworth and Peter Attia on Limitless

The current fashion is for executive physicals, which aren’t covered by insurance, but include a battery of tests, full body scans, etc. How much value do you see people getting out of those programs?

Well, I should disclose that I’m the co-founder of a company called Biograph. And while it doesn’t do “executive physicals,” it is kind of like The Four Seasons of diagnostics. It’s co-founded by me and one of my patients actually, and it grew out of a question that he posed to me, which was, “If you could have all of the best diagnostic stuff under one roof,… What would it look like? What MRI would you want to able to do for cancer screening, what VO2 max test, what DEXA scan?”

When you think about “a traditional executive physical” as something you would go and do at any of the big hospitals, they typically involve two days, sometimes one, but typically two days including a battery of tests that start with a physical exam, maybe an echocardiogram, maybe an MRI—but it’s usually some sort of nonspecific MRI—blood tests, sometimes genetic tests, things of that nature. Sometimes they’ll do cardiorespiratory testing, pulmonary function tests, and things like that. There have certainly been examples where those tests have found something that would have otherwise been missed. And so, I think there’s some value in that.

But in my experience, they haven’t yielded many benefits for two reasons. One, the tests that they’re doing aren’t necessarily the very best versions of those tests. And they’re not done with a systems-based approach. The second problem, and I think the far bigger problem, is that there is no implementation strategy. It is one thing if the executive comes in and does two days of wonderful tests. The tests say, “hey, look, your insulin resistant, your lipids are not ideal, your VO2 max is at the 50th percentile,” which by the way, they’re going to probably tell him is fine. We would

say that’s horrible your VO2 max must be in the top five percentile. But then that’s it. It’s like we’ll see you next year. The work, the real value is in how do you make those changes? How do you fix these things?

A lot of people will recognize you now from the show Limitless, where you’re the guy pushing actor Chris Hemsworth to the very limits of human capacity. (See page 87 for more.) Over the course of that show, you ran some genetic tests on him and gave him some potentially lifealtering news. Can you explain how you see the value of genetic tests like that?

I think that genetic tests, like whole genome sequencing, rarely have that much to offer beyond a great family history. That said, there are a handful of genes that we look for, and there are two genes that we care a lot about. One relates to neurodegenerative disease, specifically Alzheimer’s disease, but also to cardiovascular disease called ABO.

And another one is a gene called LPA. That codes for something called Lp(a), which is a pretty strong predictor of cardiovascular disease. The reason we think that it’s important to screen for those things is one, they’re quite prevalent, so you’re not looking for a needle in a haystack. And two— and this is the most important part—I believe that these conditions can be mitigated.

With the example with Chris, two weeks before we go on camera, I get his blood test back and realize that Chris has a pretty unusual gene. He has two copies of this very high risk APOE 4 gene that puts him in the one to two percent of the population that is at significantly higher risk for Alzheimer’s disease.

So I call Darren Aronofsky, who’s the director, very close friend. I didn’t know Chris well enough yet. But I said, look, we can’t do this live, we can’t film this live for the first time with Chris hearing us. I need at least one discussion with him beforehand. So we did

that. In Episode Five, it shows us going through this. And what I said then, and what I’ve said to many other patients in the same situation, is this is something we need to be working on. But it’s not, it’s not a fait accompli, not everyone who has this genetic pairing will go on to get Alzheimer’s disease. But there are a lot of things we need to be doing to act preventatively.

One of our features in this issue breaks down the six pillars of health: exercise, sleep, diet, stress, smoking, and social connections. Is there anything we missed?

I think the pharmacology side of it. There is an important role for pharmacotherapy here. I think that’s especially true in lipid management. Cardiovascular disease is the leading cause of death for men, and for women, in the United States and globally. It’s such a behemoth in terms of death, that we almost don’t pay attention to it. Cancer and Alzheimer’s disease get all the attention, but even together they don’t kill as many people as heart disease does. For every woman that dies of breast cancer, eight to 12 are going to die of heart disease. We just can’t lose sight of this thing.

There are really four things driving this disease that we can adjust. Modifiable risk factors include smoking, excercise, energy balance, and sleep.There are many people whose blood pressure can’t be controlled sufficiently with those things. and we have to medically manage the results. We just want to make sure we’re not losing sight of the fact that there’s an important world of pharmacotherapy here that can move the needle for people.

Very good. Well, Peter, all the rest of my questions are about archery and Formula One.

Perfect! Let’s have some fun.

Alas, that story will have to come in a future issue.

If Looks Could Kill

Body positivity advocates are trying to break up the toxic love affair between capitalism and beauty standards.

BY EVA CROUSE

Too tall, too short. Too skinny, too fat. Too skinny-fat, too muscular. Too flat, too round. And if you somehow manage to avoid all of those, the sneaky backhand: too basic. Whether we realize it or not, beauty standards and diet culture shape our conversations about health. Nutrition, mental health, exercise, and dietary supplements are all closely intertwined with the narrative around beauty. To consider them separate is a mistake.

More than 28.8 million Americans will suffer from an eating disorder in their lifetime, according to the National Association of Anorexia Nervosa and Associated Disorders. Of those, approximately 26 percent attempt suicide. This makes disordered eating one of the deadliest mental health issues in the country. Specific demographics are particularly susceptible to eating disorders, such as girls and women aged 6-25 and high school and college athletes.

Eating disorders are primarily associated with women because they make up the majority of the diagnoses and are the most vocal about the problem. But on average, one-third of people with eating disorders are men, and 25 percent of people diagnosed with anorexia nervosa are men. Many factors contribute to disordered eating, not least of which is our cultural rhetoric around body image.

You have probably noticed the nationwide conversation about body positivity. Celebrities like Rihanna, Jameela Jamil, JAX, Demi Lovato, Lizzo, Mindy Kaling, and so many others are fighting against the relentlessly inconsistent narrative of how our bodies are “supposed” to look. Instead, they are promoting a message of self-love—which, in essence, translates to relinquishing self-judgment about your appearance and appreciating your body exactly how it is.

For centuries, standards of beauty have shaped culture and behavior. And more recently, in the past 100 years or so, the diet industry has reinforced and profited from these standards. In 2022, the diet and weight loss market was valued at $175.44 billion and was “expected to grow at a CAGR of 8.50 percent between 2023 and 2028, reaching a value of $282.53 billion by 2028,” according to Expert Market Research.

Beauty standards are not a new concept, but the profitability model deployed across social media by the diet and weight loss industry is a relatively recent phenomenon—and it is having a profoundly negative impact on mental and physical health. Targeted advertising of diet products and influencer marketing, combined with practically inescapable exposure

to photoshopped and perfectly angled social media posts, has resulted in The Grand Illusion: The idea that you, the consumer, are drastically over (or under) weight, and unless you find a way to fit these standards, you cannot be considered attractive

Logic would dictate that some people must be regarded as the pinnacle of beauty, that someone must have reached the perfect fat-totoned ratio to satiate the beast of the public eye But this is not the case Even those widely considered the most beautiful women in the world publicly state that their images are photoshopped, that they have teams to make them look “perfect” before a public appearance, and that they, too, have struggled with insecurity and significant mental health issues. In a recent interview, Florence Pugh told Vogue, “From the moment you start growing thighs and bums and boobs and all of it, everything starts changing, and your relationship with food starts changing.” So, the question becomes, what are we striving for, and at what cost?

The answer is simple: money. The age-old business model of creating a problem in order to sell a solution lies at the heart of the diet and weight loss industry By creating an unattainable beauty standard, and then shaming consumers who do not fit that mold, the diet and the weight loss industry generate a problem that can be solved with their, and only their, solution The issue with this model is not that it makes money but that it does so by hurting consumers The good news is that this system is beginning to experience some pushback from powerful women determined to change the narrative

For example, let’s look at the lingerie industry. Savage x Fenty fought back against the unattainable beauty standard popularized by Victoria’s Secret with their 2018 launch of inclusive, body-positive lingerie. They sold out of their inventory in two months and, after just five years, are poised to become the leading lingerie brand by 2025, according to Culturebanx. Furthermore, Savage x Fenty experienced a 200 percent growth last year, compared to Victoria’s Secret’s consistently declining sales as they have fumbled to adjust to the cultural shift toward inclusivity. But Rihanna’s move didn’t just bury the leg-

endary lingerie brand in terms of revenue. It contributed to a massive shift away from the impossibly thin beauty standards endorsed and sustained by Victoria’s Secret. And four years after the launch of Savage x Fenty, this first step toward body positivity in a traditionally toxic space still reverberates in the omnipresent world of social media.

Victoria’s Secret, a single released by JAX in 2022, took social media by storm as the singersongwriter called out the infamous brand for perpetuating unattainable beauty standards that drive young girls to various forms of selfharm. If you haven’t already listened to the song, you should because it’s more than likely that your child has. The massive viewership of the original video, which featured JAX sitting in her car playing it for the young girl she babysits, prompted the company to respond with a statement apologizing for the harm caused by their brand in the past and promising to be more inclusive moving forward.

Similarly, actress Jameela Jamil is attacking corporations that are touting toxic messages and targeting them at young people. The selfproclaimed “annoying neighborhood watch,” Jamil has made it her business to loudly and publicly call out companies and celebrities pushing harmful products. One example is her retaliation against an Avon campaign that read, “dimples are cute on your face (not on your thighs).” Jamil clapped back on Twitter, saying, “And yet everyone has dimples on their thighs, I do, you do, and the clowns at @Avon_UK certainly do. Stop shaming women about age, gravity, and cellulite. They’re inevitable, completely normal things. To make us fear them and try to ‘fix’ them, is to literally set us up for failure.” Her retaliation was met with actual results. Avon responded with a public apology and a promise to “remove this messaging from [their] marketing materials moving forward.”

With hospitalization and even death on the line, the cost of encouraging young people to strive for an impossible standard of thinness is too great. Specific demographics are at a much higher risk of being negatively affected by social media campaigns conducted by the diet and weight loss industry. Because social media is such a central part of most adolescents’ lives, their level of exposure is exceedingly high. And it starts as early as elementary school. Accord-

ing to the National Eating Disorder Association (NEDA), “By age 6, girls especially start to express concerns about their weight or shape. 40-60 percent of elementary school girls (ages 6-12) are concerned about their weight or becoming too fat. This concern endures through life.”

Athletes are also particularly susceptible. According to NEDA, “35 percent of female and 10 percent of male college athletes were at risk for anorexia nervosa.” And “58 percent of female and 38 percent of male college athletes were at risk for bulimia nervosa.”

According to the National Library of Medicine, “A number of studies have examined the correlation between the use of mass media and body satisfaction, eating disorder symptomatology, and negative affect. The majority of the studies have demonstrated a direct relationship between media exposure and eating pathology, body dissatisfaction, and negative affect.” Furthermore, a meta-analysis of 25 controlled experiments evaluating the immediate effects of the “thin ideal” revealed that the “effect was stronger for…participants less than 19 years of age”(Groesz, Levine, & Murnen, 2002).

Marketing campaigns that shame people by playing off manufactured insecurities in order to sell a solution are not new. One hundred years ago, cigarettes (which suppress appetite due to the nicotine content) were advertised as a weight loss tool. Today, we see the exact same thing—only this time, it is the Kardashians promoting an appetite suppressing lollipop or a Flat Tummy Co. health shake, designed to reduce bloating (aka a laxative), on Instagram. We now know that cigarettes are one of the worst things for you, so tobacco companies can no longer get away with marketing their products as weight loss tools. But today, thousands of supposedly quick-fix weight loss solutions

with unknown health consequences are being targeted at the demographics most susceptible to eating disorders. And it’s working.

Even though the body-positivity movement has made great strides, the marketing campaigns for these weight loss solutions are shifting along with the cultural rhetoric. For example, Flat Tummy Co.’s most recent motto is “New year, new tummy. Look and feel your best.” With the simple addition of the word “feel,” this diet company can blend in with the self-care movement—the Trojan Horse concealing their outdated message. They aren’t telling you to lose weight to impress others; they are telling you to lose weight to feel better in your own body.

Some might be tempted to look at the body positivity movement and respond with concerns about maintaining a healthy weight. But those who do are missing the point of the body positivity movement altogether. Rampant obesity and the risk of diabetes are valid health concerns, but they are separate from this argument. For too long, people, and women in particular, have been systematically told that the way they look is incorrect. The body positivity movement isn’t about exchanging one judgment for another; it is about respecting the person regardless of what their body looks like. Because how they choose to treat and maintain their body is their business. A simple concept yes, but one that we, as a society, have struggled with for far too long and at too great a cost.

Although we have come a long way, the wily and wildly profitable diet and weight loss industries cannot be deterred so easily. They see and understand how powerful women like Rihanna, JAX, and Jameela Jamil are changing the dialogue around body image and beauty standards, and they are pivoting with that change. The motivation to adjust the conversation around body image comes from a concern for public mental health—because the cost of allowing eating disorders to be fueled by these industries seeking only to make a profit is too great. Supporting the body positivity movement is about so much more than the representation of curvy and plus-sized models. It’s about ending a century of exploiting peoples’ insecurities in order to make a buck.

“The body positivity movement isn’t about exchanging one judgment for another; it is about respecting the person regardless of what their body looks like.”

REST, RESTORE, RECHARGE

Work hard, play hard, and then take it easy at one of Worth’s favorite spa resorts.

BY KIRSTEN CLUTHE

Wellness vacations have become one of the fastest-growing trends in travel, and it’s no wonder—the pandemic fundamentally changed how we think about our health. Plus, the solitude of the lockdown caused anxiety and depression to spike worldwide. Hotels and resorts have responded with innovative new programs that address clients’ physical and mental needs, whether it’s a mindfulness treatment to relieve stress or diagnostic tests that help build a plan for lifelong longevity.

Worth has identified the best places to reboot your health, wellness, fitness, and even your palate in 2023. The choices for setting, treatment options, and activities are vast—from a secluded desert oasis to a Japanese-inspired wellness center. These resorts offer packages that promise to transform your health, your well-being, and your approach to life.

Read on to find the perfect spa for your wellness journey in 2023.

Amangiri

CANYON POINT, UT

Amangiri means “Peaceful Mountain,” a perfect moniker for this low-key but ultra-luxury retreat that’s become a favorite amongst A-listers. At the border of Utah & Arizona, Amangiri rests among five national parks, several national monuments, and the Navajo Nation Reservation, which inspires its wellness and culinary offerings. Spa journeys are designed to restore “hozho,” Navajo for “beauty, harmony, balance, and health.” Signature treatments offer comprehensive programs for all that ails— Grounding, for those seeking reconnection, stillness, and perspective; Purifying, for those seeking lightness, breathing space, and a fresh start; and Nourishing, for regeneration, recovery, and healing. Movement Journeys take you into the stunning desert landscape for restorative treatments, including hikes, yoga, and Pilates. Depending on time and desire, these programs can also include guided canyon tours and walks on one of their via ferrata trails, one of which ends on an iron climbing path designed to traverse difficult mountain landscapes and spans over a 400 ft. gorge.

The Wellhouse at Blackberry Farm

WALLAND, TN

Situated on a working farm surrounded by the Smoky Mountains, The Wellhouse at Blackberry Farm emphasizes the connection between the natural environment and the health of our bodies. Wellness programs are informed by the seasons, and ingredients for all treatments aim to utilize flowers, herbs, fruits, vegetables, and other healing elements from the farm and local area. Sign up for a Lavender and Vanilla Bourbon body drench, for example, or an Appalachian Body Purification scrub and mask created with ground coffee, sarsaparilla, honey, tobacco, and black silt clay. Understanding the ‘why’ behind their approach is essential, so Blackberry offers Learning Lectures to help guests understand more about healthy lifestyle choices. New treatments available include Deep Healing Woods Offering: Flower Essence Foraging Meditation, a forest bathing experience where guests learn about flower essences through trailside foraging on the way to their mountaintop wellness platform; and, Slowing Down and Tending the Spirit with Charlotte Hardwick: in a small group setting, Charlotte will offer meaningful and intentional practices to balance and nourish both mind and body.

Castle Hot Springs

MORRISTOWN, AZ

If the idea of soaking in a natural spring creek under the sun surrounded by the beauty of the desert sounds like the perfect way to spend your time, then Castle Hot Springs is the spa for you. The historic resort was once a retreat for Gilded Age A-listers like the Vanderbilts, Astors, and Rockefellers. It remains one of the top spas in the U.S. due to its main attraction—a network of mineral-rich, geothermically heated underwater streams that emerge into a succession of pools. Castle Hot Springs offers off-the-grid, immersive wellness experiences inspired by the unique elements of the surrounding desert. You can choose from one of their immersive wellness packages: Zen, Adventure, or Wellness Through Water—and the resort will build a custom itinerary based on your needs and desires. This May, they’re offering a Sleep Retreat—3 nights centered on reforming your sleep habits, which sounds positively dreamy.

Canyon Ranch Lenox

LENOX, MA

Located in a 19th-century manor nestled in the Berkshires, Canyon Ranch Lenox aims to give you the space, and the comfort, to focus on your well-being. When you book your stay, you are prompted to answer the question: “What Leads You Here?” Guests are encouraged to choose a “Pathway”— curated experiences based on wellness intentions. “Pathways Plus” includes medical-based immersive experiences, like an Executive Physical in which you work with an integrative physician to evaluate your body’s processes and develop a complete health profile and plan. All overnight stays include meals, access to spa and fitness classes, and resort activities like hiking, paddle boarding, tarot card readings, and more.

Fairmont Spa Century Plaza

LOS ANGELES

Can’t get away to a desert-island retreat? Let me introduce you to the Fairmont Spa, an urban retreat that was part of a $2.5 billion renovation of the storied Century Plaza Hotel in LA. This showpiece features the most modern wellness treatments, like “Biohacking,” a program that combines infrared technology, neuroscience, and compression therapy to improve sleep quality, reduce stress, and support mindfulness. Available as a 30-minute Power Nap or a more extended block of 60 or 90 minutes. The spa also features signature facial treatments by Dr. Rita Rakus, one of the leading medical professionals in the world of anti-aging.

Kohler Waters Spa KOHLER, WI

As the title (and brand) would indicate, the approach at Kohler Waters Spa is “health through water.” Located in the historic American Club in Kohler, WI, the spa offers a menu of hydrotherapy treatments like Glacier Springs, a full-body treatment that incorporates elements of warm and cold (including an ice massage!); Tranquil Tides, which begins with espresso body mud and ends with a magnesium-enriched bath; and a Stillness Bath, an “immersive journey of the senses.” The latter includes exfoliation, Vichy shower rinse, and moisturizer to promote better sleep and overall wellbeing. This April 21-23, they’re offering a Longevity and Wellness Retreat, a multi-day experience with a special culinary program, wellness plan, and fitness classes.

Shou Sugi Ban House

WATER MILL, NY

The first boutique wellness destination in the Hamptons, Shou Sugi Ban House, is a 13-room retreat that has been on ‘best of’ lists since its opening. Inspired by the principles of wabi-sabi and global wellness philosophies, the spa guides guests on a path to wholeness through reconnection to the natural world. You’ll find specialized treatments like Hydrotherapy Circuits—contrast water therapy alternating between hot, warm, and cold water, to boost circulation, immunity, circulatory and digestive systems; and Sound Therapy, a healthy vibration that results in beneficial cellular-level response and has been shown to reduce stress, anxiety, and insomnia. You can also take to the air with Floating Meditation. This is similar to aerial yoga in that you experience weightlessness through the support of aerial silks and hammocks, all while being guided through a meditation session. You’ll also find bodywork, beauty, and fitness programs, along with culinary offerings focusing on brain health, skin health, and nourishing your gut. Set in minimalist, Japanese-inspired buildings, Shou Sugi Ban House offers a place to reconnect with oneself immersed in the healing properties of nature.

Spa Solage CALISTOGA, CA

It would be remiss for us to skip a wine country spa, which has so many incredible places to choose from. Our current favorite is Spa Solage, which rests on 22 acres in the heart of Calistoga, an area blessed with geothermal pools, lowkey energy, and access to great wine. A retreat that can be experienced as a quiet solo getaway or as a shared experience with someone you love. Solage offers seasonal spa treatments, including the signature Mudslide treatment, which is a 3-part detoxifying treatment. Solange also offers mineral water therapies, a state-of-the-art fitness center with classes, and a yoga studio. Plus, guests can reserve Pelotons for their rooms, so you don’t fall behind on your training. Specialized treatments that might inspire you to bring a friend include the Starlight Nights Bathhouse Experience, an ultra-private retreat that consists of a Mudslide for two, a rose petal bath, candlelight, a bottle of sparkling wine, and chef’s bites.

The Ranch

MALIBU, CA

Healthy and balanced living through outdoor activities and appreciation of nature are the guiding principles for opening

The Ranch, an elite wellness retreat in Malibu, CA. Known for multi-day immersive health, weight loss, and fitness programs, Ranch activities include daily hikes, guided exercise, and locally sourced plant-based meals. And it’s intense—”no option” programs are a seven or 9-day commitment for a limited number of guests and include a 5:30 am wake-up call and 3-hour hikes, among other activities. The Ranch also runs a program in Italy and is expanding its footprint to the east coast with a new location just outside of New York City. The NY location will feature health programs that maintain the core elements of The Ranch—hiking, fitness, yoga, deep tissue, and a plant-based diet, but those can be experienced over three or four days and in varying intensities. The goal is to offer more options for people who may have been apprehensive to try the program; and, to accommodate the busy schedules of New Yorkers.

YO1 Yovan Longevity and Health Resort

MONTICELLO, NY

A residential wellness center located in the Southeastern Catskills of New York, YO1 boasts 66 therapy rooms, a range of recreational activities, and myriad options for a customized health program. Treatment plans for Anxiety Management, Pain Management, Cholesterol & Hypertension, Insomnia, and more are available, as well as a menu of Ayurvedic therapies that you won’t find anywhere else. YO1 was founded by Dr. Subhash Chandra as a place to practice self-healing, boost one’s immune system, and—let’s get real—drop bad habits. First-timers might want to book a stay that includes unlimited Yoga and Meditation sessions, with the breakfast package, to ease into YO1.

YO1 Is offering 25% off their Winter Wellness Package through March 31, 2023.

Worth It: Dream Home Workouts

Ten tools to help you optimize your health from the comfort of your home.

BY OLIVER RIST

As with most aspects of red-blooded American life, the pandemic stopped most people’s fitness routines cold by kicking exercise right where it hurts: the gym. Fortunately for gym owners, that’s easing up as people become less terrified of sweating near each other. But there will never be a 100 percent return to the gym because so many people have come to enjoy staying healthy at home.

COVID aside, the home workout has a lot going for it. It’s a much shorter drive, no one sees you huffing and puffing or breaking wind while stretching, and best of all, you get to shower in your own bathroom. You can build personal routines or follow one of the thousands of new workout videos available on streaming channels. They cover everything from getting your butt off the couch to advanced body sculpting. All you need is some fitness equipment.

That’s where this edition of Worth It comes in. Here you’ll find a list of ten tools to turn years of couch sag into the healthy body you know and need.

Peloton Row

You’ve no doubt heard the Peloton name, but probably only in conjunction with a very smart exercise bike. The Row is a newer device that applies the same style of workout to a rowing machine rather than a bicycle. It’s a different kind of workout and that might be very attractive to users who have become bored by the bike.

While the actual rower is pretty standard, what sets the device apart is the Peloton display. Just like the bike, the display accesses a subscription service with loads of available workouts from 10-minute introductory workouts to some really intense sessions focusing on strength or endurance. What’s nice is that just like other Peloton devices, the screen swivels, which means you can use it to show other kinds of workouts, like yoga classes or even meditation sessions.

The only downside is that you’ll need some space to use this device. The rower is over seven feet long and even though you can store it on a wall, that means drilling a hole so you can attach the dedicated mounting bracket. And even there, the device doesn’t fold up much, so its four-foot height still winds up taking significant floor space even when wall mounted.

That said, if you’ve got the floor space, the Peloton Row could be the perfect full and upper-body partner to the lower-body workout provided by your Peloton bike.

Apple Watch Ultra

Apple pulls to the top of fitness watches with an attractive new design and a slew of new features aimed at health, endurance, and outdoor activities in the new Apple Watch Ultra.

The Ultra’s aerospace-grade titanium case is practically bulletproof and a sapphire crystal protects the brightest Retina display Apple’s ever offered in a watch. Ultra also offers a low-power mode which can keep it ticking for multiple days, unlike its predessors.

The new Wayfinder face, made specifically for the Ultra, includes a compass and up to eight customizations that can sport features for workouts, waypoints, or GPS data.

Apple’s new watchOS 9 also has a load of new features, including new running metrics, workout views, and a new wind noise-reduction algorithm for clearer sound on the go.

These new features combined with three new watch bands explicitly aimed at any endurance athlete, makes the Apple Watch Ultra the new standard in wearable tech.

Hock Diskus Dumbbell Set

The Hock Diskus dumbbell set may represent the pinnacle of home gym fixtures. With it, you get six pairs of steel dumbbells with weights ranging from 4 to 18kg (about 8 to 40 pounds), but you can buy other weights for the set. It comes in either metric or U.S. pound designations.

The weights rest on a sturdy, attractive stand made from sustainably-grown and highly polished walnut. That stand also has specially crafted holders Hock has dubbed “Safeglides” designed so you can remove and replace the weights without accidentally crushing your fingers

Heybike Tyson

If you’re thinking about getting back into cycling after a lengthy sojourn on your couch, you might be worried about suddenly clutching your chest while pedaling uphill. One of the best ways to make sure that doesn’t happen is by starting out with an e-bike. And one of your best options was just introduced at CES 2023, the Heybike Tyson.

Unlike many other e-bikes that skimp on solidity and ride comfort, the Tyson is a full-suspension bike built on a light, one-piece magnesium alloy frame. Tyson says this unibody construction is a first in the folding e-bike category, increasing both durability and longevity, both of which are known problems for current e-bike entries. The Tyson’s spokeless wheels hide a powerful 750-watt electric motor with seven gears, which should make daunting hills a lot easier. As with most e-bikes, you control the motor with a thumb throttle and Heybike claims the Tyson will let you range for 55 miles on a single charge.

Heybike also touts Tyson’s hydraulic disc brakes, a great feature for when you spot that Starbucks on the corner and want to quick-stop for a coffee. And once you gasp your way home, you can fold the Tyson for easier storage. If you’re worried about it getting stolen while you’re drinking your latte, you can stop since its GPS tracking tech also works as an anti-theft device by sending you push notifications when the bike moves anywhere from 10 to 50 meters (your choice).

Lululemon Studio

Thanks to the COVID-induced home fitness movement, we now have the Studio. Originally known as MIRROR, before it was acquired by Lululemon. The Studio is a device that combines online connectivity with an expansive high-def display to give a unique in-home fitness experience.

The Studio is fairly compact, measuring 56 by 22.4 inches and weighing in at 70 pounds. You can mount it on the wall or rest it on the included stand. But the magic starts when you connect your Studio to the internet and gain access to its over 10,000 live or recorded classes through a subscription.

Bluetooth connection lets your Studio talk to your other devices to track your heart rate and workout intensity. Through the mobile app, you can take classes while on the road and share your subscription with up to six people. For music, there’s an internal playlist feature, or you can sync up your own through Spotify or Apple Music.

Since it’s narrow, it’s probably one of the most space-efficient, at-home exercise options. While the subscription means an ongoing cost rather than a one-time charge, you can’t deny the value and supreme flexibility it provides. And if you don’t like it, you’ve got 30 days to send it back.

Technogym Skillmill

The Skillmill is to a standard treadmill as a 2023 S-class is to a 2000 Corolla. If you want a serious workout, and have the space, these things rock. You’ll pay more, but Technogym has made that price bump worth it with new features and a design that you won’t get with other treadmills.

For one thing, it’s not motorized. You’ll power the Skillmill yourself, which means it auto-adjusts to whatever pace you’re comfortable with, though there’s also a single resistance dial for more customization. So right out of the gate, you’re more engaged with the Skillmill than a standard treadmill since you need to pay attention to your pace to keep the machine moving.

The curved shape of the platform is also very different from a standard, flat treadmill, and that’s also by design. Because it’s curved, you’ll run more naturally and consistently, meaning you can’t get away with sloppy shuffling while you check your texts. And even better, you’re not restricted to simply running. Add handlebars or straps and you can use the Skillmill for resistance pulls or sled pushes in addition to your morning jog.

A small display comes standard with the Skillmill and shows your primary workout data—how fast you’re going, how long you’ve been running, how far you’ve gone, and your heart rate if you’ve got a compatible Bluetooth device. You’ll get some more features if you use the mobile app, which has an indepth performance tracker and gives you access to both canned and custom workout routines.

If you’re looking for a serious and flexible workout partner, you’ll find it with the Skillmill.

Withings U-Scan At-Home Urine Analysis Device

Okay, this one isn’t an exercise entry, but it’s certainly one of the most innovative wellness products you can find. Introduced at this year’s CES show, the U-Scan urine analysis device does exactly what it says, namely, test your pee. But unlike your doctor who’ll do it once a year at your annual physical, the Withings device will do it every time you go to the toilet. That means you’ll get an immediate and wide-spectrum analysis of a long list of health markers on a constant basis and in the privacy of your home.

The solution is based on a replaceable smart cartridge that mounts inside your toilet, an easy process. Once it’s in there, it sends data to a mobile app and that data is both vast and customizable. A standard cartridge will measure up to 100 markers for up to three months using the Withings app. And those markers can be customized depending on what you need.

For example, women can use it to track hormonal fluctuations. Both sexes can use it to track nutrition and hydration and the app will even provide suggested recipes to help improve these markers if they’re below average. Withings is also promising a cartridge for healthcare professionals, so one day your doctor might prescribe a U-Scan and be able to track even more detailed health data without you ever needing to leave home.

But while the Withings U-Scan was shown at this year’s CES, it’s still not available in the U.S. since it’s pending FDA approval. The company says this process is well on its way, however, and is promising a U.S. launch in the second half of 2023.

LOVA kettlebells from Pent Fitness

If you’re looking for a complete workout, you’ll want kettlebells. Though they’re classed as free weights, kettlebells have a spherical shape with a top-mount handle. That means a different lifting motion with the weight more evenly dispersed between each side if you’re lifting it with two hands. With a kettlebell, you can access a broader spectrum of motions, including swings and routines that isolate different muscle groups than dumbbells.

If all that sounds attractive, then just like Hock’s dumbbell set, LOVA kettlebells from Pent Fitness represent the highest and most luxurious end of this equipment category. Unlike standard kettlebells, which tend to be all metal and painted in a pretty hideous matte black, LOVA kettlebells are constructed from steel and welloiled

American walnut, which means they feel nicer to the touch and look better in the den. They come with a standard wooden platform (also walnut), though these hold only individual kettlebells. So if you need more than one, you’ll want to look at one of several optional stands that can hold between four and eight kettlebells each.

And if you like that steel-and-walnut look, know that the company also makes other, equally attractive, matching exercise equipment including jump ropes and fitness mats, so you can build a very pretty home gym from a single manufacturer.

WalkingPad X21 Double-Fold Treadmill

The WalkingPad X21 was one of the most popular exercise devices displayed at this year’s CES show. It garnered popularity because it folds, making it the most space-efficient treadmill on the market. And it doesn’t just fold once; it folds twice. First, on the horizontal axis to reduce the size of the actual treadmill, but then on the vertical so it can be stored either stood-up or easily slid under a bed.

But it’s not just compact; it’s smart, even by advanced treadmill standards. A single knob on the central crossbar lets you control speed and resistance. NFC intelligent sensors let you connect to various devices to track your fitness data in realtime. There’s also a phone rest on the crossbar so you can follow your tracking info or watch online workout videos.

You can get other WalkingPads, which are differentiated mainly by their top speed, but the X21 is the top of the line because of its double-fold feature and top speed of 7.4mph. Finally, there are several accessories you can get, the neatest of which is a height-adjustable desk so you can walk and work simultaneously.

Tonal

If you need a total home gym in one device and have the budget, check out Tonal. At first glance, it looks like a slightly different version of the lululemon Studio, and that’s an accurate assessment—for the most part.

But, the Tonal has a few things you won’t find with the Studio. For one, it comes with two pull arms that provide up to 200 lbs of resistance. These work independently or in sync with specific onscreen workout routines. But the sexy feature is Tonal’s use of artificial intelligence (AI).

The AI uses 17 different sensors built into the Tonal that give insight into your strength levels, form, and range of motion, providing real-time feedback while learning. The AI tracks everything from what resistance you should be using (including upping it if it feels you’re ready) to how many reps you should do.

The display and the monthly subscription give access to a wide array of classes but also let you opt for individual coach-guided workouts or partner workouts if you’ve got a friend that also has a Tonal. There are also several accessories you can buy, like a pull-down bar, weight bench, ankle straps, and handles. Some of these are Bluetooth enabled so you can turn the digital weight feature on or off with the press of a button.

You’ll need WiFi to work the Tonal, which is true for the Studio and most similar devices. But you’ll also need professional installation with this one, which some won’t need with the Studio.

FORECAST

The End Is Not Nigh

In this month’s Forecast section, our analysts dig into the latest economic numbers to discover the impending recession may not be all it is cracked up to be. In fact, we may already be past it. We also have fresh insights into new retirement regulations that you won’t want to miss. To get weekly financial updates, sign up for our newsletter at worth.com/newsletters.

2023 Will Be Better Than People Think

Recession fears loom, but this slowdown is already much less painful than normal.

BY LARRY KANTOR AND BOB DIAMOND

Arecession hitting in 2023 is the consensus thought these days. That is no surprise, given that last year delivered the highest inflation rate, the most monetary tightening in four decades, and an inverted yield curve. However, if this slow-down is designated as a recession, it is already upon us and has been underway for many months. Moreover, it will likely end up as one of the mildest downturns on record. Recessions are typically generated by sharp declines in interest-ratesensitive sectors such as housing and manufactured goods, and we have been experiencing that for quite some time.

• Housing is clearly in a recession that began almost a year ago. Mortgage rates more than doubled, and home sales have declined for 11 consecutive months, amounting to a cumulative drop of nearly 40 percent. House prices and rents have been falling since last summer.

• Consumer spending on goods in real (inflation-adjusted) terms peaked in mid-2021 following a surge when many activities, such as travel and going out to restaurants were off-limits, and people were spending a lot more time at home. The decline accelerated toward the end of last year following consumers re-engaging in those services and a massive rise in interest rates. Retail sales in November and December plunged at a double-digit annual pace, forcing retailers to discount items to rid themselves of excess inventories, table expansion plans, and reduce their workforce.

That is what happens during recessions. The technology sector is also contracting following a COVID-induced boom in demand for tech services such as online buying and food delivery, streaming movies and shows, remote work, and video conferencing. Like in the retail industry, tech companies expanded their capacity to a level that turned out to be excessive. Typically, all of that would be enough to crash the economy, but the COVID experience delivered several unusual developments that have allowed the economy to hold up unusually well:

• A combination of factors—including early retirements, less immigration, people either sick or caring for someone who is, and a dearth of childcare services— produced a massive shortage of labor. Job openings peaked at a record 11.5 million, and there are currently 11 million openings compared with less than 6 million

people unemployed. That has allowed the economy to continue generating job growth even as labor demand weakens. As a result, household income isn’t getting hit as hard as it usually does, thus mitigating the spread from the cyclical sectors to the rest of the economy.

• Household and business balance sheets have remained relatively healthy, supported by colossal income and wealth gains generated by unprecedented monetary and fiscal stimulus. Households were able to build up a vast stock of excess savings that they are still digging into to support spending. In addition, consumers and businesses did not take on excessive leverage and debt to the degree usually seen in the latter stages of economic recoveries.

• Energy and other commodity prices have fallen sharply, contrary to the experience during the significant inflation of the 1970s and early 80s. The decline in gasoline and natural gas prices has boosted household purchasing power, while sharp drops in lumber and steel prices have helped keep production costs under control.

The path of the economy going forward will be determined largely by the future path of inflation and how central banks respond to it. Fed tightening is working: the cyclical sectors are getting clobbered, and most asset prices—including stock and bond prices—have fallen significantly. Most important, inflation has decelerated at an extraordinarily rapid pace.

The oft-quoted year-on-year deceleration does not capture the true extent to which inflation has collapsed in recent months.

• While headline CPI decreased from over 9 percent in June to 6.5 percent in December, overall

prices have been flat for the past two months (i.e., zero headline inflation).

• Much of the recent weakness in inflation is indeed due to the sharp drop in energy prices, which can’t be counted on to continue.

• That said, core (excluding food and energy) inflation—the Fed’s focus —has also decelerated impressively. Core CPI has been running at an annual rate of only 3.1 percent over the past three months, while the core PCE— a different measure of

inflation that the Fed officially targets—was up 2.9 percent, already coming close to the Fed’s objective of 2 percent.

• Even more encouraging is that it is likely to slow even further. Shelter costs—which account for over 40 percent of core inflation—ran at an annual rate of over 9 percent during this same period but will almost surely decelerate significantly. Federal housing agencies, brokerage listing services, and other private data sources show that house prices and rents have fallen since last

summer. This will be captured eventually in the official inflation data, which uses an average of rents over the previous six months to estimate monthly changes in shelter costs.

With that kind of progress on inflation already having occurred and more likely in the pipeline, the Fed hiking regime should be close to an end. Market pricing suggests that the Fed will complete this hiking cycle by the spring with a Fed funds rate of under 5 percent, which seems reasonable. But market expectations of rate cuts in the year’s second half will probably not be realized.

• The cyclical sectors of the economy are close to a bottom, making a significant further deterioration in the economy later this year unlikely.

• On the contrary, a bounce in the economy beginning in the spring or summer seems more probable than a more pronounced weakness. If the recent drops in mortgage rates and house prices are maintained, a pickup in sales sometime later this year would not be surprising. Meanwhile, excess inventories in the retail industry will probably be eliminated in a few months.

• While inflation is coming down to reasonable levels much more quickly than expected, the Fed will want to ensure that it stays that way and doesn’t pick up again.

All of this has implications for the financial markets. Current stock prices seem broadly consistent with a very mild economic downturn, as the cumulative decline since the beginning of last year is significant but less than the typical recession. The S&P fell almost 20 percent last year after a 27 percent surge in 2021. It’s up thus far this year for a net peakto-trough decline of around 15 percent. That compares with a mean drop in the S&P during recessions of 29 percent. That said, it seems too early to be overly bullish.

• Most valuation measures suggest that stocks are not cheap, and a robust economic rebound anytime soon seems unlikely.

• In addition, profit margins have peaked, and bond yields are likely to remain considerably higher than they were a few of years ago.

Bond yields are naturally trending higher than before the

pandemic, which is consistent with the surge in inflation and higher Fed policy rates. The yield on 10-year U.S. Treasuries is currently at the bottom of the 3.5-4.25 percent range they’ve been in since the fall. While that is well above the 1.5-3 percent range that persisted for a decade before COVID, the change in economic fundamentals since the pandemic suggests that bond yields are likely to end up closer to the top end of that range or even a bit above it.

• The U.S. budget deficit is significantly larger, and the Fed will not resume buying bonds again for the foreseeable future.

• Zero policy rates are a thing of the past.

• While inflation is on a significant downtrend, structural changes suggest it will not settle as low as pre-pandemic when inflation was often below the Fed’s target of 2 percent. International trade is no longer trending up, and companies no longer use cost as the sole factor in deciding where to produce or buy inputs. Instead, they are diversifying their supply chains and placing more emphasis on reliability and safety.

The U.S. is not the only country where economic prospects outperform consensus forecasts.

• China’s sharp reversal of its zeroCOVID policy, setting the stage for a rebound from an unusually slow period of growth.

• The outlook for Europe has also brightened considerably, as energy shortages resulting from the war in Ukraine have been much less severe than had been feared. The weather has been warmer than anticipated, and countries have been able to build oil and gas stockpiles from non-Russian sources. As a result, natural gas prices have fallen back to below pre-Russian-invasion levels, a very positive surprise. The deep recession that many forecasters have been expecting for the Euro area no longer looks likely.

The bottom line is that 2023 doesn’t look nearly as bleak as consensus economic forecasts and recent financial news reports suggest. The inflation surge is evaporating quickly, Fed rate hikes are near an end, and a recession—if it ends up being designated as such—is already here and is much less painful than usual.

But It Is Falling Fast

U.S. Bureau of Labor Statistics

MBA Programs Must Adapt to Navigate American Culture Wars

America’s top business schools need to account for the pressures that politics and culture wars place on corporate decision-making.

BY ARICK WIERSON AND BRADLEY HONAN

Just when the battle between Florida Governor Ron DeSantis and The Walt Disney Company over the state’s “Don’t Say Gay Law” concluded, another global brand–this time sportswear juggernaut Adidas–found itself captured by controversy. The German company was forced to part ways with hip hop megastar Kanye West over antisemitic comments that set Hollywood and social media on fire and led other major brands, such as The Gap and Balenciaga, to break with the rapper. This was undoubtedly a challenging decision for Adidas’ executives; the Yeezy brand, a collaboration between Ye and Adidas, had an estimated $2 billion yearly topline impact–nearly ten percent of the company’s annual revenue. Adidas has indicated that the split cost the company almost $250 million in income last year.

The economic significance of the fallout from the Yeezy debacle is undoubtedly the main reason those company executives stalled for weeks amidst mounting public pressure to drop its association with West. But in the end, principle beats profits. Adidas “does not tolerate antisemitism and any other sort of hate speech.” the company said in a media statement. “Ye’s recent comments and actions have been unacceptable, hateful, and dangerous.”

What course at Harvard, Stanford, INSEAD, or any other top business school, could have prepared Adidas executives to make such a weighty decision?

Given today’s politically polarizing landscape, it seems unimaginable that no prominent MBA program in the U.S. has required coursework on how politics and media shape the business environment. Few, in fact, even have courses on politics, media, and public relations offered as electives.

BIG BLIND SPOT

Of course, there are a handful of students every year who graduate with dual master’s degrees, pairing an MBA with a degree in public policy, urban planning, or related social science. But most of America’s newly minted MBAs graduate with little to no appreciation for how government policy impacts the economic climate or political winds.

And that’s a big problem.

“It’s a big blind spot not only in the C-Suite and board room but even in academia–especially in the country’s top MBA programs,” said former CNN anchor Rick Sanchez, now a communications consultant for CEOs of several Fortune 500 companies. “Business schools aren’t teaching the next generation of leaders about the real-life push and pull of operating in an increasingly politicized and polarized operating environment.”

Casual observers of both the DeSantis vs. Disney blow-up and the breakup between Ye and Adidas might chalk those incidents up as outliers. But across the board, politics and cultural wars are crossing the paths of the world’s largest corporations. Politics is now front and center in corporate decision-making, and CEOs are grossly underprepared to deal with the effects of this collision.

“As anyone who has served as an executive at a Fortune 1000 company knows all too well, government and the ebbing and waning of its policies have more impact on your bottom line than all of your competitors put together,” said Leila Aridi Afas, director of Global Public Policy at Toyota. “But in recent years, a new, separate vector has emerged that is distinct from public policy. Now raw geopolitics is gnawing at the seams of big business. New MBAs must be prepared for this new business reality— they must understand world history, geography, and policy-making. Many business school graduates don’t understand how the government works and functions, even at a basic level.”

POLITICS IN BUSINESS IS NOT NEW

The conflict between politics and big business has been smoldering for at least a decade. In 2015, there was a dust-up between Salesforce and then-Indiana Governor Mike Pence over legislation that many saw as decidedly anti-gay. With nearly 3,000 employees in the state, Benioff threatened to sanction the state of Indiana if the measure became law. “CEOs are very much the advocates of their customers and employees, as well as of the environment and local communities,” Benioff said after forcing Pence to tone down his proposal. “The most successful CEOs today are advocates for their stakeholders, not just their shareholders.”

Taking on the governor marked a bold move by Benioff, and it was no doubt a risky move. The costs of uprooting the Salesforce business and moving it out of Indiana would have been costly, but Pence blinked first. Benioff had sent a clear message to Republican governors around the country. More importantly, he communicated to his most important stakeholders—his employees—that Salesforce would go to bat for LGBTQ rights. By taking the lead, Salesforce also paved the way for other CEOs with a footprint in Indiana—from Apple to NASCAR—to take similar positions.

Benioff didn’t learn how to deal with the issue in Indiana from a textbook and certainly not from a vaunted MBA class—in fact, the billionaire founder never went beyond a bachelor’s degree in his studies. Governors and other elected politicians on both sides of the aisle are playing footsie with culture wars and putting businesses in seemingly no-win situations. As CEOs peer out from their corner offices at the rest of the C-Suite, they find that generally, no one on their leadership teams has the requisite skill set to navigate these uncharted waters. The groupthink for most C-level executives is to keep out of politics at all costs—a safe theory but hardly a tactical move when these issues are already at the gate.

“I hope that MBA programs, especially the top MBA programs that are developing new generations of corporate leaders, will include this important skillset in their core curricula,” said Gary Sheffer, former head of Communications at G.E. “But it’s a huge blind spot that needs to be addressed. MBA students need exposure to grey issues at the crossroads of corporate strategy, political acuity, and public relations.”

Harvard’s MBA program does not have any required courses dedicated to preparing future corporate leaders for a politically-fraught business environment. Stanford’s MBA program allows interested students to engage in politics outside the core curriculum. Even the MBA program at Georgetown University—often considered the premier school in the country for all things political—has not one course (including electives)—that appears to address this suite of issues related to political navigation and corporate stewardship.

“If leading MBA schools don’t start teaching public affairs as a key business strategy—and our recent study shows that half don’t—many companies will find their future leaders aren’t prepared to deal with a tough political environment,” observed Doug Pinkham, president of the non-partisan, Washington, DC-based Public Affairs Council. “Domestic and global issues are getting more challenging, not less challenging. And that means more proposed regulations, scrutiny of big corporations, and greater expectations for companies to serve the public interest.”

COLUMBIA’S MBA PROGRAM: A GLIMPSE INTO THE FUTURE

Columbia University has made a concerted effort to introduce curricula over the past decade that leans into the politics of business. “Business and politics have long been intertwined,” commented Dan Wang, the Lambert Family Associate Professor of Social Enterprise and Faculty Co-Director of the Tamer Center for Social Enterprise at Columbia Business School. “Course-

work on Corporate Strategy used to be very much finance-focused, but here at Columbia, we have added non-quantifiable issues to the mix. We want our students to learn how business decisions are connected to the spillovers from and back into society.”

“Are current corporate leaders prepared to make these hard decisions? Decidedly not; most don’t have the requisite tool kit or framework,” added Wang, who teaches two courses, ‘Business in Society’ and ‘Executive Ethics’ to MBA and Executive MBA students at Columbia. “For example, we have looked at what CEOs say about social issues or post on social media, and it’s generally all over the place. They show a certain disconnect from where society is on any given issue. CEOs trained 20, 30 years ago never had this curriculum—they never had this training.”

The Disney situation with DeSantis was a preview of what will likely become a more frequent collision course between businesses and politicians. And it will not come just from elected officials; the Supreme Court’s reversal of Roe v. Wade has thrust countless companies into uncomfortable territory as their stakeholders demand certain protections at odds with local and state laws. Many of America’s most powerful tech companies— Tesla, Amazon, Apple, and Microsoft, to name a few—moved swiftly to provide additional benefits to employees living in states where abortion laws are already being clawed back.

Current MBA students gazing out at the business world they will soon be joining no doubt wish they had been allowed to add these valuable political tools to the toolkit they will be taking into the job market.

“Politics used to be something that was mostly on the periphery of a CEO’s field of vision—now it can sometimes appear front and center in the company’s business,” explains BUC Berkley’s Budak, “As educators, we need to develop new curricula for MBA students that will help them learn to navigate these new and complex challenges.”

Fiscal Justice Investing is Changing the Municipal Bond Market

BY ANDREA RIQUIER

Government bonds have long been synonymous with public spirit. During World War I, Hollywood celebrities like Charlie Chaplin and Ethel Barrymore promoted “Liberty Bonds” to raise funds for U.S. military efforts. In the decades after the war, an irrepressible Wall Street salesman named Jim Lebenthal coined the phrase “Built By Bonds” to popularize buying local-government debt for public works projects.

A new generation of investors is imbuing that traditional sense of purpose with an awareness of those underserved in American communities and markets. The “fiscal justice” investing strategies they’re developing subvert the existing municipal bond market and use it to alleviate some of the inequities in American society.

Fiscal justice strategies are still new and haven’t yet been packaged into a product that retail—or even institutional—investors can put money into. But the idea is gaining currency among all players, including foundations, academics, and impact investors, and may represent the next wave of socially responsible money management.

“A municipal bond is an IOU from a city government,” said Chelsea McDaniel, a senior fellow with a research firm called Activest, in an interview with Worth “They were created to be impact bonds long before we thought

of them that way. The proceeds should go to equitable outcomes for schools, roads, transportation, public safety, which may not include policing, and economic development that supports small businesses and good jobs.”

Several municipal market veterans founded Activest in the wake of the violence in Ferguson, Missouri, after police killed Michael Brown. The group spent several years trying to determine whether there was a connection between the experiences of Black residents and the fiscal practices of the municipalities where they live.

Over time, that work expanded to look at how communities access the capital markets and, in McDaniel’s words, “whether that capital goes to things that benefit Black residents or lead to further disparities.”

When Activest began its work, McDaniel said, cities like Ferguson, which got its revenue from fines and fees levied on its residents,

were seen as outliers. Activest documented examples of “taxation by citation” around the country, proving that cities achieved more substantial fiscal outcomes when they prioritized the well-being of their most marginalized residents. Wharton School researchers later replicated those findings.

Meanwhile, other research documented the existence of structural inequities in the municipal bond market. Put simply, communities with higher concentrations of Black residents pay higher borrowing costs, all else equal. The phenomenon, often referred to as the “Black Tax,” troubles many municipal-market participants, who see it not only as living proof of structural racism but an insidious Catch-22 that penalizes the very communities that need capital the most.

San Francisco-based Adasina Social Capital may have been the ideal investor to put Activest’s research to work. The company calls itself a “bridge between social justice movements and financial markets.”

“We believe that spreading wealth more equitably among the population will make a more stable country and economy, and that is better for all of us,” said Maya Philipson, Adasina’s co-founder. “People are very impacted by the financial health of their municipalities, and that is a great way to start looking at the systemic racism that goes into the racial wealth divide.”

A new generation of investors is imbuing that traditional sense of purpose with an awareness of those who have been historically underserved.

“Cities achieved more substantial fiscal outcomes when they prioritized the wellbeing of their most marginalized residents.”

Adasina collaborated with Activest for a fiscal justice municipal market pilot project in 2022. With funds from the Robert Wood Johnson Foundation and other philanthropies, Adasina bought $50 million of muni bonds from various issuers—local-government entities like cities and school districts—with predominantly Black populations.

The project had mixed results. In part, it was intended to test out the process, to get investors like Adasina familiar with the quirky, opaque municipal bond market. In that sense, it succeeded. But it was less successful in making a dent in the black tax because of the small amount of money deployed versus the enormous scope of the problem.

And the project never answered a critical question that the participants had wrestled with for months: to what extent can passive investors hope to have an impact? Was it enough to buy bonds, in other words, or would they have to become muni-bond vigilantes?

“Are there bondholders that could be engaged with this information?” McDaniel wondered. “Can we encourage them to demand

more accountability and transparency with issuers?”

Eric Glass, who in 2022 left a long-held job running AllianceBernstein’s municipal impact fund, thinks the answer is an emphatic yes.

“It’s one thing to make an investment, but it’s another thing to use the leverage you have as an investor to expedite the change that the community wants,” he said in an interview. Glass’ goal, he says, is to partner with underserved communities “to expedite and to speed up the change so that we reverse decades, if not centuries, of disinvestment.”

Glass is now working on developing his fiscal justice investment strategy. He says, “incredible demand from endowments, foundations, public pensions, and others around investing in a way that aligns with their mission.”

That doesn’t even include retail investors, who may be just as hungry for such an offering. When The New York Times ran an article about one of Activest’s founders with a mention of the fiscal justice project, Adasina was swamped with inquiries.

Vance Barse, a registered investment advisor based in San Diego, has a roster of clients who’d sign up in a heartbeat—and at least one who’s tried to develop a similar strategy on her own. The woman, now in her eighties, is a “rags to riches” story, Barse said and has invested extensively in finely targeted areas near where she grew up.

A strategy developed by fiscal justice practitioners “would allow people to manifest their well intentioned investment decisions. You’re able to deploy capital to serve a purpose but also get some level of return,” Barse said. “The conversations that I have with (clients) are really about the impact, how do we change the situation? This is a way to achieve multiple objectives simultaneously for the well-intentioned investor.”

Activest hopes to be able to offer an investment product that would allow people like Barse’s client to funnel money to underserved communities while, ideally, also addressing some of the structural issues in the market. “We do not have the municipal market we dream of,” McDaniel said.

The Biggest Retirement Legislation in Our Lifetimes

BY PAM KRUEGER

Last year’s combination of inflation, economic uncertainty, tanking stock, and bond markets threw a wrench into millions of Americans’ retirement plans. Fortunately, the omnibus spending bill passed by Congress and signed by President Biden at the end of 2022 includes a list of more than 90 provisions bundled under the Securing a Strong Retirement Act of 2022, otherwise known as SECURE 2.0.

The new Act, an upgrade of the original SECURE Act of 2019, will revolutionize how millions of Americans of all ages and income levels save and plan for retirement. But savers aren’t the only ones who will benefit from this valuable package of incentives. If you’re retired, SECURE 2.0 also offers attractive features that may help you shield money you take out of your IRA and 401(k) plan accounts from taxes, both now and later.

How will SECURE 2.0 affect you personally? That depends on many factors, and you may want to meet with a fee-only fiduciary financial advisor who’s up to speed on all these changes before you take advantage of them. If you or your adult children are struggling to pay off student loans and build a retirement nest egg at the same time, these new retirement rules will help. One game-changing perk will let some college graduates shift leftover money earmarked for education to their Roth IRA. For now, let’s take a closer look at a few critical retirement-related situations where SECURE 2.0’s key features offer the biggest bang for the benefit buck.

YOU’RE PLAYING CATCH-UP WITH YOUR RETIREMENT SAVINGS

Goldman Sachs research shows that 49 percent of women said they weren’t saving enough for retirement, compared to 35 percent of men. This makes sense, even if it’s not fair. After all, many women took a break from their careers to care for their children, particularly during COVID-19. During these lost years, they missed out on making their own contributions, receiving employer matching and profit-sharing contributions, and the compounding benefits of a stock market that posted positive returns in 14 of the past 22 years–including 11 where returns exceeded 10 percent.

Fortunately, the IRS raised the maximum 401(k) and IRA contribution limits over the past few years. SECURE 2.0 will let you save even more, especially if you’re over 50 and can afford to make significant contributions. In 2023, you can make regular contributions of $22,500, plus up to $6,500 in additional catch-up contributions to your 401(k) plan. Additionally, IRA investors can contribute up to $6,500 plus $1,000 more in catch-ups. Starting in 2024, IRA catch-ups, which haven’t changed since 2006, will now adjust annually for inflation.

You’ll get the biggest catchup benefits if you’re age 60, 61, 62 or 63 in 2025 and still making 401(k) contributions. During those “super-saver” years, you can turbo-charge your catch-up contributions, up to $10,000 or 150 percent of whatever the standard catchup contribution limit was the year before—whichever is higher.

IF YOU’RE HIGHLY PAID, THERE’S A BIG CATCH.

Starting in 2024, if you’re making more than $145,000 per year, SECURE 2.0 will require all of your 401(k) catch-up contributions to be after-tax Roth contributions. (Note: These same rules apply to Roth accounts in 403(b) and 457(b) plans.)

The good news? This income threshold only applies to W-2 income you earn from your current employer. Any money you earn from freelance or gig work doesn’t count. This new rule softens the blow by giving you a couple of perks:

n All Roth 401(k) withdrawals are tax-free, even if you roll them over into a Roth IRA.

n Starting this year, you can choose to have some or all of your employer’s matching or profit-sharing contributions made as after-tax Roth contributions.

n Starting in 2024, you’ll never have to take the Required Minimum Distribution (RMDs) from your Roth 401(k) accounts while you’re alive.

YOU—OR YOUR KIDS—HAVE LEFTOVER 529 COLLEGE SAVINGS PLAN MONEY

If you—or your children—are done with college and haven’t withdrawn all the money in your 529 College Savings Plan account, you may be able to roll over up to a lifetime total of $35,000 tax-andpenalty-free to a Roth IRA starting in 2024.

However, certain conditions must be met. First, the 529 plan must have been established for at least 15 years before the rollover can occur. Then, you (or your children) must be the authorized beneficiary of the 529 plan you intend to roll over and the account owner of the Roth IRA. The amount you roll over each year counts toward your annual Roth IRA contribution and can’t exceed the yearly limit for that year. And finally, you can’t roll over contributions you’ve made (or any earnings) over the five years preceding a rollover.

There are still many gray areas surrounding this provision, so it’s essential to consult with a tax professional before you take advantage of this unique opportunity.

YOU OWN A BUSINESS AND WANT TO ATTRACT AND RETAIN TOP-NOTCH TALENT

Suppose you’re a small business owner struggling to attract and retain critical employees. In that case, it will be easier and less expensive to offer the one essential benefit that all workers should have these days: Access to a highquality, flexible 401(k) or other defined contribution plan.

Workers need and want these plans. According to research from Bankrate, one-third of all Americans have never had a retirement account. And less than one-third say that their retirement savings plan is on track.

“If you—or your children—are done with college and haven’t withdrawn all the money in your 529 College Savings Plan account, you may be able to roll over up to a lifetime total of $35,000 taxand-penalty-free to a Roth IRA starting in 2024.”

Furthermore, according to research from WTW, 44 percent of job seekers say they’re more likely to join a company with a top-notch retirement plan over one offering better pay.

Maybe you’ve been putting off offering a 401(k) plan to your employees because of costs and administrative burdens. If so, SECURE 2.0 has some great news for you if you’re starting a new plan:

n Starting this year, you could get a tax credit of up to 100 percent of qualified plan startup costs.

n You may also be eligible for an additional tax credit of up to $1,000 per employee based on the amount your company contributes to their accounts. As a business owner, these new provisions will ease administrative burdens and reduce paperwork.

n To help you encourage your employees to save, SECURE 2.0 will require any 401(k) plan you establish in 2025 or later to automatically enroll eligible employees with a starting contribution of 3 percent that will automatically go up each year. (They can choose to opt-out at any time).

n If your employees are struggling with college debt, starting in 2025, you can make additional contributions to their retirement accounts that match their monthly student loan payments.

If your business already offers a 401(k) plan, some of the “startup plan” provisions won’t apply. And you’ll need to update your plan to incorporate some of these new SECURE-enabled features.

YOUR RETIREMENT PLAN IS ALREADY ON TRACK

As we’ve seen, many of these provisions are fantastic for people trying to sock away more money. And if you’re confident in your plan, that’s a big accomplishment. If you’re retired—or will be soon—and you’ve made more than enough money to live the way you want to during your golden years, what’s in it for you?

Your main concern may be to limit the tax impact of retirement withdrawals and keep more of your nest egg growing over time. Fortunately, for many seniors, SECURE 2.0 delivers.

If you’re turning 72 this year, you won’t have to start taking RMDs from your retirement accounts as you had to in previous years. Starting in 2023, the new rule raises this age to 73, which means you can wait until next year to take your first RMD. Late-stage boomers, Gen-Xers, and beyond have an even better deal because in 2033 the starting RMD age will go up to 75.

If you’re over age 59½ or need to start taking RMDs soon, you may want to take advantage of a couple of strategies that could lower your taxable retirement income. This is especially true if the value of your retirement portfolio went down by 15 percent or more last year:

n Take some spendable money out of your retirement accounts to reduce future RMDs. Since the IRS raised the standard deduction and adjusted federal tax brackets for inflation for 2023, withdrawing the correct amount could keep you in the “Goldilocks zone” for limiting their taxable impact.

n Roll over some money out of your 401(k) account directly into a Traditional IRA, then convert that money to a Roth IRA. You’ll pay taxes on the conversion, but then you’ll never have to take money out of your Roth. And if you do, your withdrawals will be tax free.

n Use this same strategy—known as a backdoor Roth IRA conversion—to bypass income restrictions that might otherwise keep you from making Roth IRA contributions. Many thought SECURE 2.0 would close this loophole for wealthy investors, but the Act left it intact.

n If you’re over 70½ and charitably inclined, you can donate up to $100,000 each year from your IRA directly to qualified nonprofits. You can deduct these Qualified Charitable Deductions (QCDs) directly from the RMD amount you’d normally need to pay that year. And, starting this year, the annual QCD limit will rise with inflation.

n If you’re still working, consider diverting more or all of your 401(k) contributions to your Roth 401(k) account. That way, you’ll never have to pay taxes when you take out money from that account. Better yet, you won’t have to take out any money at all while you’re still alive.

MOVING FORWARD

The many benefits from this legislation will be rolled out over the next few years. While some are clear-cut, many will be open to interpretation. Most of these benefits are not going to present one-size-fits-all solutions. That’s why it’s smart to put these opportunities into context by talking with a qualified, fee-only fiduciary financial advisor. Not all advisors have this expertise. Having an advisor specializing in dynamic retirement income planning can help you understand which elements of SECURE 2.0 you should—or shouldn’t–take advantage of to secure the retirement you deserve.

“44 percent of job seekers say they’re more likely to join a company with a topnotch retirement plan.”

TECHONOMY Making the Menopause Market

Welcome to the launch of Worth’s Techonomy! Techonomy is a 10-year old brand focused on the intersection of techonology, business, and human progress. In this issue, we cover the latest research on epigenetics and look at how tech companies are jumping on the menopause bandwagon. To get weekly updates, sign up for our newsletter at techonomy.com/newsletters.

Drones Offer New Eyes in the Sky

BY KENDALL WYCKOFF

It’s all hands on deck as the impact of climate change threatens life as we know it. Projects all around the world are leveraging innovative technologies to both understand the problem and create the best solutions, but one type of technology in particular is rising to the challenge.

Drones play a critical role in combating climate change and its effects with end-to-end applications across every sector. The image resolution and documentation accuracy of drones surpasses that of satellites, while covering large expanses more quickly and cost effectively than manual efforts. Drones can access areas that would be dangerous or impossible for human surveyors (unstable terrain, aerial, and underwater), while avoiding the destruction of human and machine disturbances in these delicate areas. The ability to efficiently and successfully monitor, measure, and map in great detail enables data-driven decisions. Furthermore, drones can, in

many cases, single-handedly execute and deliver the solution.

Reforestation is another key application for drones. According to Our World in Data, approximately 15 billion trees are cut down per year over the past couple of decades. Not only does the loss of 15 billion carbon filters contribute to global warming, but this problem is further exacerbated by the of carbon dioxide generated by deforestation machinery. Currently, the quickest and cheapest way to sequester carbon is tree planting, and the excellent news is there is space to plant 1.2 trillion additional trees on Earth—enough to offset human emissions. However, manual planting is dauntingly labor-intensive, slow, and disruptive (machine use can interfere with local ecosystems, cause erosion, and accidentally introduce invasive species). Meanwhile, aerial seeding can plant up to 10x faster for one-third of the price, all while using precision planting techniques and biodiverse seed vessels to better achieve sapling success.

Extreme weather patterns have also heightened deforestation due to intensifying floods, hurricanes, and wildfires. Wildfires burn millions of kilometers of land every year—and damage is expected to increase by 50 percent by 2100. Drone technology is an essential and multipurpose tool in this fight. European technologists are using drone LiDAR data to design strategic vegetation management, and an autonomous early warning program is being developed in China. Special sensors can detect hot spots

and heat signatures, giving them the ability to locate missing people despite low visibility, identify areas that are likely to spread, and map out hazard-free evacuation routes. The autonomous aerial view also allows firefighters to safely gather information without putting humans in harm’s way, which is significant given that helicopter and plane crashes account for 24 percent of firefighting fatalities.

Beyond the environmental sector, drone technology can elevate the impact of essential humanitarian and global health efforts. Drones can help improve access to water, sanitation, and hygiene (WASH), classified as a fundamental human right by the United Nations and vital to underserved communities. According to the World Health Organization, 2.1 billion people are without safe drinking water, and 4.5 billion people lack access to adequate sanitation services, resulting in 829 thousand deaths from diarrhea annually. Global water-system leakages are responsible for losing 45 billion liters of water per day, provisions for roughly 200 million people. But opportunity is on the horizon. In tandem with the development of other life-changing innovations, drones can locate leaks and weak spots, identify inefficiencies, improve transfer, and also track disease spread patterns. Drones are not only able to detect unsanitary water sources, but spray disinfectant on the affected areas.

Drones can save critical time and money while helping initiatives calculate the most strategic and precise paths forward. Many of these at-risk communities are also receiving economic benefits in addition to the environmental assistance, as organizations are training locals, transferring skills, and ultimately creating jobs. The “drones for good” movement is not only helping affected areas create efficient and effective solutions, but allowing them to independently continue the projects and take charge of their own community and ecosystem rehabilitation.

Drones can save critical time and money while helping scientists calculate the most strategic and precise ways to redress climate change.

Cybin is a clinical-stage biopharmaceutical company developing a new standard of care for mental health conditions to improve patient outcomes. The Company is led by a team of scientific and industry experts with deep roots in biotechnology and mental health. Our team is on a mission to create safe and effective therapeutics for patients to address a multitude of conditions, including depression, anxiety and addiction.

Why You Need to Know About Epigenetics

A lesser-known genetic code influences your health—and that of your kids and grandkids.

BY MEREDITH W. SALISBURY

In the 1990s and early 2000s, the Human Genome Project enabled the first count of human genes. The result was, to be candid, a little embarrassing. Just 20,000 genes coded the marvel that is a human being, fewer than the standard lab mouse (closer to 30,000 genes) and a fraction of the genes that comprise the lowly parasite responsible for the sexually transmitted infection trichomoniasis (about 60,000).

Around the world, puzzled scientists asked: How could you explain the complexity of a human being with so few genes? Part of the answer comes from something known as epigenetics.

Suppose our genomes were sheet music, the DNA that makes each gene would be the notes. They get all of the attention and largely dictate how our genomes are “performed” by our cells. But if you’ve ever spent time looking at sheet music, you know there are other notations—symbols that tell how fast to play, in which key, and when to cut to the chorus. Epigenetic marks are like those extra notations. They ride along with the genes but aren’t part of them, and they govern how the DNA is packaged up, when and how it’s read, and which parts get skipped over.

Unlike your DNA, which is remarkably stable throughout your lifetime, the epigenetic marks on top of your genome are much more susceptible to change. New marks can be added or old marks stripped away, depending on your environment, nutrition, stress levels, physical or psychological trauma, and other factors. Exposure to toxic chemicals, for instance, can leave a severe epigenetic imprint—but that imprint may be undone over time once the exposure has been stopped.

It turns out that epigenetics explains some of the biological complexity that genes alone cannot. Epigenetic marks can turn a gene on or off or change how the cellular machinery interprets its code in our bodies. Epigenetics controls how our DNA is packaged inside the cell and how new cells are assigned specific tasks in the body. Through epigenetics, we can adapt to environmental changes quickly—something that would be impossible for our staid DNA.

Conventional wisdom says epigenetic marks get wiped clean at conception when sperm and egg cells meet. But scientists have learned that these tags can be inherited and persist from parent to child and across many generations. Epigenetic marks triggered by trauma, such as famine or violence, can be found generations later in a family—where they continue to influence a person’s health.

EPIGENETICS & YOU

Epigenetics is a biological tool; it’s not inherently good or bad. Epigenetic marks can keep your body healthy and humming along—in studies of the very young and the very old, there were far more epigenetic tags in a newborn and a young adult than there were in a centenarian, indicating that our epigenetic levels decrease as we age, much like other genetic factors that degrade and contribute to our failing health as we get older.

Epigenetics can also go awry. Certain diseases, known as imprinting disorders, are triggered when the usual epigenetic marks don’t populate correctly in an embryo or fetus. These disorders exist from birth and often affect a person’s growth, metabolism, and development. Epigenetics can also contribute to the onset of diseases during our lives: some epigenetic changes have been linked to an increased risk of cancer, especially breast and colorectal cancers.

And then there’s our epigenetic response to the environment and diet. Smoking triggers epigenetic changes, often stripping away standard epigenetic marks in proportion to how heavily someone smokes. But because epigenetics adapts, smokers who quit can eventually regain those marks and return to near-normal levels with enough time.

While scientists are still working toward a complete understanding of the myriad impacts epigenetic changes can have on our health, they have already shown that periods of stress or trauma can leave a lasting mark. Your epigenetic tags can also be influenced by the quality and quantity of foods you eat, exposure to infectious diseases, environmental factors such as toxins and chemicals, and more.

EPIGENETICS & YOUR FAMILY

While epigenetic marks can change throughout a person’s lifetime, some have real staying power—not just for one person’s life, but for

generations. Some of the epigenetic tags you have were probably passed down to you from greatgrandparents or earlier ancestors, and some of the changes that happen to your epigenetics have the potential to be passed on for many generations.

Scientists are still sorting out how this happens and how it shapes our health—the generationspanning studies required can take decades to produce results. But already, there’s enough data to show that cross-generational epigenetics is a significant driver of health and disease.

For example, limited access to food in one generation (especially during the critical years just before puberty) has significant implications for descendants. Studies from Sweden have found that people who faced hunger when they were 8-12 years old had grandchildren with longer lifespans; those who had an abundance of food were more likely to have grandkids who died younger. (Sound backwards? The theory is that our bodies learn to adapt quickly to food scarcity, and those protective adaptations may be passed on to subsequent generations.) In some cases, grandkids of well-fed people were also found to be at higher risk of cancer.

But having hungry grandparents isn’t all good news (especially for them). Other studies report that women who suffer through famine while pregnant have children and grandchildren with increased risk of type 2 diabetes. Their kids were also more likely to have coronary artery disease, high cholesterol, and obesity.

Stress has ripple effects across the generations as well. (Fortunately, not the stress you feel when you’re cramming for a tight work deadline.)

Epigenetic changes have been found in the adult children of Holocaust survivors; these changes influence how their bodies respond to stress, including the production of the stress hormone known as cortisol. A study of women who developed PTSD after 9/11 showed similar effects in their children, whose lower cortisol levels make them more vulnerable to PTSD.

But it doesn’t take genocide or a massive terrorist attack to rewrite the epigenetic code. In one study, people with distinct epigenetic changes in four genes shared a common trait: grandmothers who had reported some interpersonal violence while they were pregnant. Scientists have also found that stressors such as childhood abuse in boys lead to significant changes in the epigenetic marks in their sperm later in life, which could lead to altered epigenetics in their kids.

WHAT YOU CAN DO

While the science of epigenetics has yet to advance to the point of offering clear guidelines for interpreting the changes you might have inherited from your ancestors or ensuring the best health for you and your descendants, common-sense steps do exist. To wit: Eat highquality, nutritious food without regularly overindulging. Don’t smoke, and avoid exposure to nasty chemicals or other toxins. Incorporate exercise into your wellness routine and manage your stress carefully. And don’t forget to appreciate your body’s remarkable capacity to adapt to your lifestyle and environment—it’s incredible, especially given our humble gene count.

“Epigenetic marks triggered by trauma, such as famine or violence, can be found generations later in a family—where they continue to influence a person’s health.”

The Connection Between Global Health & Global Warming

Dr. Larry Brilliant discusses his time in an ashram, eradicating small pox, and how humans are the most invasive species on the planet.

BY DAVID KIRKPATRICK

Many will recognize Dr. Larry Brilliant as CNN’s resident COVID expert, but the epidemiologist is most famous for leading the World Health Organization team that eradicated smallpox. He’s also stewarded the philanthropic efforts of both Google and Salesforce and has been a mentor to many tech leaders, including Steve Jobs and Mark Zuckerberg. But before all that, Brilliant lived in an ashram in India for many years, studying under guru Neem Karoli Baba (also the spiritual teacher of Ram Das), who drove him to pursue a career in public health.

Brilliant sat down with Techonomy founder David Kirkpatrick at the Techonomy 2022 retreat in Sonoma, CA, to discuss his journey into public health and the connection between global warming and global health. This transcript has been edited for clarity and brevity. The full interview can be viewed on techonomy.com.

David Kirkpatrick: You had this period when you were a devoted follower of a very inspiring guru. And he inspired you then to go into public health. Tell us about that.

Dr. Larry Brilliant: Here’s the kind of inspiration he used: I would sit there, and I would meditate and he would throw apples at my testicles and say, “you should get out of the ashram.” He had really good aim. My guru, Neem Karoli Baba, told me I should go to the World Health Organization office in New Delhi and get a job helping eradicate smallpox because this was God’s gift to humanity. So, I went to WHO, which took about 17 hours on a train and a bus, and of course,

they kicked me out because I was wearing this white dress, had hair down to the middle of my back, and had a big beard.

I went back up, and I saw my guru, and he asked, “Did you get your job?” And I said, “No.” He said, “Go back.” I took the 17-hour journey back and, of course, they kicked me out again. Rinse and repeat about 12 times, but I got smart.

I trimmed the beard, I lost the dress, and I put on a suit and tie.

One time I walked into the WHO office, there was this tall American. And he said, “Are you American? Who are you?” I said, “I’m a doctor.” He said, “Okay, why are you here?”

I told him that my guru, who lives in the Himalayas, told me that I

was supposed to come work for WHO and help eradicate smallpox. “Well,” he said, “I’m the head of the global smallpox eradication program, and we don’t have a smallpox eradication program in India. But since we’re here, maybe I could interview you.” He eventually did hire me, and I became the head of the program. It took ten years to eradicate smallpox.

And you did more or less eradicate smallpox.

With 150,000 of the most wonderful, courageous people in the world. It’s the only disease that’s ever been eradicated.

You have done enormous research and communication around the pandemic. What’s the connection between global health and global warming, particularly concerning pandemics?

The primary connection is that the antecedent causes of climate change and global warming are many of the exact antecedent causes of pandemics. As the Earth gets warmer, animals from the south migrate to the north. Over a billion more people are at risk of malaria right now because the Anopheles mosquito can now breed at higher altitudes and greater latitudes. Animals meeting other animals carrying the same viruses leads to variants. We’re having a tremendous amount of spillover because the forests and rainforests are being clear-cut.

I was the science advisor on the film Contagion. We tried to make a movie that would be a fictional representation of what we thought would happen. We didn’t expect to get it so close. But the whole premise was a bat with a virus enters the human environment, which is what happened with COVID—and with SARS, and probably with MERS and Ebola.

Fossil fuels create greenhouse gases, leading to global warming. And with that, you wind up changing the way water works, the way salt works, and the entire ecosystem of the planet. The same things that cause climate change cause spillover, where animals and humans live in each other’s territory. Spillover is occurring now at five times the rate that it did 50 years ago. Every year one, two, or three new novel diseases that have never been seen in human beings are spilling over from animals, and we’re exposed to them.

All of these factors are hitting simultaneously, leading to animals and humans sharing the same habitat. That’s why we’ve gotten a cacophony of these viruses over the last ten years, like SARS, MERS, Ebola, West Nile disease, Lyme disease, and COVID.

There are a lot of other linkages to climate change. Global warming increases famine, drought, and floods and winds up putting more salt in the Earth. One of the biggest things we see in global health is that as water levels rise, they bring salt and we lose agricultural land. That means that climate change can lead to famine.

The primary culprit is modernity. The most invasive species in the world is us humans. We’re the ones that are putting the world at such ecological risk. And with it, we will find challenges to our food, challenges to our water, challenges to agriculture, and challenges to pandemics as well.

You also are very worried about COVID variants right now. Could you tell us why?

Right now, we’re in a funny stage with the COVID pandemic. Three years ago, I wrote an article in Foreign Affairs called “The Forever Virus.” And people got mad at me because we were all done with the pandemic and wanted

to move on. I hope that’s true. We may be there. Right now, there are four coronaviruses that preceded this one that retired into the retirement home of coronaviruses, which means they became colds. That’s right, half of the colds you get are Coronaviruses, which are related to SARS-CoV-2. This virus may be going through that process now.

And I pray to God that it is.

But we’ve also got five terrible new sub-variants. Each one is more infectious than the other. All of them are mysterious in terms of how many diseases they’ll cause.

And right now, we’re playing a whack-a-mole game with new vaccines that are more effective in stopping you from getting it, but great effectiveness and preventing you from dying. But we’re fighting the battle of the last variant. So, I am still determining where it’s going to go.

The theme of our conference is innovation must save the world. Do you think innovation is going to help us save the world?

A lot of innovations are pretty terrible. Nuclear weapons are an innovation that hasn’t really worked out. But I hope innovation is going to make a big difference. In the fight against COVID, for example, DARPA worked on mRNA technology for years, and as a result, we had it ready to convert into vaccines. That quickly saved millions and millions of lives.

But the innovation we need is a total change in human consciousness about compassion, altruism, and stopping to think of others as others.

When I think of innovation, I think of the infrastructure of how we allocate resources and the decisions we make. To have innovations that are going to have enduring value, we have to help bridge the gap between the rich and the poor, and do equitable redistribution of the resources that we need to make the world a better place. We’ve got to focus on vision and values.

Menopause Is Very Hot Right Now

Menopause is a $600 billion market opportunity that remains largely untapped.

BY CAITLIN HAMILTON

At a Techonomy healthcare innovation summit last fall, Ann Garnier, CEO of Lisa Health, forecasted that 2023 will be “the Year of Menopause.” And with the recent flood of high-profile investments and startup launches, her prediction seems to be coming true.

The segment is overdue for attention: fewer than 7 percent of doctors have menopausal care training. Even OB/GYN residents only get a measly two hours of instruction. When surveyed, residents often report that they do not feel comfortable managing menopause upon completion of their program. According to Midi Health, 80 percent of OB/GYNs are untrained in menopause, 75 percent of physicians are uncomfortable talking to patients about menopause symptoms, and 75 percent of women who seek care don’t receive treatment.

Those numbers are a shocking reflection of the lack of treatment women receive, but venture capitalists, health tech companies, and popular culture are finally starting to catch up. According to the Female Founders Fund, menopause is a $600 billion market opportunity that remains largely untapped. The menopause market is valued at an estimated $16 billion, and the investing trend only appears to be increasing.

Firms like Sequoia and CVS Health Ventures are predictably playing a prominent role, as are celebrity investors. Startup Evernow recently raised $28.5 million from the so-called “First Circle” of investors, including Gwyneth Paltrow, Cameron Diaz, and Drew Barrymore, who are championing the cause.

Naomi Watts is also a prominent leader in the movement. “I think it’s time to see women in this phase of life or this age group be well represented,” she wrote on Instagram. “We’ve been underserved in media, stories, and marketing for too long.”

Watts launched the Inaugural Menopause Symposium and is the founder of the wellness brand Stripes, which she started in partnership with biotech company Amyris.

Garnier said even as a knowledgeable and highly-empowered healthcare provider, she was caught off guard by menopause. “I was completely blindsided and unprepared. I thought ‘wow, if it’s this hard for me, what is this like for the average woman?’”

In partnership with the Mayo Clinic and SRI International, Lisa Health developed the Midday app, which delivers personalized insights and recommendations using science-backed assessments and symptom tracking. Powered by artificial intelligence and algorithms, the app tracks a user’s progression through each stage of menopause and provides guidance accordingly. When paired with a Fitbit, Midday provides even more individualized options. “Advancements in AI and sensor technology make it possible to unravel the confounding mysteries surrounding menopause and

bridge the gap in care,” said Garnier. “It’s imperative that we recognize menopause is a complex life stage fraught with escalating health risks. It is a unique window of opportunity to engage women with non-invasive technology that can deliver relief, restore well-being, and promote healthy aging.”

Beyond the Fitbit, menopausespecific wearables are proliferating. Designed with input from engineers, OB-GYNs, and menopause experts, the Thermaband Zone looks more or less like an Apple Watch. Sensors in the wristband monitor body temperature and produce cool or warm “pulses” to counter the effects of hot flashes and night sweats. The Zone’s health technology scans the user 24/7 to identify their “normal” temperature and can pick up even the smallest changes. Consistent data collection is critical—“the more you use it,” reads their website, “the smarter it gets.” The Zone automatically detects patterns with that data and delivers battery-powered cooling or warming.

The Embr Wave, developed by Boston-based startup Embr Labs, is another watch-type sensor that employs advanced thermal science to counteract temperature swings by cooling or warming the inner wrist “How would you like to wave today,” asks the Wave’s companion app, where users can choose from different symptom-specific sessions, adjust temperature settings, set timers, track patterns, and customize button functions. Embr Wave has conducted studies with partners including Johnson & Johnson and UC Berkeley and has multiple clinical trials in progress The device also works through the night and has been shown to improve sleep.

While not a wearable per se, Joylux’s boldly named vFit Gold Device looks less like a watch and more like a vibrator Designed by OB/ GYNs, the personal health device addresses concerns such as incontinence, vaginal dryness, sexual function, and, of course, hot flashes.

“Advancements in AI and sensor technology make it possible to unravel the confounding mysteries of surrounding menopause.”

Menopause Femtech

The vFit Gold uses red-light photo biomodulation technology and sonic vibration to promote a stronger pelvic floor. Red LED lights in the 662nm wavelength encourage blood flow, while sonic vibration aids in muscle stimulation. (Don’t forget the recommended Photonic Gel.)

ELITONE is another intimate device that provides a noninvasive solution for the common symptom of incontinence. The device can be discreetly worn under clothes, allowing users to treat their symptoms whenever and wherever they choose. The FDA-cleared automatic pelvic floor exerciser consists of an adhesive GelPad operated by a small controller, which, when worn for 20 minutes a day, helps to rebuild muscle tone and improve control. Wearables aside, increased access to telemedicine has arguably been the most impactful advancement for menopause treatment and support. “It all starts with a conversation,” says Jill Angelo, CEO of Gennev, a platform that connects subscribers to doctors, nutritionists, and health coaches. Prescription support, medical guidance, exercise advice, and mindfulness practices are all delivered virtually. “No woman experiences menopause the same as another, so her ability to receive 1:1 personalized care is wellenabled through telehealth video and text communication ” Maven Clinic, which offers services through employers like Microsoft (and nearly half of the Fortune 15), recently announced its dedicated Menopause and Ongoing Care platform The program provides access to 24/7 virtual care, peer communities, and concierge support to members across 175 countries. “The fact that even after seeking help from their provider, almost three out of four menopause patients are left untreated shows that it’s high time for a new approach,” said Dr Neel Shah, Chief Medical Officer of Maven But developing a new approach requires better information.

When asked about areas of menopause support and investing that deserve more attention, several experts pointed to the need for more research and science-backed solutions. “Studying the health outcomes related to menopause treatment is vastly underfunded and underserved,” said Gennev’s Jill Angelo. Womaness co-founders Michelle Jacobs and Sally Mueller agree and point out there is scant research and data around perimenopause and menopause despite 51 million women experiencing menopause in the U.S. alone. But they also optimistically note that many emerging menopause brands and technologies revolve around symptom tracking and data collection. They say this is critical because understanding when symptoms begin, how they evolve, and what treatments help will greatly impact future options for care.

Some government officials are working to increase funding for menopause research. Last September, Reps. David McKinley (R-W. Va.) and Cindy Axne (D-Iowa) introduced the “Menopause Research Act,” which would put $100 million into the National Institutes of Health in 2023 and 2024 to research treatments. And earlier this year, New York City Mayor Eric Adams announced an initiative to “dismantle decades of systemic inequity that have negatively impacted the health of women across the five boroughs.” Mayor Adams’ vision includes creating more menopausefriendly workplaces and expanding access to specific treatments.

The need for more treatments, research, and services is clear and thankfully financial backing and public support are mounting. “Every woman will experience this life stage,” said Garnier, “and it’s bordering on criminal neglect that women have suffered for so long in silence and [are] not getting the care and support that they need.” Let’s hope her vision for the Year of Menopause will be just the beginning.

MIDDAY APP

Understand what is happening physically and emotionally during menopause and take back control of your body.

THERMABAND ZONE

Alleviate hot flashes and night sweats with a touch of a button.

JOYLUX VFIT GOLD

An Ob-Gyn designed, intimate health device to create a stronger pelvic floor through patented redlight technology.

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Strategies to Improve Your Performance in 2023

BY JENNIFER KIM

MS, CFP®, CMFC, ChFC, CLU

If performance reports on your investments show you ended the year 2022 with an overall loss, you are not alone. Not by any means. While corrections do occur most years, 2022 was an entire year of corrections. And your investing style, whether low-risk/ low return, or high risk/high return, simply did not matter. As CNN Money put it, last year there were “few safe places for investors to park their money.”

To illustrate, if your 2022 investments leaned heavily on the bond market, here is how bonds faired.

allocations, but even making small changes can make a big difference.

Second, identify winning sectors (yes, there were/are some). For example, while tech dragged down the market—PayPal went from $308.53 on July 23, 2021, to $79.09 as of January 20, 2023—food investments did well this past year, as did energy. According to CNN Business, “The energy sector has returned more than 60 percent this year. In fact, energy made up the entirety of Wall Street’s 2022 profit gains.”

Third, identify losing sectors. Not just to avoid them, but to invest in them, or hold onto them. That’s right. As Warren Buffett famously said, “Be fearful when others are greedy, and greedy when others are fearful.” Keeping PayPal in mind, buying

it now at $79.09, even if it only returns to half its former value, you have doubled your money. And many are predicting a recovery in the bond markets.

Fourth, identify new products. For example, consider adding structured notes to your portfolio. They not only pay monthly dividends, whatever their performance, your original capital investment is returned to you.

To wrap up, while 2022 might have been a year-long correction that produced almost across-the-board losses for investors, taking a deep breath, carefully reviewing your investments, and making tweaks to your allocations won’t guarantee a profitable 2023—nothing can—but you will begin this year with a smart and strengthened portfolio.

S&P U.S. Treasury Bonds were down 10.7 percent.

30-year U.S. Treasury bonds were down 35 percent, their worst return in a century. Corporate Bonds were down 14.2 percent.

So much for the low risk “safe havens” in 2022. And if you favor stocks over bonds, the three major averages ended a winning streak of three years in 2022 this way:

The Dow was down 9 percent for the year. The S&P 500 was down 20 percent at year end.

The Nasdaq Composite Index fell 33 percent in 2022.

So, the question is, as we enter 2023, what might you do to avoid a second year of losses? Changing advisors may seem like one solution, but down performances were so widespread last year, you may regret ending a relationship that, until now, worked to your advantage. The same goes for just dumping underperforming investments because they underperformed. Instead, here is what we suggest.

First, meet with your advisor and do a thorough analysis of your current allocations. Carefully-thought-out diversification of investments has never been more important. This does not mean a major overhaul of your

Jennifer Kim, MS, CFP®, CMFC, ChFC, CLU is a Senior Partner with SEIA. Currently, she is a licensed independent insurance broker with Signature Comprehensive Insurance Services, LLC (SCIS). Her specialties include estate planning, retirement planning, and corporate benefits. Jennifer has been in the investment management and insurance business since 1993.

Since 2012, Jennifer has been featured in the Los Angeles Magazine, Angeleno, Modern Luxury, and Beverly Hills Magazine. She has also written several articles for Worth Magazine, and Investors Business Daily on various financial topics. Jennifer is currently the President of the Harvard Westlake Korean American Parent Association as well as being a member of the Parent Association Board at St. James Episcopal School. Jennifer also serves on the financial committee of AVIVA Family and Children’s Services and is involved with numerous charities, including NGA, the Covenant House, and Heart Share. Jennifer resides in Los Angeles with her husband and four children.

Estate & Investment Advisors, LLC (SEIA) is an SEC-registered investment adviser; however, such registration does not imply a certain level of skill or training and no inference to the contrary should be made. Securities offered through Royal Alliance Associates, Inc. member FINRA/SIPC. Investment advisory services offered through SEIA, LLC, 2121 Avenue of the Stars, Suite 1600, Los Angeles, CA 90067. Royal Alliance Associates, Inc. is separately owned and other entities and/or marketing names, products or services referenced here are independent of Royal Alliance Associates, Inc. (CA Insurance License #0B11807).

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Mixed Media

BY JASON ASHLOCK

BOOKS

The Myth of American Inequality

BY PHIL GRAMM, JOHN EARLY, AND ROBERT EKELUND

Post Growth: Life After Capitalism

BY TIM JACKSON

A curious new tradition has emerged among chief executives. As a calendar year draws to a close, CEOs across industries seem to find it important to tell us what they’ve read. Their gift to us is, apparently, a kind of literary performance. Such seasonal bookishness can be playful or pedantic, vapid or visceral. It depends. But because they have soared on fiscal wings above the madding crowd, our late capitalist philosophy suggests they must surely hold superior intellect as well. Thus, attention must be paid.

This brings us to a stack of books on Doug McMilllon’s desk.

The CEO of Wal-Mart is an anomaly. A product of rural America who levitated above his farmland origins to his current perch above the world’s largest employer, it’s hard not to see Mr. McMillon as a particularly American image of possibility. Every morning, more than two million humans wake up and go to work for the organization he leads. So, it is notable when, along with predictable book recommendations about the metaverse and generic self-improvement, one spots a work of peculiarly insidious denialist propaganda, The Myth of American Inequality.

The title of former Senator Phil Gramm’s recent work, a specious and ideological rereading of decades of economic data, leaves little to interpret. In the fantasy world of Gramm, all that you think you know about the wealth gap is wrong. It is, in fact, a sad story spun by leftist academics based on flawed data models that have then been

perpetuated by the government and allowed to dominate the debate for decades. Until, our noble Senator arrives to set the thinking of Thomas Pinketty, Janet Yellen, Marianne Bertrand, Lawrence Summers, and the vast majority of economists in the world straight. Like the climate change denialists with whom Gramm keeps close company, his genre is science fiction without the science.

One might expect such an apologia from a retired politician who played a significant role in the monetary policies that created an extraordinary divergence in prosperity and potential. The chief executive of Wal-Mart, of course, has a front-row seat—as both employer and retailer—to the challenges facing families and communities living in the world Gramm’s policies helped create, while simultaneously overseeing a company that benefitted tremendously from the same. So perhaps fidelity should not be surprising. But might one be forgiven for thinking it’s a little on the nose?

In his brutally clear-eyed assessment of the current state of capitalism, Post Growth, Tim Jackson would place a Gramm-McMillon alliance in the category of a declining system’s desperate attempts to defend itself against eventual demise. Where Gramm takes comfort in his tiny house of ideological defensiveness, Jackson takes to the hills, wandering a vast and diverse landscape of economists, politicians, poets, and practitioners to interrogate what he deems the “foundational myth of capitalism

In truth what Jackson describes is not one myth but many, what Arlie Hochschild names the “deep story,” a richly imbricated collection of narratives that comprise what we understand as Capitalism This particular story has held powerful sway over the imaginations and behaviors of our societies, with the assumption of perpetual growth, the refusal of human limitations, and even the denial of death dominating our decisionmaking context and legitimizing a succession of policies that have proven disastrous for the planet and its human population

Like all stories, however, this one must come to an end From Jackson’s panoramic seat, the foundational myth of capitalism has been crumbling for decades Hastening its demise are long-term trends decreasing labor productivity, subsequent collisions

between wage-earners and profit-owners, the surpassing of planetary boundaries that sustain current practices of production and distribution—dysfunctional patterns which have been increasingly obvious but easily avoided, hidden by the curtain of prosperity and the fables of leaders like Gramm.

Jackson’s view is not only backwardfacing, while his criticism of capitalism’s fallacies and foibles is needle-sharp, he is also well-practiced at the reasonable delivery of heterodox ideas. Since the publication of his seminal work Prosperity Without Growth in 2009, he has been a leading voice among the movement that ranges from the pragmatists Green New Dealers to the radical DeGrowthers, which vary in their tactics but are joined by their daring to imagine beyond the waning days of capitalism to what’s next. Such a post-growth narrative is rich with possibility, and Jackson delights in exploring the new mythic terrain. Placing in conversation thinkers as varied as Rosa Luxembourg, Pierre Thielhard de Chardin, Emily Dickinson, Thich Nhat Hanh, Martin Heideggar, Jeremy Bentham, and dozens more, Jackson makes a case for a nonincremental shift to a new social contract, one he sees made evident in the public sector response to the COVID-19 pandemic The swift and historic action taken by governments and society provides a model for bold action that can usher in a promising new era of human flourishing

An examination of insidious denialist propaganda, lessons from the world’s longest scientific study of happiness, and a new definition of mental and physical limitations.

The Good Life: Lessons From the World’s Longest Scientific Study of Happiness

BY ROBERT WALDINGER AND MARC SCHULZ

In his compelling work on the history of happiness, Darrin McMahon reminds us that happiness as an individual right is a quite recent addition to the list of fleshly desires and demands. For most of human history, the idea of happiness was linked to a heightened state in which one is lifted by the gods, a gift granted by fate. If given, you were blessed. If not, ‘twas not meant to be.

Not so for us, as Thomas Hardy laments in his famous lines: “If but some vengeful god would call to me from up the sky, and laugh…But not so.” In other words: You’re on your own, kid. In the past two centuries, we’ve managed to make happiness an obligation, an act of personal achievement that’s so damn hard to come by that we’ve propped up billions of dollars in cottage industries to help us find it.

The library of happiness is vast and varied. Populated by self-helpers and healers, thought leaders and therapists, monks, millionaires, and memoirists. Whether grounded in a method, advocating a mindset, channeling the wisdom of tradition, alchemizing personal experience, or some mix of the above, the literature of happiness tends toward trends and, as a genre, thrives mostly on its inability to deliver on what it promises

If we haven’t the gods to thank for the most recent addition to this catalog The Good Life, then we can at least be grateful to the Harvard Study of Adult Development, the longest in-depth examination of adult life ever conducted Starting just after the Great Depression and continuing to this day, the Study began by following 724 men from diverse socioeconomic backgrounds for eight decades, then expanded to include their spouses, and recently expanded again to include more than 1,300 of their Baby-Boomer children The project’s purpose is to answer the question we only began asking a couple of hundred years ago: what makes a happy and meaningful life?

The literature of happiness would like you to think there are no simple answers. Dr. Robert Waldinger, the current director of the Harvard Study, and his co-author Marc Shulz, suggest there actually might be. “Good relationships,” they write, “keep us healthier and happier. Period.”

Having read the ten chapters that somehow remain breezy despite the steady drumbeat of supportive research, one can forgive them for writing the word “Period.” There is a dramatic sense of conclusion to The Good Life that evades most books that approach the same question. Perhaps it’s the approachability and recognizability of the human stories that fill the report. Even a cynic would have a hard time resisting the blend of qualitative and quantitative that extends across the various dimensions of human-to-human interaction: from family to romance to work to casual encounters and beyond— and the constant evolution required.

The Good Life has a timeless quality to its discovered wisdom, but one can’t help but view it through the lens of postpandemic contemporaneity. As societies rethink themselves, as workers rebalance their commitments, as organizations redesign their expectations, as governments reimagine the social contract, one wonders if the Harvard Study can provide us with a direction of travel: toward a society that privileges the relational above the transactional, the accumulation of connections above commodities. We don’t have to travel a new road, of course. We can stay on the old road. At least the publishers will be happy.

And where she taught me to eat the world.”

For those who wonder what legacyleaving ought to look like, here is an artifact to study a story of how “the young get older, and the older get wiser, and the wiser sometimes find wonder again, before whatever comes next ”

FILM

Limitless with Chris Hemsworth

Humans across time and cultures, claimed James Frazer in The Golden Bough, like their gods to die.Something resonates about a melting Icarus or an arrow-pierced Baldr. It’s nice, of course, when the gods come back with a one-off reboot like Jesus of Nazareth or Dionysus. Should they, like Persephone or Osiris, die and come back often, we embed them into our understanding of time and season. Something to aspire to.

In his entertaining, educational, existential, and downright enjoyable documentary series Limitless, Chris Hemsworth, best known for his cheeky, gargantuan depiction of the Norse god Thor in the Marvel universe, aims to best them all and live forever. Well, not quite forever. But for as long as he can. And he aims to find out how.

Surprisingly slight in the months between filming, the casually charismatic Hemsworth employs a list of coaches and instructors to help him push the boundaries of his mental and physical capabilities in the search for longevity and wellness. [One such coach, is Peter Attia, who is interviewed on page 34.] The journey ventures to epic locations, includes feats of daring physicality and surprising intimacy, and along the way offers illuminating insights into the new science of health

In Hemsworth, viewers find an awkward and approachable earnestness that’s often lacking in celebrity actors who try their hand at documentary work The extraordinarily likable Leonardo DiCaprio and Zac Efron, for instance, shed nearly all charisma when they drop their characters and become themselves Hemsworth is the opposite, somehow becoming more magnetic through vulnerability

And vulnerability is, Hemsworth reminds us in the end, the road we all travel The title of his show, one hopes, is purposefully ironic This is a show very much about limits They can be pushed They can be redefined with knowledge and persistence If yours are set with self-defeating closeness, the coaches say in various voices then limits can be reset But they cannot be exceeded That human life comes with an expiration date is a truth universally despised But the acceptance of this, and the ability to thrive within the awareness of denouement, is the work of Hemsworth’s contemplation And the work of a lifetime

Time for a Women’s Movement

The rising economic power of women and their evolving tastes are shaping the watch industry.

BY CAIT BAZEMORE

Over the past decade, we’ve seen an industry rooted in centuries of tradition begin modernizing. One major shift has been in the gender binary of watches. Conventional gender roles have slowly transformed in response to female income rates and buying power changes. One of the two key forces reshaping the consumer market is women’s rising economic power, with women controlling more than 60 percent of all personal wealth in the U.S. (Federal Reserve) and 40 percent of working women in the U.S. out-earning their husbands (U.S. Bureau of Labor Statistics). Within the past few years, the pace of change in the watch industry has increased thanks to brands asserting a more substantial presence on social media and on their e-commerce platforms, making the once insular world of watches more accessible to a wider audience, including women. Women’s watches have long been typecast in a supporting role. When we traditionally consider a ladies’ model, we think of small case sizes, pastel-colored enamel dials, quartz movements, and diamond accents. Hence the trope “shrink it and pink it” has long been associated with the approach to designing women’s watches. Marketing toward women often presents an image of a man gifting a watch to a woman instead of her buying one for her-

self. However, if you look closely at the history of women’s watches, it reveals a different story, one that’s seldom told.

While women’s watches have often been relegated to narrow stereotypes, they have, in many respects, led the way in innovations and trends. Color play has long been

a part of designing women’s watches and has only become prevalent among men’s watches in recent years. Consider the widely popular rainbow trend: there was a time when these would have been considered women’s watches, and a man might never have conceived of wearing one. Now, no catalog is complete without at least one rainbow model, and we see them in bold, oversized, traditionally masculine proportions from brands like Zenith, Rolex, and Hublot. In addition, women have been serving as watch ambassadors long before official ambassadors

“She requires a timepiece with substance, one that’s made expressly for her.”

became a mainstay of every brand. Mercedes Glietz’s famous swim across the English Channel in 1927 wearing a Rolex Oyster Perpetual was one of Rolex’s greatest advertisements.

Though watches remain gendered in brand catalogs, there’s a clear movement toward unisex or genderless watches. If you look at today’s female brand ambassadors, they are often sporting so-called men’s models, like Rosamund Pike with IWC’s Portuguese or Serena Williams with Audemars’ Royal Oak Offshore. And many female celebrities with

highly respected collections, like Ellen DeGeneres, primarily consist of models designated for men This is not entirely surprising if you look at broader trends in fashion; women have long adopted men’s style from the pantsuit to the more casual plaid flannel button-down. The difference is that apparel brands have embraced these styles within their women’s collections—a woman doesn’t have to go to the men’s department to buy said suit or flannel. She can buy her variation with a cut and size that will suit her feminine proportions far better than a man’s garment ever could.

This is precisely what women are looking for in watches. The modern woman is no longer satisfied with a bracelet or jewelry that happens to keep time. She requires a timepiece with substance, one that’s just as capable and technically complex as the watches made for her male counterparts—one that reflects her command in business and politics—but one that’s made expressly for her.

There are a few brands that are doing this well. One is Patek Philippe. Patek has been a pioneer of women’s wristwatches since the 1800s, introducing its first ladies’ wristwatch in 1868. Fast forward to the modern era, Patek launched its first line specifically created for women, the Twenty-4, in 1999. While the original Twenty-4 housed a quartz movement, the brand updated the model with an automatic caliber in 2018. Before that, the brand debuted its first in-house chronograph movement in the Ladies First Chronograph watch in 2009, which has since seen numerous updates including one of the most recent additions in 2018 with the Ref. 7150. And just last year, in 2022, Patek introduced its first self-winding ladies’ chronograph in the Aquanaut Luce “Rainbow,” a 39.9mm rose gold watch that epitomizes the rainbow trend and includes a highly useful complication with the bonus of a flyback function and a sporty rubber strap. Here, we see Patek employ two stereotypical style elements of women’s watches—enamel and gem setting—with contemporary finesse. The meticulously handpicked stones have been set on metal rails that can’t be seen from the outside of the case, a technique called “invisible setting,” and the mother-of-pearl dial is rendered in the Aquanaut’s signature checkerboard motif.

Another watchmaker leading the charge in women’s watches is Breitling. When Georges Kern arrived as CEO in 2017, he set out to bring more diversity to the brand’s offerings and partnerships. By 2020, the brand had debuted its first line of Navitimer

watches for women, followed by the Chronomat in tandem with three new ambassadors joining its Squad on a Mission concept: actresses Charlize Theron and Yao Chen as well as American Ballet Theater’s Misty Copeland. In the three years since, Breitling has expanded its women’s offerings with models from its core collections, including the Superocean, Avenger, Professional, and Premier. Some of its most recent additions launched in 2022, including the Super Chronomat Automatic 38, a new size for the lineup, and new colorways of the Superocean Automatic 36 and the Navitimer Automatic 35 and B01 Chronograph 41.

Brands like Patek and Breitling are considered more traditional or mainstream. Since 1839, Patek has been designing classic timepieces focused on dress watches and complications. Starting in 1884, Breitling designed purpose-driven watches with a sportier look and feel. Seeing these industry pillars modernize their women’s collections is undoubtedly a sign of progress, yet there’s still another significant gap to be filled. With the rise of independent watchmakers in the past several decades, men now have a slew of options beyond the timeless dress watch or everyday sports watch— ones that are more unique, avantgarde, and complex that genuinely embody the art of the art form.

While fewer and far between, there are a handful of brands providing these types of offerings for women. One such maker is MB&F. MB&F is one of the most daring and playful watchmakers. Like most independents, each collection is highly bespoke and produced in limited quantities, adding to the intrigue and exclusivity. Its designs aren’t for everyone, encompassing a futuristic aesthetic that often feels as if it came straight out of a sci-fi film. However, the allure of MB&F’s watches isn’t purely aesthetic.

These “horological machines” are highly technical and breaking records, like the Legacy Machine

Thunderdome, the fastest triple-axis tourbillon ever made. This model was inspired by MB&F’s first-ever ladies’ line: the Legacy Machine Flying T. The brand began developing the Legacy Machine Flying T in 2015 and unveiled the first model in the collection in 2019, which went on to win the Ladies’ Complication prize at the GPHG awards that year. The line combines founder Maximillian Büsser’s knowledge of jewelry and gem setting (thanks to his seven years at Harry Winston) with MB&F’s signature style. Since its initial debut just a few years ago, the brand has iterated on the LM Flying T with new variations, some of which have crossed over into its Performance Art line.

The latest additions, launched in January of this year, were designed in collaboration with the independent French jewelry designer Emmanuel Tarpin, who has famously created pieces for celebrities like Rihanna. With the LM Flying T Ice

and Blizzard, MB&F and Emmanuel Tarpin take gem-setting in women’s watches to new heights while retaining the line’s signature complication: the flying tourbillon. These impressive watches also boast highly wearable proportions of just 39mm despite smaller case sizes long being cited as the reason women’s watches couldn’t house high complications. Though it still feels like the luxury watch business has a ways to go before reaching full gender equality, it has come quite a long way. This is a centuries-old industry that deeply values tradition. It is only natural it would take a great deal of time and intention to make meaningful shifts. The good news is that things are undeniably moving in the right direction, as is evident by the brands and watches we’ve highlighted here that more accurately reflect the modern woman’s desire for a timekeeper that’s beautiful but also offers substance and complexity.

“If you look closely at the history of women’s watches, it reveals a story seldom told.”

Tales of the Mocktail

The low/no alcohol movement that’s taking over your favorite bar. But how do they taste?

BY KIRSTEN CLUTHE

Afew years ago, I ordered a martini at a restaurant in Paris. The drink arrived in a pretty, delicate glass, along with a slice of lemon, and I prepared myself for the cool, clean sip that would awaken my senses on that steamy summer evening. What I tasted instead was a dry, floral …vermouth? Not the bracing cocktail I was expecting. It turns out that a martini in France is a very different drink than what we consume in the U.S.—and there are guides on how to order an Americanstyle martini in France, which would have been helpful to me before that evening—but what I learned from the experience is that I enjoy the vermouth-forward cocktail. It was light, refreshing, and easy to drink, with the added benefit of lower alcohol.

The low/no-alcohol sector has grown tremendously in the past decade, driven by people seeking healthier alternatives to traditional drinks. Fortunately, the quality of the products has also improved— gone are the days of alcohol-free wine that tastes like watered-down grape juice. But can social drinking be just as enjoyable without alcohol? Beverage companies are responding to that question by creating products that respect the elements we appreciate in our well-crafted cocktails—complex, sophisticated flavor profiles and attention to detail

demonstrated by proper garnishes and beautiful glassware.

“It’s all about balance,” says Kat Dunn, owner of Padrona, a gem of a cocktail bar in Hudson, NY where she’s been a fixture for over a decade. Her approach is kitchenoriented, “a very ‘cooking’ way of looking at things. Every cocktail, whether it’s low-proof or no-proof, it’s all about balance. Sometimes there’s an umami quality, but it’s sugar, salinity, acidity, and it shouldn’t taste like any one ingredient, but a combination of all of them.”

Dunn has been incorporating booze-free drinks into her cocktail program for the past decade. When she was behind the bar at Fish and Game, Zak Pellacio’s acclaimed restaurant (now closed), she had to figure out how to best serve the occasional customer who didn’t want to drink alcohol while maintaining the level of quality and aesthetic that the restaurant required. “Sometimes, I would know that someone was with child before their friends and family did. They’d come up to me and say, ‘Listen, I can’t tell anyone. It’s only been a month. Can you make it look like a cocktail?’ and I was like, I got you.” Dunn explains, “The drink would always be in a champagne glass or a martini glass, and I really took pride in that I knew first. That is amazing, right? Having that faith in me. So, I always went above and beyond to try and make it not only look like a cocktail but taste like a cocktail and be special. Not just be a grown-up lemonade.”

Of course, it’s one thing to have an experienced bartender create a balanced low or no-alcohol drink for you, but it’s another situation when you’re making one at home. With all the new products flooding the market, where do you start?

Dunn acknowledges that you must allow some room for error to figure out what you like. There are a few brands that have become go-tos in her bar. “For Bitter or Worse are making some great Amaros, Drink Monday is doing some decent spirits, as is Lyres.”

She confesses that she expected the Lyres Amaretto to taste like almond extract, but it tasted like a real amaretto. She has a Lyres Amaretto Sour on her menu and adds, “The St. Agrestis Phony Negroni is okay, but if you add a little bit of the Drink Monday Gin, it’s actually really good. Most of the no-alcohol spirits are things I would mix instead of drinking on their own.”

A no-alcohol cocktail is selfexplanatory, but what does it mean to be “low” alcohol? Dunn prefers

to keep her low-proof drinks under 30 percent ABV. Her Upside-Down Martini flips the martini equation to accommodate that—more vermouth, less gin. “Vermouth is at 14 percent, so that’s three ounces of the drink, and then there’s half an ounce of gin. You’re looking at 22 percent alcohol. That’s where I prefer to keep mine. I think that’s a safer number.”

It also comes down to measurements and, as noted, balancing what goes into the glass. If a cocktail tastes right with a higher-proof spirit, she reduces the amount in the glass to keep it manageable for customers without sacrificing taste.

In cities like New York, LA, San Francisco, and Portland, ME, a place Dunn says is ‘crushing it’ in terms of food and beverage, low and noalcohol drinks are becoming staples on the cocktail menu. And that’s a very good thing. Dunn describes a moment when a friend told her that Padrona was a place where people in recovery feel comfortable socializing because there are delicious, alcoholfree adult beverages on the menu. “I want people who don’t drink to be as comfortable here as people who

drink. I want people who are drinking less to feel comfortable.”

Please don’t call it a mocktail, though. “I don’t like the word mocktail. I don’t think it purports how good they are or reflects the time and effort put in. As an adult, I wouldn’t want to order one.”

When she’s not working, Dunn drinks wine and appreciates a 50/50 Martini, equal parts gin and vermouth. “To me, the juniper and herbal notes of the gin plus the herbal notes of particular vermouth are just a match made in heaven. It also has a lower ABV, so I can have a second and not feel guilty about it.” Just like the martini I accidentally had in France. J’en aurai un autre, s’il vous plait!

To get the most out of a low-alcohol cocktail, Dunn suggests starting with a classic like The Coronation, which first appeared in The Savoy Cocktail Book in 1930. The main ingredients are dry vermouth and fino sherry, which give the aperitif a lovely balance between herbal and floral (the vermouth) and crisp and dry (the sherry). Add a dash of maraschino liqueur for tart sweetness

Non-Alcoholic Brands We Love

FOR BITTER OR WORSE

Husband and wife team Shelley Elkovich and Jeff Heglie started FBOW after Shelley was diagnosed with a rare neurological condition and gave up alcohol. She missed the ritual of happy hour and started experimenting, eventually launching the brand in 2020. They currently offer four varietals—two sparklers— Eva’s Spritz and Rose City Fizz, Saskatoon, a red wine alternative, and the Smoky No. 56, a riff on whiskey.

LYRES SPIRITS

Lyres has a portfolio of spirits like Dry London, Agave Blanco, American Malt, and Highland Malt, all non-alcoholic riffs on the traditional. Our favorites are the Agave Blanco, which is a great base for a booze-free margarita or Paloma, the Dry London Spirit for a low-alcohol sparkling martini (just add 60 ml of Prosecco), or the aforementioned Amaretti for a cocktail that mimics the Amaretto Sour.

KIN EUPHORICS

Kin is a “non-alcoholic, functional beverage, designed using ingredients that nourish mind and body.” It’s made with adaptogens and nootropics, ingredients designed to reduce stress and buoy your spirit. Whatever the benefits, Kin products are delicious and there’s one to suit every mood, from Actual Sunshine, a drink to ease you into the day, to Dream Light, a nightcap beverage aimed to help you sleep. Our favorite is the Kin Spritz, an easy-to-drink sparkler that mimics an Aperol Spritz without the sugar overload and boozeinduced lightheadedness.

and a dash of citrus from orange bitters, and you’ve got the complexity of a proper cocktail.

THE CORONATION

Ingredients:

2 ounces dry vermouth

1 ounce fino sherry

2 dashes maraschino liqueur

3 dashes orange bitters

Garnish: lemon twist

To make:

1. Add the dry vermouth, fino sherry, maraschino liqueur and orange bitters into a mixing glass with ice and stir until well-chilled

2. Strain into a cocktail glass

3 Garnish with a lemon twist

CURIOUS ELIXIRS

Curious Elixirs are boozefree craft cocktails, served in stylish dark bottles that elevate the experience. Founded by an ex-bartender who started tinkering in his kitchen after deciding to create a non-alcoholic drink as good as one he’d find in a bar. Curious offers a variety of flavors to accommodate different palates as well as a rotating monthly variety pack to keep things interesting. The website also has a flavor quiz to help you find the right bottle.

SEEDLIP

British beverage company

Seedlip was founded in 2014 by Ben Branson, a naturalist who tinkered with plants from his garden and created a nonalcoholic spirit with a complex flavor profile. Seedlip is delicious on its own or with Fever-Tree sparkling or tonic water. You can dip your toe into the world of Seedlip through their cocktail kits (we like the PaNOma).

Great Teaching Makes Great Doctors

BY JIM MCCANN

Worth Media Chairman Jim McCann recently sat down with Dr. Robert Grossman, the man behind NYU Langone Health’s national success in medical education. In this excerpt, they discuss Dr. Grossman’s achievements, his next steps as an educator, and the future of medicine. They touch upon the evolution that has taken place in treatment due to COVID and how Dr. Grossman pioneered making medical education more accessible for all. This excerpt has been edited for clarity and length. The full interview is available on all podcast networks as part of Worth’s Power and Impact with Jim McCann series.

McCann: You’ve taken a sound health system and made it a great health system. And that’s hard to do. How do you reshape your next set of goals?

Dr. Robert Grossman: So getting there is just the beginning, honestly. The goal is building sustainability and continuing the dynamism, growing the vision and enterprise, having a reasonable strategic plan, and then continuing to execute that plan. You need to be totally focused on the goals you continue to set. And by that, I mean a lot of businesses, when they achieve success, they get defocused.

Vizient, an agency that collects data on health systems around the country, recently rated NYU Langone Health System as the number one teaching health system in the country. What impact has that elevation of the NYU Langone Health System brand had on the NYU brand?

We are part of NYU, but we’re also separate because health is very different from the rest of the university. The biggest part of our business is actually taking care of patients. And I use the term business as opposed to educational business. I think we’ve been a tremendous asset to the university and have a wonderful partnership with them. But culturally, we are different because we’re this big business with a large research component and a relatively small educational component. The university is basically an academic business with a small business component. I focus on trying to do the best I can for the institution.

I would like to know if, in your new set of goals, there might be the idea to increase class size from 105 students in the future?

How Dr. Robert Grossman made the NYU Langone Health System the number one teaching hospital in the country.

We think about that. What we’ve done is have a second medical school on Long Island focused on internal medicine, family practice, and primary care. We felt that if we were going to focus on primary care, it would be more advantageous to do it on Long Island. We created a curriculum that was for individuals who desired from the start to do primary care. So we did increase the size of the school.

But the problem with increasing the size of the medical school in Manhattan is that a lot of education would go on the ambulatory side. In doctors’ offices, you want to make sure the opportunities for the students are excellent. You don’t want 20 students; you want five or three students or one-on-one.

I wonder if you’re seeing any benefits of remote psychiatric services. Are people being treated more effectively and frequently through digital contact?

What I know for sure is that accessibility has had a positive effect on students particularly. When I went to medical school, I didn’t know anybody who sought psychiatric help. [Now] 40 percent of the class has engaged at one level or another in mental health counseling.

I’m going to guess that’s because of two things. One, the stigma is gone. And two is that people are having more considerable challenges because of the complications of natural life here in the city and COVID.

And how to deal with stress.

Under your leadership, the NYU Langone Health System was the recipient of a substantial NIH grant to coordinate all the national research efforts related to long COVID and what we’ll be dealing with for the next ten years. How should we think and expect to deal with long COVID for the next decade?

Well, the first thing I would say to every listener is “Make sure you’re fully vaccinated.” That is critical to prevent getting long COVID. The probability of getting long COVID increases with the severity of the disease and hospitalization.

Hospitalization doesn’t cause it; it’s just emblematic that you have a more severe case of the disease.

You can get long COVID and not be hospitalized. But if you’re hospitalized, there’s a higher probability of getting long COVID. And it’s a terrible problem.

At the Grossman School of Medicine at NYU, just a few years ago, you and Ken [Langone] announced at the white coat ceremony at graduation that in the future, there would be no tuition. The place erupted, families were crying, and people were screaming. And then you went further to say and for those of you who are already here, and on a second or third year [get the same], and of course you engineered, and revolutionarily changed the curriculum to make it a three-year curriculum rather than four. It’s changing how people look at medical education. I know it took Ken a few years to endow the school so you could do just that, and then just a week later, I think it was John Hopkins, Michael Bloomberg

wrote a check so that they could do it. How do you think that will reverberate around medical health care nationwide, maybe worldwide?

What was happening to our students was that they were graduating with this enormous debt burden. And they weren’t any different than any other students around the country going to medical school, the average debt for students in medical school was $200,000 a year. For a married medical student, it’s $400,000, $500,000 a year. So I thought it was a moral imperative to become tuition free. As a scholarship kid, I knew how to live from hand to mouth. They were living on the margin; their parents were working like crazy to help support these kids.

We wanted a lot of copycats because it wasn’t only about us. It’s about the country. Unfortunately, it’s a difficult thing to do. When you have somebody like Ken Langone, who’s your chairman, and it [still] took us 12 years to do it, it’s very difficult. It means focusing on this particular issue, as opposed to using philanthropy for other things. It was important for future doctors to graduate with a minimal amount of debt.

The two researchers who develop the Pfizer mRNA vaccine expressed some confidence that they would have a cancer vaccine within the decade, your thoughts?

You know, this isn’t a new idea about a cancer vaccine. Basically, the idea is the same in terms of immunization against cancer, which has different antigens than your normal body. So it’s very possible, it would be great.

“It was a moral imperative to become tuition free... It was important for future doctors to graduate with a minimal amount of debt.”

MARCH

Lake Nona Impact Forum

MARCH 8-10, 2023

LAKE NONA, FL

The Lake Nona Impact Forum was founded in 2012 as a gathering for companies and thought leaders in healthcare and wellness innovation. Held in Lake Nona, FL., the conference hosts 300 attendees including government and policy leaders, physicians and healthcare pioneers, prolific academics, technology visionaries, as well as promising start-ups, professional athletes and entertainers, and C-Suite executives. This year’s program will cover topics climate change and public health, brain health, health equity, cancer prevention, food as medicine, and more.

TED Conference

APRIL 17-21, 2023

VANCOUVER, BC

The theme for TED this year is “Possibility,” during which speakers and participants can explore opportunities for our current system, or lives, to expand. TED continues to be a platform for visionary thinkers, and if you can stomach the $10,000 registration fee, it’s well worth your time. Held in the beautiful Vancouver Convention Centre, which sits right on the water, you could consider the experience at TED as a vacation for your mind. Speakers have yet to be announced publicly, but you can sign up for updates here and watch previous TED conference talks to see past TED speakers.

SXSW

MARCH 10-19, 2023

AUSTIN, TX.

The inimitable South by Southwest is back and better than ever. 2022 was the first year that the tech-musicfilm-culture festival was able to resume in person, and 2023 promises to be even more active. Keynotes for this year include the CEO of Patagonia, and guests from NASA, including the team leader and several deputy project scientists for the James Webb Space Telescope. Additional keynote speakers, featured conference speakers, and musical guests will be announced in the coming weeks. Registration options include in-person or online participation.

APRIL MAY

The Met Gala

MAY 1, 2023

METROPOLITAN MUSEUM, NEW YORK

If you didn’t already know, the fashion industry’s “Big Night Out” is an annual (and very effective) fundraiser for The Metropolitan Museum of Art’s Costume Institute. This year’s theme is “Karl Lagerfeld: A Line Of Beauty” in honor of the legendary designer who passed away in 2019. Met curator, Andrew Bolton, has said that the event will not be a traditional retrospective of Lagerfeld, but a look at the evolution of his vision, via the sketches he created that, became clothing that landed on the runway. Each year, designers interpret the theme into outfits for their clients to wear to the event--clients that include the biggest names in fashion, film, music, theater, culture, and society.

Coachella

APRIL 14-16 & 21-23, 2023 INDIO, CA

The Coachella Valley Music and Arts Festival has become a must-do for many people, especially those who love music. It has also become one of the most in-demand concert tickets. Held at the Empire Polo Club in Indio, CA., the musical lineup each year is a who’s who of popular music, spanning genres and often breaking entertainment boundaries. This year’s lineup includes headliners Bad Bunny, BlackPink, and Frank Ocean, along with notable acts like Chemical Brothers, Blondie, boygenius, Charlie XCX, Bjork, and DJ Calvin Harris.

Summit at Sea

MAY 18-21, 2023

“AT SEA”

The Summit Conference Series has become a go-to experience for multi-generational conference-goers. Past speakers have included Jane Fonda, Jeff Bezos and his brother Mark, Malcolm Gladwell, DJ Mark Ronson, John Legend, and others who blend creativity with innovation and business. Conference formats range from talks and on-stage interviews to experiences like performance art, culinary events, and concerts. This year’s lineup includes designer Stefan Sagemeister, Barry Sternlicht, Chairman and CEO of Starwood, Tristan Harris of the Center for Humane Technology, Dr. Peter Attia (see this month’s cover), and DJ Spindarella, formerly of Salt-n-Pepa.

FROM SXSW TO THE SUMMIT AT SEA, THESE ARE THE MUST-SEE EVENTS OF THE SPRING