The Night a Wearable Would Score as a Failure
It’s past midnight, and the waiter has stopped pretending he wants us to leave.
He stacks chairs at the far end of the room, moving slowly, as if he no longer cares. The candle on our table is gone. We’re the last two in the restaurant, taking our time.
An old friend, one of my closest. We started the night with a Negroni each, just like we used to. Then we shared a bottle of red that was better than it needed to be. The steaks are gone. The table is covered in empty glasses and bread.
We talked about his relationship. We talked about my kids. We talked about work, especially the parts we never share online. We talked about the future, our plans, and ideas that aren’t fully formed. We even talked about our fears, the kind of conversation you only have this late, with this friend, after a bottle of wine.
I’m a doctor. I know what those drinks will do to me over the next two days. I sleep better now than I used to. I stopped wearing my Oura ring a year ago. I feel the trade-off as it happens, and I choose it on purpose.
I wouldn’t trade this night for a perfect recovery score. Not even for ten perfect scores.
There’s an honesty at this table you don’t find in a quiet office with a professional. Two old friends, past midnight, telling each other the truth about their lives.
It’s one of the best things I’ll do for my health all month. No wearable device would ever count it as a success.
A Few Days Later
I saw a man say that a night like this has ruined three days of his life.
He was speaking into a podcast microphone. He hadn’t been drunk. Just a couple of glasses of wine at dinner, he said, and it affected him for three days. He slept worse, ate worse the next day, and skipped the gym. Then he said the line that went viral: “I podcasted worse.”
Oh boy. That escalated fast.
The man was Steven Bartlett, host of Diary of a CEO, one of the world’s biggest podcasts. Within two days, he became a symbol of something many people were tired of. A BBC Radio 1 host even called for an anti-optimization movement. A man with a fitness tracker had called a normal evening with wine a three-day disaster, and people online had had enough.
I watched with mixed feelings. The physical effects he described are real. I’ve written about them before. But I see things differently.
He blamed the wine. But the wine wasn’t the real problem. What really cost him three days was the tracker on his wrist and the story it told him about a normal night.
The Part Where I Agree With Him
Let me be clear about the science. This is where I stand, and I won’t change it just to make a point.
Alcohol isn’t good for you. The largest analysis we have, covering 195 countries, found that the amount of drinking that does the least harm to your health is zero [1]. Not one glass. Zero. Even light drinking raises the risk of several cancers. For women, every 10 grams of alcohol a day, about one small glass of wine, raises breast cancer risk by roughly 10 percent. Wine is no exception [2].
And it does disturb your sleep. Alcohol helps you fall asleep faster at any dose, but then it breaks up the second half of the night. At moderate and higher doses, it also reduces your REM sleep [3]. So when Bartlett says the wine cost him a bad night and a worse next day, he’s right. I’ve felt it. You’ve felt it.
That’s why I made alcohol the exception, not the rule. I don’t have a glass most nights. I save it for special occasions, like the dinner I described. I knew the cost ahead of time, and I’m fine with it.
So if the evidence is on his side, what did he get so wrong?
The Cost of Keeping Score
Here’s where the optimized life goes wrong. The harm from an occasional glass of wine is small and lasts a day or two. But treating your body like a business report does much more harm and lasts for years.
Start with the tracker. Sleep researchers have a name for this: orthosomnia. In several cases, patients became so focused on perfecting their sleep scores that the obsession made their insomnia worse [4]. The device meant to help them ended up causing trouble.
Then there’s stress. A study of nearly 29,000 adults found something I think about often. People under high stress had a 43% higher risk of dying early, but only if they believed stress was harming them. Those under the same high stress who didn’t see it as a threat had no higher risk [5]. The belief did as much damage as the stress.
The way you think about a bad recovery score might hurt you more than what caused it in the first place.
And we’re getting worse at this. The pressure to meet other people’s standards, what researchers call socially prescribed perfectionism, keeps rising. By 2017, two-thirds of young adults scored above the 1989 average [6]. We’re making ourselves anxious by trying to be perfect. That slow, steady stress has a name too: allostatic load, the biological cost your body pays after years of stress. Over time, it wears down your heart, metabolism, and brain [7].
One more honest note, because it cuts both ways. The old idea that moderate drinking helps you live longer was mostly a statistical artifact. Once you stop counting the “non-drinkers” who are really sick people who quit, the apparent benefit mostly disappears [8]. The largest recent review, almost five million people, found no real protection at low levels [9]. So don’t drink for your health. And don’t punish yourself over the glass you had with a friend. Both follow from the same evidence.
What the Trackers Miss
If the small things are just for show, what really matters? The things that affect how long you live are usually simple, and most can’t be tracked by any device.
Connection is near the top. A review of 148 studies involving more than 300,000 people found that those with strong social relationships had a 50% higher chance of surviving the follow-up period. The authors put it on par with quitting smoking, ahead of obesity and inactivity [10]. The reverse holds. Isolation, loneliness, and living alone each raise the risk of early death by around 30%, on the scale of obesity itself [11].
It runs deeper than a headcount. Adults over 50 with the weakest sense of purpose had nearly two and a half times the risk of dying compared to those with the strongest [12]. Even meaning shows up in the mortality tables.
Think back to that restaurant table. Two old friends, talking honestly late into the night. There’s real science behind this. The same endorphins released when we laugh or sing also appear when we share a drink. This chemistry brings people closer, and those who keep up these social habits have bigger support networks and more trust in their communities [13]. The dinner was the real medicine that night. The wine was just there.
Do the Basics, Then Stop
There’s one more thing, and it’s what lets you relax.
The basics work, and then doing more doesn’t help. A pooled study of 661,000 adults found that the risk of early death dropped quickly as people went from doing nothing to meeting the basic activity guidelines, then kept improving up to three to five times that level, and then leveled off. Doing ten times the minimum added nothing [14]. Almost all the benefits come from the first ordinary dose.
That’s how most things in health work. Sleep seven to eight hours. Move and lift something heavy a few times a week. Eat mostly real food. Stay close to people you care about. Do work that matters to you. If you get these right, you’ve covered most of what matters.
It’s fun to try new things, like the cold plunge, the latest breathing app, or the supplement of the month. I do it too. But the basics give you almost all the benefits. The new stuff is just the last one percent, and you only get there after you’ve handled the basic 99%.
A landmark study followed five simple habits: never smoking, keeping a healthy weight, regular movement, a decent diet, and, believe it or not, moderate drinking. Those five added 12-14 years to life expectancy [15]. You could argue, as the alcohol researchers earlier would, whether that last one truly belongs. But notice the pattern. The gold standard for a long, healthy life includes a glass of wine. It was never about living like a monk.
We’re Coming Back to Our Senses
I think we’re at a turning point, and the way people reacted to that clip shows it clearly.
For years, the culture pushed us in one direction: more tracking, more routines, more new health trends. Some of it helped. But things kept escalating until someone could say a glass of wine ruined three days, and a million people finally said enough.
That reaction wasn’t really about him. It was a sign. People are starting to remember that connection, a few good habits, and some moderation have always been the answer. Common sense is coming back.
This doesn’t mean you should ignore the science. Your tracker can teach you something real. Wear it for a month, see how alcohol and late nights affect your numbers, and then trust what you’ve learned. The readiness score is just information. It’s not a judgment on your day, and it’s not worth chasing for its own sake.
In my Upward ARC framework, this idea fits into two pillars. Recover, because connection and a calm mind help you reset, while constant self-scoring keeps you stressed. And Capacity, because moderation, the discipline to do the basics and then stop, is what helps you keep going for years instead of burning out over a number.
Try This Today
The Occasion Rule: The goal isn’t zero. It’s to stop pouring a glass out of habit on a random Tuesday and save it for nights that matter. A dinner with an old friend is worth it. A glass alone in front of your laptop isn’t. Make your choice on purpose.
The Sunday Check: If you use a tracker, stop worrying about single mornings. One bad number means almost nothing. Check your numbers once a week, maybe every Sunday, compare this week to last, and see if you missed one of your basics. Then adjust. Checking every day mostly just adds stress.
The Standing Table: Schedule one relaxed evening with people you care about, and protect it as you would a board meeting. Keep your phone in your pocket. Don’t leave early for an alarm. Don’t feel guilty the next day. That evening is part of your health. Treat it that way.
The Subtraction Audit: List everything you do for your health right now. Then cut the one with the weakest evidence and the most effort. Maybe it’s the cold plunge you hate, the eleventh supplement, or the routine you follow just because. Cutting back often helps more than adding something new.
Last Call
It’s almost one in the morning. My friend and I finally get up, because the staff deserves to go home and we’ve said what we needed to say. I’ll sleep worse tonight. I knew that when I ordered the second bottle. Tomorrow I’ll move a little slower, drink some water, and get back to the basics I always stick to.
It will have been worth every minute.
Somewhere else, someone with a perfect recovery score is going to bed on time, proud of his podcast and tracking every detail of his evening. I don’t envy him. I think he’s missing the point.
A glass of wine might cost you a day. But obsessing over the numbers can cost you the dinner, the friend, and the honest talk at midnight. Those are the real reasons any of this matters.
Do the basics as if your life depends on them, because it does. Then put the tracker away, pour a drink for someone you care about, and stay at the table.
Moderation is the harder skill. It means knowing the science well and still choosing to enjoy the night.
Stay healthy.
Andre
PS: If this message came at the right time for you, send it to the friend you’d want to sit with at midnight. Tell them dinner’s on you. That’s how this newsletter grows, and it’s the only way I want it to.
References
[1] GBD 2016 Alcohol Collaborators. (2018). Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 392(10152), 1015-1035.
[2] Sun, Q., Xie, W., Wang, Y., Chong, F., Song, M., Li, T., Yang, Y., & Tang, H. (2020). Alcohol consumption by beverage type and risk of breast cancer: A dose-response meta-analysis of prospective cohort studies. Alcohol and Alcoholism, 55(3), 246-253.
[3] Ebrahim, I. O., Shapiro, C. M., Williams, A. J., & Fenwick, P. B. (2013). Alcohol and sleep I: Effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37(4), 539-549.
[4] Baron, K. G., Abbott, S., Jao, N., Manalo, N., & Mullen, R. (2017). Orthosomnia: Are some patients taking the quantified self too far? Journal of Clinical Sleep Medicine, 13(2), 351-354.
[5] Keller, A., Litzelman, K., Wisk, L. E., Maddox, T., Cheng, E. R., Creswell, P. D., & Witt, W. P. (2012). Does the perception that stress affects health matter? The association with health and mortality. Health Psychology, 31(5), 677-684.
[6] Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410-429.
[7] Guidi, J., Lucente, M., Sonino, N., & Fava, G. A. (2021). Allostatic load and its impact on health: A systematic review. Psychotherapy and Psychosomatics, 90(1), 11-27.
[8] Stockwell, T., Zhao, J., Panwar, S., Roemer, A., Naimi, T., & Chikritzhs, T. (2016). Do “moderate” drinkers have reduced mortality risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality. Journal of Studies on Alcohol and Drugs, 77(2), 185-198.
[9] Zhao, J., Stockwell, T., Naimi, T., Churchill, S., Clay, J., & Sherk, A. (2023). Association between daily alcohol intake and risk of all-cause mortality: A systematic review and meta-analyses. JAMA Network Open, 6(3), e236185.
[10] Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316.
[11] Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227-237.
[12] Alimujiang, A., Wiensch, A., Boss, J., Fleischer, N. L., Mondul, A. M., McLean, K., Mukherjee, B., & Pearce, C. L. (2019). Association between life purpose and mortality among US adults older than 50 years. JAMA Network Open, 2(5), e194270.
[13] Dunbar, R. I. M., Launay, J., Wlodarski, R., Robertson, C., Pearce, E., Carney, J., & MacCarron, P. (2017). Functional benefits of (modest) alcohol consumption. Adaptive Human Behavior and Physiology, 3(2), 118-133.
[14] Arem, H., Moore, S. C., Patel, A., Hartge, P., Berrington de Gonzalez, A., Visvanathan, K., Campbell, P. T., Freedman, M., Weiderpass, E., Adami, H. O., Linet, M. S., Lee, I. M., & Matthews, C. E. (2015). Leisure time physical activity and mortality: A detailed pooled analysis of the dose-response relationship. JAMA Internal Medicine, 175(6), 959-967.
[15] Li, Y., Pan, A., Wang, D. D., Liu, X., Dhana, K., Franco, O. H., Kaptoge, S., Di Angelantonio, E., Stampfer, M., Willett, W. C., & Hu, F. B. (2018). Impact of healthy lifestyle factors on life expectancies in the US population. Circulation, 138(4), 345-355.
A note for new readers:
I’m a trained reconstructive facial surgeon, medical doctor, and dentist. Before launching this newsletter, I had a varied career: competitive freestyle wrestler, management consultant (McKinsey), entrepreneur (Zocdoc, Thermondo, and docdre ventures), and corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.
Husband of one. Father of three. Split between Berlin’s urban pulse and our Baltic Sea retreat. I’d rather be moving than sitting. Not just hobbies. Research. My body is my primary laboratory; I’ve been conducting experiments for decades.
If this is your first time here, welcome. I’m excited to share what I’ve learned and will continue to learn with you.
DISCLAIMER:
Let’s get one thing straight: None of this, whether text, graphics, images, or anything else, is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.
Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.
If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in The Upward ARC. Be smart. Do your research. And, as always, take care of yourself.