Under Load

For years I've told people the same thing: get outside in the morning, move, catch some daylight. The advice came from Andrew Huberman's podcast, which I had followed for years. When his book Protocols came out on September 15, I started reading right away. After about 20 pages I stopped. The book gives morning light a dose: five to ten minutes on a clear day, fifteen if it's cloudy, thirty if it's heavily overcast. I had passed on those numbers without ever asking where they came from.So I went looking. This episode of Under Load is a doctor's check of the 47 protocols in the book, from the perspective of a physician and a busy person.The book's notes hold 1,126 numbered entries and about 1,730 references. With AI help, I matched them to 1,243 different papers in PubMed and pulled 438 Huberman Lab podcast transcripts. Then I reviewed every protocol myself. About 1 in 11 of those papers is tagged as a randomized trial. 22 of the 47 protocols give a specific number of minutes, grams or degrees that I couldn't find a study to support. Follow all 47 as written and you'd need about 25 hours a week.In this episode:- Where the morning sunlight minutes came from, and what the research on daylight, sleep, mood and mortality shows.- The "50 percent cortisol" claim, and the lab study of eight sleep-deprived men behind it.- A reader who wakes up in the dark nine months a year, my Berlin winters, and the 10,000 lux lamp on our breakfast table.- Caffeine: where the book and the data agree, and the morning coffee delay I couldn't find a trial for.- Alcohol: why I'd replace the 8-hour rule with a simpler one. No amount has been shown to help you live longer.- Strength training: what the mortality data support, and why I train six to seven hours a week anyway.- Why health research describes the average person, and how to test advice on yourself without doing anything harmful.- Two protocols where the risk outweighs the benefit: warming the bedroom before waking, and sun on bare skin for testosterone.The episode closes with seven habits that made the cut, most of which take no extra time: a fixed wake time, a coffee cutoff, no nightcap, about 7,000 steps a day, strength and cardio twice a week, and a mostly unprocessed diet built on protein and plants.[Visit The Upward ARC and subscribe](https://www.andreheeg.com).Under Load is the Sunday edition of The Upward ARC, by Andre Heeg, MD, DDS, physician and reconstructive facial surgeon. This edition sits within the Activate pillar: sleep, movement and food.This episode is general health education, not individual medical advice. For your own symptoms or decisions, talk to your doctor.### Key sources- Huberman, A. D. (2026). *Protocols: An Operating Manual for the Human Body*. Simon & Schuster.- [Burns et al., 2021, *Journal of Affective Disorders*](https://doi.org/10.1016/j.jad.2021.08.056): outdoor light, mood and sleep in UK Biobank.- [Windred et al., 2024, *PNAS*](https://doi.org/10.1073/pnas.2405924121): day and night light exposure and mortality in 88,905 people.- [Leproult et al., 2001, *Journal of Clinical Endocrinology & Metabolism*](https://doi.org/10.1210/jcem.86.1.7102): morning bright light and cortisol.- [Pjrek et al., 2020, *Psychotherapy and Psychosomatics*](https://doi.org/10.1159/000502891): light therapy for seasonal affective disorder.- [Gardiner et al., 2023, *Sleep Medicine Reviews*](https://doi.org/10.1016/j.smrv.2023.101764): caffeine and sleep.- [Zhao et al., 2023, *JAMA Network Open*](https://doi.org/10.1001/jamanetworkopen.2023.6185): daily alcohol intake and all-cause mortality.- [Bagnardi et al., 2013, *Annals of Oncology*](https://doi.org/10.1093/annonc/mds337): light drinking and cancer.- [Gardiner et al., 2025, *Sleep Medicine Reviews*](https://doi.org/10.1016/j.smrv.2024.102030): alcohol and sleep.- [Momma et al., 2022, *British Journal of Sports Medicine*](https://doi.org/10.1136/bjsports-2021-105061): muscle-strengthening activity and mortality.- [Okamoto-Mizuno & Mizuno, 2012, *Journal of Physiological Anthropology*](https://doi.org/10.1186/1880-6805-31-14): thermal environment and sleep.- [Parikh et al., 2021, *Cell Reports*](https://doi.org/10.1016/j.celrep.2021.109579): UVB exposure and sex hormones.- International Agency for Research on Cancer, 2012, IARC Monographs Vol. 100D: solar and ultraviolet radiation.- [Windred et al., 2024, *Sleep*](https://doi.org/10.1093/sleep/zsad253): sleep regularity and mortality.- [Ding et al., 2025, *The Lancet Public Health*](https://doi.org/10.1016/S2468-2667(25)00164-1): daily steps and health outcomes.- [Bull et al., 2020, *British Journal of Sports Medicine*](https://doi.org/10.1136/bjsports-2020-102955): WHO guidelines on physical activity.

My flight from Berlin to Munich was delayed by an hour, so I found a seat in the lounge and opened the October issue of manager magazin. The cover story, "Das große Rauswerfen," says tens of thousands of German executives are losing their jobs. In 2025, Germany had an average of 49,000 unemployed managers, the highest number since 2015.As I read the article, many of these managers spent years coordinating other people's work. Their companies asked them to do exactly that. I don't know why any one of them lost a job, and I won't guess.The article made me ask one question: what am I doing to protect myself from a professional setback? My honest answer was uncomfortable. Over the years, I've lost the skill of making things.This episode of Under Load looks at what happens to skills you stop using, and at what I've been doing about it.In 2025, 4 economists published data on German adults aged 16 to 65 who took a reading and a math test, and took them again about 3.5 years later. On average, skills kept improving into midlife. Reading peaked at 46 and math at 41. People who used their skills more showed no average decline at any age. For people who used them less, the decline began in the mid-30s. The study measured reading and math only, and it can't prove that using a skill protects it.I also look at the hardship we buy: cold showers, the sauna, the misogi, backyard ultras. I like all of it. I haven't found any evidence that it keeps work skills sharp.We also cover:Why a promotion changes what you do every day, and which tasks are often handed off first.What Andrew Huberman told Joe Rogan about hard things and impulse control, and why I leave that question open.The misogi and Marcus Elliott's 2 rules, as told by Michael Easter.The IKEA experiment from 2011: people who built a storage box bid $0.78 for it, others bid $0.48, and the effect only appeared when they finished the job.Huberman's story of the man at the edge of the boxing ring.What my first LinkedIn posts with 5 likes taught me, and 4 things I've built since.One open question I don't answer: what happens over time if we hand even more of the thinking and doing to AI.The episode closes with 3 things to try: take stock of what you no longer make, create one first version yourself, and try a small misogi at work.Visit The Upward ARC and subscribe.Under Load is the Sunday edition of The Upward ARC, by Andre Heeg, MD, DDS, physician and reconstructive facial surgeon. This edition sits within the Capacity pillar: what you can still do, kept alive by actually doing it.Key sourcesmanager magazin, October 2026 (issue 10/2026): cover story "Das große Rauswerfen."Handelsblatt, January 14, 2026: unemployment among managers in Germany.Deutsche Presse-Agentur via Autohaus, September 30, 2026: BMW management cuts by mid-2027.Hanushek, Kinne, Witthöft & Woessmann, 2025, Science Advances: age and cognitive skills, "use it or lose it."The Joe Rogan Experience, No. 2553, Andrew Huberman, September 14, 2026.EconTalk, July 19, 2021: Michael Easter on the comfort crisis and the misogi.Itzler, 2015, Living with a SEAL: 31 Days Training with the Toughest Man on the Planet.Runner's Tribe, June 26, 2025: backyard ultra record of 119 loops.Norton, Mochon & Ariely, 2011, Harvard Business School Working Paper 11-091: the "IKEA effect."

"No one knows this yet." A friend I've known for more than fifteen years said it at lunch, just before the waiter arrived. Her career looked very solid. She was thinking about what comes next anyway. Within a few weeks, I heard almost the same question from five people who don't know each other.None of them are in trouble, and none of them want to retire. They're still building, still have financial goals, and are asking in the middle of their careers: how many more years do I want to keep doing this, and how do I want to spend them?This episode of Under Load looks at why that question arrives in midlife, and what it means for your health.In 1968, the psychologist Bernice Neugarten described middle age as the point where life is restructured around the time left rather than the time since birth. Laura Carstensen's research at Stanford explains the mechanism: when time feels limited, we shift from collecting knowledge, contacts and status toward what matters emotionally. Her studies showed the shift depends on perceived time, not age. It appeared in older adults, in young adults in Hong Kong before the 1997 handover, and in young men living with HIV.I argue that counting backwards is the same shift, applied to work. Age can move your horizon, and so can a health issue or an uncertain future. For me, it started with severe back pain and a summer evening on a terrace in 2024.We also cover:Why nobody says it out loud, and what psychologists call pluralistic ignorance, including a study of board directors who each doubted a failing strategy and stayed quiet.What the "midlife crisis" data shows, and why the people aged 49 to 53 in one study described "shortened futures."A German study of workers in their fifties: those who wanted to change profession but didn't had worse mental health.Purpose in life and health, from a 2026 meta-analysis of nearly 490,000 people.The honeymoon-hangover effect, and why a new job title rarely settles the question.Why any answer has to cover the household first, and why years and healthy years are two different counts.The episode closes with five things to try: the backwards count, the five-year test, a small real-world experiment, telling one trusted peer, and putting a number on the money fear.Visit The Upward ARC and subscribe.Under Load is the Sunday edition of The Upward ARC, by Andre Heeg, MD, DDS, physician and reconstructive facial surgeon. This edition sits within the Capacity pillar: what you can still learn, the skills you build, and the reserves your mind and body carry into later life.Key sourcesNeugarten, 1968, Middle Age and Aging: "The awareness of middle age" and time-left-to-live.World Economic Forum, 2025: The Future of Jobs Report 2025, employer-survey projections to 2030.Carstensen, Isaacowitz & Charles, 1999, American Psychologist: socioemotional selectivity theory.Fung, Carstensen & Lutz, 1999, Psychology and Aging: time horizons, the imagined 20 extra years and the Hong Kong handover.Carstensen & Fredrickson, 1998, Health Psychology: HIV status, age and perceived time.Westphal & Bednar, 2005, Administrative Science Quarterly: pluralistic ignorance in corporate boards.Wethington, 2000, Motivation and Emotion: what Americans mean by "midlife crisis."Garthe & Hasselhorn, 2022, Ageing & Society: changing and wanting to change profession in later working life.Bigos et al., 1991, Spine: job enjoyment and reported back injury.Sutin et al., 2026, Psychological Medicine: purpose in life and mortality, 488,765 participants.Boswell, Boudreau & Tichy, 2005, Journal of Applied Psychology: the honeymoon-hangover effect.Garmany & Terzic, 2024, JAMA Network Open: healthspan-lifespan gaps in 183 countries.

In a dusty square in Kathmandu, men waited for minibuses in a deep squat. I took those minibuses to the hospital, where I worked in traumatology, and began wondering why I rarely used that position myself.Years later, during an hour's wait outside an embassy with my family, I was the only person in the queue squatting.This episode of Under Load looks at mobility as we age, with a practical question for anyone whose working week involves a lot of sitting: which everyday movement do you want to keep being able to do?I discuss how flexibility, strength and balance contribute to getting into and out of a position. The LIFE trial gives us evidence about preserving walking ability in older adults with physical limitations. Stretching studies help estimate how much practice may be useful, although much of that evidence comes from younger adults.The episode covers the estimated ten minutes of stretching per muscle group each week, why that estimate needs care, and what researchers mean by tissue stiffness and stretch tolerance. I also look at resistance training's effects on flexibility and the limits of the comparisons between different training intensities.The practical section contains a supported squat, a hip-flexor stretch, a calf stretch and a supported one-leg stand. The sequence and starting amounts are my recommendation; the exact routine hasn't been tested as a package. I explain how to begin with support and observe progress without making every session harder.The closing question is about the movement you've started avoiding. That gives the practice a purpose you can recognize outside an exercise session.[Visit The Upward ARC and subscribe](https://www.andreheeg.com).Under Load is the Sunday edition of The Upward ARC, by Andre Heeg, MD, DDS, physician and reconstructive facial surgeon. This edition sits within Activate, with Capacity as the reason to continue.Key sources:- [Pahor et al., 2014, JAMA](https://doi.org/10.1001/jama.2014.5616): the LIFE randomized trial of structured physical activity and walking disability in older adults.- [Guirguis-Blake et al., 2024, JAMA](https://doi.org/10.1001/jama.2024.4166): exercise interventions and falls in older adults.- [Ingram et al., 2025, Sports Medicine](https://doi.org/10.1007/s40279-024-02143-9): static stretching dose and flexibility.- [Oba et al., 2026, Sports Medicine – Open](https://doi.org/10.1186/s40798-026-01066-1): age and other characteristics in stretching adaptations.- [Ingram et al., 2025, Sports Medicine](https://doi.org/10.1007/s40279-025-02204-7): possible mechanisms behind changes in range of motion.- [Favro et al., 2025, Journal of Strength and Conditioning Research](https://doi.org/10.1519/JSC.0000000000005000): resistance training and flexibility.- [NHS balance guidance](https://www.nhs.uk/live-well/exercise/balance-exercises/) and [strength guidance](https://www.nhs.uk/live-well/exercise/strength-exercises/): supported starting exercises and gradual progression.Audio noteAndre reads the written newsletter, adapted for speech. Some figures are rounded and inline citations are omitted. The written edition contains the full references and exact reported figures.Medical noteThis episode provides general education. Adapt exercise to your health and current ability. Stop for pain, numbness or tingling. Recent surgery, restricted joint replacements or recurrent falls call for individual guidance from your clinician or physiotherapist.

Karla said people were too loud. Everyday voices suddenly felt overwhelming after doctors put small tubes in her eardrums.Our youngest had spent years struggling to hear us and tell us what she needed. She’s six now, and I’ve finally felt ready to write about it.This episode follows her progress, our doubts about a bilingual kindergarten, and the conversations I want people to be able to follow at work and at home. My wrestling ears make an appearance too, along with an expensive pair of custom earphones that finally stayed in.### In this episode- Karla’s glue ear and the long wait for answers.- A study of middle-aged adults with normal standard hearing tests, and what their pupils suggested about effort after listening in noise.- The difference between hearing-related fatigue and the need to recover from a working day.- What employees with hearing loss said made video meetings easier to follow.- The ACHIEVE trial’s overall result and its often-quoted 48% subgroup result, with the comparison and limitations explained.- Practical questions for a hearing appointment, and Karla starting first grade.### Written edition and subscriptionFind Under Load and subscribe at [andreheeg.com](https://www.andreheeg.com).All 16 references are included in the written edition.Under Load is the Sunday edition of The Upward ARC, written by Andre Heeg, MD, DDS, on executive health, longevity and sustained performance.### Key sources- [NICE guidance on glue ear in children](https://www.nice.org.uk/guidance/ng233/chapter/Recommendations) and [adult hearing assessment and care](https://www.nice.org.uk/guidance/ng98/chapter/recommendations).- [MacKeith and colleagues, 2023](https://doi.org/10.1002/14651858.CD015215.pub2): the Cochrane review of ventilation tubes for children with glue ear.- [Zink and colleagues, 2025](https://doi.org/10.7554/eLife.102823): listening effort in adults with normal standard hearing tests.- [Holman and colleagues, 2021](https://doi.org/10.1177/23312165211052786), [van Leeuwen and colleagues, 2022](https://doi.org/10.1097/AUD.0000000000001127), and [Gussenhoven and colleagues, 2017](https://doi.org/10.1177/2331216517692304): fatigue and recovery outcomes across different study designs.- [Marsja and colleagues, 2026](https://doi.org/10.1177/10519815251398498): interviews about access to video meetings for employees with hearing loss.- [Ferguson and colleagues, 2026](https://doi.org/10.1002/14651858.CD012023.pub3): hearing aids for adults with mild to moderate hearing loss. [Ohlenforst and colleagues, 2017](https://doi.org/10.1097/AUD.0000000000000396) reviewed the separate outcome of listening effort.- [Lin and colleagues, 2023](https://doi.org/10.1016/S0140-6736(23)01406-X): ACHIEVE, which tested hearing care against health education in older adults.- [Cantuaria and colleagues, 2024](https://doi.org/10.1001/jamaoto.2023.3509): the observational Danish study of hearing loss and later dementia.- [NIDCD guidance on noise-induced hearing loss](https://www.nidcd.nih.gov/health/noise-induced-hearing-loss).### About the audioAndre reads the written newsletter, adjusted for speech. Reference numbers are omitted from the recording; the written edition carries the citations.AI assisted with research, drafting and adapting this piece for different formats. I chose the argument and examples, reviewed the evidence, edited the final text and take responsibility for every published claim.This episode is general information and does not replace an assessment by your own clinician. If your hearing suddenly worsens over three days or less, seek medical assessment within 24 hours. [NICE guidance](https://www.nice.org.uk/guidance/ng98/chapter/recommendations).