The Peter Attia Drive Podcast on longevity, supplements, protein, fasting, apoB, statins, & more

276 ‒ Special episode: Peter on longevity, supplements, protein, fasting, apoB, statins, & more 145,746 views Oct 23, 2023 The Peter Attia Drive Podcast Watch the full episode and view show notes here: https://bit.ly/491o7WL Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ In this special episode of The Drive, Peter discusses a variety of topics, breaking away from the typical deep-dive format to explore a wide range of common questions submitted by listeners. Peter tackles subjects like the viability of living to 120 and beyond, addressing some of the optimistic theories regarding achievement of this remarkable feat. Peter then shares his drug and supplement regimen while emphasizing how individualized these protocols need to be. The conversation also touches on lowering apoB, the long-term use of statins, the myth of good vs. bad cholesterol, the complexities of nutrition research, the quest for the ideal diet, and Peter's strategies for hitting daily protein goals. Peter finishes with a discussion about his favorite health-tracking wearables, the role of CGM in non-diabetics, and more. We discuss: 0:00:00 - Intro 0:00:55 - Overview of topics and previous episodes of a similar format 0:03:00 - The viability of living to 120 and beyond: some optimistic theories 0:13:21 - The potential of mTOR inhibition as a mid-life intervention, and longevity potential for the next generation 0:17:00 - A framework for thinking about geroprotective drugs and supplements in the context of a lack of aging biomarkers 0:27:10 - Supplements Peter takes and how his regimen has changed in the last year 0:39:41 - Pharmacologic strategies to lower ASCVD risk, the limitations of statins, nutritional interventions, and more 0:53:10 - Misnomers about cholesterol 1:07:07 - Why nutritional research is so challenging, some general principles of nutrition, and why Peter stopped doing prolonged fasts 1:06:17 - Optimizing protein intake 1:11:46 - Wearables for sleep and exercise, continuous glucose monitors (CGM), and a continuous blood pressure monitor on the horizon -------- About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/ Chapters View all Explore the podcast 252 episodes The Peter Attia Drive Podcast Peter Attia MD Podcasts Transcript Follow along using the transcript. Show transcript Peter Attia MD 472K subscribers Videos About 397 Comments rongmaw lin Add a comment... @PeterAttiaMD Pinned by Peter Attia MD @PeterAttiaMD 11 days ago In today's episode, we discuss: 0:00:55 - Overview of topics and previous episodes of a similar format 0:03:00 - The viability of living to 120 and beyond: some optimistic theories 0:13:21 - The potential of mTOR inhibition as a mid-life intervention, and longevity potential for the next generation 0:17:00 - A framework for thinking about geroprotective drugs and supplements in the context of a lack of aging biomarkers 0:27:10 - Supplements Peter takes and how his regimen has changed in the last year 0:39:41 - Pharmacologic strategies to lower ASCVD risk, the limitations of statins, nutritional interventions, and more 0:53:10 - Misnomers about cholesterol 1:07:07 - Why nutritional research is so challenging, some general principles of nutrition, and why Peter stopped doing prolonged fasts 1:06:17 - Optimizing protein intake 1:11:46 - Wearables for sleep and exercise, continuous glucose monitors (CGM), and a continuous blood pressure monitor on the horizon 26 Reply 15 replies @daveoatway6126 @daveoatway6126 7 days ago Very interesting video. I am 79 and active (I walk 5-10 miles almost every day, and exercise 2x a week, usually in tropical sunlight in Mexico and Florida) and no prescription drugs, and feel great. All my usual annual health exams are WNL. I do take NMN/TMG, 100mg ASA, an electrolyte drink, D3/K2, glycine, Taurine, AAKG and Metformin (my A1C is under 5 now.) I keep a roughly low carb diet - heavy on meat and vegetables, salmon and sardines. I try to get 1.2 gm/lb protein. Almost no sugar or refined flour most of the time. But live to enjoy life with my Mexican girlfriend! Living in Oaxaca Mexico most of the time, I am partial to Mezcal! And Mole! I occasionally take a week long drug holiday. I notice a reduction in energy and activity level. They return within a few days when I re-start. I sometimes (rarely) over indulge in excess sugar/flour when unique desserts are presented, or I just fall off the wagon. I try to get back on ASAP since I always feel bad after! A few moments of pleasure and a day or more of discomfort!. I am very scared of instances of questionable balance. I'm not sure the exercises to improve balance have been useful, but I do them! l hiked the Inca Trail 5 years ago but would not try again. I always like to have hand rails! I have also noticed a decrease of memory - can't remembers things I used to - but can usually recover those instances - names are most problematic. Analytical powers are still good - I do successful expert witness work for complex healthcare cases, and program in Python and MS SQL for analytics of data. I monitor walking and sleep with a smart watch. Sleep is variable but above average for my age. Still trying to optimize. I use KetoMojo to measure glucose and ketones daily. I am focused on health span, and agree to the concept marginal period -I hope less than a decade! Any time I have now is a bonus!. I want no tubes to keep me alive! I would love to see a discussion between Peter Attia and David Sinclair. I admire them both! 27 Reply 4 replies @IsaAvasa @IsaAvasa 11 days ago Thank you for this episode. Peter - is is NOT a waste of time for some of us to hear you talk about ASCVD management. I live in NZ and the ASCVD management is 20yrs BEHIND. No ApoB or Lp(a) testing allowed unless self directed. If I obtain my own testing, the results are not understood my many “cardiologists” here. I struggle mate! 4 Reply @kkcarricaburu6042 @kkcarricaburu6042 11 days ago Peter is always serious. As he should be on these topics, but todays smiles were great. 5 Reply 1 reply @cabolynn @cabolynn 11 days ago I'm in my md 60's now and one of my supplements that I know works well for me, is essential amino acids with an added bonus of leucine added. Dr. Robert Wolfe is an expert on these and has over 400 research papers published. He's in his mid 70's now and he looks and sounds fantastic. 16 Reply 5 replies @joanfrisinabowles1369 @joanfrisinabowles1369 11 days ago My Mom is 100 years old, and she has vascular dementia.. and all she has is High Blood Pressure for years. No doctor paid attention to this.. then we saw the cognitive decline. WE need to keep mind and body healthy as long as possible. That can be achieved. My MOM did not pay attention to these things.. neither did her doctor. And she stopped exercising. 6 Reply 2 replies @rocambole93 @rocambole93 4 days ago thank you Peter...very edifying as always; I am a retired RN still visiting patients at home and it helps me a lot, for my own health and to give health advice. Reply @juliesill8074 @juliesill8074 10 days ago (edited) I love Dr Attia’s transparency & ability to synthesize very complicated topics. Thank you!! And I also love AG1 🎉 6 Reply @nwobob @nwobob 11 days ago Ninja Creami has been a game changer for me. I use a no sugar protein powder, kefir, egg yolk, and herbs or berries as a base. The pleasantness of the experience while getting a low carb, low fat, high nutrient dense protein hit is extraordinary. No more slurping down liquid chemical protein concentrate. 2 Reply 1 reply @Test-eb9bj @Test-eb9bj 10 days ago The protein issue of the right amount (age related!) resource and quality vs. performance /muscle growth and growth of cancer cells is an aspect I still struggle with. Me, as a 54 year old woman, whole foods vegan for 8 years with a very well composed food portfolio (including the right protein composition & distribution over a day), perfect weight of 128 pounds, have been able to build CONSIDERABLE muscle mass which on top shows nicely - but it took me 2 years of consistent (5x/per week), demanding, well targeted workouts in the gym. As Peter put it: age (& menopause) is a bitch and the investment in just maintenance of muscle mass and fitness while you have to train with caution to save your joints and tendons is really, really high. I achieved it on a protein intake of 60g/day (~1g/kg). I keep protein low to decrease the risk of promoting growth of cancer cells. 11 Reply 4 replies @ambition112 @ambition112 11 days ago 0:07: 🎙 Peter Attia discusses the importance of using current tools for primary and secondary prevention of disease to maximize lifespan and health span. 6:53: 💡 The speaker emphasizes the importance of taking preventive measures for health optimization and lifespan maximization. 13:45: ✨ The speaker discusses the potential benefits of pharmacologic inhibition of mTOR in extending lifespan and health span. 20:14: 🧪 The lack of biomarkers to measure the effectiveness of anti-aging treatments is a significant challenge. 54:00: 😅 There is no such thing as good and bad cholesterol, and the terms originate from the differentiation between LDL and HDL. 26:44: 📚 The speaker discusses the risks and rewards of taking supplements and shares his framework for evaluating them. 33:28: 🔍 The speaker discusses their use of supplements and their willingness to reevaluate based on new data. 40:49: 💊 Pharmacology is the most effective way to lower APO B and manage lipoprotein risk factors in ASCVD. 46:42: 💊 There are well-documented side effects of statins, including muscle aches, liver function test elevations, and insulin resistance. 59:24: 💡 Maintaining energy balance is crucial for metabolic health regardless of the type of diet followed. 1:05:52: 🥩 The speaker is open to changing their mind about the benefits of fasting if there is evidence of positive effects on the body, but currently finds the cost too high. They also discuss the controversy around protein consumption and aging. 1:12:15: 💤 The speaker discusses an app that measures sleep quality and readiness for training. 1:19:07: 🩸 Continuous blood pressure monitors are already available in Europe and show similar results to automated cuffs. Recap by Tammy AI 18 Reply 1 reply @yvonnekiwior9633 @yvonnekiwior9633 11 days ago I care what you are doing NOW and that still after having your book, you have invested so much of your life taking care of yourself and others. Lets be honest you have lots of knowledge to share, and I from 🇨🇦 appreciate you and what you share. Thanks for the awesome BOOK! 3 Reply @peterlewellyn2389 @peterlewellyn2389 11 days ago This is a point that a medical oncologist made to me recently. I have been taking 23 supplements with each have some anticancer effect.. They 27:09 were suggested by two individuals that survived stage 4 cancers. One having prostate cancer and the other having cervical cancer. Both successfully succeeded in reaching long term remission. In one case for over 17 years. Both had researched the selection of supplements. After researching the supplements myself, I began taking them and provided the full list to my oncologist. She did not have any objections to them because she saw no conflicts with the medication she had prescribed. However she said to me that “ I was very bold.” I took her point to mean exactly what you were presenting. There is danger in taking supplements that have not had serious long term testing for their safety. Of course, I acknowledge that however, the standard of care she was providing was clearly going to eventually lead to a dead end ……literally. Measuring the long term effect of a supplement is a worthless exercise if you have a short term to live. Therefore, the reward, living, rather than dying well exceeds the risk. 5 Reply 6 replies @joanfrisinabowles1369 @joanfrisinabowles1369 11 days ago Love Dr. Attia's book. An excellent tool. Thank you! 2 Reply @energysourcelove @energysourcelove 11 days ago When was this recorded? Because last time I checked Morpheus no longer had a wrist or armband. The heart rate monitor is required for the morning reading and daytime activity tracking. Has that changed? Great episode! Thanks so much. Have gifted Peter’s book to several people including physicians. 💌 1 Reply @mitchellgould2053 @mitchellgould2053 11 days ago I’d be curious to hear Peter’s thoughts on Cyclarity in terms of their pipeline for reversing atherosclerosis. 1 Reply @semaaral2498 @semaaral2498 11 days ago Thank you for this podcast. I found it informative to reply to the questions 👏💙 Need another one every 3/6 months pls. So we can compare ourselves as well🙏with many other health biomarkers as we think is right✨🌟💫💯 10 Reply @rollingrock3480 @rollingrock3480 10 days ago Thanks so much for the info Dr. Attia! Hopefully all is well! Reply @mattgullage6720 @mattgullage6720 11 days ago Bought your book. Thanks for all you do. 👍 1 Reply @kenzierenea @kenzierenea 11 days ago I have really appreciated the insight into medical health at a low or free cost. I also know he’s just providing what he does because many have asked, but admittedly, if he potentially spends up to $50 a day on just his deer snacks I think emphasizes the inaccessibility of some recommendations. I get he’s not telling people they need to do it, and others can find other sources, but that could be $1500 a month on venison sticks. I’ve liked his content and others’ that share it, but I still think it’s important to realize income disparity in the health sector when some of these videos or made. Otherwise, it limits who this information is really for. 9 Reply 1 reply @kingpoopthe7th @kingpoopthe7th 10 days ago I don't know if this is the right place but I would love to see a series about primary considerations in an age window. Eg. 10-20 , 20-30, 30-40, 40-50 where you cover health risks, considerations for future benefit, diet, exercise, bio markers and categories 7 Reply 3 replies @frankoben2030 @frankoben2030 2 days ago (edited) Boy.. do we love Dr Peter Attia… the energy he exudes is beautiful. His articulation of the topics and speech delivery is short of arrogance.. thank you Doc and the organizers of this podcast Reply @BongShlong @BongShlong 9 days ago I'm looking forward to trying your new proprietary blend of bird feathers and testicular juice Peter. When can we expect the release and will there also be a grapefruit flavor? 3 Reply @stevelk1329 @stevelk1329 11 days ago Member here, who stopped ranitidine after listening to your podcast before watching the Zantac shelves clear at Walmart. Thank you for that. Can you point me to a podcast or liturature regarding how a type 1 diabetic should be living their life - if they should be supplementing their CGM, pump etc; very concerned about my 24-year-old. Thanks again. Reply @patriciawallace14 @patriciawallace14 9 days ago I am working hard to improve the quality of my years with science-based info as opposed to quantity of my years. I agree the science fiction out there about longevity is a lot. Ty for being spicy & informative. Reply @kwilliams1958 @kwilliams1958 11 days ago So appreciate this format...thanks, Dr. Attia and Company... 1 Reply @peterbedford2610 @peterbedford2610 11 days ago HIIT 3 times a week has been the most beneficial thing I've done in years. Male, 65. 6 Reply 1 reply @albertoverenzuela5641 @albertoverenzuela5641 8 days ago Thank you very much for the episode, thank you for sharing the knowledge. Very helpful, now I come with a question. Do you know anything about Lithium as a supplement having benefits in neurodegenerative disease? There is this book recently released called “the promise of lithium” and is wrote by a Movement specialist disorder neurologist. Thank you Reply @JamesMaccarone @JamesMaccarone 11 days ago Peter is a watch guy! Rocking a Silver Snoopy!! 1 Reply @tomgooch1422 @tomgooch1422 6 days ago I think Peter Attia has the best net I've seen on longevity. Nature is geared to evolve and time and repetition are its primary tools. The dramatic extension of a single copy is neither a design target nor a near-term possibility. An aging analog can be observed by taking a pristine sheet of paper filled with numbers, symbols, and letters and copying it fifty times. The fiftieth copy of a copy shows the problem...and why nature opted for genetic iteration, not epigenetic perfection. We should focus on keeping the copying machine in good order until and unless we've perfected the tools to detect, analyze, and correct negative epigenetic changes from our original epigones, meaning each newborn must be provided a 100% thorough and accurate epigenetic file. This might actually be useful for space exploration. Accumulating errors must be detected if we are ever to have any hope of correcting them. Random gamma rays, SNPs, protein misfolds, etc,. etc. all render significant life extension a fool's errand without tools to manage them. Reply @patriciahoke4722 @patriciahoke4722 11 days ago (edited) The question I would have about vitamins is if Peter bases what he takes based on the amount of physical activity he does. IOW, absent a lot of phys act. would he take less? (He takes a LOT of supplements! I'm honestly surprised.) Second, the kids in Toronto - sad story for sure. But wasn't the reward peer-based? (At the time) 1 Reply @slocheltreejr @slocheltreejr 10 days ago I really appreciate the level of detail. Thank you. Reply @CC-kl4nh @CC-kl4nh 11 days ago My mother was a nurse and she is dying. Peter Attia is brilliant. Reply @toddashton9696 @toddashton9696 11 days ago Thanks for this video. I really liked your t-shirt Peter. It reminded me of the 70's elf F1 car that had 2 front axels (4 steering tires). Reply @TheYassau @TheYassau 11 days ago What I am having trouble to understand is how do you combine the concepts of : inhibition of mtor as benefiting longevity AND the fact that grip strength (and overall strength) is the second best predictor of longevity (after VO2max) ? Strength being strongly correlated to muscle mass (with mtor playing a major role in muscle building) 6 Reply 3 replies @olyav5819 @olyav5819 11 days ago Great podcast! Reply @scottk1525 @scottk1525 9 days ago Why is Peter such a poopy pants about discussing his supplements? Given how well informed he is on the topic, it's very valuable for people like me that don't have a team of researchers, or even time to pour through studies endless papers to try and determine which supplements live up to his rigorous risk/reward standards. Not to mention learning which brands he considers high quality and reputable. How is it lost on him that this is useful information to his followers? For instance, Ahwaganda is a supplement I've been considering taking for a while now, but have never really had a warm and fuzzy that it's safe (or at least "low-risk.") But if Attia considers it safe enough to take, that gives me some reassurance that it's at least not going to shut down my liver or anything. The only "waste of time" from this segment was Peter whining about it. 7 Reply @carmelgrace6402 @carmelgrace6402 11 days ago i love it! you guys are the best! Reply @JuliMoodyStunts @JuliMoodyStunts 11 days ago Excellent as always Thank you❤👍 Reply @TheJust22az @TheJust22az 11 days ago (edited) The moderator has the perfect voice for those who have a sleep disorder. 6 Reply 1 reply @IP.1 @IP.1 10 days ago Remember, we are interested in what supplements you (Dr Attia) take, because of the great research, and your enormous public compain to educate us, which is true of every expert in his/ her field. That must have been a sarcastic question. 1 Reply @prestonshirley9864 @prestonshirley9864 11 days ago The way I like to put it is instead of focusing on getting more years in my life, strive for more life in my years. 19 Reply 1 reply @joannepizel2728 @joannepizel2728 11 days ago My Cardiologist laughed out loud at me when I asked for statins and PCSK9 inhibitors. My CT angiogram showed zero plaque BUT my aboB is 90!! 🤷‍♀️. I am 49. Anyone else in same boat? 8 Reply 23 replies @warmfires @warmfires 11 days ago it's always nice to hear Dr. Attia. His very strong stance on statins a few years ago is slowly changing. Nice. he says he doesn't have side effects of the statins. However he can't quite remember the rather small list of supplements, most of which (with the exception of the B6), he takes daily. And it was astretch for him to recall he's taking Atheletic Greens and Glucose control, both of which he is personally invested in. Peter, please. I really appreciate your honesty and change thro the years, and i have learned so much from your videos and your book, but please please look into the cognitive side-effects of even 5mg of rosuvastatin. It took me 10 years to re-build my memory after taking this item for a few months. And the memory went just like the above... very slowly at first and then boom. Gone. Take care, you are so very appreciated by so many. Don't wait too long, Dear One. 7 Reply 12 replies @timoti_makaurau7153 @timoti_makaurau7153 11 days ago A Peter special 🙏 6 Reply @kathleenmahanwilliams7491 @kathleenmahanwilliams7491 11 days ago It makes me crazy that CGM’s are only available by prescription. Or you pay hundreds of dollars for a monitor. Both my parents had Type II DM and I have avoided it so far. But as someone on Medicare, I CANNOT afford hundreds of dollars per month. Please tell me there is an easier way than to WAIT to get diabetes before I can track my blood glucose! 1 Reply @WilliamStonerock @WilliamStonerock 4 days ago This one broke through to me. I've been a subscriber (paid) for about 5 years. Focused and committed to my health. But hearing him say that if we follow the latest research we might get 10 years so that 90 year old me can lug 20lbs rucksacks or something drove home how futile it all is. I excercise, but don't enjoy it. I deny myself food that's not good for me. I spend lots of money on tests physicals. But I'm still going to die a horrible death from cancer. None of us are making it to 120, especially when the experts dont even believe we can. So, I canceled my subscription. I bought the book but haven't read it yet, so saved myself some time there. Going to soend that $15 a month on COSTCO muffins instead. I'm already happier! 1 Reply 1 reply @charloottie @charloottie 11 days ago 0:18: 🎙️ Peter Attia discusses the importance of using tools for primary and secondary prevention of disease and optimizing lifespan and health span. 7:06: 💡 The speaker believes that current advancements in technology and medicine are not the best they will ever be, and therefore we should take advantage of the tools available to optimize health and lifespan. 13:45: ✨ The speaker discusses the potential of pharmacologic inhibition of mTOR in extending lifespan and improving healthspan. 20:14: 🔬 The lack of measurement in targeting the underlying mechanisms of aging poses a challenge in determining the effectiveness of zero protection interventions. 26:57: 📝 The speaker discusses the importance of considering the risk and reward when taking supplements. 33:58: 💊 The speaker discusses their use of supplements and their willingness to reevaluate their use based on new data. 40:42: 💊 Pharmacology is the most effective way to lower APO B and manage lipoprotein risk in ascvd, while nutrition has a less significant impact. 46:42: 🔍 The speaker discusses the efficacy and side effects of statins, stating that while there are documented side effects, they are relatively small and should not be ignored. 53:25: 😅 There is a misunderstanding about good and bad cholesterol, with LDL being bad and HDL being good, but it's actually the carrier molecules that are labeled as such. 59:24: 💡 Maintaining energy balance is crucial for metabolic health, regardless of the specific diet followed. 1:05:52: 🍽️ The speaker is unsure about the benefits of fasting without a biomarker, and emphasizes the importance of protein in the diet. 1:12:15: 💤 The speaker discusses an app that measures sleep quality and readiness. 1:19:21: ✅ The Actia device is a bracelet that optically measures blood pressure and is as effective as automated cuffs. Recap by Tammy AI Reply @hendy24 @hendy24 11 days ago Thank you Peter! Reply @Shelby_Wald @Shelby_Wald 10 days ago Really good episode. Thanks Reply @kingpoopthe7th @kingpoopthe7th 11 days ago I would love to see a vitamin D Deep dive4!!!!. I live in rural Ontario and I'm thinking of trying it to offset seasonal dips in mood/energy 2 Reply 5 replies @bullonabike @bullonabike 4 days ago Love the F1 shirt, Peter. Would love to sit in a room with you and talk Healthspan and Formula 1. Appreciate the work you do. Reply @rigaleb @rigaleb 9 days ago (edited) Here are the missing things about the blue zones you doged gracefully: , -eating a diet adjusted to the environment and latitude -very low exposure to artificial light, especially blue light, especially at night -a lot of sunlight exposure -low electromagnetic pollution -much more physical connection to nature But now, those zones lose their advantages because destructive behaviours are catching up with those people, too. 1 Reply @stphnsn @stphnsn 11 days ago The BP wearable Akita is already available to the US. Between 2 and 3 hundred dollars. I personally don't need the governments approval for any health decision in my life, especially a BP monitor lol. 1 Reply @chrisservoss9513 @chrisservoss9513 11 days ago (edited) Nexlizet ~350USD/month Repatha ~500USD/month Just these 2 are like 10,000USD/year Rosuvastatin 5mg daily ~11USD/month - Just worth considering 5 Reply @chrisg8995 @chrisg8995 11 days ago Peter- People care what you take because you are extremely studied and knowledgeable. They may be inspired to research something new, consider changing their regimen, and perhaps stop taking something via the information you provide. Yes people need to do their own research and take what is needed for them, but it is an extremely difficult field to navigate to an uneducated person. 1 Reply @kokoseattle @kokoseattle 11 days ago Which Pendulum supplement does Peter take? I take (and enjoy!) AG1 in the morning too and would like to know how the Pendulum probiotic supplements interact with the Lactobacillus acidophilus and Bifidobacterium in AG1. Thank you for sharing your expertise! Reply 3 replies @ukaserex @ukaserex 11 days ago Would love for Peter to have a talk with Vince McMahon. That dude is closing in on 80 and is jacked; supposedly only sleeps a few hours a night and wants to live to be 120. Reply @Fwuuaaark @Fwuuaaark 5 days ago Peter Attia is genius! Reply @ivojager2143 @ivojager2143 11 days ago Peter: Don't do as I do. Me: I hear you, I will do everything you do. Does being grumpy help too? 6 Reply 1 reply @bluecrewfan88 @bluecrewfan88 11 days ago I have one copy of the ApoE 4 lipoprotein. I take krill oil for EPA and DHA, and choline. Any other ApoE 4 specific recommendations for those of us with fragile brains who want to reduce the risks of Alzheimer's? 1 Reply 1 reply @1971spots @1971spots 11 days ago Masterpiece! Reply @nikbiz @nikbiz 8 days ago Aspirin - an NSAID, also increases the risks of ulcers and dysbiosis. The Risk:reward isn't there. 1 Reply @bella_trixx6589 @bella_trixx6589 11 days ago Nick has the most perfect, NPR, relaxing voice I have ever heard. 27 Reply 7 replies @josieb3238 @josieb3238 11 days ago (edited) I’m all about lower A1c and building muscle for longevity. I’m 74. Planet Fitness is good for me. Reply @downtownjb100 @downtownjb100 11 days ago 24 pk of Maui Nui venison sticks for $102. $4.25 each, not including tax and shipping. Peter throws down 5 to 10 a day. Good lord 24 Reply 9 replies @fathiselmi1315 @fathiselmi1315 11 days ago We just want to know what supplements a "specialist" in longevity consider to be valuable to take ... 6 Reply @SilverFan21k @SilverFan21k 11 days ago Ty for covering longevity 1 Reply @cdixon1108 @cdixon1108 11 days ago Peter knows how to have fun? 😂 Reply @ironry1061 @ironry1061 11 days ago Amen! 💛🤌 2 Reply @user-is2gw4mu2o @user-is2gw4mu2o 11 days ago Does blood glucose rise with age? I have seen some studies that indicate that’s the case. So for people over 70, what is a good A1C? I have read <7. But standard recommendation is < 5.5. Reply 2 replies @juliemydarlingdarling9500 @juliemydarlingdarling9500 11 days ago Can we increase the individual cell life, that is increase G1 phase of cell life, through exercise or dietary interventions? What will be the protocols may look like if we can delay cell division through environmental Influence? Reply @nvmidiae @nvmidiae 9 days ago thank you MR/DR peter Reply @ked4864 @ked4864 9 days ago Off topic -- but what brand watch is Peter wearing? It looks good, and I'm tired of trackers! Reply @northern4112 @northern4112 11 days ago Fire episode 👍 Reply @williamhenry3337 @williamhenry3337 11 days ago I am on Social Security and live in San Diego the most expensive area of the USA. My food budget is $5.65 a day so I'm certain 10 "deer sticks" a day is out. My only "wearable" is a $15 pedometer. 7 Reply 2 replies @Mansell5Senna8 @Mansell5Senna8 11 days ago (edited) I keep listening to all these, but in reality, I can't workout due to multiple tendon issues and even walking is a struggle, and I struggle to eat a normal diet due to gerd and reflux... Dr has tried all the meds and nothing works, being referred to hospital, and physio hasn't a clue either on healing the tendon issues and im being referred to a specialist. My diet right now is breakfast is porridge with fruit and whey protein, lunch is mince and rice with salad leaves live spinach etc, dinner is a chicken salad with avo and egg mixed in and some mayo. I get plenty of protein, but always tired, joints ache etc. My quality of life isn't great, I feel like I am 80 but I am 40... Don't mean to come across as poor me, but it is very frustrating when following all the advice but I don't get the results. 3 Reply 7 replies @paddy3622 @paddy3622 11 days ago cholesterol is so misunderstood by 99% of all healthcare professionals. it's easy to Rx Lipitor and tell the patient, I'll see you in 6 months or a year. Reply @hankfowler8194 @hankfowler8194 15 hours ago If you get regular aerobic exercise, which you should, it reduced fibrinogen levels in the blood and your chances of throwing a clot are greatly reduced. Reply @sanwuyiwu @sanwuyiwu 11 days ago this episode is gonna be good 2 Reply @catcan221 @catcan221 11 days ago Have you tested these fish oils? The problem is processed oils are oxidized and you'll do more harm than good. Fresh, wild caught fish is the better option than consuming oxidized oils. 1 Reply 3 replies @Juanito.San55 @Juanito.San55 11 days ago (edited) You prescribed a 4 day fast for Chris Hemsworth during his Limitless series on the National Geographic channel. Now you say you see no bio-markers that indicate the benefits of extended fasting. #trendsetter 1 Reply 1 reply @bellelacroix5938 @bellelacroix5938 11 days ago Yep, enjoyed. Thanks! Reply @5kribbles @5kribbles 11 days ago "Why would anyone care what I take" I don't know maybe because you're an MD who has devoted your entire professional attention to improving health and lifespan, you have an entire team of expert researchers constantly doing literature reviews staying up to date on the latest results with a critical eye. Maybe because you've positioned yourself as a very public face for knowledge and advice giving. Maybe.... 49 Reply 9 replies @dhuang5881 @dhuang5881 9 days ago What supplements is good for high cholesterol? 1 Reply @milenabellotti9771 @milenabellotti9771 10 days ago Does anyone else get despondent with our general practitioners vs these guys? Honestly, they struggle curing a UTI let alone dealing with the Horsemen. Reply @omnimesh4096 @omnimesh4096 10 days ago So on the sleep side I have an eight sleep and a whoop. The problem is im a short sleeper. I’ve never needed more than 5 or 6 hours sleep. I’ve tried to sleep longer an literally now sleep in a light proof “tent” around my bed and no matter what I do I can’t get passed 7 hours. No caffeine in my diet and I eat very little refined carbs. Not sure how I can adequately Meade my sleep quality other than some of the other metrics on the 2 devices. I’ve never gotten above fair on the eight sleep for quality. Not sure what to do. 1 Reply @kunjshah1129 @kunjshah1129 11 days ago He said pottyweight instead of bodyweight 😂 Reply @chucktowndawg8219 @chucktowndawg8219 10 days ago Dr. Peter…I’m recently new to the channel. You may have spoken on this already. You mentioned 10 years and 1 bill for FDA approval. Where do you stand on C-19 vacc approvals and if you recommend. Reply 1 reply @maxallen8430 @maxallen8430 11 days ago Can you drop a link for the crushed bird feathers and testicular juice? That's sounds right up my alley Reply @william9104 @william9104 11 days ago Wanting to win the centenarian decathlon while eating 5 servings of processed meat sticks per day is an interesting dichotomy Reply 1 reply @JMSsssssss @JMSsssssss 7 days ago I wonder then what the significance of the cholesterol ratio is. They like it to be under 5 i think, but is that truly significant, when it's all the same? Reply @markpalmer5311 @markpalmer5311 11 days ago I didn’t hear a mention of creatine. Did I miss it? Not that I wish to rile up the good doctor! Reply 1 reply @ngerstner753 @ngerstner753 3 days ago "why do people care what supplements I take?" Because most people have limited $$ and want to know what supplements are worth buying for their health and wellness. And usually people like Dr. Attia will only offer the advice they are confident in, but they will personally do the things they have some belief or hope in. Reply @hypocriticalpacifist @hypocriticalpacifist 9 days ago So you put Hemsworth through that four day fast and got him to add fasting to his routine for nothing?😂 2 Reply @Brianquinn-cq3kj @Brianquinn-cq3kj 11 days ago Any concerns about Sodium Laureth Sulfate in Slow-Mag? Reply @maryjackson795 @maryjackson795 3 days ago What about the risks of colon cancer with increased meat consumption? Beans and legumes have probiotic fiber and protein and are less expensive than meat and probiotic supplements.🤔 Reply @backside060 @backside060 10 days ago Please forgive me for asking an irrelevant question, but could someone tell what earpiece Dr Attia is wearing. It looks very unique. Thanks Reply @endgamefond @endgamefond 7 days ago (edited) That chicken subway game. With high risk might have some rewards for those kids (in economic behavior). The kids might get anticipatory utility, experience util, or even decision util or even ego util. But it was dumb game after all. Reply @terpfan2279 @terpfan2279 10 days ago How much does all that cost monthly is the real question. Need to do a cost benefit analysis as well. No one wants to spend 2k a month 1 Reply @RandomDaniel_ @RandomDaniel_ 2 days ago Why would LDL be bad when the body creates it? Isnt ldl and the cholesterol crucial for tissue repair? Reply @CC-kl4nh @CC-kl4nh 11 days ago It’s a luxury to eat like the Okinawans in the US. 1 Reply @SurjyaSen-ll1to @SurjyaSen-ll1to 4 days ago I'm surprised by the lack of mention of creatine. Reply @supernumex @supernumex 11 days ago sodium in the venison sticks seems quite high to be taking 5, 10 a day, no? Reply @ScottSummerill @ScottSummerill 11 days ago (edited) Aktiia is available. Priced at 199 pounds and free shipping. NM - they will not deliver to the US. Reply @JIMSmith-in3js @JIMSmith-in3js 3 days ago (edited) APO B OF 30-40, so would have to go on a statin or PSK9 inhibitor in your 30s and stay on forever. What about all the studies done on low cholesterol and cancer? or the ones that show cholesterol does not CAUSE atherosclerosis. And lots of people (even as smart as Peter) are saying this and its getting hard to ignore the mounting evidence. Wonder if he will revise his stance on this as he did on fasting in the future? He has such a large reach now due to his publicity tour post book release I think prescriptions will take off lol Does he or anyone he's affiliated with have any financial interest/stocks in any company that may be working on any future drugs in this area. He was in the financial world previously so just curious. It would be great to just take a pill and take all risk away like he says I would MUCH prefer to do that! But it's never been shown to do that. Reply @thomasgrimm1664 @thomasgrimm1664 10 days ago Spicy Pete, I love it! Reply @NOFBDYBS @NOFBDYBS 9 days ago Not seeing much talk of COq10 anymore for BP Reply @mariejones7136 @mariejones7136 1 day ago Im 69 and i can still walk 6000 steps a day and more.i can walk up and down stairs all day long lol ...Im always going out doing things like hiking and biking and living life..i love pickle ball...shopping is excercise lol... fasting has gotten rid of the pain in my knee and turmeric..i eat less calories...my glucose is low..i take berberine to lower glucose... Reply @susanblevins127 @susanblevins127 23 hours ago Delightfully brave plunking down into Dr, Attila’s medical boogiie boos, you must be brave and let’s be honest, you must have known how addressing these topics would set him into the next galaxy Reply @DoctorPrepperMD @DoctorPrepperMD 11 days ago Aspirin use and bleeding in head injury has been studied and not a real risk. Even plavix does not significantly increase surgically concerning bleeding with head injury. I see a lot of injured heads. Reply 1 reply @jeffadams5413 @jeffadams5413 11 days ago I admire Dr Peter Attia. For many reasons. Mostly because of his honesty. He is very careful about sharing advice. He is more than willing to share his knowledge. What he is very adamant about is exercise, sleep, and diet. And if you pay attention he is telling us to live a happy life. 55 Reply 9 replies @dc2090 @dc2090 11 days ago So many people tell me they don't want to live to 100! but then they say something like being in a wheelchair for 10+ years...at 80...90... Reply @michaelhimes8778 @michaelhimes8778 8 days ago Given his belief that fine tuning our epigenetics is a fruitful horizon, I wonder if he has done the full genome sequencing on his children… i.e. the test that Chris Hemsworth took. Reply @philipmarx1819 @philipmarx1819 10 days ago No creatine monohydride? That’s surprising 1 Reply @newdata @newdata 11 days ago mice with same genes , but smaller size due to CR and protean restriction , survive longer 2 Reply 2 replies @gil8e @gil8e 11 days ago (edited) Peter You said you are trying to limit saturated fats intake but also said you are eating 150-180g of protein mostly from animal foods (besides the whey). How is that make sense?? Most animal protein contains a decent amount of saturated fats. From what I know venison is not a lean protein as chicken, and I’m sure you are eating steaks as well (as you live in Texas) 1 Reply @dorothycharginghawk1244 @dorothycharginghawk1244 1 day ago True. He has lots of money. But if you are broke, but can hunt, you can make your own jerky .. If you are broke and urban— you can buy tough hunks of roast and jerk that. If you are stuck on food stamps, you will have a problem , and have to depend on WIC and food shelves etc BUT if you have at least some disposable income, you can cook at home, buy “eat or freeze right away” meat— it won’t kill you, I promise !! You can STOP eating things that taste sweet. You can do time restricted eating. You can read labels or just get food without labels at all. And go for walks !! Reply @Tinker-bell @Tinker-bell 16 hours ago (edited) What about the cockroach protein powder that includes the whole animal?🦒 I was told that eating the whole animal is better than eating only one part constantly. Is it better to eat a raw mouse whole or cook it first? Is it better to starve our bodies to barely living once in a while to rid the body of all the toxins and atherosclerosis? Do people who go bald live longer than people that keep their hair? Reply @olyav5819 @olyav5819 11 days ago What is the blood pressure devise approved in Europe? Reply 1 reply @reason3581 @reason3581 11 days ago 41:05 ”Dramatically reduce carbohydrates” ? I thought that only refined carbs raise trigs? I don’t think it’s those sweet potatoes and black beans that is keeping people’s ApoB elevated. Reply 7 replies @cz2165 @cz2165 11 days ago Secrets to longevity: Don’t be poor. No smoking. Little to no alcohol. Long- lived relatives ( genetics) Exercise or be active through each day . Wear your seatbelt. Get help if depressed. No guns in the house. Stay away from opiates. Don’t be in a minority group in the USA. Don’t live in the USA if you can live in a country with lower mortality rates and better longevity (many countries out- perform us). Get cancer screening tests on time. 3 Reply @virginiapantoja8993 @virginiapantoja8993 11 days ago I am from Brasil, and I am a medical doctor. You must try and see Reply @Dan-jo8py @Dan-jo8py 11 days ago I think the big failure is the conflation of 10 years with 20 years. Realistically the solution would need to come within 25 years from now. The suggestion that in 1998 we could have predicted accurately where we are now is ridiculous, and it's just as ridiculous to say you can in any real way predict the advances available in 2048. 1 Reply @marian7440 @marian7440 11 days ago I’m surprised that supplementing Vitamin C was not mentioned. 1 Reply 6 replies @radicaltyro @radicaltyro 23 hours ago each deer snack has 380mg of sodium, or 17% of one's daily allowance, so Peter eating 5-10/day he's at 85-170% his allowance just from this snack alone? 🙄 Reply @chrisocony @chrisocony 10 days ago Here's my list of supplements: nothing! Seems like studies have shown for the most part, absent special needs, there is no benefit. Hope that's right. Lots of fruits and vegetables and other vitamin, supplement rich foods! Reply 1 reply @luisfer14240 @luisfer14240 11 days ago 👍🏻 Reply @RR-sj1vc @RR-sj1vc 11 days ago Nick seems to annoy Dr. A as much as Nick annoys me. 😂 1 Reply 1 reply @BrendannKellyy @BrendannKellyy 11 days ago I heard Huberman say you have to cycle on and off Ashwaganda. Is this true? 1 Reply @Nicksonian @Nicksonian 8 days ago (edited) One threat to humanity that Attia doesn’t mention is overpopulation. Having another child at 44 just because you have a younger partner and are rich and can support a bevy of children doesn’t mean you should. The risky teen behavior he describes sounds like classic, Type-A mentality, which leads to doing things because you can, not because you should. Calls into question all his risk vs. reward advice. 2 Reply @forester057 @forester057 9 days ago (edited) Low energy theater. Think I’ll go watch some carnivores. They seem to have what men need. If Peter doesn’t have answers or feels too low to share them then get someone who does like Anthony Chaffee. Dude has it figured out. No low energy defeatism there. 1 Reply @salim986ms2 @salim986ms2 10 days ago On fasting, what about Warburg effect? Reply @jelangman @jelangman 11 days ago He is very dismissive of just about everything but exercise. Not everyone is an endurance athlete, Peter. 1 Reply @DoctorPrepperMD @DoctorPrepperMD 11 days ago Thoughts on red rice yeast instead of statins? 1 Reply 1 reply @unholyquail4560 @unholyquail4560 9 days ago (edited) Sorry but his reaction to the "blue zones" and that they are very diverse diets and have no common denominators, or atleast not enough to draw conclusions from, is just wrong. It shows a huge laps of understanding of this literature and how there projects and conclusions were done. I know he isn't an epidemiologist but at least state you don't understand the literature on it int he fullest before making statements like that. As long as he does not have the skills and ability to do studies like that and do the analysis.. you should be cautious in making statements like these. Also the Blue zone studies did have a few very solid conclusions and common denominators that gave very strong indications of where we need to look in livestyle and diet and what to research. Leading to some recent publications afterwards that are confirming the thesis on Blue zone outcomes... Also "I am at high risk for heart disease so need to lower ApoB".. to then go on a 5 venison stick per day protein pitch is a bit off for me. Those sticks are increasing the amount of lipoproteins... So why bother using drugs and shots to get it under the 30-40 range and then chew down some sticks to negate that. It is a really weird thing. PS: This wasn't a Q&A this was a stickup for his book, his meat company and his blood pressure monitor. Reply 2 replies @mariejones7136 @mariejones7136 1 day ago What about checking ketones with a keto mojo? Reply @whiteninja9481 @whiteninja9481 11 days ago WHY would this most intelligent Doc not take CoQ10/Uniquinol? How about more minerals? What about Astaxanthin and Lutein? 5 Reply 1 reply @ricardotemporalgrein4482 @ricardotemporalgrein4482 11 days ago Fuck YES PETER Reply @Tinker-bell @Tinker-bell 4 days ago What about nicotine tablets? Causes arterial constriction! Or beets for arterial relaxation! Reply @desreelawrence1434 @desreelawrence1434 10 days ago What do you think about taking berberine Reply @kylekermgard @kylekermgard 11 days ago He's eating like $30 of venison stocks per day 1 Reply @terpfan2279 @terpfan2279 10 days ago No mention of creatine. 3 Reply @ildegenero @ildegenero 21 hours ago what are the three drugs he takes to lower cholesterol? Pcsk9 inhibitors... and then? I can't understand... Reply @privatetatum @privatetatum 11 days ago He's looking right at me, giggle. Reply @charlenecausey105 @charlenecausey105 11 days ago Spicy! LOL! 🌶 😅 1 Reply @kristinemeints @kristinemeints 7 days ago CoQ10 depletion with statins? Reply @TheFullofrage @TheFullofrage 1 day ago You were saying that you didn't find any benefit from fasting, if I understood correctly, but what about autofagy? Reply @evelynramos445 @evelynramos445 11 days ago To carry a baby aspirin if one is having Reply @Joseph1NJ @Joseph1NJ 11 days ago Why do people care what supplements you take? Was that a rhetorical question? I couldn't tell if he serious or not. If he was,, because you're MD, a self described longevity doctor, an author, and a YouTube influencer? I mean COME ON Peter. 3 Reply 5 replies @dawngonzalez508 @dawngonzalez508 11 days ago Shouldn't you be taking K2 with the D? 7 Reply 1 reply @travistial @travistial 5 days ago Is the host guy wearing a To The Stars T-shirt?? Reply @Arthurboid @Arthurboid 11 days ago No k2 because you find enough of this vitamine on food? 1 Reply 2 replies @primarySequence @primarySequence 11 days ago snoopy speedymaster! 1 Reply @russellclark4447 @russellclark4447 8 days ago Do u take creatine? 1 Reply @scottk1525 @scottk1525 1 day ago Attia acting like a hostage in his own video Reply @Cass-gi4kk @Cass-gi4kk 11 days ago Peter please tell me why do you not take creatine??? Reply 4 replies @krissche1863 @krissche1863 11 days ago "I'm good"? No "how are you?" back? 1 Reply @mariejones7136 @mariejones7136 1 day ago Thats depressing about fasting but dr Annette Bosworth swears by it .i still do it ... Reply @downtownjb100 @downtownjb100 11 days ago No creatine?? 8 Reply 3 replies @william9104 @william9104 11 days ago He was clearly in a bad mood when this was recorded 1 Reply @chrisg8995 @chrisg8995 11 days ago AG1 is a total scam for 2 reasons. 1 - Proprietary blend. The consumer has no idea what dosage they are taking. 2- AG1 charges twice as much as comparable and/ or higher quality brands for no reason other than profit and to maintain an extremely high advertising budget. 2 Reply @mazz777 @mazz777 8 days ago why do people care what supplements do you take. why would people care. come on peter. Reply @kasujjaahmed3311 @kasujjaahmed3311 1 day ago Crushed bird feathers and testicular juice huh😅😅 Reply @virginiapantoja8993 @virginiapantoja8993 11 days ago i do intermitent fasting and take the substances of david sinclair. I can say young again...is true...in my body. others, i do not know 1 Reply @rebeccagriswold282 @rebeccagriswold282 7 days ago Can he not put a battery in that clock that sits on his shelf? Kind of annoying. 1 Reply @rigaleb @rigaleb 9 days ago Peter, talk to Michael Levin. Reply @Dylaniated @Dylaniated 11 days ago Sooooo sounds like LDL is bad... 1 Reply @WalkDisneyWorld @WalkDisneyWorld 11 days ago Time to cut the ashwaganda mr grumpy pants Reply @mry5892 @mry5892 10 days ago I call it testosterone poisoning. Reply @singerthomas @singerthomas 11 days ago No offense but the moderator needs to spice it up. Is he broadcasting form a library? Sounds like NPR 3 Reply 1 reply @evelynramos445 @evelynramos445 11 days ago In the know 1 Reply @lynnbottini4834 @lynnbottini4834 7 days ago Maui maui meat 1 Reply @mattkison6073 @mattkison6073 6 days ago Your co-host has a creepy bedroom voice. I feel like I'm listening to an erotoc audio book. 2 Reply @vznquest @vznquest 6 days ago 06:27 is that a diss towards David Sinclair? Reply 1 reply @jamdec123 @jamdec123 10 days ago Awwwwr. 35 seconds in and the inetrviewer has fully creeped me OUT. 2 Reply 1 reply @lukebayshaw1958 @lukebayshaw1958 9 days ago Lots of initials lol Don’t even know what they’re talking about Would help if they explained it Reply @lukebayshaw1958 @lukebayshaw1958 9 days ago Come across quite rude and not much time for people trying to learn 1 Reply @alexanderkullik4583 @alexanderkullik4583 4 days ago If he believes in climate change then we are wasting our time here. Reply @rustinpeace9303 @rustinpeace9303 3 days ago None of this content is proven to do anything Reply @NicksHEAT1995 @NicksHEAT1995 11 days ago Dr. Sanjay Gupta from the channel York Cardiology said it best... 1-Age 2-Genetics 3-Bad(or Good) Luck 4-Lifestyle In that order. Accept and move on. Reply 5 replies @stevestone9526 @stevestone9526 2 days ago This interview was so horrible..... How can two people speak so many words and say nothing in the end.....???? After your guest and you went on and on I still have no idea what steps can be taken to improve my health through exercise. He was so so much in his head, just to hear himself talk, thinking he was so smart. He talked about it, from every direction and never said what everyone was waiting for him to say. You need to exercise in this way and this how you do it.... It was torture to listen thinking he may finally get to the point and never, never does. You didn't help at all.... Reply @stevestone9526 @stevestone9526 2 days ago This interview was so horrible..... How can two people speak so many words and say nothing in the end.....???? After your guest and you went on and on I still have no idea what steps can be taken to improve my health through exercise. He was so so much in his head, just to hear himself talk, thinking he was so smart. He talked about it, from every direction and never said what everyone was waiting for him to say. You need to exercise in this way and this how you do it.... It was torture to listen thinking he may finally get to the point and never, never does. You didn't help at all.... Peter Attia's Supplement List 185,687 views Oct 24, 2023 Get the 5 Tactics in My Longevity Toolkit and my weekly newsletter here (free): https://bit.ly/3s04Owp Watch the full episode: • 276 ‒ Special episode: Peter on longe... Become a member to receive exclusive content: https://bit.ly/3O0pEnY This clip is from 276 ‒ Special episode: Peter on longevity, supplements, protein, fasting, apoB, statins, & more. In this special episode of The Drive, Peter discusses a variety of topics, breaking away from the typical deep-dive format to explore a wide range of common questions submitted by listeners. In this clip, we discuss: - What products Peter takes - Why Peter’s lowered his vitamin B-6 intake - Peter’s daily magnesium target - What Peter takes in the morning versus at night - And more -------- About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/ Transcript Follow along using the transcript. Show transcript Peter Attia MD 472K subscribers Videos About 617 Comments rongmaw lin Add a comment... @user-bx5we3kl9p @user-bx5we3kl9p 10 days ago Peter's Supplement Intake Summary: Vitamin B6: * Initially: 50mg daily. * Adjusted to: 50mg three times a week due to potential neuropathy concerns and re-evaluation of B6 needs. Fish Oil (EPA & DHA): * Brand: Carlson's (highest EPA version). * Intake: 4 capsules daily (around 2g of EPA and 1.5g of DHA). * Aim: Achieve a red blood cell membrane concentration of EPA and DHA of about 12%. Vitamin D: * Intake: 5,000 IU daily. * Brand: Not specified. * Mentioned the need for more rigorous studies on vitamin D's benefits. Magnesium: * Types: Slow Mag, Magnesium L-Threonate, Magnesium Oxide. * Aim: About 1g of total/elemental magnesium daily. Folate & B12: * Type: Methyl folate and Methyl B12. * Brand: Jarrow. * Dosage: Standard dose. * Aim: Maintain homocysteine below nine. Baby Aspirin: * Intake: 1 a day. * Purpose: Cardio protection (though he admits the evidence is weak). Night Supplements: * Ashwagandha: 600mg (Brand: Solgar). * Glycine: 2g (Brand: Thorne). * Magnesium L-Threonate: NOW Foods brand with "Magtein". * Occasionally, for travel: Phosphatidylserine from Jarrow's (400mg). Others: * Athletic Greens (AG1): Taken in the morning. * Probiotic: "Glucose Control" by Pendulum (2 in the morning with AG1). 528 Reply 36 replies @Notsorandomwalk @Notsorandomwalk 10 days ago Thank you for this. As someone with an iodine sensitivity that has the potential to trigger lymphatic thyroiditis, I am curious about the iodine content in the omega 3 supplements. I have been taking vegan versions and have taken cod liver oil and have an longstanding difficulty in maintaining adequate levels of hdl cholesterol. The fish anchovy based supplements give me an allergic rash. Reply @zenpig6605 @zenpig6605 6 days ago just found your site. Pushing 70 my vit D is 53 in summer and around 47 in winter. The only other supplement I take is a teaspoon of cod-liver oil every morning. work out 6 days a week and like my 96 year old mom says, "just eat natural food you buy yourself and get outdoors" so simple it is difficult for todays people. 7 Reply 2 replies @Qlorck @Qlorck 10 days ago So cool ! Can you make another on the different protocol that you follow? (training/mobility,..sun..cold/warm, other, for heart, cancers...) Thank you so much for your hardwork and making our lives better 4 Reply 2 replies @StarHarvestOfficial @StarHarvestOfficial 10 days ago As somebody suffering from B6 toxicity, thank you so much for bringing awarwness to this. Do NOT high dose this vitamin if you do not have a specific medical condition that needs it. 27 Reply 6 replies @shawnfaust2165 @shawnfaust2165 10 days ago I really appreciate that Dr. Attia shared this amount of detail. I completely understand his hesistancy, but is another data point for listeners to consider for their personal decisions. 26 Reply @apeusmaximus5601 @apeusmaximus5601 6 days ago (edited) Love your work Peter. Could you discuss the theory that ingesting supplements lowers the body’s capacity to extract vitamins and minerals from actual food? 1 Reply 1 reply @Cathy-xi8cb @Cathy-xi8cb 9 days ago THANK YOU for explaining the risks of baby aspirin. Folks that are amazingly healthy in their 70s think that that means these risks won't matter to them. Until they start bleeding internally or hit their head. I feel sorry for their doctors because they have to explain the calendar and how you can't twist it just because you can wear your college jeans! 2 Reply @macclift9956 @macclift9956 8 days ago During the mid-twentieth century, supplements and fashionable oils were almost unheard of; so were cancers and debilitating conditions such as MS. Cod liver oil was around for a while but even that disappeared, thank goodness. One just has to read E. Hane's comment on Amazon to understand why "thank goodness". Reply @redtrek2153 @redtrek2153 10 days ago "P-5-P" is the proper form of B6 for supplementation. Non-phosphate forms like pyroxidine are inactive and compete with active forms in high doses. 3 Reply 2 replies @ThomasAT86 @ThomasAT86 10 days ago Totally get his hesitance on sharing this and that he wants people to individualize their supplement regiment. For example, his night stack, Ashwagandha, Glycine, Mg-L-Threonate and PS -> ALL of them make my sleep worse. Now that's something very obvious and which can be experienced very quickly, but there's other things that one may not experience quickly but rather over the course of weeks or months or maybe even years and one may not correlate the negative effects with the supplements being taken. 18 Reply 3 replies @agontop1 @agontop1 9 days ago Highly processed and nutrient absent foods, Sleep deprivation AND STRESS are the big reasons the supplement industry has become so vital and necessary in comparison to how people used to live to 90+ years on average. 8 Reply 1 reply @illt3ck @illt3ck 10 days ago I really appreciate this video because finding trustworthy brands of supplements is so hard. I don't intend to copy your supplement regimen but it's helpful to hear recommendations from an expert when our interests overlap. Thank you! 15 Reply 1 reply @lorenzolietti8864 @lorenzolietti8864 6 days ago roughly $500/mo worth of supplements...as usual very detailed information and incredible podcast but rarely accessible and actionable for the average civilian 9 Reply 4 replies @awells10000 @awells10000 10 days ago Hi Peter - Great info - I think the Carlson Omega you were referencing is the Carlson Wild Norwegian Elite Omega-3 containing EPA/DHA at the 800mg/600mg levels respectively per 2 caps serving. 1 Reply 3 replies @Cathy_Louise @Cathy_Louise 8 days ago (edited) Let me tell you a story. I took magnesium glycinate supplements for over year at the recommended dose on the bottle. I already ate a nutrient rich diet sufficiently high in magnesium, but being postmenopausal, I hoped the magnesium would help my sleep. Then I started to get cardiac dysrhythmias: mostly ventricular ectopics - and lots of them. Also some fast irregular rhythms. Cardiologist asked for measures of various serum electrolytes, including magnesium. Turned out I had too high blood levels of magnesium. Everything else was normal, including renal function. I stopped the magnesium supplements and although it took a few weeks, my ectopic beats disappeared. Lesson learnt. Just eat a nutrient rich diet and forget the supplements. 8 Reply 6 replies @wakjob961 @wakjob961 8 days ago The only benefit of taking Ashwaganda for me was really wild and lucid dreams. Especially when combined with Boron. 3 Reply @mahmoodakhter1491 @mahmoodakhter1491 10 days ago Thank you very much , Dr Attia.Very useful info for me. 5 Reply @tyler4351 @tyler4351 10 days ago If Peter does this, I should do this seems like a perfectly logical framework to me 😂 5 Reply @stevenmishos @stevenmishos 10 days ago Pendulum Glucose Control is $165 per 30 count bottle (or $215 without subscription), so that's least a $330 per month decision at 2 per day). Reminds me of the Maui Nui venison bone broth rice suggestion which costs $169.00 for 10 servings (I believe the recipe called for 2 portions). Non-trivial costs here. 4 Reply 3 replies @LoiolaALG @LoiolaALG 10 days ago (edited) Consider taking Nattokinase in lieu of Baby Aspirin. I also take Serrapeptase with Nattokinase. Others include Vit K2 Mk-7, Tocotrienols, Ubiquinol, ALA, Glycine and NAC, several type of probiotics (including Akkermansia from Pendulum), and a few more still. 7 Reply @Vospi @Vospi 10 days ago Let's hope it's a great remedy to Peter's fear of it ending up online with no context. Clear title, all the details provided, and also linked to the official channel. Reply @BoostYourBiology @BoostYourBiology 8 days ago 💎Peter I hope you're aware of the ANHEDONIA associated with Ashwagandha usage. The effect of chronic Ashwagandha (8+ weeks) on 5-HT receptors, at least on depressed rats, is allegedly comparable to that of chronic SSRI or ECT treatment. This is probably the most useful way to look at it The study says this effect is reduced sensitivity of 5-HT1A and increased the sensitivity of 5-HT2 receptors, as measured by response to selective agonists of each. My theory is that presynaptic 5HT1a or autoreceptors — which are independent units with different location by my understanding — do almost nothing, except inhibit serotonin when upregulated, which improves my motivation and emotional anhedonia (terrible motivation and emotional anhedonia when downregulated with Ashwagandha). Stimulation of the 5‐HT2C receptor with 5‐HT2C agonists results in delay of ejaculation in male rats, whereas stimulation of post‐synaptic 5‐HT1A receptors results in shortening of ejaculation latency 7, leading to the hypothesis that men with premature ejaculation (PE) may have hyposensitivity of 5‐HT2C and/or hypersensitivity of the 5‐HT1A receptor. Ashwagandha significantly enhances the sensitivity of 5 HT2 (serotonin-2) receptors in the brain and a reciprocal sub-sensitivity of the 5HT1A receptors (19). Enhanced sensitivity could indicate reduces binding, as over-stimulation of a receptor will reduce it’s sensitivity. 5-HT2 stimulation increases prolactin (5-HT2A) and ACTH (5-HT2C) release. This may indicate one of the mechanism at which ashwagandha is potently anti-cortisol, as it reduces 5-HT2C sensitivity, thus reducing cortisol synthesis. 7 Reply 1 reply @HeavenAndHell-oz2zd @HeavenAndHell-oz2zd 10 days ago Supplements and pharmacology is extremely subjective, of course not everyone should take the same things, do what you need to do for you. I never understood why people are so fanatic about "WHICH SUPPLEMENT DO I TAKE" 6 Reply 1 reply @MaureenLeeful @MaureenLeeful 9 days ago I just spent about an hour watching and looking at reviews on YouTube with Dr opinions on vitamin D. Couldn’t find one person to agree with his point about poor studies. 1 Reply @modanafil @modanafil 9 days ago (edited) You may not wish people to copy you but consider how overwhelming and complicated the space is for most nonexperts! Do you think people would be better off copying this list exactly, or taking nothing (maybe a multi)? Reply @gillesdc @gillesdc 9 days ago I suffered two months of crippling neuropathy; doctors had my whole body and brain imaged, tested for all kinds of neurological and auto-immune disorders then I stopped taking a multivitamin with b6 and all symptoms subsided at once 1 Reply @slporter722 @slporter722 10 days ago I was taking B6 and now have neuropathy. I have none of the top 7 causes of neuropathy nor do I have a pinched nerve that i’m aware of. I’m having an EMG on Thursday. I first started with restless leg syndrome which I never had before. I thought the B6 might have something to do with this since I just started taking that a week before RLS. I stopped taking it. Neuropathy kicked in in a very painful way. My nerves were on fire! RLS stopped. The neuropathy has subsided. Will wait for EMG test to see what and where this came from. 2 Reply 12 replies @DD19701 @DD19701 7 days ago Does Peter have a video of excellent brand of supplements he advises his clients that can address certain medical concerns, as an example if a patient has fatty liver he would tell them to take XYZ? Reply @MyPathToNirvana @MyPathToNirvana 10 days ago Pendulum Glucose Control $165 per month. Athletic Greens $129 per month. Add in all the other supplements he is taking, it is roughly $350 per month. That is $4200 per year. 34 Reply 6 replies @charissefilteau3372 @charissefilteau3372 10 days ago Curious as to what you think about D3/K2 (as Mk7) and Magnesium combination for better D absorption? Recently diagnosed with Osterperosis in my spine and trying to optimize D3 intake. Thanks! 8 Reply 4 replies @dino_not_dyno @dino_not_dyno 5 days ago I had B6 neuropathy and still have residual effects from it. It was an awful experience to go through. My EMG/NCV was not pretty.Do not supplement synthetic B6 EVER and don’t drink Vitamin Zero etc Reply @zardi9083 @zardi9083 10 days ago I'm supplementing daily with lots of vegetables, fruits, spices, nuts, seeds, whole grains, olive oil, tea, fish, dairy and fermented foods! (And I take the very occasional vitamin d supplement) 31 Reply 8 replies @grigolli9072 @grigolli9072 10 days ago That´s a lot of capsules to take from things you can get mostly from food, lots of studies that question the absorption of standalone vitamins without food. I have had my share of trying these capsules and honestly never felt effect or missed them. 5 Reply 2 replies @davidb9670 @davidb9670 10 days ago (edited) How in the world did my grandmother make it to 98 eating mostly fatty pork, mashed potatoes, whole milk, and sauerkraut, and zero supplements? 319 Reply 113 replies @ParanoidBishop @ParanoidBishop 10 days ago I thought Ashwaganda shuts down cortisol production, important for people who exercise. I did use it to come off alcohol and it worked a treat. Now I just run & train. 12 Reply 2 replies @les0nick @les0nick 10 days ago (edited) I wonder if the anti blood clothing effect of the fish oil would eliminate the need for other supplements such as aspirin? Is there any way to check/control it? 10 Reply 2 replies @SquatFull @SquatFull 10 days ago Once you have an understanding of nutrition and exercise physiology which you have access to from the basic to the advance levels through the internet you can evaluate if his list is relevant for you. 2 Reply @johnford9455 @johnford9455 10 days ago Peter, I eat a lot of fish and take Omega 3s. Over the last three years I've moved my Omega3 Index from 7% to !8%. Is that too high? I've noticed more bruising than usual. 1 Reply @thecostanzatheory @thecostanzatheory 10 days ago Which pendulum probiotic? Metabolic daily or Akkermansia? I have elevated A1C, been pre diabetic for a while now so Im looking to try this and se if it helps. Fortunately, I’m very active, cut way back on sugar for over a year now, so I’m guessing that has saved me from full on diabetes. Thx for the content, Peter. 1 Reply 1 reply @bakalhau83 @bakalhau83 8 days ago I bet Peter is super happy about this post 😂 Reply @CreateNowSleepLater @CreateNowSleepLater 9 days ago Its weird because although he doesnt take B6 daily but he does because its in AG1. AG1 also has a nutrient extract blend which has K2 and Coq10 in it. They dont give the breakdown however but if you count everything in AG1, his supplement list is a lot higher. Im sure he considers it a food but im just saying. 2 Reply @Draziell @Draziell 10 days ago B6 causes neuropathy because excess of Pyridoxine blocks the coenzyme form P-5-P... So you should take both forms of B6 or focus on P-5-P 1 Reply @koderken @koderken 10 days ago He totally blanked on his copious daily intake of Topo Chico! 5 Reply @Black_Adam911 @Black_Adam911 9 days ago I took one baby aspirin a day for years and one day a did a physical with my doctor and got my labs back. My blood work was out of wack. I can't prove it was the aspirin but all I know is that I stopped and 6 months later I did my blood work and my liver and kidneys went back to normal. I stopped. Reply @marktapley7571 @marktapley7571 9 days ago So Attia like Huberman is on the AG1 scam wagon. Kind of like how everyone who goes into the gastroenterologist office needs a colonoscopy now that the doctors are all invested in that racket too. 27 Reply 9 replies @jasonlocke76 @jasonlocke76 10 days ago So much great information. Thank you. Peter I would also like to know where you got that shirt. Huge fan of your work. Reply @ai_108 @ai_108 10 days ago Thanks for sharing Peter 💎 6 Reply @heidirexin5141 @heidirexin5141 9 days ago Does ashwagandha balance cortisol levels or just lower it? All 4 points are low for me on saliva adrenal testing, so I sure don't want to lowercase further. Reply @kaliplaya86 @kaliplaya86 9 days ago Why not just take us to your med cabinet and walk us through your daily/weekly meds? Ground root level production. Feel like you are one of us. I would love to see what. 1 Reply @macclift9956 @macclift9956 8 days ago In an otherwise well-nourished person, a low level of a particular vitamin may just mean that the body isn't storing what it doesn't need. Reply @stevensantora2976 @stevensantora2976 4 days ago Great stack of supplements. Thank you Dr. Attia. Reply @Adamsilvernail1881 @Adamsilvernail1881 10 days ago (edited) Any insights on taking that much (1g) magnesium a day? I know most articles I've read adivise not taking over 400-450mg a day for adult men. Would love to hear your reasons/insights. 2 Reply 3 replies @endgamefond @endgamefond 10 days ago (edited) Mr. Peter.. Please invite a guest or please teach us about mitochondria and our body metabolize for energy so it turn to energy or not for people who have or dont have depression or not depression but just basically sudden worriness. I feel like if keto helps it must be generation of low energy so our brain dont over stimulated on negative thoughts. Less enegy means less brain activity. We need to learn more 3 Reply @non9886 @non9886 9 days ago i miss vitamin C. even if it is contained in AG i still don't know how much he takes. if he doesn't take any it is kinda suprice, especially considering that he is taking some kind of fringe or arguable things like aspirin (which is imho quite useless when you take so much fish oil and exercising, going to sauna etc.). and vitamin C has some benefits like aspirin too... 1 Reply @kst157 @kst157 9 days ago Supplements - when independently tested outside of the company’s involvement the majority prove to be fake & don’t contain what’s claimed. Many have unknown fillers… 1 Reply @user-zn3cs6hl3p @user-zn3cs6hl3p 6 days ago Thank you. Really helpful. Why not creatine? Reply @TheWiseDJ @TheWiseDJ 4 days ago For Vitamin D I’d recommend a book by Dr. Michael F Holick called the vitamin D solution. I don’t think anyone has done more research than Dr. Michael Folick on the hormone vitamin D. Reply @stefanweilhartner4415 @stefanweilhartner4415 9 days ago in the morning: i sprinkle in about 1...2g of MSM and sometimes 1g of NAC. because these two are a bit hard on the stomach, i add 2g magnesium malate and 2g glutamine. that makes it smoother. in the evening: 4g glycine + 3g taurine + about 12g EAA Reply @TombstoneTube @TombstoneTube 10 days ago What brand of protein powder does he use? 1 Reply @Ken-iu2zp @Ken-iu2zp 2 days ago Is it best to take supplements first thing in the morning or after a meal? Reply @magnuslang-ree8645 @magnuslang-ree8645 10 days ago (edited) Reasonable to ask whether the irritation from all of the «other ingredients» in this massive regimen outweighs the positive effect. «I’ve helped more people by getting them off supplements, than on» -Ray Peat 3 Reply 1 reply @wread1982 @wread1982 8 days ago My grandma is 101 still drives and lives on her own. She eats whatever and has high blood pressure since the 1960s. She puts in hungry man tv dinners and hot dogs in the microwave and says it’s “hungry man timmmmmme” she also loves coffee with cream and grape sodas 3 Reply @LordsChamber @LordsChamber 6 days ago Try us. We will understand. Thank you Very much, Peter, for this information! You can't know how it helps. And it helps a lot. Reply @thefpvlife7785 @thefpvlife7785 7 days ago Does AG1 reveal the dosage percentage…amount per serving? They only tell us what’s in it but not how much. Reply @jamessullenriot @jamessullenriot 10 days ago Unless you can test all this stuff near real time in your body and know how everything is interacting, it's like a crap shoot. What we really need is all the data to be sorted out and close to real time tests that can be run. In other words, its going to be a crap shoot for a really long time 12 Reply 3 replies @NewBlueType @NewBlueType 10 days ago I wonder why he didn't mention rapamycin. Maybe cause he doesn't consider it a supplement? I can't imagine he's not taking it anymore. And what about an NAD booster? NR, NMN? 10 Reply @shawnfaust2165 @shawnfaust2165 10 days ago Curious as to why take a B6 and B12 supplement when AG1 contains 176% of B6 and 917% of B12? Reply 5 replies @erick6102 @erick6102 10 days ago Please let us know when you drop the ashwagandha and start TRT. I’m right at the low end of normal range and 50 years old and researching whether or not I should start. 2 Reply 1 reply @matthewhill7572 @matthewhill7572 3 days ago I don't think I would be hungry all day taking all those pills. Reply @Rocko1990 @Rocko1990 8 days ago What about multivitamin? I'm just concerned with the megadoses of certain vitamins they come with. Are they harmful? Reply @rays9033 @rays9033 10 days ago I take the Carson Finest fish oil in liquid form (lemon flavor), it has very little fish oil taste. The Carlson fish oil capsules make me burp fish flavor all day, the liquid does not. 1 Reply 1 reply @sunmoon-84 @sunmoon-84 8 days ago Is there a rebound effect if you stop taking the aspirin? Reply @hikerJohn @hikerJohn 9 days ago I live in sunny Southern Calif so I only take Vit-D in the winter because you only need a fraction of an hour of sun to get enough Vit-D production and I'm in the sun for hours. Reply @cherylwilliams2347 @cherylwilliams2347 9 days ago (edited) Was just about to purchase but should we be concerned about all the vitamin E(13.4 mgs) that comes with this? Referring to The Very Finest 700mgs of Carlson's? Reply @IvdAEROvm @IvdAEROvm 10 days ago Just post the dosage and brands in your description. Fishoil Vitamin D Magnesium and Magnesium Treonat? These ones seems like a good start. 6 Reply 1 reply @marktapley7571 @marktapley7571 9 days ago I thought the exorbitantly priced AG1 had everything in it so why is Attia supplementing with a bunch of other stuff? Ag1 must not be kicking enough back to the till. 1 Reply @thedanishmalik1 @thedanishmalik1 10 days ago can someone please make list with brands if he mention also how much ? Reply @madridista1611 @madridista1611 10 days ago So any other credible company manufacturing Magnesium L threonate should be avoided if they do NOT have the Magtein license? Reply @YuraL88 @YuraL88 10 days ago Magnesium + glycine before sleep Morning 500 mg DHA, b complex, zinc 22 mg, vit D 2000 ME 1 Reply @Aetherius88 @Aetherius88 10 days ago Surely he forgot to mention creatine and a protein supplement..? If not then I'd suggest to add it. Other supplements I take are hydrolyzed collagen peptides and hyaluronic acid. I feel like AGI is sooo not worth it for the average person. 3 Reply @julianajb @julianajb 3 days ago Can someone explain me because I can't understand about his dose of B6? he says he takes 50mg, but I see online "The recommended daily amount of vitamin B-6 for adult is 1.3 milligrams" and also my multi vitamin has 2mg and it says it's 118% of the DV. Doesn't his dosage seem like 25x higher of what's normal? Or how I am misunderstanding miligrams and grams? Reply @dsha2006 @dsha2006 6 days ago I'm super exhausted quite often. Any idea what things I could test for? Reply 2 replies @cz2165 @cz2165 10 days ago (edited) A lot of the way he monitors himself involves expensive testing that one pays out of pocket.. 5 Reply @kiramiftari9486 @kiramiftari9486 8 days ago SO… no Rapamycin or Metformin… very clever of Peter to not get swept back up to these meds… let the time show ALL pros and cons ✌️✌️✌️ Reply @Dccole3214 @Dccole3214 9 days ago Why take capsule methyl folate and methylcobalamine given the high concentrations already in AG1? Reply @rossfletcher4986 @rossfletcher4986 10 days ago Isn’t magnesium oxides bioavailability terrible? Glycinate? 4 Reply 3 replies @lizanal1521 @lizanal1521 9 days ago Can you talk about MCT oil? Reply @generalsixty2133 @generalsixty2133 10 days ago He’s checking his bloodwork regularly, and he’s studying emerging data in real time. A good start is getting your bloodwork and get check ups. Don’t follow advice from influencers like David Avocado Wolfe. 1 Reply @67NewEngland @67NewEngland 6 days ago - I’m surprised he didn’t mention taking K2 with his vitamin D. Reply @erinhiner9114 @erinhiner9114 10 days ago I am very confused about the magnesium recommendation, is it three products? I’m looking at SloMag brand but just see it with calcium. Please advise! Reply 1 reply @Lunde42 @Lunde42 10 days ago (edited) Hello! No creatine in the supplement list Mr. Attia? Or is not considered a supplement?`Thank you for your answers! 3 Reply 1 reply @JulesLife @JulesLife 10 days ago That mag threonate thing you said to look for… is that only if you live in USA? Mine doesn’t have it but I’m in Canada. 1 Reply @jeffreyjohnson7359 @jeffreyjohnson7359 10 days ago What's the difference between glycine and TMG? Reply 2 replies @loopba @loopba 10 days ago Creatine is a top 3 overall (arguably number 1) given the brain, muscle, energy benefits. Im my experience would be no noticeable benefits from any of those others 1 Reply 1 reply @erick6102 @erick6102 10 days ago Why Phosphatidylserine for long flights? What’s the connection? Reply @mrpatonki @mrpatonki 10 days ago Honestly he could take none of these and probably live just as long and happy 32 Reply 13 replies @hartmutneuendorf4915 @hartmutneuendorf4915 5 days ago I'm 72 year old white male, and I regularly take supplements! I'm feeling very good at the moment! My goal is to have a quality good life....😊 Reply @donwinston @donwinston 9 days ago I thought TMG was best for lowering homocysteine. Reply @ericvandenbranden6711 @ericvandenbranden6711 10 days ago What about low dose lithium? So many things Peter has talked about, but isnt taking... weird 1 Reply 1 reply @erinhiner9114 @erinhiner9114 10 days ago Can someone clarify what SLO Mag variation to buy… I don’t see word Magteam or magtine as he referenced. Reply 1 reply @Southerncyclist @Southerncyclist 8 days ago Im one of those people who get the neuropathy from too much B6. Reply @bennozoid1 @bennozoid1 4 days ago if you have Rosacea, and several other conditions, you need to speak with a doctor before taking many of these supplements; in particular B6, B12 and VitD - some studies have linked these supplements with increased Rosacea symptoms...... Reply @TheCyclingCardio @TheCyclingCardio 8 days ago Unless they have significant CAD, PAD, or soft/vulnerable atherosclerotic plague, I never prescribe antiplatelet to my patients Reply @TheShumoby @TheShumoby 1 day ago I'm already most except the aspirin and greens tablets. I also take glucosamine chondroitin + Boron for my joints. Reply @marcusumbro @marcusumbro 10 days ago Why magnesium oxide ? Isn't that form badly absorbt ? Why not glycinate ? Reply 1 reply @charlestoddsullivanforpres6628 @charlestoddsullivanforpres6628 10 days ago What about Vitamin K2? 3 Reply @SamShank175 @SamShank175 7 days ago Hmm, I've taken Nordic Naturals for several years now and never had a broken capsule. Reply 1 reply @jimryan6023 @jimryan6023 10 days ago I'd be embarrassed to have a list like that 😂😂 4 Reply 1 reply @ToeMass123 @ToeMass123 8 days ago Is food so nutrient deficient that we should take supplements? I eat healthy. Meat and veg for dinner, very little carbs, oily fish, eggs, beef, chicken and organ meats. Reply @thomaswipf7986 @thomaswipf7986 9 days ago Jigsaw Cod liver oil for 30% vit d + 89% vit a + natural sun is probably best. Reply @Nuatida @Nuatida 8 days ago 😂 this video is what he said he hates most 😂 Reply @technoshaman2063 @technoshaman2063 6 days ago No, thanks; I prefer receiving all I need from my diet and only look to supplement deficiencies through synthetic forms in times of last resort. Could you guess how it works? To each his own, I respect all opinions you have. Reply @toddboothbee1361 @toddboothbee1361 10 days ago He takes orange baby aspirin because he likes its flavor. 1 Reply @MrQuadcity @MrQuadcity 9 days ago Here's a detailed summary of Peter Attia's supplement list based on the transcript from his YouTube video: ### Introduction Peter Attia starts by cautioning that his supplement regimen is personalized to him and should not be taken as general advice. He emphasizes that the context and clinical history are crucial for understanding why he takes certain supplements. ### Supplements for General Health 1. **EPA and DHA (Fish Oil)**: He takes Carlson's EPA and DHA, aiming for roughly 2 grams of EPA and 1.5 grams of DHA per day. He mentions that he is treating to a red blood cell membrane concentration of EPA and DHA of about 12%. 2. **Vitamin D**: He takes 5,000 IU of Vitamin D daily, although he couldn't recall the brand. He believes that most studies on Vitamin D are poorly done but takes it because he sees low risk and potential benefit. 3. **Magnesium**: He takes Slow Mag, magnesium L-threonate, and magnesium oxide to get up to about a gram of total or elemental magnesium per day. 4. **Methyl Folate and Methyl B12**: He uses Jarrow as a brand and takes these to keep his homocysteine levels below nine. 5. **B6**: He used to take 50 mg daily but has reduced it to 50 mg three times a week due to concerns about potential neuropathy. 6. **Baby Aspirin**: He takes one a day for cardio protection, although he admits the evidence is weak. ### Nighttime Supplements 1. **Ashwagandha**: He takes 600 mg and recently switched to the Solgar brand. 2. **Glycine**: He takes 2 grams and uses the Thorne brand. 3. **Magnesium L-Threonate**: He uses the Magtein brand. 4. **Phosphatidylserine**: He takes 400 mg, particularly for travel to help overcome time zones. ### Additional Supplements 1. **Athletic Greens (AG1)**: He takes this green drink in the morning. He discloses that he is an investor and advisor in the company. 2. **Pendulum Glucose Control Probiotic**: He takes two of these in the morning and is currently experimenting with it to observe its effects on his average blood glucose levels. ### Changes Over Time - He wasn't taking Pendulum probiotics or Ashwagandha a year ago. - He switched brands for fish oil due to quality issues. - He wasn't consistently taking baby aspirin or possibly Vitamin D a year ago. - The dosage of B6 has been reduced from daily to three times a week. ### Final Thoughts Peter Attia reiterates that his supplement regimen is subject to change based on new data and personal health metrics. He also stresses that what works for him may not work for everyone else, and it's essential to consider one's medical history and consult healthcare professionals. Reply @napnap609 @napnap609 10 days ago I thought most or all the studies on fish oil supplements show that supplementing with fish oil doesn't show any real benefit. Reply @chrisp6044 @chrisp6044 10 days ago No longevity aids? Spermidine, Resveracel by Thorne? 2 Reply @shaneglean217 @shaneglean217 9 days ago Assuming he takes a hydrophilic statin too, just hasn't mentioned it because it's not strictly speaking a "supplement" Reply 1 reply @pelletey @pelletey 10 days ago Is Peter not taking Rapamycin anymore or is it rather just not a supplement? Reply 1 reply @edward8009 @edward8009 8 days ago No doubt genetics are king! People who live a long life are descendants of others who have generally lived a long life. Offspring of professional athletes are generally better athletes than those who are not. Like in sports people don’t pick the sport the sport picks them. All you can do is not smoke, stay away from drugs, eat generally healthy and maintain a reasonable weight. Warren Buffett and Charlie Munger have this figured out, he knows insurance which leads to him know about longevity. Reply @stevet5549 @stevet5549 9 days ago (edited) It is sad that Intelligent people jump into the supplement rabbit hole never to come back out. No matter how smart they are, all the biohacking they do,they still don’t really know if the supplements are helping or hurting. The answer is so simple and it is not in a bottle. Just eat a whole food unprocessed diet, manage stress, sleep, socialize and exercise. The rest is a crap shoot. 3 Reply 1 reply @pinkiepinkster8395 @pinkiepinkster8395 3 days ago I'm following the Bryan Johnson Blueprint protocol supplement and vegan food diet and i feel great. Reply @Libertas_P77 @Libertas_P77 5 days ago Peter’s stack is mid. But then this is the same guy who kept going on about metformin for years and was taking it, so I’m not too surprised. My stack is much larger, independently arrived at via extensive reading of research papers and it’s very similar to Bryan Johnson’s blueprint protocol. That’s to me the far more interesting protocol to look into. Attia is just cynical to the point of ignoring potential benefits unless absolutely proven. For example where the hell is NAC to go alongside more glycine than a mere 2g? Taurine similarly, and what about creatine? It’s sub optimal supplement list in my view. Reply @jft8994 @jft8994 10 days ago Replace aspirin with nattokinase? 1 Reply @SirGalaEd @SirGalaEd 10 days ago If you look at Vit D get Dr. Rhonda Patrick again. Sje really knows this literature well. Reply @bertbog5088 @bertbog5088 10 days ago my problem with taking all of these different supplements your getting a great deal of fillers - if I take anything in a gel capsule I get the the worst stomach problems Reply @ZeuzBluez @ZeuzBluez 10 days ago None of these except d3. I take vit c, omega oil, zinc n magnesium, d3, nac, saw palmetto, glucosemine, Creatine, whey protein. 1 Reply 1 reply @shawnmartin6210 @shawnmartin6210 4 days ago (edited) I'm surprised to hear Peter takes low-dose aspirin, especially since he follows a healthy lifestyle. Using aspirin has it's place in preventing heart attacks and strokes, but mostly as secondary prevention(meaning the person has already had a heart attack). It is adviced against using it as a primary prevention tool(meaning the person hasn't had heart attack), unless there is a 10% or greater risk they will have one within the next ten years. And there is no high risk of bleeding issues(ulcers, etc.). You would of course have to talk to your doctor about using aspirin as a primary prevention is right for you. Amoung the tests you should take, a CAC score(cornery artery calcium) is gonna be the most important. So really, unless you have talked to your doctor and it has clearly been established that your at a 10% or higher risk of having a heart attack AND you don't any significant bleeding risks, you should NOT be using aspirin as a primary prevention. Reply @bogdanliviusson @bogdanliviusson 6 days ago Was expecting B1 to be in there Reply @Seanbrickss @Seanbrickss 9 days ago This channel and your expository teachings has been my major drive, and that's why with $32,000 weekly returns I was able to live my life-long dreams of sending 30% of my weekly interest to the sick old ones in my neighborhood. Reply 34 replies @DCA55 @DCA55 10 days ago While your encouragement for everyone to focus on diet, exercise and sleep are admirable, your advocacy for supplements is disturbing as, to your point with vitamin D, there are virtually no long term, or, most cases, even short term clinical studies that prove the efficacy of any of them. It's all smoke and mirrors claims made by the makers to boost unproven claims in an effort to capitalize on the never ending quest for the fountain of youth by folks looking for a short cut instead of the diet, exercise and sleep regimen. 5 Reply 2 replies @Markus-fw4px @Markus-fw4px 10 days ago (edited) I have to throw up frequently a few hours after taking Ashwaghanda (Shoden). Nope, not for me. Reply @nequestns @nequestns 10 days ago No K1 or K2 with that high does of vitamin D? You may want to research the need to do that particularly with that much vitamin D. Reply @miketoni1012 @miketoni1012 8 days ago What you think about taurine? Reply @crholling1 @crholling1 10 days ago Had you considered Vitamin K2? 8 Reply 6 replies @user-ky1bt4cg7w @user-ky1bt4cg7w 4 days ago Good food is medicine. Bad food needs medicine. Reply @zibtihaj3213 @zibtihaj3213 10 days ago I thought AG 1 is now considered garbage ? 1 Reply @seansletters @seansletters 10 days ago Is rapamycin not counted as a supplement? 3 Reply 3 replies @billybvogan4204 @billybvogan4204 9 days ago I was surprised no creatine ? 1 Reply @csabakarai4497 @csabakarai4497 10 days ago Why only 2 grams of glycine ? All pundits say we need min 10-20 grams/day. Reply @explorewithsteggie1913 @explorewithsteggie1913 10 days ago I take 715 of Carlson's Algae Reply @johnrule108 @johnrule108 9 days ago No K2 with the D3? Reply @BlueNGold09 @BlueNGold09 9 days ago No creatine, collagen, zinc or Hawaiian astaxanthan? Reply @bootneck4514 @bootneck4514 10 days ago This may work for you but that dose of fish oil gave me toxic levels of vit A. Reply @gabbechico8471 @gabbechico8471 6 days ago 7:51 lost me at AG1… Reply @jonnylons1 @jonnylons1 10 days ago …”oh and I take AG1…and full disclosure I’m an investor…” Reply @evelynramos445 @evelynramos445 10 days ago Some of these needed Reply @michaelkennedy4444 @michaelkennedy4444 10 days ago I take Carlsons Cod Liver oil . It’s pricy but you pay for quality . Reply @DEM78976 @DEM78976 4 days ago Magnesium Oxide, interesting choice. Reply @ttfan3257 @ttfan3257 4 days ago (edited) excess B6 = neuropathy, Vit-D 5K Reply @MrInferno007 @MrInferno007 10 days ago Ashwagandha daily? Shouldn't you cycle it? 8 Reply 2 replies @AustinBigWig @AustinBigWig 9 days ago No Vitamin C or Lysine? What do you think of the Linus Pauling Protocol? What do you know about CAVADEX Cyclodextrin? Reply @jakub6495 @jakub6495 8 days ago Fabulist Reply @thelarson1000 @thelarson1000 10 days ago Mg oxide is poorly absorbed. Try glycinate 3 Reply 1 reply @rider65 @rider65 10 days ago Interesting. No K2 MK7.... 🤔 I had tried ashwaganda twice for a month each time. Garbage. Placebo. Other than that, most of what you listed. B, Mag, D3, Probiotics... Reply 1 reply @DarthNoshitam @DarthNoshitam 10 days ago How is B6 toxicity possible, isnt any excess peed out? 2 Reply 3 replies @glomesocial @glomesocial 9 days ago Can we glome you Peter? We want to copy you as AI glome and let your fans chat with him Reply @JeanMopis @JeanMopis 4 days ago What happend to creatine, doc? Reply @JOHNWAYNE1920 @JOHNWAYNE1920 9 days ago Glucose control is $165 a month, lol. Reply @geoffwhite3385 @geoffwhite3385 10 days ago I reckon he forgot to mention he's on an SGLT2i Reply 1 reply @evelynramos445 @evelynramos445 10 days ago Insulin insensitive probotic? 1 Reply @rambolambo @rambolambo 1 day ago If dude said he did cocaine everyday, I’d do it. Wait… Reply @mikeholchendler8751 @mikeholchendler8751 10 days ago @peter attia why no NMN? 1 Reply @Themata @Themata 8 days ago No need for the K2, getting it from diet? Reply @user-fd2uy2pp8u @user-fd2uy2pp8u 10 days ago In your book you mention the Covid vaccine is both safe and effective. Do you still support that? 30 Reply 22 replies @capcomfan82 @capcomfan82 10 days ago Might as well put it out yourself instead of everyone else lol. 1 Reply @j-uk2189 @j-uk2189 10 days ago No berberine, or citrus bergamot? Nac? 6 Reply @devonjon @devonjon 3 days ago Interesting - no creatine Reply @Victoria-sk2zs @Victoria-sk2zs 5 days ago YOU NEED TOREALIZE MSN ALSO HAS CHRISTAIN DIRECTION. TO ALWAYS IMPROVE OURSELVES. SO PETER PLEASE START SOME TRALS!!! ITS YOUR BUSINESS. THIS WAS A INFORMATIVE SHOW THANKS. Reply @b-sideplank @b-sideplank 2 days ago Ok, what is a baby aspirin? Reply @boriskrizan7447 @boriskrizan7447 5 days ago No vitamin C? Reply @sebastianandrzejak5540 @sebastianandrzejak5540 6 days ago I could add Astragalus.. Reply @Qlorck @Qlorck 9 days ago No creatine? 1 Reply @JorgeDiaz-um4qx @JorgeDiaz-um4qx 5 days ago Jeez man! With that meds cabinet who needs a pantry and a fridge?? Reply @evelynramos445 @evelynramos445 10 days ago Body talking in the hands Reply @jmphome9793 @jmphome9793 10 days ago For the Algo 🥩🧈🥓🍳👍✌️ Reply @tomekwolny5606 @tomekwolny5606 9 days ago Where is the creatine? 1 Reply @priusskipper @priusskipper 10 days ago Only surprise was ashwaganda Reply @haruki5401 @haruki5401 9 days ago I keep it simple, I take animal pak, fish oil and creatine. Reply @hiz-n-lowz1577 @hiz-n-lowz1577 10 days ago what, no circumin??? Reply @TheMrKlassy @TheMrKlassy 1 day ago idk about athletic greens, especially for how much they try to hock it for... Reply @anonymous134y @anonymous134y 10 days ago 8:25 I thought seed is the only probiotic with scientific support? Reply 1 reply @juliussabonas3749 @juliussabonas3749 6 days ago Just because i take you shouldnt take it... of course im gonna take it :D Reply @anujteotia2180 @anujteotia2180 5 days ago The Blue Zone people who live 100 years don't take any supplements. Why so many supplements. Humans are doing well without these supplements and suddenly there are so many. Only exercise, happiness and real food are needed to be healthy. Reply @Timxtrem1 @Timxtrem1 9 days ago When magnesium oxide son?? Reply @jenniecaverley4781 @jenniecaverley4781 10 days ago Peter Attia aren't you concerned about how all this stuff you are taking effecting your liver? Do you check on your liver enzymes too? 15 Reply 1 reply @scotts6305 @scotts6305 10 days ago Big meg. You say you are not sponsored by any of these - oh wait except ag1. And you take ashqaganda, which is also in ag1 and you are not supposed to take long term. And you take baby aspirin for no reason. Great science based stuff here… /s Reply @JohnEnergy2012 @JohnEnergy2012 10 days ago I take beef and eggs. 4 Reply @santosvella @santosvella 21 hours ago No idea what the Tricycle and the coins was all about. Bizarre. Reply @veliborvasovicofajax5358 @veliborvasovicofajax5358 10 days ago im a little thick..do I need supp lements? Reply 1 reply @nijazg.5152 @nijazg.5152 10 days ago Baby aspirin!!?😏🙄 Reply 1 reply @kaizen5180 @kaizen5180 9 days ago The food in North america is so bad. I understand why you will want to have a stacked supplement list, those old people in Okinawa, japan might not need any of this. Reply 1 reply @dude861 @dude861 10 days ago I cannot take anyone serious that takes Athletic Greens. If you have that, just throw that unhealthy shit in the trash, where it actually belongs. 1 Reply @JOHNWAYNE1920 @JOHNWAYNE1920 9 days ago Wtf is the tricycle analogy? 1 Reply 2 replies @user-hm4jm1cy7m @user-hm4jm1cy7m 10 days ago so much uncertainty around omega supplements'.. so many people say its all oxidized by the time you get it and is useless 1 Reply 1 reply @michaelacton6246 @michaelacton6246 3 days ago Magnesium oxide is garbage Reply @stelmarsky6778 @stelmarsky6778 10 days ago Only people to have the licence? Please explain. Reply @saintman4468 @saintman4468 6 days ago If God gives u 60years of quality functional happy life u good..if God gives u 100yrs of pain especialy last 30yrs of your life than no good...goal is not just longevity its quality Reply @mazakmarson4496 @mazakmarson4496 9 days ago No creatine? 1 Reply @cularu1 @cularu1 9 days ago No creatine? Reply @TheJosquire @TheJosquire 5 days ago No creatine? Reply @BerneseNoef @BerneseNoef 9 days ago I eat meat, eggs, dairy, fruit and salt. Done 1 Reply @liveloveride1676 @liveloveride1676 10 days ago Clickbait for supplement companies, I bet they paid him a lot of money for dropping their names out, he would not have done that for nothing. Reply @evelynramos445 @evelynramos445 10 days ago Vit d3 Reply @erick6102 @erick6102 10 days ago Ha ha. I know he hates this but EVERYONE wants to hear. 1 Reply 2 replies @selma5885 @selma5885 10 days ago K2? 4 Reply @evelynramos445 @evelynramos445 10 days ago Walk alone want to be an able-person. Aged Reply @purplesalad @purplesalad 10 days ago (edited) 5000 IU 🤯 I stick with 1000 2:46 2 Reply @evelynramos445 @evelynramos445 10 days ago Nursing home not yet Reply @jicalzad @jicalzad 10 days ago I dunno, to me it seems like a lot of supplements 2 Reply @ananavarrete7218 @ananavarrete7218 10 days ago I see why he is annoyed by listening this😅 Reply @ElverGalargaChupas @ElverGalargaChupas 3 hours ago Penal para hambrientina!! Reply @evelynramos445 @evelynramos445 10 days ago K2? 2 Reply 1 reply @mani.m.84 @mani.m.84 6 days ago Researching and taking supplements is waste of money and time. Not only the impact is minimal you can damage your body. We don’t know anything about human body let alone knowing how how to adjust things with supplementation. Focus on sleep and exercise and then eating whole unprocessed foods. Reply @evelynramos445 @evelynramos445 10 days ago Probotic diabetic? Reply 2 replies @mending_chord6787 @mending_chord6787 10 days ago Gonna get banned posting this type of content, now. Reply @rsanghi24 @rsanghi24 10 days ago Mr. Manager, i wonder how much peter dislikes this thumbnail and title. Reply @nijazg.5152 @nijazg.5152 10 days ago Sponsoring video!!? Seems like you all try to sell something to us, all of you!!😮‍💨 Reply @RealMTBAddict @RealMTBAddict 10 days ago Obsessing about supplements creates stress. Stress ages you. Age kills people. Pay attention. 1 Reply 3 replies @maxaj6116 @maxaj6116 6 days ago Don’t be a sheep .. what works for him not necessarily work for u .. do ur own research and experiment on urself Reply @evelynramos445 @evelynramos445 10 days ago Too high 1 Reply @ttwarrior1 @ttwarrior1 8 days ago if he says the scam supplement d3, im leaving Reply 1 reply @evelynramos445 @evelynramos445 10 days ago Probotic Reply @stevestone9526 @stevestone9526 2 days ago This interview was so horrible..... How can two people speak so many words and say nothing in the end.....???? After your guest and you went on and on I still have no idea what steps can be taken to improve my health through exercise. He was so so much in his head, just to hear himself talk, thinking he was so smart. He talked about it, from every direction and never said what everyone was waiting for him to say. You need to exercise in this way and this how you do it.... It was torture to listen thinking he may finally get to the point and never, never does. You didn't help at all.... Reply @borisleoro8943 @borisleoro8943 10 days ago Awful list. Expected better from Peter Reply @jeffortega3949 @jeffortega3949 7 days ago More scams Reply @GuardianDivine @GuardianDivine 10 days ago outlier Reply AWS | Scale Sponsored aws.amazon.com Learn more Ladies Seeking New Love Seeking Love, Romance or Fun? 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PHOTOTHERAPY Aly Simmons Gwin 1 view 5 hours ago New How to lower your apoB Peter Attia MD 82K views 8 days ago Get the 5 Tactics in My Longevity Toolkit and my weekly newsletter here (free): https://bit.ly/404Pvz6 Watch the full episode: • 276 ‒ Special episode: Peter on longe... … 314 Comments rongmaw lin Add a comment... @jaysonmatthews3333 @jaysonmatthews3333 8 days ago 🎯 Key Takeaways for quick navigation: 00:00 📚 Over the past two decades, new tools have emerged for managing apolipoprotein B (apoB) levels, reducing the need for high-dose statins. 00:27 🏋️ Exercise has minimal impact on apoB, and managing lipoprotein risk primarily relies on pharmacology and nutrition. 00:40 🥦 To lower apoB through nutrition, you can reduce carbohydrates to lower triglycerides or cut saturated fat to reduce cholesterol synthesis. 01:07 🍔 Reducing saturated fat intake can upregulate LDL receptors, pulling more LDL out of circulation, potentially lowering apoB. 02:45 💊 For those needing to lower apoB significantly, pharmacology options like PCSK9 inhibitors and specific drugs can be effective without major side effects. Made with HARPA AI 45 Reply 1 reply @Shabana-hv9ic @Shabana-hv9ic 7 days ago (edited) Super interesting facts regarding the effects of statins at high doses vs low. Both my parents are on 40mg of atorvastin and their A1C always comes back high regardless of being on a low sugar diet. Will def discuss lowering their dose with their doctors. Thank you Peter for sharing such vital health information all the time. 3 Reply 4 replies @aquamarine99911 @aquamarine99911 3 days ago (edited) I was in good shape on a strict keto diet, with an ApoB of 186. I added two cans (~600 g) of beans/lentils per day, cut out red meat and eggs, and dropped my ApoB down to 85. Apart from reducing SFA and dietary cholesterol - for those of us who are hypersensitive to such things - the easiest way to drive down cholesterol is dietary fiber. Since I am fit with good BP in my 60s, I'm happy to have my ApoB in the 80 to 90 range. I don't want to take drugs, because then I wouldn't follow my diet so strictly. I just want to feed my body what it seems to want. 1 Reply 1 reply @MiguePizar @MiguePizar 8 days ago As someone who was morbid, had high cholesterol, pre diabetes and things like that, and now have excepcional blood work, it all started with losing weight, Intermittent fasting, and working out, and I eat quite lot of meat and carbs, but because I do what I said before, my blood work is very good, and no drugs. Best 26 Reply 10 replies @Sa7biUK @Sa7biUK 8 days ago 39 year old male. Mildly active - 10k steps per day. Generally eat one meal a day and lots of intermittent fasting. 6ft, weight 74kg. Recently had Apob taken and it's 136. 90th percentile!! Have ordered fish oil, Citrus bergamot extract, and garlic extract. Going to up my steps and cut out sugar, and start cooking myself instead of takeaways. Will re-take the test in 6 months and see how I get on but I think statins in a year, right after my 40th. Getting old sucks 16 Reply 14 replies @tonycrouse6544 @tonycrouse6544 8 days ago For most people all you need is a balanced diet of minimally processed foods. I do believe some supplements are beneficial like vit D, vit K2 and fish oil. Don't panic about all these lab numbers because no one knows when your time is coming. I worked 30 years in cardiac critical care and saw many pts who had excellent lipid panels but still developed heart disease. When I worked in general care I saw many older pts who had crappy lipid panels and NO heart disease. Try to find joy in life and embrace gratitude. 78 Reply 17 replies @doubleunderfire7964 @doubleunderfire7964 8 days ago Love the level of detail provided in these videos. Excellent video. 2 Reply @cyclingmaven @cyclingmaven 7 days ago Mate, you're a keeper and your courage is recognised and appreciated. Reply @FuryduckedUsyk @FuryduckedUsyk 8 days ago (edited) Had a recent blood test and I have have a HDL of 1 and my LDL is 3.6 (should be below 3.0). My non HDL is 3.9. Total cholesterol is 5.0 which is just on the limit. My Triglycerides are 0.9 which is excellent. Have never had my ApoB checked so no idea what it issue. My total and LDL cholesterol is quite stubborn & very hard to get down and I don’t know if I should be worried about it or not - there’s so much conflicting info out there. I’m an omnivore and dunno if I should cut saturated fat out completely. I’m very active (resting HR of 41 at 41 years of age!) and find it hard to keep weight on so I’m very reluctant to cut out the animal products completely and become an malnourished skeleton. My sugars and HBa1C were absolutely fine as well, even eating a teaspoon or two of raw honey a day along with other carbs like oats in the morning. The doctor marked the blood test as normal & no further action but I’d still like them to be better than they are. 3 Reply 6 replies @generalx-ray7833 @generalx-ray7833 8 days ago Peter, have you talked/written about the work of David Diamond, PhD and others who seem to think elevated LDL-C / apoB may not always be problematic? 17 Reply @danielcisco @danielcisco 8 days ago I have an ApoB of 146 😢 TG is between 55-75. Going to speak to my DR because I have been working hard on lowering it for more than a year. 20 Reply 22 replies @sbain844 @sbain844 8 days ago Thanks for this. I'm 50, my dad died at 69 of a heart-attack, and his post-mortem results revealed that he had a 90% stenosis. I have metabolic problems with carbs. Carnivore makes me feel a lot better, but I frequently have carb cravings that I give in to, and I always suffer after-effects as a consequence (eczema, skin lesions, stomach upset, and even blood in my bowel movements if I persist with carbs). These, of course, are just the immediate effects of the carbs that I eat, but I worry about what the long-term effects might be, I can't imagine that they are good... I also worry about apoB, even though I'm comforted that triglycerides are reduced on carnivore, and when I stick to carnivore it makes me feel so much better. I guess I need a hug... I know apoB will be high on carnivore, and triglycerides will be low, but does the one compensate for the other? Many thanks. 5 Reply 10 replies @zack_120 @zack_120 7 days ago Blood TG concentration doesn't necessarily go together with LDL/ApoB. My TG dropped below 100 through diets along with vigorous exercises, both aero- and anaerobic, but LDL didn't. 1 Reply 3 replies @Mike-du1dc @Mike-du1dc 8 days ago As always very informative! Thank You! Reply @simonphuket7782 @simonphuket7782 7 days ago (edited) Insane! Still subscribing to the cholesterol myths. I follow the GAPS diet formulated by Dr. Natasha McBride, she regards cholesterol as protective and we do not fear high cholesterol. I recently did a CAC test my results were 0 in every artery. My cholesterol was about 290, slightly higher than usual as I had an infection at the time. I have been doing the GAPS diet for over 8 years. I take no pharmaceuticals and 2 supplements which are food based: probiotics and cod liver oil. I am in my late 50s and was in 0-25% for the CAC test. Good luck with your method! BTW, before I discovered the GAPS diet p, I was probably on my way to a stroke, taking far too many supplements without fully understanding their effects on in the body in particular the microbiome. 4 Reply 2 replies @antekaramatic4747 @antekaramatic4747 7 days ago I dropped my ApoB to 0,67umol/L (35ish mg/dL) with fasting, high protein/fat, low carb, weight lifting and swimming. Which one of those is the most important one? I do not know, but my ApoB/ApoA is 0,4. I dropped 25kg in the process (while increasing muscle mass by 2kg). At the age of 42. 4 Reply 3 replies @tommydinob @tommydinob 8 days ago I’m limited financially. Dropped rosuvastatin from 20mg to 5mg daily. Eat low carb. Run regular release niacin 1000mg twice daily. My numbers are sweet despite the fact that I eat a lot of meat. 11 Reply 10 replies @sectionalsofa @sectionalsofa 8 days ago (edited) My jaw drops at the comments below. So many folks are on low carb diets-- keto and carnivore-- and don't know why their ApoB is elevated. What would you expect? A diet high in fiber and phytonutrients and low in saturated fat is the way to lower APO B with diet. Not that it will necessarily get you to goal, but at least it will point you in the right direction. 17 Reply 18 replies @qilinwang5889 @qilinwang5889 8 days ago Like Peter, I really hate the low carb vs high carb fight, and I think everyone should be nuanced about this. Food source only accounts for fairly small amount of cholesterol, and even though saturated fat causes ApoB to increase we should know that it is particularly detrimental to the hyper-responsive. For the rest it is a cost that must be weighed against the benefits of keto and carnivore, because they do offer unique benefits in other areas. At the end of the day, sugar + high carb is devastating, sugar + high saturated fat is also devastating, if you are eating sugar a lot then the fight on diet style is almost irrelevant. 1 Reply 1 reply @GlobalDrifter1000 @GlobalDrifter1000 8 days ago (edited) I am in a trial of Olpasiran by Amgen. Phase 3 trial of a siRNA. in phase 2 it recuced lp(a) 95%. A subcutaneous injection once every three months- fingers crossed. 6 Reply @jjuniper274 @jjuniper274 8 days ago Dr. Attia, would you kindly address dry eye and complications from it like permanent damage to the cornea that are directly correlated to some statins and ACE inhibitors, and other BP meds? I have been trying to find information on how to correct this. Help please. Thank you. 6 Reply @lauriell2297 @lauriell2297 7 days ago Are the alternatives to statins that lower Apo B proven to decrease heart disease with certainty? 1 Reply @luismarioteixeira658 @luismarioteixeira658 8 days ago To low apoB, reduce Applebee’s first 77 Reply 6 replies @jabon112 @jabon112 8 days ago Thank you- wish you were my doc. I had no idea there were alternatives, my doc just put me on a low dose statin. 1 Reply @Tate123 @Tate123 6 days ago I am on Rosuvastatin 20mg, Repatha and Nexlizet. Still not at target LDL levels of 50. Reply @peterrecchia6830 @peterrecchia6830 8 days ago (edited) If my lipid numbers (including APO B) are within "normal" range, am I likely to have a pharmacological intervention prescribed and then covered by insurance? 3 Reply 1 reply @scasti70 @scasti70 7 days ago (edited) @PeterAttiaMD : doesn't the ratio of LDL towards HDL matter any more, when it comes to cholesterol considerations? 1 Reply 1 reply @jimmccall8030 @jimmccall8030 8 days ago Great information, thank you. Reply @Joseph1NJ @Joseph1NJ 8 days ago I think we regularly underestimate the influence of diet in managing lipid levels. Of course every~body is different, but you don't need to be vegan or vegetarian, just smart about what you ingest, along with some trial and error. 3 Reply 7 replies @williamhenry3337 @williamhenry3337 2 days ago What about APOE2? I have the E2/E3 combination. No one in my family has has heart or alzheimers issues (all died from cancer). I am 75 years old and have held a 19.5 BMI my entire life. Reply @SH-jg5zq @SH-jg5zq 8 days ago (edited) Thanks 🙏🙏🙏 I have high apoB but high apoA too…I’m guessing the two cancel each other 😂😂😂 3 Reply 1 reply @luisfer14240 @luisfer14240 3 days ago Para poner mis dos centavos. Con residencia permanente , tienes derecho a estar en Australia de manera PERMANENTE. Mucha gente se estrella contra una pared viniéndose como estudiante sin tener después una manera de quedarse y con muy alto riesgo de tener que regresarse al país con las tablas en la cabeza Reply @evalpoul1470 @evalpoul1470 8 days ago My husband had a thalamic stroke 7 mo. ago and he cannot take statins due to rhabdo. We're in Ontario Canada and so I'm wondering if there is a more natural supplement route to explore. Reply 1 reply @bartl.7390 @bartl.7390 8 days ago (edited) Wait a minute, hold on. I love Peter Attia but I have to disagree here. Low carb doesn't necessarily lower apoB, it's the low glycemic index/load that probably contributes to the actual lowering. Fiber is a carbohydrate and it actually lower apoB. Beans are loaded with carbs and in studies lower cholesterol and apoB along with other sources of soluble fiber. 7 Reply 1 reply @user-xk9ic5xg6e @user-xk9ic5xg6e 8 days ago What do you feel about taking Repatha mixed with a statin to reduce triglycerides? Reply 1 reply @seanmclaughlin7415 @seanmclaughlin7415 8 days ago He is on three drugs as he claims to reduce cholesterol and claims that his diet is good. Also, look up the common side effects of those drugs he mentioned, key word “Common.” For every one or maybe two actions of a drug being proactive, there is a cascading effect of mechanisms the body is trying to correct due to the actions of the drugs. Trying to get the body back into homeostasis and out of a sympathetic state. This is why you have side effects. 9 Reply 1 reply @MsQ275 @MsQ275 8 days ago Super appreciate the LPa pharma info! 1 Reply @mariejones7136 @mariejones7136 19 hours ago (edited) Ive had high cholesterol for years and im 69..i just started eating meat and no processed food after being vegan and having cancer .i don't take any drugs ..i do excercise and my glucose is good and i keep inflammation low..no idea what my cholesterol is now ..the last heart check i had was excellent..i take coq10..plus 20 other supplements..oh i do low carb diet and i fast every day and two days a week. Reply @michaelwatts1186 @michaelwatts1186 8 days ago See I'm getting mix reviews on if APOB being high is a bad thing.... If your other blood markers are in optimal range. Im really trying not to think that many Drs dont know how the lipid suite really works due to the different variances of different diets. 1 Reply 2 replies @lingrell @lingrell 7 days ago If heart disease is primarily an inflammatory condition, and statin have a side effect of not just reducing cholesterol but also reducing inflammation wouldn't switching to bempedoic acid lose that anti-inflammatory benefit? Reply 1 reply @pb7762 @pb7762 8 days ago it would be great to see you have a podcast with Dr Paul Mason 18 Reply 4 replies @KevinSmith-4Liberty @KevinSmith-4Liberty 8 days ago I have had 4 CAC Score scans. Statins do accelerate the calcification of your arteries! My score was 20% annual increase, not on statins. On statins and it shifted to a 45% annual increase in my CAC score. Repatha, Ezetimibe and prescription fish oil for me now. 8 Reply 11 replies @chris-do6nr @chris-do6nr 8 days ago (edited) A great DIY calculator for ApoB is the following: Your ApoB=0.65 x TC (total chol) -0.59 × Your HDL +0.01 × Trig, if TG are < 270 I am 42 WM. My Apo B is around 89. My ApoA was 253 (yes, 253- perhaps it was an error). I have a 0 on the calcium score test, and my TTE showed zero signs of ascvd. Moral of the story.... Nobody knows anything. (sarcasm but you know what I mean) 2 Reply @morgo72 @morgo72 5 days ago I appreciate the detail about this but I think people freak out and think they have to go all hectic with this , my nan lived to 95 and ate what ever she wanted , did some gardening and was happy with her life so not everything has to be this strict , just my 10c worth. Reply 1 reply @qigong1001 @qigong1001 8 days ago Just looked up the price of pcsk9 inhibitor and it's $500/month per injection. So $1000/mo for Peter if he is doing it twice/mo. 6 Reply 4 replies @AnthonyShaw-ty9pi @AnthonyShaw-ty9pi 8 days ago (edited) Well, does statins cause alzheimer? Memory loss as you age🤔 Just curious, because my Apo-b is 139. Triglycerides are 74. I'm 66. Got a 71 on a CAC Score. Reply 1 reply @billytheweasel @billytheweasel 8 days ago Thanks team Attia, so glad Dr Dayspring is here now too. Reply 2 replies @mannymotta2174 @mannymotta2174 5 days ago Is lipoprotein (a) related to apoB 1 Reply @user-vp9hm6bf6c @user-vp9hm6bf6c 8 days ago Please explain why APOB is simply not just a marker? Most everyone I listen to speak of it implying it as causal. Meaning, speak of lowering VLDL LDL for most and Lpa where possible and therefore, lower triglycerides and LDL...lower carbs , low sat fat, fish oil, lots of fiber and statins when necessary. 1 Reply @leadimentoobrien1221 @leadimentoobrien1221 1 day ago I heard one of those cholesterols have an IMMUNITY function. Can u expand on this? Reply @hccparamedic1985 @hccparamedic1985 7 days ago Does this combination of meds lower cardiovascular inflammation like rosuvastatin does? My understanding is that is also a benefit of rosuvastatin Reply 1 reply @erick6102 @erick6102 7 days ago Does Nexlizet and Repatha interfere or effect TRT treatment for males in any adverse way? Reply @citadelo5ricks @citadelo5ricks 8 days ago What about ApoB / ApoA ratio, important? 6 Reply @tama5570 @tama5570 8 days ago Where does joy come into all of this Peter? 3 Reply 3 replies @meet4sarfraz @meet4sarfraz 2 days ago How to test apoB, we dont get normally recommended for apoB in Pakistan. Is there anyway to know my appB value. My bad cholesterol is 134. Reply @JohnHarrerHorses @JohnHarrerHorses 8 days ago Is a high apoB still a concern for someone who is age 70? Reply 1 reply @rapidhealthimprovement @rapidhealthimprovement 8 days ago (edited) how do I have a daily diet of 500 g of carbohydrates, but have a triglyceride number of 49 if lowering carb intake reduces triglycerides? 1 Reply 7 replies @akfodysvn @akfodysvn 8 days ago Rosuvastatin caused my dormant gynocomastia to drastically flare up. Reply 1 reply @maciejsiedziako680 @maciejsiedziako680 8 days ago It’s all good, until they won’t prescribe any drugs for me with 90-100 apoB. How to tell your cardiologist you want drugs so he could prescribe you them? Reply 1 reply @leadimentoobrien1221 @leadimentoobrien1221 8 days ago (edited) I bought ur book expecting u 2 to discuss med thal minor but u did not. I wanted 2 c if it affects A1C. I read elsewhere it does but decreases it, and mine increased. 1 Reply @Alaskaventureswithbrodie @Alaskaventureswithbrodie 7 days ago I get the lower carbs and saturated fats but why does no one talk about the two things that have cholesterol in them? Meat, dairy and eggs? I know they have saturated fats so maybe you meant them as well but why do people not say it? Reply 1 reply @xtdude @xtdude 3 days ago amazing what people are willing to do to keep eating animal products. twisting into logical pretzels just to make sure we can get our butter. 1 Reply @cyclingmaven @cyclingmaven 7 days ago I respect any 'expert' who says "probably" and "I don't know". 1 Reply @JasonActualization @JasonActualization 8 days ago The lipid lowering paradigm is wrong. ApoB isn't even the true arsonist, it's simply found at the scene of the crime because it is a carrier of lipids that happen to be prone to oxidation such as LDL and VLDL. The key is this: optimize for what renders said lipids less prone to oxidation. It's not a traffic jam of cholesterol buses that causes atherosclerosis (i.e., it's not caused by excess native cholesterol) but rather, cholesterol buses that break down due to oxidation. This oxidation is mediated by myriad things, but most notably, industrial seed oil consumption, intake of excess PUFAs, inadequate antioxidant intake (from fruits and vegetables), smoke inhalation, exposure to toxic exhaust fumes, and dare I say it, a LACK of the scapegoat of the century, which in fact confers a systemic antioxidant effect, SATURATED fat. 7 Reply 9 replies @jenniferwilson8131 @jenniferwilson8131 8 days ago I can't get my doctors (internist and cardiologist) to even care about ApoB. They wouldn't even order the test. 3 Reply 6 replies @pininfarinarossa8112 @pininfarinarossa8112 8 days ago (edited) Ways: 1. No carbs 2. No saturated fats Bempedoic Acid in Liver- pro Drug 85% - at 5 mg Rosovastatin 1 Reply 1 reply @Innocence44 @Innocence44 3 days ago Is he talking about complex carbs or junk food carbs? Reply @jmdennis1967 @jmdennis1967 7 days ago I know some talk about taking Niacin to lower this. Reply @bryanspencer4856 @bryanspencer4856 8 days ago What about using red yeast rice? 3 Reply 2 replies @alwaysgoclockwise6019 @alwaysgoclockwise6019 3 days ago Will fiber help? Reply @TheShumoby @TheShumoby 3 days ago I don't know why I'm on here my great grandparents and grandparents lived to 99-106. I'm sure they had high LDL aka apob 😂 Reply @leadimentoobrien1221 @leadimentoobrien1221 8 days ago I've been reading ur book non stop. Too bad in my 60s I'm where u were in ur 30. Wish i knew sooner. saturated fat?! I thought it did not affect cholesterol? Reply 1 reply @5876efcn @5876efcn 8 days ago We old folks are tired of this diet at work. We want to feel normal again Reply @mariejones7136 @mariejones7136 19 hours ago What is APO b Reply @DerKesekuchen @DerKesekuchen 8 days ago What are the names of the drugs he takes? I find it difficult to find the correct spelling with these unusual names Reply @user-wz9pu7ty9z @user-wz9pu7ty9z 8 days ago My apoB is sky high and I am 28 year women with a BMI of 15. Wat am I suppose to do. Already tried super low carb keto 😢 Reply 2 replies @EthanE3 @EthanE3 8 days ago Low carb for the win. Easy peazy lifestyle so far.... 3 Reply 1 reply @samvandervelden8243 @samvandervelden8243 8 days ago Don't forget fiber 2 Reply @leadimentoobrien1221 @leadimentoobrien1221 1 day ago U spoke so fast r u saying pksk9 inhibitor? Reply @leadimentoobrien1221 @leadimentoobrien1221 1 day ago U r saying words i have no idea to spell i don't see a CC option. Can u please add a transcription. Reply @HocDolliday @HocDolliday 8 days ago Repatha & Nexlizet 4 Reply @Nicksonian @Nicksonian 7 days ago Enough about Dr. Atilla’s personal anecdotes. I don’t care about anecdotal evidence. What is the best available balance of evidence? It’s discouraging and not very useful to spend a lot of time on drugs that are not going to be available to the average person. Tired of hearing about entitled doctors who have access to stuff none of the rest of us can get. 2 Reply @ivalani @ivalani 8 days ago There were so many acronyms I don’t know and tired of googling, I quit listening within the first 2 minutes. 2 Reply @johnseberg6989 @johnseberg6989 8 days ago I wonder how many of the commenters have had their apoB tested? I'd bet <1%. Just pure noise. Reply 1 reply @selma5885 @selma5885 8 days ago Amla berry? 1 Reply 4 replies @evelynramos445 @evelynramos445 8 days ago Liver transplant Reply @jbrew434 @jbrew434 4 days ago Drugs, drugs, drugs. Good luck. Reply @user-yd5zv3jw2w @user-yd5zv3jw2w 7 days ago Eat n b merry.......Yolo! Reply 1 reply @jakeminer7354 @jakeminer7354 3 days ago This advice is all wrong, and it's a bummer there is so much of this out there, this is one of the main reasons the population is so sick. Reply Peter Attia's nutrition advice & why nutrition research is flawed Peter Attia MD 472K subscribers Subscribe 118K views 6 days ago Get the 5 Tactics in My Longevity Toolkit and my weekly newsletter here (free): https://bit.ly/402Ja7a Watch the full episode: • 276 ‒ Special episode: Peter on longe... … 449 Comments rongmaw lin Add a comment... @elvislee3339 @elvislee3339 5 days ago I am grateful that both my mother and father taught my sisters and I proper nutrition. Everyday they were perfect examples to follow and not follow. My dad ate everything my mom made for him. Every week mom went grocery shopping and the farmers' market. Every night my mom cooked dinner that all five of us shared at the family table. 16 Reply @Anima7e @Anima7e 5 days ago As a Registered dietitian I agree, but one thing he missed is those calories being intake should be nutritionally dense. The best way you can achieve that is by eating whole foods. Some people can’t comprehend that. 6 Reply 3 replies @michaelriggall6862 @michaelriggall6862 5 days ago Congratulations Dr Attia for saying what has needed saying for a long time now! 4 Reply @pinksupremacy6076 @pinksupremacy6076 5 days ago We already, to a large extent, have the answers of what constitutes a species specific healthy diet for a human being: We go back in time a couple of generations and look at what people used to eat when we lived in tight knit communities outside of urban environments and before processed foods became a thing. What we always see, with no exceptions, is an animal based diet but still an omnivorous diet, containing properly prepared plant foods as well (fermentation being a big thing). Quality is very important. 5 Reply 3 replies @victoryshieldtacticalllc3534 @victoryshieldtacticalllc3534 5 days ago They could study Soldiers on deployment. It's usually a set period of time 1 year. Age range will be pretty confined. And diet would be almost completely controlled, more so in Soldiers who are on small bases with less access to outside food. Also, Soldiers get medical checks before deployment, so there would be a baseline of physical fitness, though I'm sure an actual study would want precise data that they don't test for. 2 Reply 1 reply @yousufazad6914 @yousufazad6914 5 days ago I love this guy! He boils down seemingly complex/controversial topics to simple variables 2 Reply @drnorma594 @drnorma594 1 day ago I heartily agree with Dr. Attita's perspective on nutrition. I am an RDN with two Master's degrees in different aspects of nutrition, a PhD in Public Health. I had dual career of teaching nutrition at the university level as well as a nutrition counselor but I finally walked away because many of the nutrition "facts" barely achieve the scientific criteria for a weak theory. I was unable to spend adequate time with clients to help determine an honestly appropriate nutritional approach because of the Medicine 2.0 practice in which I worked. Keep up the good work, Dr. Attia. 3 Reply @davidpowell3469 @davidpowell3469 5 days ago (edited) I came off my 5 years of pretty strict Keto diet when I retired to Thailand and it was pretty much impossible to continue and enjoy the local food choices. Fortunately I work out hard so I still feel good even incorporating noodles etc. that I would never have eaten before. Anyway, here is my 2 cents about this topic and it aligns with what Peter said in this video. Eliminating the clearly bad stuff like sugar, processed food and alcohol is job #1. Once you have that under control you need to really analyze your diet and IMO "reward" yourself with foods you like but spike your insulin like bananas (for example). I have a banana after a hard workout as a "reward" - so my theory is that if you have that sort of guilt built up (where banana is your cheat food) you are set for the long-term and I am very unlikely to "fall off the wagon". I also buy canned sardines and good beef that I eat at home to "round out" my diet because those items are difficult to find here. 3 Reply @medved3027 @medved3027 6 days ago This man knows what he's talking about 5 minutes densely packed with advice. So unlike most health "advice" one would find on this site. 1 Reply @lusciouslou250272159 @lusciouslou250272159 6 days ago I lost 88lbs in 18 months, These were the non-negotiables; - 8 hour eating window - 3 Litres of water per day minimum - 7.5 - 8.5 hours of sleep - 1,750 calories per day (wasn't obsessed with macros tbh. The deficit and nutrient dense foods were the priority). - 3 days of strength training, 2 days of interval training on the treadmill, 2 days of lower-impact long distance running (eventually got to 14.5km on Wednesdays and 18.5km on Sundays). - Cheat meal every 2 weeks (after a long run) as a treat to myself I did some other stuff which showed marginal losses, but the 6 points above probably contributed to 95% of the progress. 15 Reply 8 replies @grantbratrud4949 @grantbratrud4949 6 days ago Some of the early theorists were likely wackos: Will Kellogg, Sylvester Graham, Nyoichi Sakurazawa, for example. Others were likely beholden to the NIH and other fascists, as likely were Ancel Keys and Ivan Frantz. Does the Ralston Purina Golden Retriever study still show longevity enhanced in canines under calorie restriction? Were coronary heart disease rates very much lower (as was obesity) 120 years ago when rates of lard consumption were 80 times higher than they are today? One sure guideline I take it is to ask this or that "authority" whether it's true that "a calorie is a calorie is a calorie". Their vehemence for the affirmative corresponds exactly inversely with their reliability. 1 Reply @hoyit @hoyit 6 days ago I think oddly the problem is how readily available all of our food is. The reason I say that is because rather than eat when we’re are experiencing true hunger, we instead eat whenever we want to or according to a set schedule. This ultimately has us eating more than we really need to, and eating is such a pleasurable experience that we can’t wait til we have enough room for our next meal. We are constantly in these digestive states instead of healing states. Tack on all the additional foreign chemicals and additives and you have just a cauldron of all sorts of shit traveling through our bodies. That chaos then manifests in our behavior. I think if we somehow became a little less gluttonous, I think we would start to see some improvement in our collective consciousness. However, that just looks nearly impossible as we are at our probably most indulgent ever in human history. In unsustainable and I’ll be honest it scares me to think about what’ll happen when it all comes crashing down. I don’t think any of us are prepared for it. 1 Reply @thunderbird3694 @thunderbird3694 6 days ago Wish I understood better the science behind caloric restriction. I mostly hear shoot for 2500, but since going on keto/low-carb diet a couple years ago I lost my hunger. I am satisfied at 1500 calories and must force myself to eat just to hit 2000 averaging maybe 1800. I concentrate on getting enough protein, shooting for 120g and occasionally reach 150g 1 Reply 3 replies @emsea1658 @emsea1658 6 days ago This might rub people the wrong way but it's not meant to be that way but sometimes I think part of the complexity in nutrition science is that before modern transportation humans were stuck in distinct regions and adapting to those conditions uniquely. The inuit in Alaska or peoples in African deserts etc but then modern transporation shuffled everyone around the globe like never before. And all these specific adaptations just get mixed with all others. So everyone has an unprecedented blend of adaptations that have no relation to their environment. 14 Reply 10 replies @andersemil5541 @andersemil5541 5 days ago I’ve always been a little chubby, not fat, just with excess around the waistline. The only time I ever managed to lose it was when I went very lowcarb in my mid-30s. I went too far tho and ended up with palpitations, dizziness, headfog and many other servere symptoms. I went back to a healthy moderate carb diet, the slight excess fat is back but feeling awesome and highly active in my late 40s Reply 2 replies @futures2247 @futures2247 5 days ago as always balance is key but hard to find 9 Reply 1 reply @Carlos.Rivera @Carlos.Rivera 6 days ago We need to "grow" our food like how grandparents did back in the days 16 Reply 3 replies @andrewrivera4029 @andrewrivera4029 6 days ago Been very fortunate to have started OMAD over 5 years ago, through that time I’ve incorporated KETO/ low carb and carb cycling depending on my energy needs. In addition my wife and I fast during the winter fasting Monday and Thursday every week, a 72 hr fast one a month and a 5 day fast once a year. So true about energy needs, I find during the summer I’m most active and need the carbs as I ride mtn bike, day hike climbing mountains and generally I’m sweating more during the summer than winter. Reply 1 reply @CarnivoreDMD @CarnivoreDMD 6 days ago I’m using a Garmin 500 with training Zones 1-6. Is Zone 2.8 still technically Zone 2 or do you think anything over Z2.0 is now MORE than Z2? I did a 45min spin on “perceived” Z2 by making sure I could sing for at least a minute on occasion. Jumped off bike & ck’d LA & it was 2.4😢. 1 Reply 4 replies @Parker_Miller_M.S. @Parker_Miller_M.S. 6 days ago Nutrition research CAN be flawed but so can quite literally any other field of research or study design, so I don't get the unique hate/scrutiny nutrition research gets. Given that epidemiological research has effectively had 70 years of refinement we now have many validated tools that give us pretty accurate insight into diet disease relationships especially when we follow cohorts for many years. If we look at smoking we can even see that causality can be infered given a large enough body of evidence and consistent results. The same can be infered for saturated fat and heart disease based on how robust the body of evidence is and the concordance between RCTs and longer term prospective cohort studies. I don't see the relevance of the monkey calorie restriction argument as that's not done in humans. I understand the point that multi decade RCTs aren't really feasbile but thats why we have the validated tools for cohort studies. I do agree with the advice that a diet should be sustainable and the big picture aspects should be emphasized, whole grains, unsaturated fats, limited or no alcohol, fruits, vegetables, lean protein (preferably more plant predominant given the data but white meat, fish, and low fat dairy are likely health promoting). This is where the food patterns from epidemiological studies shines through and gives us the above recommendations as we see superior health following a long term dietary pattern consisting of those food types. So in short, I disagree with the sentiment that we can't have high quality informative evidence from nutritional research, especially epidemiological studies, specifically cohorts. 3 Reply 4 replies @6140LIBRA @6140LIBRA 6 days ago Energy balance is the new term for the failed counting calories paradigm 7 Reply @jota55581 @jota55581 6 days ago The key Word to many things in life is balance . 4 Reply 5 replies @ReflectedMiles @ReflectedMiles 6 days ago The comment section is kind of an illustration of Peter’s points. 8 Reply @cudgee7144 @cudgee7144 6 days ago Very good observation and comment about eating regimes. Whether it's Keto, Low Carb, Vegan, Mediterranean or whatever, it's still all about consumption and expenditure. Calories in versus Calories out. You consume more than you need, the results are negative. 3 Reply 5 replies @saras.3389 @saras.3389 6 days ago The easier way to put this would be to shop at the grocery store mainly on the edges instead of the middle, and learn to understand what your body is telling you and then trust that it knows what it’s talking about. Reply 2 replies @tadghsmith1457 @tadghsmith1457 6 days ago Can we not do dietary experiments on prison inmates? I'm sure lots of inmates would jump at the chance to go on carnivore for 20 years! 10 Reply 1 reply @colinb8332 @colinb8332 6 days ago We really need to stop making this so complicated. The less a food is processed from source to table, the overall healthier it will be. THEN, from that, people need to eat and see how different foods affect them. Get more in tune with your body. If you find that eating more gluten has you feeling sluggish or inflamed, we’ll stop. Same goes for red meat (which it does for me) or dairy or nightshades or whatever. And don’t overeat. If you are gaining weight and not intending to, cut back on food or exercise more. 28 Reply 11 replies @curious1264 @curious1264 6 days ago Real natural foods and wants works for one person doesn't always work for another Reply @craigmooney2630 @craigmooney2630 6 days ago Genetics play a big part in outcomes 5 Reply @KevinJDildonik @KevinJDildonik 6 days ago "Limit carbs" ia good general advice if that's all people will listen to. It's so easy to drink hundreds of calories of sugar. But for many people like me, really counting fat is a game changer. When I work out hard and eat clean, on 3 meals a day, I can end up where dinner includes 6 pieces of whole wheat bread and a whole pile of broccoli to make my healthy carbs - for that single meal. Meanwhile 2tbsp of olive oil might blow my fat budget. Realizing how much we all tend to under-count fat, and what a healthy amount of fat really looks like, would probably rock most people's understanding of a healthy diet. For me personally, it's usually healthier to eat a huge bowl of brown rice, than to melt a half pat of butter to make pan sauce for a chicken breast. I just meet my RDA of fat so much easier than any other macro. 7 Reply 5 replies @gerard6629 @gerard6629 6 days ago I wish every so called expert would admit no one has the answer to the question what is the best. 4 Reply 1 reply @raingerhaslem6487 @raingerhaslem6487 1 day ago Nutrition research isn’t flawed inherently, most people are just trying to ask a hammer to be a nail and that will never happen. Epistemic knowledge comes from the culmination a mixed interventions and observations that end up in principles and patterns. People always want to know if the “x,y,z” diet is best and it will never be the case Reply @mikemorgan8646 @mikemorgan8646 6 days ago It has to be sustainable for "you", I don't care what fancy terms you use, or how many doctorates you have, or how much you get paid by ...=) 2 Reply 2 replies @BryanDibben @BryanDibben 6 days ago (edited) WHAT DIET IS THE HEALTHIEST? Perhaps a good starting point would be a diet (& lifestyle) that reflects how the world’s longest-lived people ate for most of their lives. E.g. the Blue Zones. 6 Reply 5 replies @ForexChamp @ForexChamp 6 days ago (edited) Best diet is protein, vegetables, soluble fiber. Must have some carbs for energy and just enough fat to cook and for taste. If you still don’t lose weight just start exercising. The combination will work. 21 Reply 18 replies @Seanonyoutube @Seanonyoutube 6 days ago Gotta love the comment section in this one 😀 10 Reply 2 replies @christophervann @christophervann 6 days ago Peter, I listened to your interview with Sam Harris and I've listened to a lot of your other interviews. Have your read The China Study, and are you familiar with T. Colin Campbell? Or Dr. Caldwell Esselstyn, who published heart disease reversal, as did Dr. Dean Ornish? What about Dr. Greger and "How Not to Die"? Or Dr. Neal Barnard who wrote a book about reversing diabetes? 1 Reply @lovenottheworld5723 @lovenottheworld5723 3 days ago Butter and honey shall he eat. That was a prescribed diet in 700 BC and science came full circle and said it was bad, but now it's good again. Reply @monicricri @monicricri 6 days ago So much common sense. Love it Reply @darwincrawford8821 @darwincrawford8821 6 days ago one of my favorite one-liners from this guy is "if you can't deadlift twice your bodyweight and do 15 pull-ups, then you probably shouldn't be allowed to give nutrition advice" 21 Reply 14 replies @SoyElta @SoyElta 6 days ago You need protein, carbohydrates, and fat. You can't tell me any different 😂😂😂 Reply 2 replies @martyrichard3092 @martyrichard3092 1 day ago No study is perfect, and no diet is either. Nothing will guarantee 100% health. Too many factors. But the truth is, eating a 100% plant-based diet composed of whole foods will do so much, for the vast majority, to attain optimal health. I speak from experience. And the most critical and mentally sound thing one can do to avoid the abuse and slaughter of innocent animals by excluding them 100% from your consumption. This is why veganism is a principle, not a diet, which leaves its followers physically and, even more important, mentally stable and ethical. There has never been a greater injustice in the world than what we do to these innocent, vulnerable farm animals...for NO REASON. 2 Reply @DK-pr9ny @DK-pr9ny 5 days ago Link to book? 1 Reply @tomhendriks5434 @tomhendriks5434 6 days ago @PeterAttiaMD at 03.43 you answered a question regarding energy balance. You say anything in excess will cause the buildup of adipose tissue. Isn’t it true that energy balance doesn’t add up in a diet when it’s only animal based? 1 Reply 3 replies @asiseeit1782 @asiseeit1782 6 days ago (edited) Over consumption is the main problem today! No matter what you eat! 6 Reply 2 replies @gjcoop5625 @gjcoop5625 6 days ago (edited) He sounds authoritative. But there are two issues. 1. Having reasonable metabolic health doesn't mean you can eat what you want. Healthy food does not mean balanced calorific intake. 2. And he underestimates the power of huge numbers and twin studies. He's solving one major problem, metabolic health, and ignoring other serious health concerns. He cherry-picks his data and his arguments. I'm sceptical. 9 Reply 6 replies @emerson-sheaapril8555 @emerson-sheaapril8555 6 days ago There are many humans that would love to never have to leave the house and be fed. My gf is one of them...also...people in jail? Reply @glennbishopsmagicmysteries7119 @glennbishopsmagicmysteries7119 6 days ago Calories are a measurement of heat in the science of physics and have nothing to do with fat loss. The myth of a calorie restriction diet, calories in calories out, eat less, exercise more is a great way to gain fat, not muscle. How? Because to restrict calories is to restrict nutrition and when a person restricts nutrition they crave - and binge eat. Add to that the human body doesn't have any calorie receptors, it has hormones. I think that Charles Poloquin was correct when he said, "winning the war against fat is winning the war against insulin". Or as Vince Gironda wrote in his classic book "Unleashing the wild physique" - "Fat is only burned as fuel in the absence of carbohydrates". Thanks for showing what you don't know! 2 Reply 2 replies @philiproesel7885 @philiproesel7885 6 days ago We need to go on a bike ride! 1 Reply @xTruncz @xTruncz 1 day ago Nope, the optimal diet for a human is a whole food plant based diet, preferrably organic, with the elimination of most or all animal products and highly processed foods. There, answered the question for you :) Reply @michaelphanX6 @michaelphanX6 6 days ago doesn't the epidemiology suggest that vegans live longer and better. don't know why a vegan diet was listed as something you could do excessively. 1 Reply @AdamScottfit @AdamScottfit 6 days ago Someone is sitting there, getting triggered that you said....calories matter. 1 Reply @jbosson82 @jbosson82 6 days ago Peter s nutrition advice : just ignore the science there is and keep bulking up 🙈🙉 Or how to establish a mental strategy to keep enjoying meat all day. Everyday. 1 Reply @squashduos1258 @squashduos1258 6 days ago (edited) Even pharma science is flawed….so many confounders….I can poke holes in everything…reductionism and probability estimates without absolutes is just flawed methodology…I am speaking out of having studied statistics….n=1…get to know yourself… 1 Reply @williamcarter9066 @williamcarter9066 1 day ago What does a grizzly bear eat nuts, berries ,grass and seeds , fish and meats an it can out run a race horse over a certain stretch and it can chase down a moose that’s the greatest organic diet ever an if follow that to our human consumption we will be really happy as well as healthy as hell 😅😅😅 Reply @edmundblackaddercoc8522 @edmundblackaddercoc8522 6 days ago I eat meat and animal fats/dairy daily nose to tail , i only eat twice a day. I have friends who are vegan/vegetarians who eat several times a day,which of us is 'damaging' the environment more? They have to eat around x4 portions than what i eat. That's more agriculturally more harmful than my two meals a day. 4 Reply 8 replies @littlethuggie @littlethuggie 6 days ago You mean it's not just CaRbs sPiKinG mUh iNsULiN?! Reply @jeffreyjohnson7359 @jeffreyjohnson7359 6 days ago I think it's pretty clear that a diet which emphasizes fiber, unsaturated fats, and protein, and minimizes trans fats, refined carbs and saturated fats is best for health and longevity. And is moderate in calories. 98 Reply 61 replies @ianidas300 @ianidas300 6 days ago I guess mars is the nutrition testing ground Reply @DCA55 @DCA55 6 days ago Ironic that the same reasons he states for the lack of quality nutrition/diet research also applies to supplements, yet it doesn't stop him from not only taking them but from recommending them to his patients. 3 Reply 3 replies @johnking2740 @johnking2740 6 days ago Has there ever been a Nutrition Specialist that has formerly been overweight? The only specialists I have encountered have never been overweight in their life, so to me their whole spiel about nutrition is "Do as I say, not as I do" . . . .a total hypocracy, it should be "Let me lead by example". Reply 4 replies @kierangallagher5687 @kierangallagher5687 6 days ago Just eat whatever is found in nature and tastes good to you. No processed foods. Done. Reply 4 replies @peterwilson1038 @peterwilson1038 6 days ago OMAD + CARNIVORE = ANCESTRAL = OPTIMAL Reply @helenpaton491 @helenpaton491 6 days ago Just eat real food, not too much, and not too often. 2 Reply 1 reply @ninaeverest2520 @ninaeverest2520 5 days ago This channel and your expository teachings has been my major drive, and that's why with $32,000 weekly returns I was able to live my life-long dreams of sending 30% of my weekly interest to the sick old ones in my Neighborhood. 36 Reply 116 replies @jimmycain8669 @jimmycain8669 5 days ago If grand pappy didn’t eat it neither do I and he died in 1948. Reply @luciaceba4640 @luciaceba4640 6 days ago i dont know where people get all this money to actually be overweight... yes junkfood is cheap but then i dont understand how you can function as a person in any task by eating crap... 1 Reply @hhhhippo @hhhhippo 4 days ago Take er easy on those cuts 1 Reply @donwinston @donwinston 6 days ago Energy balance! Calories in vs calories out trumps EVERYTHING. It is not remotely close. Your hormones will not enable the human body to defy the laws of physics. Reply 3 replies @bobcocampo @bobcocampo 6 days ago Test with prisoners in the Philippines Reply @user-hm4jm1cy7m @user-hm4jm1cy7m 6 days ago I dont consider meat based diet "extreme" 8 Reply 7 replies @magicalfrijoles6766 @magicalfrijoles6766 5 days ago Stop smoking and drinking lots of booze. Don't eat fast food and overly processed carbs and deli meats. Eat your veggies and some salmon and some black beans. You'll be fine. You got fat from candy and potato chips, not because you weren't obsessing over labels. Reply @BeefLoverMan @BeefLoverMan 6 days ago The comments on this are a mess. 3 Reply 2 replies @elizabethk3238 @elizabethk3238 6 days ago Your clothes are not supposed to be stretched out like his teeshirt. Reply @alexi2460 @alexi2460 5 days ago Why you flip flop Dt. Peter. Recently you said food makes no difference. Needless to say nutrition is important but ago related eating should be fine tuned. Carb restriction but sugar also Reply @TruckerJoe @TruckerJoe 6 days ago #bluezones. People are the longest healthiest people on the planet. 90-95% plant based and many live to 💯 or more. 2 Reply 2 replies @troykilmister3804 @troykilmister3804 1 day ago But you have no hair...What went wrong there ? Reply @KJSvitko @KJSvitko 6 days ago Health care costs are out of control. Going WFPB vegan can save money, pain and suffering from disease. Lower your chance of high blood pressure, heart disease and cancer by going vegan. Hospitals, doctors offices and schools should be places where good nutrition is taught and provided not places that contribute to disease and obesity. It is crazy the hospitals are feeding people the very food that caused the heart disease, high blood pressure or cancer that they are treating. Every person in the hospital should receive some nutrition education before being released. Every doctor visit should be an opportunity to educate patients about how food choices impacts their health outcomes. The fact that doctors do not get nutrition training as part of their training makes no sense. Medicare and Medicaid should require nutrition education as part of patient care. Focus should be on food choices. Reply 3 replies @aa-xn5hc @aa-xn5hc 5 days ago Ridiculous music Reply @RootCauseRehab @RootCauseRehab 6 days ago What a joke. Never read Kempner and believes low carb is good for insulin resistance. Fat causes insulin resistance Peter Reply 5 replies @stx7389 @stx7389 6 days ago Epidemiology match randomized trials in 70% of the cases, cut the BS Reply @johngoldsworthy7135 @johngoldsworthy7135 6 hours ago Needlessly complicating nutrition. 2023 and this is nutrition ‘science’? Laughable Reply @mr0glass @mr0glass 6 days ago I wish I could "only" sustain a diet for 3-6 months! 🥲 1 Reply r. Peter Attia: This Is What You Need to Do to Live Longer | Amanpour and Company Amanpour and Company 354,344 views Jun 22, 2023 #amanpourpbs Peter Attia says he has the secret for living a long, healthy and happy life. In his new book, he lays out a how-to guide for longevity, focusing not on treatment but on preventative measures. Attia joins Hari Sreenivasan to discuss the best habits for a healthier life. Originally aired on June 22, 2023 ---------------------------------------------------------------------------------------------------------------------------------------- Major support for Amanpour and Company is provided by the Anderson Family Charitable Fund, Sue and Edgar Wachenheim, III, Candace King Weir, Jim Attwood and Leslie Williams, Mark J. Blechner, Bernard and Denise Schwartz, Koo and Patricia Yuen, the Leila and Mickey Straus Family Charitable Trust, Barbara Hope Zuckerberg, Jeffrey Katz and Beth Rogers, the Filomen M. D’Agostino Foundation and Mutual of America. Subscribe to the Amanpour and Company. channel here: https://bit.ly/2EMIkTJ Subscribe to our daily newsletter to find out who's on each night: http://www.pbs.org/wnet/amanpour-and-... For more from Amanpour and Company, including full episodes, click here: https://to.pbs.org/2NBFpjf Like Amanpour and Company on Facebook: https://bit.ly/2HNx3EF Follow Amanpour and Company on Twitter: https://bit.ly/2HLpjTI Watch Amanpour and Company weekdays on PBS (check local listings). Amanpour and Company features wide-ranging, in-depth conversations with global thought leaders and cultural influencers on the issues and trends impacting the world each day, from politics, business and technology to arts, science and sports. Christiane Amanpour leads the conversation on global and domestic news from London with contributions by prominent journalists Walter Isaacson, Michel Martin, Alicia Menendez and Hari Sreenivasan from the Tisch WNET Studios at Lincoln Center in New York City. #amanpourpbs Transcript Follow along using the transcript. Show transcript Amanpour and Company 366K subscribers Videos About 331 Comments rongmaw lin Add a comment... @sonialewis1222 @sonialewis1222 4 months ago I am 72 I walk with my dog 7 days a week. Eat Mediterranean diet and go to gym and Pilates 3/4 times a week and do about 30 laps weekly. Have as much if not more energy than when I was 40. Healthy lifestyle and a positive mindset helps beyond words💯👍👌 145 Reply 11 replies @richardmonson8657 @richardmonson8657 7 days ago One of the most concise and clear explanations of the problem with our health care system I’ve seen or read. 1 Reply @sidstovell2177 @sidstovell2177 4 months ago 88 years, female. 5'7", 130 lbs. Was a runner in my '40's, walked hills in my '60's, then rheumatoid arthritis finally got me. Now housebound. Do breath work, and 14:10 intermittent fasting. Stay tuned. 85 Reply 9 replies @duanefrench3500 @duanefrench3500 4 months ago (edited) I have been a student of Peter for a couple of years and longevity for years. We have switches we can all control. Through exactly what Peter has researched. The human body has an amazing ability to heal itself and change our health span. Over nutrition and exercising in the grey area are the things I am learning about recently. Over consumption of carbohydrates/ sugars can cause problems for people who think they are eating healthy. I have two autoimmune diseases. I am in the process of trying to reverse through the ketogenic process. Education is the key to a long life. 28 Reply 3 replies @Lisa_688 @Lisa_688 4 weeks ago Great interview. Outlive is a phenomenal book and Peter Attia is such a leading voice in this discussion, an instrumental thinker and scientist and has completely changed the way I think about how I want to live the rest of my life and what I need to be doing NOW to improve health span, quality of life and longevity. He is way ahead of his time and I am grateful to have found his work in my own research. I only wish I had known what I have only recently learned 10 years ago. I wish the medical community would catch up to him. I think average people do not know the science and are not learning this from their doctors. 1 Reply @votephilwilliams @votephilwilliams 4 months ago I am a huge fan of this book and this man. This is his BEST interview to date! Dr. Attia seems relaxed and in the zone. 36 Reply 1 reply @sallywallace8038 @sallywallace8038 3 weeks ago What amazing timing ~ To see this interview. It's so reinforcing! I'm 71and spouse is 75. We just had our first brush with a life threatening episode. My husband had a heart attack three days ago. This happened when I was 200 miles away on a solo trip so he was home alone. He was in and out of the hospital in 30 hours with two stents added to his medical physical profile now. . We've always been active, he was a distance runner in his youth, changed to walks in his 60's and I've always been a walker not a runner for my fitness . We both have family history of ancestors with heart attacks & strokes so our life choices for dietary health and exercise has been intentional. Yesterday we did a shorter walk just to 'test the system' so to speak so it was on the flat for just a little more than 1.5 miles. ( Luckily no major tissue damage was done, so a full recovery of activity is expected.) The big difference right now for us is the emotional impact! The ambulance was within a few minutes reach to intervene right away. Next week we had a hunting trip on the calendar where he would have been in the woods, out of cell coverage and there's no way I could have carried him out on my own! These are the things that now cause us to think about it differently. Maybe once we get passed this a bit well find a way to balance the risk and benefit of our activities. We've always done back country/into nature activities. Time will tell. We softened our MO a year ago and bought a travel trailer so we could continue getting out there without ask the heavy work of tent and camp gear set up. Perhaps well just explore getting a satellite phone coverage plan for our deep woods trips. (Just noticed my profile photo... I was only 60 at that time😄) 1 Reply @sumdude23 @sumdude23 4 months ago I've almost finished "Outlive" and it is without question the most important book I've ever read. Dr. Attia is 25 years ahead of what he calls "Medicine 2.0." Exercise is a panacea, get moving! 51 Reply 2 replies @adilduredoran2477 @adilduredoran2477 4 months ago Dr peter Attia taught me so much . He is the only key player in longevity subject from the standpoint of living longer and healthier. The book is amazing I read it twice and it helped me so much ❤ 34 Reply 1 reply @williambarlow7428 @williambarlow7428 2 months ago I’m 68 and heading to Finland to compete in the Ironman 70.3 World Championships Dr Attia is brilliant and a guiding light for me!!! The Diogenes of the elderly 11 Reply @RD-nq7fl @RD-nq7fl 2 weeks ago (edited) I recently turned 51 so longevity is on my mind. I just bought the book and looking forward to learning how increase my longevity. Reply @SilverFan21k @SilverFan21k 4 months ago This is awesome, only found this just now. Thank you PBS for having on Peter Attia and covering Longevity! ❤ 28 Reply @viveviveka2651 @viveviveka2651 4 months ago (edited) The psychological issues are largely ignored by most doctors and nutrition gurus. More important than diet and exercise (given the basics of those), are things like love, inner peace, humor, and freedom from worry and fear. 76 Reply 5 replies @ronkirk5099 @ronkirk5099 4 months ago (edited) Exercise, healthy diet, healthy environment, no vices and the rest is up to genetics. I'm 73 and still going on long paddling trips, bicycle tours, and backpacking trips. Barring accident, I may still be active into my 80's. 155 Reply 14 replies @knittingknut @knittingknut 3 months ago (edited) I’m 70. Eat a highly nutritious, low carb, mostly carnivore diet. Still working part time, staying active and doing regular strength training and Pilates. I suspect I’ll live a good life well into my 90’s as did my mother and grandmothers but I’m already healthier, stronger, and more active than they were in their 70’s. I did a mitochondrial test that placed me in my early 60’s. 23 Reply 4 replies @corinnehall7326 @corinnehall7326 3 months ago I think connection and having a good time has a very beneficial effect on health. Not selling your soul, stick to your values, not sure how you might measure stuff like this but building resilience and wellbeing, creativity, it is important to making life 🎉. Build a life worth living. 9 Reply @SilverFan21k @SilverFan21k 4 months ago Thank you PBS for having Peter on and covering Longevity. ❤ 11 Reply 2 replies @maverickwong671 @maverickwong671 4 months ago (edited) awesome interview and info! so many of us either ignore or ignorant to the basic fact that we are part of nature and evolution. Proper proactive and consistent management of physical and mental health using proper exercise, rest, diet and stress management is necessary for good overall health and longevity. It's not about getting sick and popping magic pills and pray for recovery or late intervention using medical procedures etc. So start getting healthy early and make it a habit. 3 Reply @SquatFull @SquatFull 2 months ago I've been resistance training since my thirties. Hydrostatic testing at age 52, my body fat was 10.8%, body weight was 206 lbs. My body composition measured by DEXA was 9.7%, age 68, and body weight 183 lbs. My body fat measured by three site skin-fold tests is 9.1% body weight of 187 lbs, age 74. My body weight averaged 200 lbs before I followed Dr. Peter Attia's videos on the ketogenic diet. I ended that diet due to a downward trend in my lean body mass. I have recovered some back despite being in the age group with issues of sarcopenia. Time will determine if lean mass and resistance training for maintaining strength benefit longevity. 1 Reply @Jaykay586 @Jaykay586 4 months ago Hari, your interviews are brilliant, thank you! 27 Reply 3 replies @brianevans2819 @brianevans2819 4 months ago (edited) Brilliant informative interesting content Doctor. I am 74 next week, still working showing potential tenants around properties. I play walking football and swimming at every opportunity, also involved daily in my 3 grandchildren’s lives aged 6, 11 & 14. I was thinking of retiring as I have worked since I was 15 and before. Until I had a meal with a friend’s in law a 84 year old and he said to me, if I could get a start working again tomorrow, I would do. Have a meeting tomorrow regarding my decision. 5 Reply @tslilbearshoppe9870 @tslilbearshoppe9870 2 months ago I think happiness is the key to longevity. A good attitude, taking things in stride, prayer, rest, love, joy and peace. You can be perfect in all areas but if you don't have a good mindset you are screwed. 14 Reply @jdenino6022 @jdenino6022 3 months ago My stepdad smoked till age 79, ate lots of sugary foods and dank lots of alcohol. He weighed over 230 lbs at 5’6” and didn’t exercise. Despite becoming diabetic and not taking his diabetes medication he lived till age 85 1/2. He got covid and died in the hospital. His 02 dropped into the 60s and went into cardiac arrest. His doctor said he exceeded his expiration date due to his good genetics. 7 Reply 2 replies @sharigraves6385 @sharigraves6385 3 months ago Brilliant! Concise explanations. Thank you Dr Reply @peoplefirstleadershipcoach1238 @peoplefirstleadershipcoach1238 3 months ago Much of our health is in our own hands! Starts with a positive mind every day! 6 Reply @runner2008 @runner2008 3 months ago As we age, we have to have passion for living and a purpose. And it can be anything we do. Just keep it going and enjoy awhat you do. 9 Reply @corinnehall7326 @corinnehall7326 3 months ago I read ,"The Okinawa Way" and found it bery helpful in understanding longevity, as I aged I followed the information from this book, with one side of the family living habitually into their nineties and the other side very sickly I took advice from my mom and decided to attend to my health. 1 Reply @jjkk8974 @jjkk8974 3 months ago Finally, a health practitioner in an English speaking country is realizing human is not just a body, after hundreds of years. Long ago, over 1050 years ago, Dr Sina in Persia was teaching n practicing medicine, even performing surgeries, considering the whole person... Mind, body, emotions, soul... to find out which aspects of the client were CAUSING the condition. He was looking for the Cause, to eliminate, treat, etc... not MANAGE the condition, often meaning use of man made drugs. While my doctors in German speaking countries where more inclined to a Wholistic approach to diagnosis n solutions, my doctors in two English speaking countries I've lived long in, are totally focused on the body alone...to the extent that they don't even consider nerves, stress, n environment as contributing to the condition. Emotions, thoughts, n soul or spirituality helping to be in tune with our soul and Inner Source are actually Causing our body to be sick or in pains. The body doesn't get sick by itself. Drinking, smoking, unhealthy life style, are because of worries, fear, stress, n nerves sensitivity...leading to poisoning our body, mind, emotions, n soul more. A vicious circle...WE CARE MORE ABOUT OUR PETS EMOTIONS THAN PPL! Thank you for touching this very important point, which needs to be thought in our medical schools. Reply @lesliebannerman5316 @lesliebannerman5316 4 months ago Excellent interview! Insurance companies are greedy greedy greedy greedy greedy. Everything to heal your body is in the ground! Exercise Exercise Exercise! Thank you Dr. Attia! 11 Reply 2 replies @chopincam-robertpark6857 @chopincam-robertpark6857 4 months ago Hari always nails it.. 27 Reply @warwickpadmore4644 @warwickpadmore4644 3 months ago Possibly THE most enlightening insight and practical medical advice I’ve received from a healthcare professional. My LPa says I’m doomed, but my calcium score says my cardiovascular health is in the top percentile. I’ll accept the latter, gladly, but act on the former. 2 Reply 1 reply @Nernst96 @Nernst96 3 months ago During a bear market, the headlines will focus on negative news, whether it's declining economic growth, geopolitical upheaval, cultural and legal turmoil, or some combination of all three. I listened to a podcast of someone that grew his reserve from $120k to almost $460k during this Red season, can you share tips on how to make such aggressive proceeds in short periods?. 474 Reply 4 replies @ptortland @ptortland 3 months ago (edited) What he says is not new. But he has a compelling way of presenting it. Sadly, the vast majority of Americans want a pill or quick fix, and aren't willing to put in the time & effort. That's why I got out of primary care and went into sports medicine. My life is too valuable to waste it trying to convince people to do what's right. In primary care you're begging people to get off the couch and get moving. In sports medicine I'm begging people to STOP moving so that they can heal!😆 I'd much rather deal with the latter! Personally, I'm 63, and I'm hitting personal bests in some of my lifts. I lift hard 4 days a week and do cardio 2 days a week. I practice what I preach as a physician. And I'm not going down without a fight! 12 Reply 1 reply @JockFindlay @JockFindlay 7 days ago I don't want to live longer than whatever it plays out to be for me (this world is crazy man) - BUT... I DO want to feel fit and strong while I'm still here. Reply @Cathy-xi8cb @Cathy-xi8cb 4 months ago Have a great life, enjoy it to the fullest. Be who your dog thinks you are. The biggest fear we all have is losing our marbles. The two biggest factors for that are genetics and age. You cannot change the first, and your risk magnifies with each year after about 75. By age 95, the number of people still holding most of their marbles is not that large. So living longer may not be worth it. I think my relatives who suffered for a short time and kicked off in their 70s suffered less than my mother and her sister, who lived at least 10 years in progressively declining health and abilities. 19 Reply 6 replies @sharathahuja8261 @sharathahuja8261 4 months ago For Someone born and brought up in the Southern Indian City of Bangalore. I can say that our way of living and eating was THE BEST, everyone lived a long and happy life. Alas no more, aping the West, with it's food and it's lifestyle has destroyed every fabric of our lives. 9 Reply 1 reply @ldtoner @ldtoner 2 months ago Excellent interview and information. This basically hits all the same points as emphasized in “The Blue Zones” by Dan Buettner, but with more specific medical information. Reply @ChrisB-xl4tq @ChrisB-xl4tq 2 months ago What a great interview ,nice job and have made respect for peter Reply @KikiAndJeffreyPearl @KikiAndJeffreyPearl 4 months ago Great Video! Great topic and it needs much more focus especially here in the US Reply @michaelboguski4743 @michaelboguski4743 4 months ago The first prescription a Doctor writes should be Physical Therapy and Insurance plans should pay it 100% without deductible..... The second prescription should be Mental Therapy and Insurance plans should pay it 100% without deductible. 49 Reply 1 reply @seanandrews5606 @seanandrews5606 3 months ago Just bought Dr Attia’s book! Can’t wait to read it! Reply @viveviveka2651 @viveviveka2651 4 months ago Love is the most important, and should be given first priority. 16 Reply 6 replies @billyrock8305 @billyrock8305 3 months ago #1. Eliminate all STRESS. That’s simply it. 4 Reply @josephbarnett2566 @josephbarnett2566 3 months ago I counted 13 in a row retirees on my Appalachian trail hike that were cyclists! Here are numerous 70s..early 80s living like 40 year olds...the bike about 50 miles a week! 1 Reply @mattarndt4452 @mattarndt4452 13 days ago To me quality is just as important as longevity. We can only stay healthy for so long. We only control so much. Reply @lindajudy1495 @lindajudy1495 4 months ago A cheerful mind, light diet, regular work and rest, suitable exercise, good environment, mountains and rivers, accompanied by a good person, a comfortable and restrained sex life is also very important! 3 Reply 1 reply @sylviaoroth3088 @sylviaoroth3088 2 months ago I’d love to talk to this doctor. I may be able to shed some light on aging. I’m 70. People think I’m 50. I don’t know for sure, but I think I’ve found a secret formula to reversing the aging process. I’m getting younger. I have a concoction of supplements and herbs and vitamins that I came across by accident. I know, I know… it sounds crazy. But if I sent you before and after photos you’d be shocked. I need to write a book. But I need to write it with Dr. Attia or Dr. Huberman, or both. I go to the gym. I meditate. I think positive thoughts. My hair is growing in thicker. My skin is youthful. I’m very flexible. Reply @tonimuller7493 @tonimuller7493 2 months ago This is why I switched to a functional medicine practitioner. They focus on treating the cause and not just symptoms. Reply @oksanasum321 @oksanasum321 3 months ago Oh god, how i wish these people live forever, they're the last hope for us and our kids❤❤❤ Reply @theironforce3000 @theironforce3000 3 months ago Excellent info again from peter. As a pt working with middle aged for severak years, all these points are the same thst ive been repeating myself. A little goes a long way. Reply @sonialewis1222 @sonialewis1222 4 months ago I am reading your book as I send this 😊awesome read 💯👍👌 Reply @karenkaren3189 @karenkaren3189 4 months ago I have always exercised and have good ( but not perfect) health. Most people think I am 10 years younger than my age, 67. I also eat mostly well, don’t smoke or drink and sleep about 8-9 hrs a night 8 Reply @kardste8114 @kardste8114 2 months ago Sounds best if we all become organic farmers.. and thus get as much “exercise “ and nutrients as we need.👍👍 Reply @javedfazal59 @javedfazal59 4 months ago Great advice! 1 Reply @michelefallo9762 @michelefallo9762 13 days ago I can say it in a fewer words here’s the title of my book …”STOP eating crap and shake your ASS” 😂..love this Doctor 🙌 1 Reply @zibtihaj3213 @zibtihaj3213 4 months ago 11:20 you can say about sugar cravings also… But I do agree with Peter in all matters - he is IMPORTANT Reply @carolyncampbell6718 @carolyncampbell6718 3 months ago My daughter exercised religiously and still ended up with metastatic breast cancer and died. 7 Reply 4 replies @user-tf5jb4hr5r @user-tf5jb4hr5r 1 month ago Well, my wife (the love of my life) passed away in June. Now I know know what not to do to extend my life. Thank you! Reply 2 replies @kimberlyhoward4032 @kimberlyhoward4032 2 months ago Speak your mind, refute oppression, and live in individuality not fear!!!!! Reply @TonyMoze @TonyMoze 4 months ago Wow Attia’s camera quality is WAY better than the news 😆 2 Reply @alexi2460 @alexi2460 4 months ago Addressing senior's needs is so freshing. We need balance in life style after 60 or 70 not medicine.Problem is real pain from arthritis and other degenerative pathology 4 Reply 3 replies @nataliemeenakshithegreat7780 @nataliemeenakshithegreat7780 1 month ago Iam’now living in paris I had free healthcare now I got to pay 80 percent of it all because my daughter who is doing her master universities are free of cost here in paris is also working part time so at 57 I got to make sure I don’t get sick so I got to âge well and stop smoking it roshoshana am the new year for Jews and I want to gift myself with a smock free life amen 🙏 1 Reply @lindajudy1495 @lindajudy1495 4 months ago The secret to longevity: A cheerful mind, a light diet, regular work and rest, suitable exercise, a good environment, mountains and rivers, accompanied by a good person, a comfortable and restrained sex life is also very important! No long-term smoking of marijuana, dependence on tobacco and alcohol, bad habits of excessive overdraft of electronic products! Oriental Chinese Medicine Story: Wei Wendi Cao Pi asked Hua Tuo, who was the most famous at that time: "The three brothers in your family are all good at medical skills and are famous doctors in the world. So, if you were divided into siblings, who has the highest medical skills?" Hua Tuo said, "The three of us have our own research focus and strengths, but in terms of medical skills, the eldest brother is the best, the second brother is the second, and I am the worst one." When King Wen heard this, he was very puzzled, so he asked again: "But, you are a well-known miracle doctor in the whole country! Their reputation is obviously not as good as yours. So since your medical skills are not as good as theirs, why are you the most famous? Is it not worthy of the name? " Hua Tuo explained calmly: "Brother treats diseases mainly before the onset of the disease, because most people don't know that he can eradicate the disease beforehand, so his reputation cannot be spread, only our family knows. The second elder brother mainly treats diseases at the beginning of the disease. Most people think that he can only treat mild diseases, so his reputation is only spread in the village. And I, Hua Tuo, treated the most serious diseases when they were the most serious. Most people saw that I could perform major operations and bring them back to life. Therefore, they thought that my medical skills were superb, and my reputation naturally spread all over the country. " This story looks like it has nothing to do with human nature, but let me change the analogy: Mr. A is a propagandist who promotes anti-fraud knowledge. He always promotes anti-fraud knowledge in places where fraud has not yet occurred, but in the eyes of everyone, he is too wordy to make people feel irritated and even make people feel that he is selling anxiety. Fear, people here think they are extremely smart. How could it be easily scammed? ! Mr. B freezes other people's accounts to prevent others from losing money when there is a fraud and is about to trade. But this is also an annoying guy in the eyes of others because he prevents the opportunity to "make big money" for those who indulge in traps and scammers Mr. C is a debt collector who recovers losses for others after the fraud has occurred, in order to collect a certain percentage of returns. So in the eyes of others, Mr. C is the savior who saved their economic losses. The reason why it is difficult to be a good person. It is because the bad is chasing the good. In my opinion Mr. C is the most insidious. He watched people being cheated but did not act. Instead, he waited until someone came to ask him to make a final decision, thus gaining rewards and fame. In the long run, there will be fewer and fewer people who stop crime, and more and more people who wait to commit crimes. Good people will be driven away. Governing a big country is like cooking a small dish, and a genius doctor specializes in treating diseases that may occur with a high probability in the future. Just like a sentence in the Tao Te Ching, "The highest goodness is like water, water moistens all things without fighting, and deals with the evil of others, so it is more than Tao." TCM emphasizes prevention over cure! Emphasis on "prevention before illness, timely treatment to prevent deterioration, and prevention of recurrence after recovery" Any food in nature is a medicinal material, and Jinshi Cordyceps flowers and trees are all medicines! You need to be cautious about your diet, the best for your body is the best! 4 Reply 1 reply @richardjaffe9972 @richardjaffe9972 3 months ago “ centenarians on average are more likely to smoke,drink exercise less and not eat well” maybe because they have a greater reason to live. Better relationships. Found greater purpose and meaning for life. 😊 3 Reply 1 reply @TheSarah730 @TheSarah730 3 months ago Always like watching hari Reply @carolinelewis952 @carolinelewis952 3 months ago Not sure why Dr. Attia doesn't discuss staying away from processed foods. These poisons hurt our bodies so incredibly bad. 1 Reply @lordemed1 @lordemed1 4 months ago Hard to believe- this guy is 103 yrs old! 5 Reply 1 reply @IusedtohaveausernameIliked @IusedtohaveausernameIliked 1 month ago The basic problem is that if more people exercise many fewer people make money. Exercise is great for health but not so good for corporate profits. We as a species need to decide if we value health more or money more. I know which one I choose. Reply @janeamorba5111 @janeamorba5111 4 months ago I have a Great interest in performing better physically and putting in the time so I can travel better ! 2 Reply @imbitterman @imbitterman 3 months ago I am relieved to hear that all calories are the same. I can dismiss my prior information that carbohydrates spike insulin and cause fat storage and prevent fat burning. Now I can get back to my potato and bread diet. 3 Reply @honnorjustice @honnorjustice 3 months ago Adventists have a high rate of centurions and they live a healthier lifestyle and have a faith. You can live a longer healthier age if you exercise, eat healthy, drop the junk food, get rest, and drink water. National Geographic did an article on them. What we put in our mouth does affect our longevity. 1 Reply @greggutierrez6997 @greggutierrez6997 2 months ago 63 year old surfer. Live hard surf hard. Blessings and love. Reply @ms.taylor-kay6076 @ms.taylor-kay6076 4 months ago In other words, we can pray that we are related to Keith Richards. 😎 13 Reply @thelaughingcat7051 @thelaughingcat7051 4 months ago In Traditional Chinese Medicine the key is balance and prevention.... 10 Reply @gigilaroux762 @gigilaroux762 2 months ago Stress kills. Most those blue zone centenarians have a relatively low stress load and good mental attitude. 1 Reply @grantferrigan3837 @grantferrigan3837 4 months ago I think most experts are way over thinking this. Breathe, move and eat the best you can. Meditate and sleep. The end. 6 Reply @Bruno-tm3xo @Bruno-tm3xo 1 month ago Life expectancy means nothing……it s life expectancy in good health that’s important 2 Reply @houseofroos @houseofroos 4 months ago Relative to diet. What about a high fiber diet that is higher bulk, less calorie dense, and seems to have benefits for the gut flora? Also what about beneficial phytonutrients from vegetables and plants? I think there’s more to diet than just “energy balance.” 8 Reply 2 replies @joriver5739 @joriver5739 4 months ago Living longer is not as important as Living Well... 13 Reply 1 reply @angelmatos9143 @angelmatos9143 4 months ago Living healthy & passing at 70 is perfect for me. 😂 1 Reply 2 replies @srcs62 @srcs62 4 months ago Fitness does not mean just Physic - need to be fit in the areas of Mental peace / balanced food / family happiness / contention / compassion - having these as priority will enable 8 to 12 hours good sleep and nice blessed appetite to eat one or two meals in 60's and beyond. Rest is Genes and environment. Reply 1 reply @PhuongTran-pg4ui @PhuongTran-pg4ui 3 months ago Thanks Dr. Attia, I do think an individual who has emotion, anxiety or depression illness could lead his/her to have heart disease?. Reply @brian4990 @brian4990 2 months ago You cannot exercise your way out of a bad diet (like the standard American diet). Real whole food is priority. No sugar, no processed food, no fast food. 1 Reply @PhilippeOrlando @PhilippeOrlando 3 months ago And nobody ever asks one of those quality life, longevity doctors how they know what they want us to believe they know. Dr. Attia, have you conducted double blind randomized experiences on how to increase quality of life? Of course he hasn't because it's impossible. Let's see, how would we do this? First let's take real twins, oh, let's make sure we have a lot of twins so we can apply statistics to our results, so they can't be dismissed because we have a small sample. So, let's find 5000 sets of identical twins, all in their twenties, who all agree to be part of the following experiment: One twin will live exactly the way they want, for the next 50 years or so, and the other twin will live according to Dr. Attia's rules. That's how we'll find out. It's never been done and never will be. So what is Dr. Attia's doing ? Selling books telling us what "he thinks" not what he knows. Everything he knows has been done...on mice and fruit fies. The lack of scientific education and critical thinking of the US population is beyond mind numbing. People, people, people, do you understand that most if not guys who's spent years in training to become GPs or practice in non lucrative specialties just want out and a book is basically the easiest way? Reply @fontainerouge @fontainerouge 3 months ago French centenarians I've known : real food, little sugar (morning coffee & Sunday pie), moderate alcohol consumption, few chemicals (cleaning products & cosmetics), lots of walking. And genetics. 1 Reply @stevechance150 @stevechance150 4 months ago I expect that during the next 25 years, advances in anti aging technology, made by AI, will increase the average lifespan by 30 years. And over the next 55 years, AI discovered new meds will make it possible to halt the aging process. 2 Reply 1 reply @nataliemeenakshithegreat7780 @nataliemeenakshithegreat7780 1 month ago IAM 57 but looks 40 i guess it’s my genes however I had vices I cut smocking weed and god it reduced my panic attacks I stopped anti depressants iam more active now I need to quit tobacco iam getting to it I don’t drink any sodas anymore drinking more water fruits veggies practice meditation iam single a single mom sometimes I get lonely iam trying to go back into my singing and looking for a job so I don’t isolate myself 1 Reply @rogerbernard9572 @rogerbernard9572 1 month ago I’m 72. Taking no medications/ prescription drugs, swim every other day, and walk if car isn’t necessary to get from one place to another. I also try to avoid doctors/ doctor’s offices for a number of reason. I don’t trust Phrama! 1 Reply @elbowroom3663 @elbowroom3663 4 months ago Excellent presentation, of course, but what is left unmentioned is that food is climate. Make no mistake about this. To protect the world for humanity we must evolve to whole-food, plant-based diets. Period! 3 Reply @markcampbell7577 @markcampbell7577 3 months ago We are way out of line with the proper use of antibiotics prescription to avoid chronic diseases of bacterial infections like arthritis dementia AFib MS ALS and scleroderma. These are the effects of bacterial infections without treatment. 1 Reply 1 reply @youtubeKathy @youtubeKathy 3 months ago wow! so I'm not crazy. never have I ever heard a centenarian, when asked, say they eat a plant based diet, or work out, yet every single one says they drink hard liquor, eat chocolate and meat. why don't we promote these habits of longevity? Reply @timothykowalewski3943 @timothykowalewski3943 1 month ago PeterAttia was the flag bearer for Keto for years, then said it is nothing more than a method of calorie restriction. Then, he was the king of fasting. He now says there's no benefit to it besides being a mean of calorie restriction. What's next to keep people watching? 2 Reply @markcampbell7577 @markcampbell7577 3 months ago We are grossly misinformed about antibiotics prescription power generation and the effects of chemical pollution. 2 Reply @debmanrique6466 @debmanrique6466 4 months ago $$$- Also, Malpractice insurance won't cover any natural treatments- vitamins, herbs, etc, so most doctors feel obligated to stick to medicine only. 4 Reply @markcampbell7577 @markcampbell7577 3 months ago The majority of the antibiotic resistant bacteria are coming from genetic engineering production and research industry snd short-term antibiotics prescriptions . 1 Reply @walterscott2286 @walterscott2286 4 months ago Numbers, numbers, numbers! I'm so sick and tired of hearing about lab tests for cholesterol levels. From studies I've read, HALF of the people who have/had heart attacks have cholesterol levels in the "normal"range at the time of the occurance! And another study said that the group of people who have the MOST heart attacks were among those with the LOWEST cholesterol levels! Then there's the studies that showed people with higher than normal (i.e. "healthy") cholesterol levels tested higher than average on intelligence tests! (Recently, my young Doctor wanted me to get on statin medication...he said "160" LDL was too high! Even with a reading of 42 HDL! He tried to explain to me that if I'd get the LDL down below 70, my chances of having a heart attack would be almost ZERO! Such misguided...and potentially harmful...advice!) And NEVER do I hear a single word about the Ayurvedic understanding of the basic 3 different body types! Clearly, if you know anything at all about ancient Ayurvedic Science, NOT ALL people have the same inherent risk levels of developing heart disease, clogged arteries!! The out of whack, overheated, hard-driving "Pitta" type, for instance, is far more susceptible to high blood pressure and build up of arterial plaque than a balanced, easy-going, relaxed "Kapha" type. None of this is even taken into consideration in the primitive Western medicine, laboratory "numbers game". 1 Reply @sandray7609 @sandray7609 4 months ago Whole food plant based diet is the most important. Someone bedridden will live longer because they aren't consuming foods thatcause chronic disease. Abs are made in the kitchen not the gym. Fitness strength flexibility are important so yes we need exercise but I fundamentally disagree with his diet advice. Fit looking people have heart attacks because of their diet. 2 Reply @gate-gate6863 @gate-gate6863 3 months ago (edited) 15:02 hand-pink-wavingAPO b hand-pink-wavingLPa (genetically determined and only needs to be measured once in a lifetime) hand-pink-wavingAPO e genotype （a gene that plays important role in 🧟‍♂Alzheimer's and 💔cardio diseases.） 1 Reply @matthewsaunders4820 @matthewsaunders4820 4 months ago The only way this could have been better was if the guest was in his 80s 9 Reply @thomashumphrey7395 @thomashumphrey7395 2 months ago Very bright dude. Reply @lilmsgs @lilmsgs 4 months ago He really didn't want to talk about his keto phase of advice he no longer believes in. Now he's in a different phase and has a book to sell. 17 Reply 11 replies @garrettweiner7924 @garrettweiner7924 2 weeks ago Let’s just ignore what’s going on around us. You’re not going to outlive collapse… Reply @SB-mg3ho @SB-mg3ho 4 months ago Yes, we all need to live longer... I agree... it's the only way..... I vote for nanoids. Reply @margo3367 @margo3367 4 months ago What if you didn’t know you had the longevity gene and so you went without smoking or drinking, and exercised like a fiend, without it being necessary. 3 Reply 4 replies @josephludwig1126 @josephludwig1126 3 months ago Thank You Reply @zxcvbnmmasdfghjkl @zxcvbnmmasdfghjkl 2 months ago It’s crazy how we only get one shot at this, this is it. Don’t fuck it up y’all. Reply @patriciahoke4722 @patriciahoke4722 4 months ago I do NOT agree that a diet that has no added sugar is effective because it's an indirect way to limit calorie restriction. One, sugar drives craving for other foods (as Attia has said). Two, sugar triggers insulin which is a key for fat storage (as Attia has said). 500 calories of milk chocolate is NOT the same as 500 calories of red pepper salad or meat for that matter. I am disappointed in this new tack of his. 3 Reply @terrymokihana1421 @terrymokihana1421 2 months ago (edited) Respect Dr Attia but his theories on diet seem to change monthly. Attia was a fasting extremist. Anyone in good health who practices fasting knows( feels) benefits. Anyone in good health who exercises most days knows (feels) benefits, both dont need "recent research" to feel them both and feel good. 1 Reply @markcampbell7577 @markcampbell7577 3 months ago Diabetic neuropathy is unusual but E coli genetic inserts of insulin is becoming common low blood sugar neuropathy. We casually say diabetes.. Reply @lindaanderson1016 @lindaanderson1016 1 month ago The doctors labor to make the vast complicated details understandable to us. Then they all credit evolution..... As the Scripture says in the Psalms," We are fearfully and wonderfully made."....The human body is irreducibly complex. It is obviously created. See scientist John Lennox, James Tour 1 Reply @PhiveIncognito @PhiveIncognito 3 weeks ago (edited) The longest living Americans, the 7th day adeventists, are vegans and vegetarian, exercise daily and live rich spiritual and social lives. Same goes for longest living populations on earth or populations where lifestyle diseases are virtually unheard of - largely plant based diet, physical activity daily at moderate intensity, strong social connections. Follow populations and proven longetivity strategies not Peter Attia and other fads that needlessly complicate things to sell books. We know how to live longer, we have populations as clear evidence for it. Reply @stevec404 @stevec404 2 months ago The answers are out there. We are not trained to ask, or to listen. 1 Reply @volodymyrv5897 @volodymyrv5897 4 months ago The development of Western countries is the isolation of Russia. Complete isolation of Russia and everything Russian. And also the isolation of countries that support Russia.!!!!! Reply @carinwiseman4309 @carinwiseman4309 4 months ago So now I need to be responsible for planning and instituting "plans" between 80 and 90 years. Ugh. Just more work Reply @marktapley7571 @marktapley7571 4 months ago Attia always tries to inject his belief in evolution when in fact there is no mechanism in organisms to bring about the advancements he ascribes to. All organisms are hard wired with coded information at inception. This cannot be done by random chance any more than a person can build a house by dumping raw materials on a vacant lot. The irreducible complexity of even the simplest bacterias makes the idea of so called evolution ridiculous. Where is the evidence for this evolution in the fossil record, in the geographic strata or in the world we see today? There is none. Reply @anzaleening7145 @anzaleening7145 2 months ago Lets see how long he lives. 😂. I feel this is an elitist game and will loose steam soon. Happiness is missed and compassion is not included in the book at all. 1 Reply @SilverFan21k @SilverFan21k 4 months ago 😯🥰 1 Reply @yawnybgood2787 @yawnybgood2787 2 months ago My simple theory "If you want to keep moving, keep moving. Reply @FairBeautyEssentials @FairBeautyEssentials 2 weeks ago 2:41 OK first of all no one is there true age. When we women are carrying the child for nine months. the child is already how long, 6 inches, 9 pounds or whatever inside of our stomach’s kicking, long legs, and have a full-blown heartbeat. By the time we deliver, the child is still nine months. The following month the child is 10 months but no we human start over and say they are one month old. No that is incorrect!!! The child is 10 months old, not one month old. 1 Reply @frankmiller668 @frankmiller668 4 months ago This is a similar message that Dr Stein Ekburg Reply @AndreAndFriends @AndreAndFriends 2 months ago 15 min !!!! YOU WELCOME Reply @JuicyJuice1313 @JuicyJuice1313 2 months ago Is it, eat healthy, stay active, don't smoke, limit alcohol intake....? Reply @chicagomike @chicagomike 4 months ago I am exhausted to exercise 😮. 1 Reply @jn052159 @jn052159 3 months ago exercise eat right ground breaking Reply @theobserver9131 @theobserver9131 4 months ago I'm already three times older than I ever planned to be. I'm tired now. Want to go "home". 5 Reply 5 replies @goldstandardaviation1667 @goldstandardaviation1667 3 months ago (edited) I'm 65 and in great shape. My 50 yo girlfriend keeps me young 😉 Reply @syedarsalanahmad @syedarsalanahmad 2 months ago Attia of the Julii, I call for justice Reply @lordjim3109 @lordjim3109 2 months ago I`ll save your time: he says just exercise every day. That`s all he has to say. 1 Reply @LarryHable @LarryHable 4 months ago 13 minutes. shaking your head "no" when talking about insulin, money, and big pharma. Reply @nebilsabo1386 @nebilsabo1386 4 months ago Living healthy, sure. But why live longer? You're already old, it's vanity to want to live over 100. We should be taught more about death and how to pass peacefully and with dignity. Reply 1 reply @chicagomike @chicagomike 4 months ago There is nothing new here. Watch what you eat, exercise, watch calories and sleep. 2 Reply @mknels1299 @mknels1299 1 month ago I paint abstract,do dog walks, swim, pray no alcoh9 or cigs Reply @Garcia-elf @Garcia-elf 2 months ago (edited) 13:58 life expectancy* not span. Span is the same Reply @BethHolloway-de1hq @BethHolloway-de1hq 3 months ago A longevity "expert" promoting a keto diet? Beware. Follow the MDs/PhDs doing the research for your guidance, and choose a physician who has read the data. 1 Reply @marianasalles242 @marianasalles242 7 days ago Vegan diet🌍💚✨👍🏻 Reply @lonzo61 @lonzo61 3 months ago Why the hell would I want to live longer? Reply @zbyszek511 @zbyszek511 3 months ago I am 513 have more energy when I was 200 Reply @lanellgranger1920 @lanellgranger1920 4 months ago Not evolution! Design! Marvelous Design by an amazing Creator! Evolution is random and always degenerative! Reply 1 reply @ih8mcfly @ih8mcfly 3 months ago If you have Jesus, you will live a long and happy life. Simple. Reply @peterbedford2610 @peterbedford2610 4 months ago Exercise and sleep. 2 Reply @leonkennedy4680 @leonkennedy4680 4 months ago I disagree with everyone needing to know their apo-e status Reply @tracyrodgers5179 @tracyrodgers5179 3 months ago Do centaurians love themselves more? Reply @tatianafoule6257 @tatianafoule6257 3 months ago So bullish is Hard???? ❤❤❤ uuufiii Reply @KJSvitko @KJSvitko 1 month ago Health care costs are out of control. Going WFPB vegan can save money, pain and suffering from disease. Lower your chance of high blood pressure, heart disease and cancer by going vegan. Hospitals, doctors offices and schools should be places where good nutrition is taught and provided not places that contribute to disease and obesity. It is crazy the hospitals are feeding people the very food that caused the heart disease, high blood pressure or cancer that they are treating. Every person in the hospital should receive some nutrition education before being released. Every doctor visit should be an opportunity to educate patients about how food choices impacts their health outcomes. The fact that doctors do not get nutrition training as part of their training makes no sense. Medicare and Medicaid should require nutrition education as part of patient care. Focus should be on food choices. Reply @maypalmer @maypalmer 1 month ago (edited) And then you die....No matter how long/hard you fight to exercise, diet, etc., death is coming for us all. What good is it if a man gain the whole world and lose his/her soul? Repent and recieve the good news of the forgiveness of your sins through God's Son, The Lord Jesus Christ. In Him is Life Eternal. Reply @garrettweiner7924 @garrettweiner7924 2 weeks ago He was just getting into the interesting part and it ends?? Reply @ciarraibuzz @ciarraibuzz 4 months ago 100 year old smoke more, drink more, exercise less. It is all genes. Reply @flybefree @flybefree 4 months ago Fitness makes you sexy … la la-la la la … and you live longer …. la la-la la la. Reply @anna-tn8mg @anna-tn8mg 3 months ago Well, Doctor, I can assure you that we won't live long if you continue sponsoring this group and the like. Any chance you and other "medical doctors" notice ... larger reality? dr anna (not this kind of doctor) Reply @lorettanericcio-bohlman567 @lorettanericcio-bohlman567 4 months ago Blah blah blah, live well, enjoy life, drink lots of water, mountain bike, garden, rock out to fabulous music, smoke a little pot now and then and be kind. Not that hard, really 4 Reply @CAM-fq8lv @CAM-fq8lv 3 months ago Outlive human extinction? 1 Reply @WOLF-ib7xx @WOLF-ib7xx 4 months ago Easy get off the Standard American Diet. 6 Reply 2 replies @druodil3428 @druodil3428 4 months ago Why didn’t anyone fact check this guy? He said there is no common factors to longevity 😂. The blue zones have many similarities, diet being the main thing. First, they eat the opposite of a Keto diet. They eat grains many times a day. Little to no meat/ saturated fats. They get most of their protein from grains and beans, plants. What about smoking? What a joke, is this sponsored by tobacco and the meat industry? You know this guy thinks you can eat bacon, eggs, sausage and follow it up with a cigarette as breakfast. But, oatmeal is not a healthy breakfast. Keto does nothing to prevent the diseases he said you need to avoid to live long. The short answer is to eat like the blue zones and add exercise to increase the quality of life. Please remove this video as it is full of false information and no science to back up the lies. Unless you count the studies funded by tobacco and the meat industries. 4 Reply 2 replies @stever7207 @stever7207 3 months ago Less hair, more years? 1 Reply @Kumurajiva @Kumurajiva 4 months ago Sex😂, he forgot 1 Reply @dinomiles7999 @dinomiles7999 1 month ago Where's the scientific data proof. Peter is only human . Reply @lexiamour5734 @lexiamour5734 3 months ago Nothing new! Every decade or so someone writes a book about healthy lifestyle, what we should and should not do. We all have to be proactive in our own health and well being. You can't go to the doctor and complain about let's say GERD take a pill, but still eat whatever you want. That's not going to help you. We have to have the desire, interest and curiosity to do our own research and you would know all this. I am surprised by all the praises... 1 Reply @judyk.657 @judyk.657 1 month ago Really? Why would anyone want to live longer? Reply @stevestone9526 @stevestone9526 2 days ago This interview was so horrible..... How can two people speak so many words and say nothing in the end.....???? After your guest and you went on and on I still have no idea what steps can be taken to improve my health through exercise. He was so so much in his head, just to hear himself talk, thinking he was so smart. He talked about it, from every direction and never said what everyone was waiting for him to say. You need to exercise in this way and this how you do it.... It was torture to listen thinking he may finally get to the point and never, never does. You didn't help at all.... Reply @johnmaisonneuve9057 @johnmaisonneuve9057 3 weeks ago He drop the F bomb in an interview! Disgusting, despicable! Puts him in a club of low-life. Reply @alphaomega8373 @alphaomega8373 4 months ago A lot of fluff. 1 Reply @marcusryder95 @marcusryder95 3 months ago Who is this interviewer. Maybe read the book first and at min learn how to say the name of your guest. Reply @houseofroos @houseofroos 4 months ago Microdosing 3 Reply @dinomiles7999 @dinomiles7999 1 month ago Bryan Johnson Blueprint, Ai will soon take the guess work out of it and all gurus and snake oil salesmen will soon be gone. See you in 2500 Reply @Acm1pt4567 @Acm1pt4567 10 days ago A scam crated on YouTube. Reply @user-hz4zo6sf8v @user-hz4zo6sf8v 4 months ago face-blue-smilingface-blue-smilingface-blue-smilingface-blue-smiling 1 Reply @howardhdavidson @howardhdavidson 3 months ago Don’t watch YouTube… Reply @toms5974 @toms5974 2 months ago Don't watch, terrible Reply @castillomark @castillomark 11 days ago What about access to quality health care? Not everyone has that privilege in this country. 1 Reply @janeteddddd @janeteddddd 2 months ago Wv a xx ines and c on trast d ye ruined my health. Do This Exercise Before It's Too Late - P. Attia | J. Peterson Let's be Healthy 27.1K subscribers 552,711 views Aug 29, 2023 #longevity #exercise #health Dr. Attia, a prominent figure in the field of longevity research, brings his deep understanding of medical science to the table. He shares the latest insights into how exercise acts as a potent elixir, not only enhancing overall fitness but also significantly influencing the aging trajectory. With a wealth of research at his disposal, Dr. Attia uncovers the fascinating mechanisms by which exercise positively impacts cellular health, cognitive function, and the prevention of age-related diseases. Throughout the discussion, viewers will gain invaluable insights into designing exercise routines tailored to the needs of the elderly. From strength training to cardiovascular workouts, the conversation covers a spectrum of approaches that empower seniors to reclaim their vitality and embrace a higher quality of life. Whether you're a fitness enthusiast, a caregiver, or simply intrigued by the science of aging, this video offers a wealth of wisdom to inspire positive change. Discover how the fusion of medical knowledge and psychological support can unlock the secret to a longer, healthier, and more fulfilling life for our beloved elderly community. Don't miss this opportunity to learn from the best minds in the field and take a proactive step towards a brighter, healthier future. 💊 Looking for high-quality supplements for a reasonable price? Use "YOUTUBE20" for extra discounts. https://letsbehealthy.co/ #longevity #health #exercise Music 1 songs Beyond Patrick Patrikios Beyond Music Transcript Follow along using the transcript. Show transcript Let's be Healthy 27.1K subscribers Videos About 8:17 Neuroscientist: The Only Supplements You Need - Dr. Huberman (Part 2) by Let's be Healthy 365 Comments rongmaw lin Add a comment... @lets-be-healthy Pinned by Let's be Healthy @lets-be-healthy 2 months ago 💊 Looking for high-quality supplements for a reasonable price? Use "YOUTUBE20" for extra discounts. https://letsbehealthy.co/ 6 Let's be Healthy Reply @wishbone103 @wishbone103 2 months ago (edited) I will soon be 76. I started lifting when I was 14. Still doing it even though some arthritis has slowed me down a tad. Getting into health and fitness at a young age was one of the smartest things I ever did. It will help keep you young looking from the neck down for a very long time. From the neck up, just smile a lot 😁! 387 Reply 42 replies @vivacepianostudio @vivacepianostudio 1 month ago Never too late to start an exercise program! Once my kids were grown and out of the house, I walked into a gym for the first time. Age 50, 40 pounds overweight and couldn’t walk up a flight of stairs without huffing and puffing. Had no idea what to do so I hired a trainer who helped me with diet as well as fitness. Now I’m 71, 116 pounds and have powerlifting world records. Highly recommend! 28 Reply @itzmejax @itzmejax 2 months ago Absolutely correct..."You are what you consume" and it's not just limited to food but to everything be it content, books, conversations. So be careful about what you are letting in your body, mind and soul. 177 Let's be Healthy Reply 2 replies @50Something @50Something 1 month ago I'm 56, I started running 4 years ago because I was in constant pain and really quite depressed. I have never felt better and I have been improving significantly every year. I've managed to reverse the aging process and actually heal my body! 12 Reply @howardparker4558 @howardparker4558 1 month ago Consistent exercising is truly “the fountain of youth.” 53 Reply 2 replies @marks.7593 @marks.7593 1 month ago Thank you, Dr. Peterson and Dr. Attia, for the much-needed wake-up call. My strength and mobility have decline in the the last two year, but I'm going to get them back! 7 Reply @Jimbob-zn6bl @Jimbob-zn6bl 1 month ago Been bodybuilding for 47 years and I believe it helps tremendously!!💪😊🙏 8 Reply @SuperThunder911 @SuperThunder911 1 month ago Thank you for this awesome video,I’ll be 70 on 9/11 and I’ve been working out all my life and still going strong,yes it’s always been about choices that we make in life,💪✌️ 39 Let's be Healthy Reply 2 replies @Skwid-Lives @Skwid-Lives 1 month ago Soon to be 47. Started doing pull-ups some years back and can still hit sets of 15 at 185lbs. It’s not getting any easier but I’ll keep it going as long as I can 30 Reply 1 reply @calvintrainer1212 @calvintrainer1212 1 month ago (edited) I'm 67 and my muscles and strength still peaking. Meaning I'm currently bigger than I was 25 years ago. Many of my friends call me "long live teenager". Continuous training with good eating habits do that to my body. Of course I have my own program too 7 Reply 4 replies @johnkennett3265 @johnkennett3265 1 month ago I worked out at gyms since teenager, scuba diving, swimming etc. I am now age 81, and two Years ago fell backwards with a 100 pound barbell pressed overhead, it crushed my chest to concrete floor. My conditioning saved my life. But stopping workouts cost me loss of 40 pounds. I am now balancing morning aerobic walking, jogging with dumbbell and safer low and high Cable work outs. Weakness was the motivation to get my act together. 63 Let's be Healthy Reply 7 replies @zacbhr3720 @zacbhr3720 1 month ago 61 this yr. doing walking for 6km 3 times per week. doing light weight. reduce my intake of sugar, salt, rice and bread. feeling much vetter than in my twenty. love from 🇲🇾 13 Reply @mstina7346 @mstina7346 6 days ago I am 71 and female. I’m in good enough shape to feed 5 horses daily, walk dogs on some acreage, and do my own house cleaning. The problem is past injuries. With a somewhat bad knee and arthritis in my hands, even holding weights over 5 pounds creates more pain. But I keep pushing. It’s just hard to get progress past the limits of these drawbacks. Reply @tomharvey5466 @tomharvey5466 1 month ago The doc says so much in a short time it's power packed. Love it 6 Reply @mariecurie7491 @mariecurie7491 1 month ago (edited) My fitness regime started at age 49... I had had my hip replaced and received no physiotherapy. My surgeon told me 5 weeks post-op that I could throw away my crutches, " it is just a matter of confidence". Wrong. After years on crutches, I had 2.5" muscle wasting in that leg. Over the first year, I had 9 falls. In the last fall, I put my hand through a glass panel. At that point I took myself in hand. An hour's workout 3 times a week in the eveningafter work, and half an hour every morning. I built up my muscles, and had no more falls. I have just turned 70... swim, cycle and do yoga. I keep being asked why I don't get an electric bike 😂🤣 15 Let's be Healthy Reply @david894 @david894 1 month ago One of the best videos on health I've ever seen!!! Thank you. 41 Let's be Healthy Reply @adamwuttemberger7923 @adamwuttemberger7923 1 month ago I'm 53 and I just added 30lbs. To my bench press. 5 sets 8-12 reps . I'm 170 lbs. I'm benching 140lbs. My BMI is about 15-18%. 10 Reply 6 replies @Behappy62 @Behappy62 1 month ago I am more on the lazy side, your video has hit home. I will definitely be upping to 3 hours a week the benefits are a no brainier thank you 4 Let's be Healthy Reply Let's be Healthy · 1 reply @jimmycarney7650 @jimmycarney7650 2 weeks ago I’m so thankful for all your Videos an information I’ve pumped iron for over 60 years I am 80 years old I’ve watched so many of my friends an relatives go yes muscle mass is so important Reply @robertsandidge441 @robertsandidge441 4 days ago Well thanks for that info. I’m 62 years old been bodybuilding and powerlifting since I was 11. Most of my life I was training 6 days a week 3 hours a click. Now a days I’m at about 5 days a week 2 hours per session. This video makes me feel really good that I started this 50 years ago.👍 Reply @paultweedley2026 @paultweedley2026 1 month ago Agree with most of this but if you're over 60 l would say two hours a week broken down to four days of 30 minutes exersise is enough. Or even 30 minutes Monday, 30 minutes Wednesday and say one hour Friday. That's still enough to stimulate muscles and raise your cardio vascular! Of course not smoking and drinking alcohol regularly is also a huge factory not mentioned here, exersise and being a non smoker and moderate drinker go hand in hand. 5 Reply 1 reply @carinwiseman4309 @carinwiseman4309 1 month ago In late 60s, I can tell you that if I am not hanging onto something, no way could I do this box step up without injury. 4 Reply @barrybkopicz2845 @barrybkopicz2845 2 days ago Probably the best video I've seen regarding the benefits of excerize and how to incorporate into ones life.❤ Reply @ginnel_snicket @ginnel_snicket 3 weeks ago Dr. Peter Attia is spot-on - qualified, no flash and one of the very best. Please ignore many of the images in this video of people doing things with really bad form though - and bicep curls which have no reflection on PA or JP. SMH. Reply @dorrisbehr4725 @dorrisbehr4725 1 month ago I’m in my mid 70s and just started to get off my butt. I now jog 1 mile every morning and do some weight lifting. I noticed that I feel lighter on my feet while walking. I will start to strengthen my grip, it’s gotten really bad due to arthritis. I know this will probably help my arthritis. Will also try the step up thing. 13 Reply 8 replies @RichardSnook @RichardSnook 1 month ago Yes I have been dong isometrics and my strength is coming back and so is my muscle mass it’s up 14% and I am over 70 15 Let's be Healthy Reply 2 replies @hawkeyeinthehouse2995 @hawkeyeinthehouse2995 1 month ago Thank you for the 411, I'm 71 and have had a bad knee since 1983, hasn't gotten better. That has slowed me down quite a bit since then. Unfortunately the last few years I've gained TOO MUCH WEIGHT (240 at 5'8"). What is the best way to LOOSE WEIGHT, I've heard starving yourself isn't the best way to go. Please help!!!! 1 Reply 3 replies @kobalt77 @kobalt77 2 months ago I am soon to be 64, great info for me , thank you so much ! :) 9 Let's be Healthy Reply @kcorymsidogmaricel2356 @kcorymsidogmaricel2356 1 month ago (edited) Still working out at the age of 69. I've changed a lot my training as I've gotten older. I no longer do beach presses, replaced it with weighted push-ups. My works consist of pull ups, dumbell curls, weighted push-ups, dumbell militaries and I finish my workouts banded shoulder lifts. 30 second rest between each set on the days when I only do 2 rounds. On the days I do 3 sets I give myself 1 to 1 1/2 minutes rest. Also do 2 sets 5 reps of deadlifts per wk. I could still lose about 7 to 10 pounds, but that will come once I start training for masters track and field meets, in the next few months. I've got to start slowly, I injured my left calf starting out to hard, I had to learn the hard way. I'm 5'6 157 lbs I think I need to get down to 150 to 145 to take the stress off my legs to compete at the level I want. It's nice to have goals that are realistic. Btw, I'm the father of a 8yr old a 4yr old and a 2yr old. Heavy weights do help with the testosterone as well as supplements. I don't do testosterone replacement therapy. 4 Reply @tomhart5232 @tomhart5232 4 weeks ago Thank you for this valuable information. 1 Let's be Healthy Reply Let's be Healthy · 1 reply @davidguthrie3739 @davidguthrie3739 1 month ago Zone 2…I used to run occasionally with a buddy who put in way more miles than me. We ran hilly terrain and would always start out chatting away. Before long, the conversation became very one sided with my friend chatting away comfortably while I couldn’t say a word! One man’s zone 2 is another man’s zone 4. 27 Let's be Healthy Reply 4 replies @nickwest1476 @nickwest1476 1 month ago Excellent advice 1 Reply @spark_6710 @spark_6710 1 month ago Very good & important video to watch !! Thank you so much !!👍👍💜🥁🐉🎤🎶💞 5 Let's be Healthy Reply @FlyBabies123 @FlyBabies123 1 month ago I'm in a wheelchair (15 years after 14 hip surgeries) and I was muscular until I brought COVID home from the hospital after shoulder surgery a year and a half ago and my muscles went down the drain after being in bed for 2-1/2 months. My shoulder still hurts every night and is exacerbated bye exercise. Have continued to go to the gym three times a week but I'm just having trouble getting any muscles back. Am I doomed? 1 Reply 2 replies @christopherbrathwaite440 @christopherbrathwaite440 1 month ago Great thanks for sharing, this is good information. 1 Reply Let's be Healthy · 1 reply @roundearth5572 @roundearth5572 1 month ago Encouraging to se Peterson participate in factbased circumstances 👍💪 9 Reply 1 reply @shelfcloud487 @shelfcloud487 1 month ago Sounds good but I’ll stick with my weightlifting/cardio routine. I’m 57 and workout 7 days a week. I practice 18/6 intermittent fasting daily and I don’t eat any food on Saturday. I also avoid processed foods and sugar for the most part. 👍💪 7 Reply 2 replies @vercingetorix3086 @vercingetorix3086 1 month ago Go Calisthenics, I trained all my life hard in many sports , i’am 53 my body look like a 30 year old man actually I haven’t change much since my late 20 , the only difference now is injuries more and more often as I still work as hard as before also the decrease in testo is the worst for a man especially for a man that train really hard , your head is ok to do the same unfortunately your muscles are not responding as they use to so I believe around 50 for a man you have to go to TRT not to get huge but just to get where you was In your 30s and enjoy what you love the most and so training, gym , calisthenics, running, cycling …… and I mean long run like half marathon for training and long cycling like 80klm for training and all sports combined at last 5 to 6 time per week if I could do 7 day I’ve done it unfortunately pushing the machine to hard too often and too many hours per days can result in overtraining i’ve be there too so I have to give a day for rest and try to avoid injuries that’s what scares me the most now being off for weeks or months 1 Reply @BillyBullshitter @BillyBullshitter 1 month ago I'm 98 years old. And I am healthier than a 20 year old. That's because I eat healthy and exercise every day. I don't spend all my time sitting Infront of a computer or on my phone. I walk every day. So go to the gym 3 times a week. I have other extra curricular activities that I don't want to mention on here. Nudge nudge wink wink. (Nothing illegal) Life is what you make it 11 Let's be Healthy Reply 2 replies @jeanettemelendez4967 @jeanettemelendez4967 1 month ago Awesome, I'm 65, I go to the gym 2x a week....just stared.....🎉❤ 1 Let's be Healthy Reply Let's be Healthy · 1 reply @ntujqubqab3479 @ntujqubqab3479 1 month ago Thanks I’m 45 now n just retired… life is too short so the sooner the better …. N now time to do regular exercise… I used to at one point but quit for years, now time to go back.. Reply @greggapowell67 @greggapowell67 1 month ago I believe VO2Max (Stamina) and Muscle Mass is only 1/2 the story. The other is to eliminate insulin resistance and inflamation in the body and arteries, stop eating all sugar and drinking soda (no artificial sweeterners either), reduce carbs to a bare minimum, stop eating nearly all bread, stop drinking all alcohol. Some may consider this too dificult. It is simply a matter of self discipline. I won't even mention don't smoke. 31 Let's be Healthy Reply 5 replies @jedlimen123 @jedlimen123 4 hours ago Outstanding guest. New listener. Thank you!! Reply @michaelmcginnin1126 @michaelmcginnin1126 1 month ago At age 68 I do five minutes of “dead hangs” (1 minute average) every day, in addition to 5 miles running (treadmill), and three days per week of weightlifting. Dead hanging is extremely difficult, but improves your grip strength by 1000%. Another key factor is my carnivore/intermittent fasting lifestyle. No need to watch your calories or weight. Carbs/sugar/processed foods have to go!! 17 Reply 5 replies @gh4534 @gh4534 1 month ago Yes but there is another study that has shown that there is a negative impact from overstressing/overworking out. There is a significant benefit from exercise and as you do more, the benefit plateau’s and what is interesting is when you do even more, the life span actually decreases. But who in the 60’s plus puts in more than 120 minutes of exercise. So overall yes exercise of this kind has real benefits. 9 Reply 5 replies @brandycat8513 @brandycat8513 1 month ago All these strength exercises bar aerobics can be done through isometrics and with less stress on the body Reply @jxn0010 @jxn0010 1 month ago I will be 52 in a few days iv been weight lifting since I was 17 .. I’m stronger now as I was when I was in my 20’s 4 Reply @jonerrek7806 @jonerrek7806 1 month ago I live in a home with two flights of stairs. As my memory deteriorates, and having forgotten why I went down into the garage, up and down the stairs I'll go. Always looking for the positive side, my legs are in great shape, though my wife now thinks twice about asking me to get the frozen hamburger out of freezer in the garage. Chances are I'll bring up a sack of potatoes. On the positive side, my wife's legs are looking real good. 9 Reply @jimmycarney7650 @jimmycarney7650 1 month ago I’m almost 80 was a power lifter I built my strength when I was young I still do dead lifts and barbell squats Reply @olddouchebag @olddouchebag 1 month ago Guess what? Fitter and stronger people live longer! This guy is a genius! 🙄 1 Reply @boontan6636 @boontan6636 1 month ago Muscle mass is not enough without Cardio exercises. Regeneration and detoxification are the complete process of aged health. 1 Reply @williemclean3224 @williemclean3224 1 month ago I’m 68, I hit my speed bag and heavy bag two days a week and light weights the other 3 days. Reply @swdw973 @swdw973 1 month ago (edited) There is one "activity" that is on about the same par as a metric as exercise is for length of life- sleep duration. 3 Reply @ronaldmiller3619 @ronaldmiller3619 1 month ago Iam 80, doing light wt instead of heavy wt. Enjoy it more, do more excercises. Wt 161 work in the yard daily until winter As you get order you need to do light wts so you wont hurt your joints. Reply @cgkuch4184 @cgkuch4184 1 month ago Weight training even at a moderate level has more benefits than running. A decent diet, with some fasting, and good supplementation, proper rest, your body will thank you as you age. 13 Reply 11 replies @dorisbest7580 @dorisbest7580 3 days ago Who of you guys remember Eugen Sandow's dumbell system? It has adjustable grip system to train MBM (mind-body-mind) connection,as a grip training has a very special influence on our CNS (same as jaw clench I guess) Reply @Kathy-kr1sv @Kathy-kr1sv 1 month ago I'm 73. I'm healthy. Only thing that affects my grip is a bit of arthritis But it won't stop me I still run upstairs. And train religiously I am low carb and I. F. SEE you guys when you get to my age. 😊🤣 3 Reply @NMIBUBBLE @NMIBUBBLE 1 month ago knew a ww2 veteran that smoked everyday up to her last! She worked on biplanes engines too! 92 yrs young. She didn't work out she read books, did puzzles and she was sharp. RIP Mudder! 5 Reply 3 replies @snaggletooth14 @snaggletooth14 1 month ago My doctor told me to run 5 miles a day, for two weeks…I called him up and said “Doc! I’m 70 miles from home!” RIP Rodney Dangerfield 1 Reply 1 reply @dort5436 @dort5436 2 months ago Both my grandmothers and mother lived into their 90s. They ate and drank what they liked and I never saw them exercising doing strength training. They were all avid gardeners. What happened to my generation to have to all this exercising? 13 Reply Let's be Healthy · 13 replies @beoz658 @beoz658 1 month ago I use to hang. At 64 with a torn rotator cuff I no longer can hang. I still work out 7 days a week, but I miss hanging. Reply @nanacybersliver8411 @nanacybersliver8411 1 month ago Omg!😱... I'm turned 60 February. This is bloody scary! I have no choice but pull the finger out!!😅😂❤ Reply @likeasparrowinthewildernes8333 @likeasparrowinthewildernes8333 1 month ago I answered and said, "If I have found favor in thy sight, O Lord, show this also to thy servant: whether after death, as soon as every one of us yields up his soul, we shall be kept in rest until those times come when thou wilt renew the creation, or whether we shall be tormented at once?" 76 He answered me and said, "I will show you that also, but do not be associated with those who have shown scorn, nor number yourself among those who are tormented. 77 For you have a treasure of works laid up with the Most High; but it will not be shown to you until the last times. 78 Now, concerning death, the teaching is: When the decisive decree has gone forth from the Most High that a man shall die, as the spirit leaves the body to return again to him who gave it, first of all it adores the glory of the Most High. 79 And if it is one of those who have shown scorn and have not kept the way of the Most High, and who have despised his law, and who have hated those who fear the Most High -- 80 such spirits shall not enter into habitations, but shall immediately wander about in torments, ever grieving and sad, in seven ways. 81 The first way, because they have scorned the law of the Most High. 82 The second way, because they cannot now make a good repentance that they may live. 83 The third way, they shall see the reward laid up for those who have trusted the covenants of the Most High. 84 The fourth way, they shall consider the torment laid up for themselves in the last days. 85 The fifth way, they shall see how the habitations of the others are guarded by angels in profound quiet. 86 The sixth way, they shall see how some of them will pass over into torments. 87 The seventh way, which is worse than all the ways that have been mentioned, because they shall utterly waste away in confusion and be consumed with shame, and shall wither with fear at seeing the glory of the Most High before whom they sinned while they were alive, and before whom they are to be judged in the last times. 88 "Now this is the order of those who have kept the ways of the Most High, when they shall be separated from their mortal body. 89 During the time that they lived in it, they laboriously served the Most High, and withstood danger every hour, that they might keep the law of the Lawgiver perfectly. 90 Therefore this is the teaching concerning them: 91 First of all, they shall see with great joy the glory of him who receives them, for they shall have rest in seven orders. 92 The first order, because they have striven with great effort to overcome the evil thought which was formed with them, that it might not lead them astray from life into death. 93 The second order, because they see the perplexity in which the souls of the ungodly wander, and the punishment that awaits them. 94 The third order, they see the witness which he who formed them bears concerning them, that while they were alive they kept the law which was given them in trust. 95 The fourth order, they understand the rest which they now enjoy, being gathered into their chambers and guarded by angels in profound quiet, and the glory which awaits them in the last days. 96 The fifth order, they rejoice that they have now escaped what is corruptible, and shall inherit what is to come; and besides they see the straits and toil from which they have been delivered, and the spacious liberty which they are to receive and enjoy in immortality. 97 The sixth order, when it is shown to them how their face is to shine like the sun, and how they are to be made like the light of the stars, being incorruptible from then on. 98 The seventh order, which is greater than all that have been mentioned, because they shall rejoice with boldness, and shall be confident without confusion, and shall be glad without fear, for they hasten to behold the face of him whom they served in life and from whom they are to receive their reward when glorified. 99 This is the order of the souls of the righteous, as henceforth is announced; and the aforesaid are the ways of torment which those who would not give heed shall suffer hereafter." 100 I answered and said, "Will time therefore be given to the souls, after they have been separated from the bodies, to see what you have described to me?" 101 He said to me, "They shall have freedom for seven days, so that during these seven days they may see the things of which you have been told, and afterwards they shall be gathered in their habitations." 102 I answered and said, "If I have found favor in thy sight, show further to me, thy servant, whether on the day of judgment the righteous will be able to intercede for the ungodly or to entreat the Most High for them, 103 fathers for sons or sons for parents, brothers for brothers, relatives for their kinsmen, or friends for those who are most dear." 104 He answered me and said, "Since you have found favor in my sight, I will show you this also. The day of judgment is decisive and displays to all the seal of truth. Just as now a father does not send his son, or a son his father, or a master his servant, or a friend his dearest friend, to be ill or sleep or eat or be healed in his stead, 105 so no one shall ever pray for another on that day, neither shall any one lay a burden on another; for then every one shall bear his own righteousness and unrighteousness." 2 Esdras 2:31 ''''''''''''' 1 Reply @none-ng4cl @none-ng4cl 1 month ago Great Stuff! Let's be Healthy Reply @GRB777 @GRB777 1 month ago Is it possible to improve vo2 max through strength-based circuit training? I absolutely hate doing traditional cardio. 3 Reply 2 replies @deemisquadis9437 @deemisquadis9437 1 month ago That work they did, is way too much then necessary! I know the truth. I built my muscle mass without body building lol. Now I am resting because we are going through lots with the sun. Rest right now. Reply @anitabouwhuis6350 @anitabouwhuis6350 1 month ago Hi, I'm 61 years, I sport 5 times a week. 🎉🎉 1 Reply @kelleymoore6080 @kelleymoore6080 5 days ago I read an article a couple years ago that said your ability to bend and touch the floor is also a marker of your "real" age. Reply @angelathomas1159 @angelathomas1159 1 month ago Thank you. 1 Let's be Healthy Reply @JaxFit12 @JaxFit12 1 month ago As long as people dont do gear or minimize gear use as it is prescribed now regularly. Reply @user-pf1st2fy5n @user-pf1st2fy5n 1 month ago Iam right there with this idea of activity and strength training equates with longer life. However why are not body builders and heavy weight lifers understanding the same? Why do they die so young? Reply @chill6789 @chill6789 1 month ago the direction this world is headed in, who wants to live longer 1 Reply @crand20033 @crand20033 1 month ago Don't run on hard surfaces. Your knees and hips will wear out and you'll need to get replacements. 2 Reply 2 replies @KJSvitko @KJSvitko 2 months ago Even children today have signs of artery disease. Fast foods and sugary drinks have long term consequences. There is an obesity epidemic today where over 60% of the population is overweight or obese. What is common today and "NORMAL" is not healthy. The average person today is not healthy and is taking medications. Heart attacks were once only common in people over 65. Today people in their 40 are having heart attacks. Add more plants and vegetables to your diet and less junk and overly processed foods 11 Let's be Healthy Reply @savannahtraderful @savannahtraderful 1 month ago The stat on 65% of people dying within a year after getting hip replacement surgery is an old stat. They've come a long way with that surgery and outcomes are much better now days. 4 Reply 4 replies @EnlightenedRogue24 @EnlightenedRogue24 1 month ago Weight training is medicine. ☝️🥴 1 Reply @marcdaniels9079 @marcdaniels9079 1 month ago This guy sprays stats so fast and so definitively it’s easy to be taken in. He is just one more influencer selling something using fear and promising miracles 6 Reply 2 replies @deemisquadis9437 @deemisquadis9437 1 month ago You can lift the same way with imaginary weights. Easier on the body. Not damaging. Reply @vishalchaudhary-nf6gr @vishalchaudhary-nf6gr 1 month ago viewers get motivated by these type of informational videos, As Planet Ayurveda's Health-related tips and guidance motivate patients Reply @indigenousnorwegianeuropa4145 @indigenousnorwegianeuropa4145 1 month ago When death comes I will embrace it🫵 2 Reply @tonyfisher4113 @tonyfisher4113 2 weeks ago (edited) Psalms 139:16 16 Your eyes saw my substance, being yet unformed. And in Your book they all were written, The days fashioned for me, When as yet there were none of them. So yes you can impact quality of life not longevity of life. Man is brought into the world and our of the world by ways and means all providentially determined by God. Just as with your spiritual birth is accomplished by the power of the gospel of God when God quickens the mind and transforms the heart. Reply @josephakendrick529 @josephakendrick529 1 month ago I am struck by the contrast between the lyrical call of the Blue Zones for long living and this guys narrow, gothic approach to longevity. I'll go with the Blue Zones. 1 Reply 1 reply @lymedog3176 @lymedog3176 1 month ago It’s amazing, most you tube videos who talk about long life and the importance of exercise/ VO2 max use models that are obviously on performance enhancing substances! Those substances or drugs are practically guaranteed to shorten your life! Just like a lot of so called health influencers are on those same substances,so just because you look good doesn’t make you healthy! 4 Reply 3 replies @tonyfisher4113 @tonyfisher4113 2 weeks ago Yes you increase the quality of life and reduce the chances of injury. But you don't add one breathe to your life. Reply @franciscolopez3229 @franciscolopez3229 1 month ago Can mowing a huge lawn once a week and biking to work five days a week be considered a sort of excersise? Plus doing three minutes dead hang everyday? Reply 1 reply @PInk77W1 @PInk77W1 1 month ago Me 62. I do pull ups every day Reply @johnlapham100 @johnlapham100 1 month ago I wonder what the effect of TRT in the elderly would do? 1 Reply 2 replies @paulcohen6727 @paulcohen6727 1 month ago I walk with a cane, not to support my weight, but because dogs leave me alone when I have it in my hand, especially if I shake it at them. Reply @williambailey8931 @williambailey8931 1 month ago Really good listening to this positive out look fine gentlemen helping all if you listen thank you much super stuff. Reply @stephenromey6348 @stephenromey6348 1 month ago Great video - hopefully the many fit people posting here have not taken the jibby jab. If they took one or especially one or more, they have a long road (or in some cases, a very short read) ahead of them. Exercise will not fix that. 4 Reply @dougsalmon1563 @dougsalmon1563 2 months ago "Mass moves mass" Hypertrophy is a better term than "strength training". How many are "overmuscled? Reply 2 replies @janeserovy666 @janeserovy666 1 month ago How does an energy drink affect your body? Reply @bakhtyarjanjua74 @bakhtyarjanjua74 1 month ago Black velvet beans works wonders for any aged lads Reply @undesignated3491 @undesignated3491 1 month ago Tower Rigger, you won't need too much gym, just the odd run to blow cobwebs out. Haven't been sick in over a decade, not so much as sniffles. ! Reply @thedogfather4552 @thedogfather4552 4 weeks ago 💯 Reply @DG-ti1jb @DG-ti1jb 1 month ago Disagree that nutrition is not key. Yes, VO2 max, muscle and strengh is very important but you can never outrun a poor diet. Reply @daniele_osaino @daniele_osaino 1 month ago (edited) So which would be exactly THE exercise we should do you mention in the title of this video? 1 Reply @RS-gn8nv @RS-gn8nv 1 month ago (edited) Just don’t live more. Don’t listen to Peterson. Simple principle. Take your life with ease ! Imposing their ideas on to your life makes you stressed. Stress means cortisol. Means less cognitive skill and libido and energy. Meaning your life is fucked. So keep it simple and just fucking love your life. Do things to reduce stress. One way is gym but more than that - it’s just about getting the TODOs done at the right time. Reply @MartinJutras @MartinJutras 7 days ago (edited) The Western understanding of longevity is so narrow. "Eat this", "do that exercice", lol. Longevity is more complex than that and has much more to do with your thoughts and emotions than what you actually do. Yes, it's important to have a certain livestyle, but you mindset and emotional regulation is way more important. Reply @ianbrown_ @ianbrown_ 3 weeks ago ❤ Reply @tonyfisher4113 @tonyfisher4113 2 weeks ago If you embrace a biblical worldview you will understand that you can impact the quality of your life but you will never impact your longevity. God has determined all the days of your life before you were ever born. I've seen the weakest linger into thier 90s and yet another healthy vibrant person dies in their 50s 60s 70s. It's not longevity it's quality of life that you add to the span of your life. Reply @KJSvitko @KJSvitko 2 months ago You are what you eat. Your diet impacts your health. Lower stress, reduce obesity and more exercise are key to a healthy life. Obesity in children and adults is rising across the world. Fast food and sugary drinks are contributing to the problem of poor health and obesity. Eat a healthy plant based diet and exercise regularly. Reduce or ELIMINATE cows milk, eggs, cheese and meat. Eat more salad greens, beans, fruit and vegetables. Eliminate fast food, snacks like cookies, cakes, chips, and sugary drinks and juices. Every adult and child should own a bicycle and ride it regularly. Regular exercise will help you sleep better. Yoga is a great stress reducer. Obesity is all too common today. Get off the couch. Get off the phone, ipad or video game. A variety of stretching and other exercises help with increased mobility. Ride to work, ride to school, ride for fun. Every city should be a bicycle city. Speak up for bicycles in your community 3 Let's be Healthy Reply 1 reply @a3300000 @a3300000 1 month ago A high vo2 max is hereditary. Reply @TheBlueskyson @TheBlueskyson 1 month ago zero to 3 hrs exercise p/week cuts yo chance of death by 50%? Wow. Lets go! Reply @TheBlueskyson @TheBlueskyson 1 month ago Pull ups are what he's talkin bout. ty Reply @christopherkirkbride5730 @christopherkirkbride5730 1 month ago Unfortunately the youngsters are taking things that will shorten their life to gain muscle. 1 Reply @bwnco @bwnco 1 month ago im 66 my girlfriend is 32, Making a point here.....I worked out since gradeschool, plus I have read Mind books for sports since 8th grade. So MANY PEOPLE AGE THEMSELVES DRIVES ME CRAZY!! stop saying Im OlD, stop talking about old anything!!. tMost people guess me as 50 ish. I have had a ton of injuries from sports but the mind mind mind part also of it people stop destroying yourself. I date young because I love still to bike, climb, ride horses, hunt, without hearing...oh im to old!!! I hang out with people when worked from 22 to 45 ish... I never state may age or say my age unless trying to motivate others.. My body works great dispite tons of pins, screws, rods from injuries. I also suffered years from depression but change way you think an talk an you will Want to do Box steps etc. Elimate from now on ever stating your age! Lie about it... Be 45 for life....!!! God Bless!!! 21 Let's be Healthy Reply 3 replies @jantzfitzgerald6115 @jantzfitzgerald6115 1 month ago In two separate studies one of 20 years and one of 40 years involving tens of thousands of men the number one indicator was as JORDAN SAID. GRIP STRENGHTH. NO DEBATE. NONE. Reply @sunnyfitnessandworkout @sunnyfitnessandworkout 1 month ago Extra ordinary important lacture Dr Reply @sonandsanford4963 @sonandsanford4963 1 month ago Ok, According to an article I read years ago on top 10 things centennials have in common. I only remember 3. 1.None of them smoke. 2.They all drink small amount of wine. 3. They were all consider under weight. Reply @MountainManFred @MountainManFred 1 month ago How does hiking on say the Appalachian Trail once a week fall in to all this? Or hiking similar to that.. Thx Reply @ronaldmiller3619 @ronaldmiller3619 1 month ago Saw a man yesterday doing the rowing machine, 96 Reply @beniirama4076 @beniirama4076 1 month ago i believe you refers to the natural process? because recently there's a trends that body builder die young.. Reply @broadfall1 @broadfall1 3 weeks ago Except getting hit by a car while exercising. That risk of death increases. Reply @user-fk8rb8ue5h @user-fk8rb8ue5h 1 month ago Crikey, my grandma lived to be 98 without doing that exercise and she died from a fall rather than an illness. Maybe if she done that exercise she would've lived to be 1000. Somehow I don't think so,. Reply @bobmanp8653 @bobmanp8653 1 month ago Ill be 100 in 10/67 Reply @2cupojoe136 @2cupojoe136 1 month ago It’s too late, I’m dead.😅 Reply @deemisquadis9437 @deemisquadis9437 1 month ago Not true. We need to rest right now, 😢this isn't true for what we are going through right now, this will kill you. We need to rest. The mass time will come. I did my research ❤ Reply @philipsimmonds1103 @philipsimmonds1103 1 month ago ....and they closed gyms during covid 😂 7 Reply @RoidfreeSenior @RoidfreeSenior 2 months ago preaching to the choir here 2 Reply @MrGtargy @MrGtargy 1 month ago Where is original video/interview??? Don't see a link anywhere. Reply @deavman @deavman 1 month ago I wish influencers would stop using the useless arm curls when demonstrating weight training. It is really making you look silly. 1 Reply @deemisquadis9437 @deemisquadis9437 1 month ago He is selling gym time. Lol😅😂 Reply @greenogre22 @greenogre22 1 month ago sorry, but if you just show bodybuilders here with an enormous amount of muscle mass, then i have to say that those people are normally not the ones who live the longest. why? such people often rely on a lesser natural diet and a pretty amount of odd means to gain that muscle mass. it‘s not how the human body is supposed to be composed. it‘s evident that many bodybuilders have died at a young age. but media is good in a way, right? 😉 it’s so clear that just one value like the vo2max can not be a universal means for having a long life. there are many other factors which are vital as well. it’s never just the one thing because one’s body and it’s environment is too complex. i‘ve got a certain age now and i‘ve experienced a lot of people. the oldest ones were always the ones who had a life with a diet far from industrial food, were often lean but not always, did some sports but mostly in a non-competitive way, consumed only little alcohol and cigarette smoke, were embedded in decent social structures and had not too much stress. having the feeling being self-determined seems to be another key element. i cannot think of a bodybuilder or a competitive athlete, sorry, but i wouldn’t dare to exclude them. the people that are talking here are just media kings in a big city who at this point in time are not even knowing how long they will stay on earth. by the way, city dwellers live shorter than country men, that‘s a fact which you can look for in national stats. it‘s obvious why. it‘s not just the air that‘s more often free from smoke at the countryside. Reply @Athena-le7rm @Athena-le7rm 1 month ago I dont agree. You never have to slow down strengthwise. Keep lifting weights and doing Yoga. Also dont eat sugar or dairy products.. It doesnt change if you keep usuing your mucles, the muscles dont change if you keep usung them. Im proof of this at 77. Reply @le832 @le832 1 month ago Why then do women - statistically- live longer than men when generally men have more muscle and I presume stronger grip strength? 5 Reply 7 replies @d1427 @d1427 1 month ago yep, the blind obsession with long and meaningless lives, at any cost... size is not always the most important thing... Reply @garzascreek @garzascreek 1 month ago 4:24 - How to actually pronounce eccentric: https://www.youtube.com/watch?v=QnALYCszzMg Reply @Thelivelyone @Thelivelyone 1 month ago This is not the same for hamsters . Reply @Thelivelyone @Thelivelyone 1 month ago Kick scooter 😊 Reply @timgrady4630 @timgrady4630 1 month ago Believe THIS if you want to live forever: John 3:16 & Epesians 2:8-9 . Little children can easily understand and believe in Him for His doubtless Guarantee of Everlasting Life , instantly having irrevocable Life at that moment . No better news , ever . Reply 1 reply @johnrodriguez3509 @johnrodriguez3509 1 month ago Where's that one exercise you spoke about ? Reply 1 reply @paulcarlson4230 @paulcarlson4230 1 month ago Why di i have to watch the whole video anytime somebody has some get better quick idea, then just tell me and move on if you really care Reply @anachronistofer @anachronistofer 1 month ago Explain Keith Richards. Reply @Faxismoazigortu @Faxismoazigortu 2 days ago Why does everyone in this video look old? Reply @lowellcalavera6045 @lowellcalavera6045 1 month ago Jordan couldn't lift a wheel of cheese. Reply @yeoweehuathuat8926 @yeoweehuathuat8926 1 month ago Live longer do u hv the money to sustain tht long Reply @jasonschorn3866 @jasonschorn3866 6 days ago Yeah I generally turn to quack psychologists for exercise/longevity advice. Another reason I hate YouTube more everyday. Reply @paulg4672 @paulg4672 1 month ago Start walking backwards too 2 Let's be Healthy Reply @yt_hatesfreespeech @yt_hatesfreespeech 1 month ago workout in bikini? soon there wont be any need for strip clubs in our society hahahaha 1 Reply @gmathieson7184 @gmathieson7184 1 month ago so where's the science on going from 0 to 3 hours a week...back to 0 a week....back to 3 hours a week... rinse and repeat. lol. Reply @JoeMoore0617 @JoeMoore0617 1 month ago Stats, stats, stats, and more stats on how you age out and nothing of substance on the exercises you can do to prevent or reverse the effects. 2 Reply Let's be Healthy · 3 replies @garrettweiner7924 @garrettweiner7924 1 month ago At 6:15 the guy doing push-ups has very bad form…just asking for a shoulder injury nor is he getting a full range of motion… Reply @deemisquadis9437 @deemisquadis9437 1 month ago Weight is to build bones, the only way you can keep density in your bones is lift weights, and it only takes 5 lbs. This man knows nothing about what he is tell you. I was told that I would advance into a wheelchair like that. I call them a liar, I am proof they are a liar. Get the truth. Don't listen to this man. He is estimating everything, no proof of anything. 😢 Reply @ervinreyes6302 @ervinreyes6302 1 month ago Thanks bezos Reply @chattactics5804 @chattactics5804 1 month ago First, never drink as much as Jordan. Reply @donaldleegrim9756 @donaldleegrim9756 1 month ago LOVE AND BEING NEEDED IS A IMPORTANT Reply @MrDamon888 @MrDamon888 1 month ago Still gonna die in the end 3 Reply @anna-tn8mg @anna-tn8mg 1 month ago What did humans do without you and yours "do this exercise before it's too late?" Ah, they all died. So will you with this nonsense and me who despises all this and, frankly, the last thing I need is lifting. Ah, actually, some had long lives. Artists come to mind immediately: Titian, Michelangelo, Wit Stwosz (Veit Stoss), etc. Reply @user-js2kf7ds6x @user-js2kf7ds6x 1 month ago I hate these fruadsters who put up FAKE photos on the ads for their videos that have NOTHING to do with what's in the video itself. This is a classic example. Move on. Fraudster here. Reply @pramodksharma3298 @pramodksharma3298 1 month ago Facebook harassed whats up chief he resigned explaining to zackerberg in detail how your staff entered everything in his bed room tak Par woh admi tha me tuje maut tak dinkha dunga facebook Reply @sunestjern3749 @sunestjern3749 1 month ago Thanks! goodvibesthanksdocwashhandswashhandswashhands💯💢👍👍👍💥🍀🌺🍀🌺🍀🌺🍀🌺 Reply @user-il1nx9bl9z @user-il1nx9bl9z 1 month ago Go snowboarding 🏂 Let's be Healthy Reply @PeterKKraus @PeterKKraus 1 month ago Isometrics Reply @larrym2434 @larrym2434 1 month ago Make face and point finger Reply @jeroenberger9064 @jeroenberger9064 1 month ago (edited) Total bs Reply @kraftwerk974 @kraftwerk974 1 month ago Funny all these images of men juicing... 1 Reply 2 replies @bouldernelsonbigfoot @bouldernelsonbigfoot 1 month ago (edited) . Delay loss of muscle, period, F ur grip strength theory bs, lol. Reply @pramodsharma8912 @pramodsharma8912 1 month ago fb still teaching neibhours i v some god kanaiha kumar hinjde n hinjde would selling at fb Reply @s.wesley6707 @s.wesley6707 2 weeks ago I highly recommend Dr. Attia's book Outlive. Reply @silviawillers @silviawillers 1 month ago learn one important rules: not make first cardio and than muscle training. do one day running, next day pilates or stretching. or break. 3. day muscle training full body. and so you find more and more your favorite, your praxis. and take subblements how: zinc, selen, mg, creatin, eaa`s, chrom. and go googeln what you can/n´T take together or not. vegan eating: creatin kapseln and ahferdrink with erbsen-protein.shake. or pane cake powder. kokos öl is the best oil for all. for healting, egg`s, pane cake, or vegetable. its can help by herbezide...pestizide... glyphosat if you do it in potatoe water.. not take butter, take kokos oil Outlive by Peter Attia - Animated Summary 247,598 views Jun 3, 2023 I waited a very long time for this book, and now that I am done with it, I'm happy to share what I learned from it with you! IMPORTANT SIDE NOTES: I made a mistake in 1:18 when I say that saturated fats raise triglycerides and cause heart disease. Triglycerides are simply a contributor to apoB when they are high, but apoB is what negatively affects the heart. Saturated fats can directly increase apoB particles, but they have no effect on triglycerides (carbohydrates do), and that’s why they can be bad. In short, keto will almost certainly lower triglycerides (regardless of the saturated fats consumed) because carb intake is so low, but saturated fats on their own can increase apoB and negatively affect the heart. I made a second mistake in 2:41. The olive oil group was provided with a liter of olive oil a week, but they were required to consume at least 4 tablespoons a day (28 tablespoons a week), not the entire liter. Sorry about that! I’m not an expert, just a fan, but I'll be more careful with the information I put out from now on. Disclaimer: This is NOT medical advice! Outlive: The Science & Art of Longevity: 00:00 Medicine 2.0 vs. Medicine 3.0: 00:23 Heart disease: The Deadliest Killer On the Planet: 00:45 Keto (MISTAKE HERE, READ DESCRIPTION): 1:07 PREDIMED Trial (MISTAKE HERE, READ DESCRIPTION): 2:15 Flossing and Sauna: 3:32 Lipid-Lowering Medications: 4:24 Omega-3 Fatty Acids: 4:56 Exercise: The Most Powerful Longevity Drug: 5:50 Alzheimer's Disease and Other Neurodegenerative Diseases: 7:18 Sleep: 8:59 Cancer: 11:02 Fasting with Cancer: 13:50 Immunotherapy: 14:25 Continuous Glucose Monitoring: 16:48 Stability: 18:16 Rapamycin and mTOR: 18:52 Metformin: 20:48 Fasting and Protein: 21:31 Buy the book here: http://bit.ly/3CafZnu Stability exercises: https://peterattiamd.com/outlive/videos/ Chapters View all Transcript Follow along using the transcript. Show transcript Love Sense 15.7K subscribers Videos About 235 Comments rongmaw lin Add a comment... @hjander @hjander 2 months ago It is not easy to accurately summarize another person's words and thoughts, especially when it applies to such a complex discipline like medicine. Well done!!! 28 Love Sense Reply Love Sense · 2 replies @tywonellington @tywonellington 3 months ago Regarding the case of the guy who "cured" himself with fasting: If you have severe cancer, losing muscle and testosterone isn't a huge issue, as your priority is immediate survival. If there is no immediate threat to fix, it MAY be a better idea to have the muscle mass and robustness associated with protein intake and not regularly fasting. This could protect you against other future threats, as well as increasing quality of life. Attia's recommendations aren't necessarily about living the longest possible life to the last second, but living the longest healthy, rewarding life. 49 Reply 2 replies @maya8792 @maya8792 3 months ago I really needed this. I love the book, but many people in my life, who need it, will simply not read it. I do hope they can get trough this excellent summary. You rock! 36 Love Sense Reply Love Sense · 2 replies @dieudonnejb @dieudonnejb 12 days ago Great job at summarizing such a complex book! 1 Love Sense Reply Love Sense · 1 reply @CD318 @CD318 2 months ago Great job--love the summary of Peter's book. 6 Love Sense Reply Love Sense · 1 reply @leypek8948 @leypek8948 3 months ago Thanks for this great video! I am a bit confused about what to do because of the two schools of thought when it comes to protein intake. I read Dr Valter Longo's book two years ago who says too much protein is bad (but he also says after age 65-66 we need more protein) and now I am learning about Dr Attia's ideas. 5 Love Sense Reply Love Sense · 1 reply @alexcalive @alexcalive 2 months ago This is brilliant! Thank you for your effort making this video! 5 Love Sense Reply Love Sense · 1 reply @rijd2304 @rijd2304 4 months ago Let's not forget mindfulness meditation. This book goes well along with the one titled "30 Days to Reduce Anxiety" by Harper Daniels. 23 Reply 1 reply @edwardwong654 @edwardwong654 3 months ago This is an excellent video and summary of Outlive. Thanks for doing it. 39 Love Sense Reply Love Sense · 1 reply @tallybrillembourg6211 @tallybrillembourg6211 3 months ago Outstanding synopsis of Peter Attia’s book “Outlive”! Your technique is most appealing ! Your take on analyzing what bothers you about the book is most helpful! Grateful to you! Looking forward to more reviews! Have you done “Life Span”? 12 Love Sense Reply Love Sense · 2 replies @Kommentar125 @Kommentar125 3 months ago Love your summaries. Looking forwar to the next videos 😍 5 Love Sense Reply Love Sense · 1 reply @markanderson1448 @markanderson1448 1 month ago Thank you so much! Very informative! 1 Love Sense Reply Love Sense · 1 reply @jnic2165 @jnic2165 3 months ago What a great video, I loved the book and this summary is easy to understand for people like me who don't have a great understanding with the technical pionts in Peter's book 5 Love Sense Reply Love Sense · 1 reply @utek66 @utek66 1 month ago A+ summary. Thank you for this. 1 Love Sense Reply Love Sense · 1 reply @aulusagerius7127 @aulusagerius7127 2 months ago I have the book now, from the library, after a long wait. You got more out of it than I did - I'll try harder! I especially appreciated the sections on exercise and stability. I also was confused by the section on fasting, intermittent fasting. I have also learned to trust Roger Seheult at Medcram during the last 3 years. 1 Reply @evadeanu1 @evadeanu1 7 days ago Awesome video! I’m reading his book now. Thanks. 1 Love Sense Reply Love Sense · 1 reply @ethercept @ethercept 3 months ago Great summary thanks I love people like you who do some videos that I can send to friends and family that will never actually read the book, cheers 5 Love Sense Reply Love Sense · 1 reply @prslespaul @prslespaul 3 months ago A majority of the studies I've come across indicate caloric restriction in general improves lifespan, which is not specially limited to a fasted application. Especially intermittent fasting which Attia has said in several podcasts, doesn't take advantage of cell autophagy. Which is the main known benefit of fasting. 4 Reply 2 replies @deborahkearns2656 @deborahkearns2656 2 months ago As I was listening to your summary of the book there were red flag that my institution said that doesn’t feel right to me and all the research I have done . I am a firm believer. You take what you need only the rest there… I was pleasantly surprised to see that at the end of this video, you have the same thoughts as I did… Yes, I’m grateful that the book was written, and I may check it out… But I agree with all your comments at the end. 1 Reply @philforrence @philforrence 2 months ago Great stuff! Any plans to do this for more books? 6 Love Sense Reply Love Sense · 1 reply @kuzdogan @kuzdogan 3 months ago (edited) The difference between Peter and others about protein can be because Peter, I feel, gives importance to the healthspan and this includes having a sound body. As he says being "a kickass 90 year old" and being able to play and throw your grandchildren. Now you don't necessarily have a broken body if you don't, but odds increase by far. I also agree it's not worth the risk and having higher life quality is sometimes more important than living longer. Edit: He discusses the tradeoff here as far as I can remember https://youtu.be/BqmG2y4IeY8 3 Love Sense Reply 2 replies @DiegodelaVina @DiegodelaVina 3 months ago Amazing summary, thank you. 4 Love Sense Reply Love Sense · 1 reply @TSLApilot @TSLApilot 3 months ago (edited) 2:45 As I’m reading it, they had to consume >= 4 Tbsp per day(0.4 L) of olive oil, but they were provided with 15 L per 3 months to account for the family’s needs (so make sure they had an adequate supply of olive oil). 1L per week of olive oil would equal about 8500 calories per week, …even the 4 Tbsp amounts to about 3400 calories per week of just olive oil. 5 Reply Love Sense · 4 replies @andrehalim469 @andrehalim469 2 months ago Great summary ... of what turned out to be a very complicated protocol. 1 Reply @merceneuman6377 @merceneuman6377 4 months ago Thank you! very insightful and the information is well sectioned 5 Love Sense Reply Love Sense · 1 reply @oscarcarrillo2016 @oscarcarrillo2016 3 months ago Great summary. Haven’t read the book but I’m very familiar with Peter Attia’s perspectives. Interesting that he left off the blue zones and find the fasting/blue zone/mtor/rapamycin stuff conflicting. I tend to think some mild fasting AND a little more protein is probably the best combo as one ages. 8 Reply 5 replies @Anima7e @Anima7e 3 months ago Just discovered your channel, you got really interesting topics. Keep going!! 4 Love Sense Reply Love Sense · 1 reply @rowantree198 @rowantree198 3 months ago The problem with extended fasting is its implementation in the general population. The benefits of "daily fasting" by skipping breakfasts are similar to caloric restriction, so take your pick. Only a few people are willing to choose 3+ days without eating for the additional benefits. Doing an extended fast safely and effectively is another discussion. The downside of extended fasting is hypoglycemia, gallstones, osteoporosis, increased stress, social isolation, eating disorders, and more. You don't often hear about those. Also, a large subset of the population is overweight and malnourished simultaneously. They need to both decrease calories and change to healthier foods. You set them up for success by making a variety of small habit changes over time. 11 Reply 2 replies @onzbrau @onzbrau 2 months ago Great you pointed out the high protein contradiction, also worth mentioning that Dr. Valter Longo, who pioneered the research on fasting (and FMD) in cancer patients, recommends the opposite of Peter's advice. As much as I love Peter and his work, he's a passionate hunter and lifter, so there is clearly some confirmation bias here. He has a lot of personal reasons to eat high amounts of animal protein, and he wants to hold on to extra amounts of muscle that's not required outside of the gym. 4 Reply 2 replies @21972012145525 @21972012145525 2 months ago This was great. Appreciated! 1 Love Sense Reply @alexakalennon @alexakalennon 3 months ago The way I thought of it is, people who are mentally sharp have a good grip strength, but it not because they train handmuscles, it's because of overall muscularity which leads to a higher grip strength. One can't just train hands and stay sharp 4 Love Sense Reply Love Sense · 1 reply @armandofelipe3462 @armandofelipe3462 3 months ago Thank you for this video 🙌🏻 4 Love Sense Reply Love Sense · 1 reply @Sirianphillips @Sirianphillips 3 months ago High value video bro. Good job. 7 Love Sense Reply Love Sense · 1 reply @ludobmw540i @ludobmw540i 3 months ago Great review, I personally follow almost all his guidelines. For rapamycin I use a 13mg 2 weekly dose like Bryan Johnson 5 Love Sense Reply Love Sense · 1 reply @Hambo04 @Hambo04 3 months ago Thank you, appreciate your summary. 2 Love Sense Reply Love Sense · 1 reply @ninobach7456 @ninobach7456 2 months ago excellent video, I found it really interesting. Though I will say that oftentimes I wonder if correlation and cause were confused. For example, how do you get a lot of grip strength? By working out, by actively building something with your hands etc. Maybe its just that people who do this, will not get neurodegenerative diseases. Because I doubt that artificially training grip strength with a specialized machine will make your brain function much better. Reply @mxdhxv9 @mxdhxv9 4 months ago Amazing content ❤ 4 Love Sense Reply Love Sense · 1 reply @FreeSpirited01 @FreeSpirited01 3 months ago So helpful this is! 2 Love Sense Reply Love Sense · 1 reply @vegtalk8920 @vegtalk8920 3 months ago (edited) In predimed trial the low fat diet was not mediteranian. It was AHA recommended diet. And it turned out not to be low fat it had 37% calories from fat which is higher fat than average american diet that has 35% of calories from fat. 4 Reply @faisal-ca @faisal-ca 3 months ago Saw an interview where Peter Attia said he doesn't do Keto anymore. For practicality reasons. 7 Love Sense Reply Love Sense · 1 reply @augustin19tube @augustin19tube 5 months ago my man!! thanks for the always interesting content 3 Love Sense Reply Love Sense · 1 reply @williammartin9450 @williammartin9450 2 months ago I did try to get through Attia's audiobook but as many, many people have said the book is overly long and jumps all over the place trying to cover all possible bases in order to support his own view of himself as a leading authority on everything. You have only confirmed my own and others' opinions on this book and the good doc. Another YouTube legend who crowned himself king. 1 Reply @mayurteli91 @mayurteli91 4 months ago Thank you for sharing ❤️ 2 Love Sense Reply Love Sense · 1 reply @mariams1031 @mariams1031 3 months ago Your personal comments at the end of video (on what left you confused) was what I enjoyed best 7 Love Sense Reply Love Sense · 1 reply @27Gmyz @27Gmyz 4 days ago You should further check the types of proteins David and Steve talk about. Animal protein is not something those authors promote. In fact, you can go with proteins from legumes, fruits, and vegetables while minimizing the amount of animal proteins, and still consume optimal levels of protein. Reply @susanarodrigues1579 @susanarodrigues1579 3 months ago Thank you so much for this resume 2 Love Sense Reply Love Sense · 1 reply @k14pc @k14pc 3 months ago Thanks for the summary. On the ending, that whole topic I think is legitimately up for debate and is not settled, that's why it's confusing. One side will say that we have rat studies where high protein levels are bad, the other will say in that same study a combination with high protein was longest lived. One side will say blue zones, the other side will say most blue zones likely exist due to welfare fraud rather than actually longer lifespan. One side will say human correlational studies show high protein is bad, the other side says those are just correlations and are likely picking up confounds, etc etc. Fwiw how I'm practically thinking about it: all else equal less calories is obviously good, fasting per se is probably good for cancer treatment and maybe cancer prevention, the biggest downside is muscle loss which is important so if you are at risk of sarcopenia or could just use more muscle I would focus on that over fasting 2 Reply @lucymouse8012 @lucymouse8012 3 months ago Petter is huge on protein/amino acids but takes rapamycin to inhibit mTor for longevity. I guess it’s up to one to decide how much muscle/gain can be traded for autophagy Reply 1 reply @KJSvitko @KJSvitko 3 months ago You are your own best health advocate. Eat a healthy whole food plant based diet, reduce stress, get adequate sleep and exercise regularly. Every adult and child should own a bicycle and ride it regularly. You will be healthier, happier and have lower transportation and health care expenses. Make a bicycle your first choice for short distance travel. 6 Reply 1 reply @ChicoValenciaTv @ChicoValenciaTv 3 months ago Great review, thanks bro! 2 Love Sense Reply Love Sense · 1 reply @ScrapPalletMan @ScrapPalletMan 3 months ago I have attention deficit and find reading difficult. Thank you for this summary. Seriously 4 Love Sense Reply Love Sense · 1 reply @nichtsistkostenlos6565 @nichtsistkostenlos6565 2 months ago (edited) The research on lifespan and consumption of protein is mixed. The research on healthspan and consumption of protein/muscle growth is extremely clear. If you want to have as long of a healthspan as possible and live an enjoyable life into your 80s and 90s, you will need the excess muscle tissue and training of those muscles to maintain your mobility into your later stages of life. I've found that Peter is much more thoughtful about the balance between healthspan and lifespan than most other people in the longevity space which is what has led him to different places than others. Reply @susymay7831 @susymay7831 2 months ago Hidden gem channel!!💎 1 Love Sense Reply Love Sense · 1 reply @tobiash_k3229 @tobiash_k3229 3 months ago Grip strength alone is a signifier for your mind muscle connection and therefor a good and easy indicator for your fitness. Don't confuse this for the causation. People who work manually, typically have great grip strength values. But it is the physical work and movement- often outside- that keeps them young and fit. Training your grip strength alone does not hurt, but it is a big problem of the longevity movement to manipulate biomarkers, using supplements that move them, instead of treating the cause of that set biomarker: E.g. if you only train your grip strength and do cardio, you will look great on certain tests because they feature a those exactly. Still you need to do real training and physical labour along with maybe some complicated movements, that challenge neuroplasticity like playing an instrument to really prevent the degrading of that part of your brain. 3 Love Sense Reply Love Sense · 2 replies @mikeyd7733 @mikeyd7733 2 months ago There is no study demonstrating that animal protein in isolation is linked to shorter lifespan. It is silly to come to the conclusion that "This person ate more meat and had cardiovascular issues therefore meat is the problem". The majority of the meat consumed in industrialized countries is factory farmed and loaded with saturated fat and preservatives. Attia is spot on with this topic. Add clean protein and exercise to utilize it properly. Do not avoid animal protein due to an incorrect fear it is dangerous, just be selective with the sources. 1 Reply @traceler @traceler 7 days ago You forgot to mention the top gerontologist in US who has done most of the research on fasting and fmd creator Valter Longo PhD as well as Mark Mattson who ignite the " Intermittent Fasting" thing and did a lot of research on fasting and brain at John Hopkins Medical school, they advise against high protein diet ... you can read more about Valter Longo in his book " The longevity Diet" 1 Reply @protoplast.youtube @protoplast.youtube 3 months ago thanx!!! + really GREAT 👍🏻 that you keep being sceptical/critical!…. (cos me too i think fasting helps a lot cod of autophsgy and too much protein = silly) 1 Reply Love Sense · 1 reply @chuckkolb1270 @chuckkolb1270 3 months ago I, too, question the amount of protein and fasting. Intermittent fasting - yes - but I do no prolonged fasting. Exercise and healthy diet mostly plant based are the keys for the vast majority of people in my opinion. 1 Love Sense Reply Love Sense · 1 reply @Cass-gi4kk @Cass-gi4kk 3 months ago I hate the fact that now that I moved away from Finland, everyone says you should use Sauna. 72 Love Sense Reply Love Sense · 13 replies @21972012145525 @21972012145525 2 months ago Peter attia for health czar! Reply @gillonblank @gillonblank 3 months ago You make it sound like Peter Attia promotes a specific diet or food in the book outlive. For nutrition Peter Attia states that the studies on nutrition are confounded and don’t even show great changes in the hazard ratio. At end of the chapter he suggests that if he did not mention your special diet or food, it is better to get out and exercise. 7 Reply @killaknut @killaknut 3 months ago Thanks for the summary, it sounds like I can skip this one. As you point out Peter has a number of rather odd views on things, which the more credible sources go against. I would recommend How Not To Die, for fact based nutrition, which is really the core of it. Reply 1 reply @deborahw5777 @deborahw5777 5 months ago Thank-you GREAT REVIEW 2 Love Sense Reply Love Sense · 1 reply @rahabosornotorroella3755 @rahabosornotorroella3755 3 months ago I think Peter Attia is right about proteín. I am not sure thouth. I do know I feel a lot better when I eat more proteína and exercise more. 4 Love Sense Reply Love Sense · 1 reply @michealfriedman7084 @michealfriedman7084 3 months ago Your triglycerides will not increase from saturated fat. Your triglycerides will increase from eating an excessive amount of sugar and grains. 3 Love Sense Reply Love Sense · 1 reply @21972012145525 @21972012145525 2 months ago I think what’s confusing about peters fasting recommendation is that he fasts himself. He should signal what he actually does to ensure he meets his nutrients 1 Love Sense Reply Love Sense · 2 replies @tommyiaq @tommyiaq 3 months ago CGM are avaiable without prescription, at least in Italy. Reply @Wellston-ec7qv @Wellston-ec7qv 3 months ago @12:37 per David Sinclair, it's actually not the AMOUNT of food they ate or that you eat, but the longevity is from eating at one time each day, which means you're not eating for all the rest of the day. actually the longevity effect occurs due to genes turned on after about 8-12 hours of not eating, genes which cause cellular autophagy; a general repairing and clean up mechanism. in theory, you can actually eat 3 meals in 1 if you do it all in 1 hour's timeframe per day and get the same effect, so technically to say "if you eat less" is incorrect 1 Reply @michaelcale272 @michaelcale272 2 months ago ❤ thanks 2 Love Sense Reply Love Sense · 1 reply @heimatau06 @heimatau06 3 months ago man the first couple of mins of this video is not my key takeaways from the book at all. sure he talks about keto but that's in relation to one of the "four horsemen" (metabolic dysfunction,) and also on how that type of diet may be useful when combating neurogenerative disease. also, the bit on flossing and sauna are correlated but not causal. (eg like the bacteria found in the mouth related to gum disease has also been found in folks with dementia in larger numbers than those without gum disease, but in the book he admits the relation is still unclear) 3 Reply 1 reply @pardogg @pardogg 4 months ago Saturated fat may cause apoB counts to rise which is a risk factor for coronary artery disease. Can you please double check your information since you reported it was the rise in triglycerides that is bad for the heart. apoB particle count is more relevant to cardiovascular disease risk than serum triglycerides, generally speaking. 4 Love Sense Reply Love Sense · 5 replies @deanchance1442 @deanchance1442 2 months ago He says he's not into keto anymore in the book 2 Reply @CraigHocker @CraigHocker 1 month ago This is a nice summary. I have issues with the metformin part in that Peter did a recent journal club with Huberman in which pretty much rips up the whole idea of metformin as a longevity drug. So it sounds like the book is already out of date on that. I strongly disagree Peter about fasting. Not because of what Sinclair or Gundry says, both of whom you should really be very skeptical of as authorities in longevity - they have far too many conflicts of interest due to the businesses they are involved in. No, it’s because Peter will admit that he is a compulsive intense exerciser. He would do heavy workouts even when prolong fasting and that is something all the research shows you should NOT do if you want retain lean tissue while fasting! One does not lose muscle mass if one does only moderate exercise such as walking during prolonged fast. One should not be totally sedentary but one should engage in intense exercise either. Mild, moderate activity. So yes, if Peter can’t do that, then he shouldn’t engage in regular prolonged fasting if he wants to maintain muscle mass. For saner folk without his compulsions, his choice isn’t the way. There is also a good deal of evidence higher levels plant derived protein don’t have the downsides of higher intake of animal protein, so if one wants the benefits of higher level of protein suggested over 65, choose to increase plant derived protein intake rather increasing animal derived protein. Reply 2 replies @vikitor21 @vikitor21 1 month ago Love the video and the animations Could dial down the music, you've got a nice voice and the music makes it harder to understand Reply @dude861 @dude861 2 months ago First of all, Attias Book is very good and your summary is pretty much on point. Besides that, Steven Gundry is a con. Don't even consider whatever he says. Sinclair is not a con, he is probably a good researcher on his field, but nutrition is NOT his field. His point of view on animal protein is garbage because he is basing this almost entirely on animal studies that simply cannot refer to humans. Mices are omnivores with a very clear and big focus on plant based foods. Humans evolved on meat and became the biggest and by far most skilled hunters on the planet. And humans don't live in a lab with full time care and in a germ- and stress-free environment. There a no mechanistic human studies that show animal protein could be harmful for us. The only human studies he refers to are epidemiological and basically show nothing. However, there are tons of studies that show plant based diets can harm us. Sinclair also said, that "when you eat is far more important than what you eat" - and that's probably the dumbest and worst nutritional advice I've ever heard of. Reply @mr_heathen6319 @mr_heathen6319 3 months ago Well this was a joy... 3 Love Sense Reply Love Sense · 1 reply @robert111k @robert111k 3 months ago The Blue Zones thing is a bluff. Sardinia is one of them and it is qlso a European region. According to official statistics from Eurostat (the UE statistics agency) it don't even make the top ten among the European Regions in life expectancy indicators Reply @waynela3485 @waynela3485 3 months ago There are articles that kind of debunk the Blue zone studies. 1 Love Sense Reply Love Sense · 4 replies @tedcat117 @tedcat117 4 months ago Lipid Lower Meds and Early Health screenings AKA not covered by insurance... 3 Love Sense Reply Love Sense · 1 reply @EstelaAletse @EstelaAletse 3 months ago Regarding Keto: Is not what Peter recommends. He has said and written, that Keto is not sustainable. He does recommend to have a good quality source of protein. You need to get those facts right. 4 Reply 2 replies @peterfrancisharris @peterfrancisharris 2 months ago (edited) Attia is wrong on statin use. A meta study on statin use ($1trillions sales world wide) have shown that they increase longevity by about 3 or 4 days, statistically insignificant, with considerable down side regarding side effects. Reply @blahizake @blahizake 3 months ago Hilarious to have a statin on the thumbnail. Like it’s somehow synonymous with health and longevity. Future generations will look back on statins and be completely bewildered that their grandparents were alive when people took them. 1 Reply @jerryjoyce5781 @jerryjoyce5781 3 months ago Hong Kong consumes more meat per person (1.5 pounds per day) than any other nation, with a life expectancy of 84.3 years, the worlds highest. India has the second lowest meat consumption in the world and a life expectancy of 68.3 years. I know there are a lot of other variables. I would like to see long term carnivores and long term vegans both do an age test., such as True Age or Novis. WE have the technology now to tell if what you are doing is making you older faster or slower. I think there are many more variables in the Blue Zone than just diet also. I can't be that restrictive with my diet either way. Reply 2 replies @EdwardsNH @EdwardsNH 5 days ago Cancer survival rates are drastically better! They just past 50%!! What you misinterpreted was that once cancer has metastasized... those rates haven't changed much Reply @alphabeta8403 @alphabeta8403 3 months ago 9:25 Importance of good sleep 11:20 Preventing cancer 14:00 Fasting and Immunotherapy 16:55 Glucose monitoring 18:00 Stability 21:00 Metformin 21:30 Fasting-Protein is the most important macronutrient 22:40 Animal protein can be problematic 8 Love Sense Reply @Yes-Yes1 @Yes-Yes1 2 weeks ago Fasting might be beneficial in some aspects but it also kills testosterone levels. Which is essential for men. Reply @0hleg @0hleg 3 months ago Can you make a video like this but on testosterone? 1 Love Sense Reply Love Sense · 1 reply @zibtihaj3213 @zibtihaj3213 3 months ago Thx a lot , what about David Sinclar book - so one for that also pls 2 Love Sense Reply Love Sense · 1 reply @jimmiferfreddette8583 @jimmiferfreddette8583 3 months ago You should have time stamped this 1 Love Sense Reply Love Sense · 1 reply @tommyiaq @tommyiaq 3 months ago Sleep should be 7 to 9. Reply @georgeharrisonOK @georgeharrisonOK 3 months ago 2:45 how on earth can someone consume A LITER (1/4 gallon) of oil in a week???? 1 Reply 1 reply @LoLHahaLolHahaLol @LoLHahaLolHahaLol 3 months ago (edited) What’s a sownaa ? ?🤣😂🤣 😭😭good video thank you 🙏 ❤ P.s. very recently metformin has been debunked 😢😢I take it for type 2 diabetes so it’s bad news 🗞️ for me 🥺😤😳 you should do the carnivore diet next 😈on the channel 🍖 🥩 🙏❤️❤️ 1 Reply @FoldedArt @FoldedArt 2 months ago I don't find the study on (Mediterranean) diet very convincing. The confidence intervals between estimates overlap, and I don't see the authors presenting statistical tests that can discern the effects of the diets. Even if you take the estimates at face value, the differences between groups aren't shocking. 1 Reply @ybwang7124 @ybwang7124 3 months ago 'could' 'potentially' work in a population that, surprisingly, already take to sauna as a national past-time. Confirmation bias? Reply @hupat77 @hupat77 3 months ago AI voice is hilarious ! 1 Reply @tashfit6323 @tashfit6323 3 months ago Well doNe 1 Love Sense Reply Love Sense · 1 reply @FrankWalking @FrankWalking 3 months ago Noel from Frasier narrating Reply @tconcotelli @tconcotelli 2 days ago Carbs increase triglycerides, not fat. Love Sense Reply Love Sense · 1 reply @cmacmenow @cmacmenow 3 months ago Fasting! 2 Love Sense Reply @daveouterspace @daveouterspace 2 months ago I need a sowna Reply @345kobi @345kobi 3 months ago 10 2 Love Sense Reply @arbiter3297 @arbiter3297 3 months ago "She" basically explains @ 9:14?? Uh, Peter is definitely not a "she". 1 Love Sense Reply Love Sense · 1 reply @kaylagentz4964 @kaylagentz4964 2 months ago Lost me at Keto lol Reply @melarchuleta8886 @melarchuleta8886 2 months ago (edited) Sow na ??? Try sauna saw na Reply @user-wp4sl6vq3v @user-wp4sl6vq3v 3 months ago Was this AI generated? 🤔 2 Love Sense Reply Love Sense · 1 reply @KTravRuNEr @KTravRuNEr 3 months ago Nothing new in this book. Good for the public to read though. 2 Love Sense Reply 1 reply @felixschaffer7708 @felixschaffer7708 2 months ago bro nice video, but stop that annoying background music 1 Reply @icebox_Intruder @icebox_Intruder 2 months ago They researched racist monkeys for longevity? Interesting. Reply 1 reply @CIA.Langley @CIA.Langley 3 months ago Joke of a book. Reply 1 reply @shutthefuckupbiatch @shutthefuckupbiatch 3 months ago A liter of olive oil is ~8000 calories that's about half a week worth calories for a large male, most of it for a female. 3 Peter Attia on Lifespan, Healthspan, and Outlive 9/25/23 EconTalk 2,190 views Sep 25, 2023 We spend too much of our health care focus on lifespan and not enough on healthspan--the quality of our life as we get older. So argues Dr. Peter Attia, author of Outlive: The Science and Art of Longevity. Attia speaks with EconTalk's Russ Roberts about what kills us, what slows us down as we age, and the weapons we have to allow us to live better and longer. Links, transcript, and more information: https://www.econtalk.org/peter-attia-... Subscribe to EconTalk on YouTube: / @econtalkwithruss Apple Podcasts: https://podcasts.apple.com/us/podcast... Stitcher: https://www.stitcher.com/podcast/econ... Spotify: https://open.spotify.com/show/4M5Gb71... and wherever you listen to podcasts. Transcript Follow along using the transcript. Show transcript EconTalk 18.9K subscribers Videos About EconTalk Podcast Archive - Econlib Discover more at EconTalk.org 7 Comments rongmaw lin Add a comment... @ShalomFreedman @ShalomFreedman 1 month ago The last part of this conversation was very surprising. In all the conversations of Econtalk that i have listened to Russ Roberts has been friendly, considerate and generous. Each person he speaks to is spoken to with respect. And there is praise for the work or thought discussed which may in fact seem more than it deserves. It is very difficult to see the self-described angry Russ Roberts in this conversation. The Russ Roberts I have witnessed interacting with many people is a smiling warm and shining countenance. I have never witnessed anyone so welcoming of so many others. And I have often admired and envied his ability to communicate so warmly with so many others. So where is the angry Russ Roberts hiding? 1 Reply @c5jp904 @c5jp904 1 month ago Great discussion! A lot of this was discussed by Dr. Dean Edell on his radio show and his two books Eat Drink and Be Merry and Life Liberty and the Pursuit of Healthyness well over 20 years ago. 1 Reply @marcbolan1818 @marcbolan1818 1 month ago Healthcare is holisitic and numbers are meaningless without actionable insights that are easy to translate to patients. Most humans will not begin to engage in healthcare until 40+ A lot of great talk on fine tuning here for those who are focused on their health (more likely to be motivated by actionable insights), but the majority of chronic cases consuming healthcare spend today are not taking the responsible steps to be their own stewards of their own healthcare: fast food multiple times a week, high sugar intake; high fat; processed foods; alcohol intake; smoking; abusing drugs. Reply @robinmcbride4057 @robinmcbride4057 1 month ago Interesting that you picked out emotional health as the key issue, a theory of moral and emotional sentiment. The real 'wealth' of nations is the quality of emotional transactions with others. 1 Reply @bennguyen1313 @bennguyen1313 1 month ago Regarding the 30m-46m mark on colon-cancer screening.. aside from asking your endoscopist’s adenoma detection rate (ADR) , Cecal intubation rate , number of perforations they caused, major intestinal bleeding episodes during routine screening, and their withdrawal time... why is that some clinics give you the OPTION to be asleep and others let you watch on screen? I would think that if you can manage some discomfort, the latter would be much safer than induced-coma. BTW, would love to hear Peter discuss screenings with Vinay Prasad! Regarding the 1h5m on a prostate app (name?) and how the risk is better estimated using PSA velocity (should be less than .45) and PSA density (should be less than .1), any thoughts on Andrew Vickers' 4Kscore vs Prostate Health Index (PHI)? On the MedCram episode, Peter talks more about the prostate (48m), but doesn't mention the name of the app! Reply @FlamingBasketballClub @FlamingBasketballClub 1 month ago 11:00-12:00 I like the question that Russ asked in today's podcast episode. Reply @HoobaBros @HoobaBros 1 month ago excellent 1 Reply the transcript: Outlive: The Science & Art of Longevity 0:00 of all the longevity doctors out there 0:02 Peter attia strikes me as one of the 0:04 most trustworthy so years ago when I 0:06 heard him say that he was writing a book 0:08 I knew I was going to read it as soon as 0:10 I could I got the book shortly after it 0:13 came out and finished it in a little 0:15 over two weeks and in this video I'll 0:17 talk about the things that I found the 0:19 most interesting in Peter attia's book 0:21 on longevity outlive Peter is frustrated Medicine 2.0 vs. Medicine 3.0 0:24 with the current medical system that 0:26 begins treating patients once they are 0:28 already sick he calls this medicine 2.0 0:31 and believes that the system should 0:33 change and help people prevent diseases 0:35 in the first place he calls this 0:37 medicine 3.0 and although he talks about 0:39 a lot of things that can help people 0:41 heal after getting sick his book is 0:43 mainly about prevention heart disease is Heart disease: The Deadliest Killer On the Planet 0:46 the leading cause of death in the United 0:48 States and Peter was especially afraid 0:51 of it because a lot of the men in his 0:52 family died of heart disease at 0:54 relatively young ages and his own father 0:56 had a cardiac event at some point 0:58 although he fortunately sir survived the 1:01 good news is that medicine is advancing 1:03 quickly in this area and heart disease 1:05 is becoming easier to treat and to 1:06 prevent Peter talks about the benefits Keto (MISTAKE HERE, READ DESCRIPTION) 1:09 of following a ketogenic diet that is 1:11 mostly composed of monounsaturated fats 1:13 like extra virgin olive oil macadamia 1:16 nuts and avocados I think it's safe to 1:18 say that most of the people who follow a 1:20 ketogenic diet mainly eat saturated fats 1:23 and although some people can handle 1:25 saturated fats without an issue a large 1:28 percentage will see their triglycerides 1:30 rise because of the saturated fats which 1:32 is bad for the heart a ketogenic diet is 1:35 probably also good for the brain and may 1:37 help prevent Alzheimer's disease in a 1:39 state of ketosis the brain begins to use 1:42 ketones for fuel which can be beneficial 1:44 because even though the brains of people 1:46 with Alzheimer's disease can no longer 1:48 metabolize glucose they can still 1:50 metabolize ketones this can improve 1:53 cognition and memory in people with 1:55 early stage Alzheimer's according to 1:57 Peter the problem is that a ketogenic 1:59 diet it is already very restrictive 2:01 having now to restrict the kind of fats 2:04 you can consume can definitely add to 2:06 the challenge but consuming plenty of 2:08 extra virgin olive oil and nuts even if 2:10 you're not an a ketogenic diet can do 2:12 wonders for your heart and brain PREDIMED Trial (MISTAKE HERE, READ DESCRIPTION) 2:15 Peter is skeptical of many human 2:17 clinical trials but says that he finds 2:19 the predimate trial to be quite 2:21 convincing the predimate trial was a 2:24 study conducted in Spain that divided 2:27 7447 people between the ages of 55 and 2:30 80 into three groups all of the subjects 2:33 were at high risk of developing heart 2:35 disease but had no heart disease at 2:37 enrollment two of the three groups had 2:39 to follow a high fat Mediterranean diet 2:41 one of these two groups had to consume a 2:44 liter of olive oil a week the other had 2:46 to consume the same amount of calories 2:48 that the other group consumed in olive 2:49 oil but in nuts the control group was 2:52 instructed to follow a low-fat 2:54 Mediterranean diet the study was 2:56 supposed to last six years but it was 2:59 halted after four and a half years after 3:01 it became clear to the researchers that 3:03 the olive oil and the nut group were 3:05 getting healthier while the low-fat 3:06 group was getting unhealthier the olive 3:08 oil in the nut group not only had a 3:11 significantly lower incidence of major 3:12 cardiovascular events but also had 3:15 improved memory while the low-fat group 3:17 had worse cardiovascular health and 3:19 worse memory and it would have been 3:21 unethical to keep the low-fat group on a 3:24 low-fat diet in short for better brain 3:26 and heart health eat plenty of healthy 3:28 monounsaturated fats like nuts and olive 3:31 oil Flossing and Sauna 3:32 flossing your teeth daily and going to 3:34 the sauna is also a good idea as they 3:37 can both prevent neurodegeneration and 3:39 heart disease Peter used to be skeptical 3:41 of these but he is now more convinced 3:43 people with good oral health tend to be 3:45 healthier overall and microbes that grow 3:48 in the mouth that are known to cause gum 3:50 disease and Cavities are often found in 3:52 other parts of the body causing all 3:54 sorts of problems for example one 3:56 microbe called pigeon javalis that is 3:58 known to cause gum disease is often 4:00 found in the brains of people with 4:02 Alzheimer's disease using the sauna at 4:04 least four times a week for at least 20 4:06 minutes at high temperatures 179 degrees 4:10 Fahrenheit or 82 degrees Celsius or 4:13 hotter could potentially improve brain 4:15 and heart health Finnish studies show 4:17 that men who use the sound are regularly 4:19 have fewer cardiac events than those who 4:21 use it less often or don't use it at all Lipid-Lowering Medications 4:24 to help feed those who already have 4:26 elevated triglycerides and LDL 4:28 cholesterol Peter talks about the 4:30 benefits of certain statins such as 4:32 Crestor as well as a few other medicines 4:34 such as nexilitol Zetia pcsk9 Inhibitors 4:38 and vasipa all these medications work to 4:41 lower LDL cholesterol in some way 4:43 vasipai found especially interesting 4:46 it's derived from fish oil and it 4:48 contains a high dose of pharmaceutical 4:50 grade EPA an omega-3 fatty acid that 4:53 helps lower LDL and triglycerides Omega-3 Fatty Acids 4:56 Peter doesn't really talk about that 4:59 many anti-aging supplements and 5:00 medications in his book at least not as 5:03 much as I thought he would but he does 5:05 talk about omega-3 fatty acids a good 5:08 omega-3 supplement will contain both EPA 5:10 and DHA as I already said EPA is good 5:14 for the heart while DHA is good for the 5:16 brain Peter says the DHA could 5:19 potentially prevent neurodegenerative 5:21 diseases such as Alzheimer's Parkinson's 5:23 and dementia so taking a good quality 5:26 omega-3 supplement may be a good idea 5:28 especially because very few people have 5:31 optimal omega-3 levels one would need to 5:34 consume very large amounts of fatty fish 5:36 such as sardines to reach optimal levels 5:38 of Omega-3 Peter doesn't mention any 5:41 Brands but I've heard him say that he 5:43 trusts Nordic Naturals and Carlsons and 5:45 if you're vegan or vegetarian take an 5:47 algae derived omega-3 supplement Exercise: The Most Powerful Longevity Drug 5:50 probably the most important thing one 5:52 can do to prevent not only heart disease 5:54 but also neurodegeneration and cancer is 5:57 to exercise exercise is good for pretty 5:59 much everything according to Peter 6:01 exercise is the best thing you can 6:03 probably do to increase your lifespan 6:05 and health span it is the best longevity 6:08 drug and if you love to eat things that 6:10 you probably shouldn't be eating the 6:12 more you exercise the more you can get 6:14 away with without damaging your health 6:16 everything from aerobic training to 6:18 endurance exercise to strength training 6:20 will benefit your health and 6:21 significantly reduce all cause mortality 6:24 plus those who exercise are more 6:26 muscular and muscle can protect one's 6:28 body from getting injured from a fall 6:30 older people tend to not be very 6:32 muscular making them more susceptible to 6:35 getting injured or even die if they fall 6:37 and Falls are not to be taken lightly 6:39 they cause the most accidental deaths in 6:41 those ages 65 and older with all that 6:45 said exercise can do more harm than good 6:47 if you're doing it incorrectly if you're 6:49 doing the wrong movement you can get 6:51 injured and if you get injured bad 6:53 enough chances are that you won't be 6:55 able to keep exercising and you will be 6:57 missing out on all the health benefits 6:58 that come with it so don't force 7:00 yourself to lift more weights than you 7:02 can handle focus on doing every movement 7:04 correctly to prevent injuries it is not 7:07 a bad idea to film yourself exercising 7:09 from time to time to make sure that 7:11 you're actually doing the movement that 7:13 you think you're doing instead of some 7:15 other movement that can get you in 7:16 trouble in the long run there are Alzheimer's Disease and Other Neurodegenerative Diseases 7:19 different theories of what causes 7:20 neurodegenerative diseases such as 7:22 Alzheimer's and Dementia for example 7:24 something called amyloid beta in 7:26 something called a tower both often 7:28 found in the brains of patients with 7:30 neurodegeneration but the reality is at 7:33 least according to Peter that scientists 7:35 are not entirely sure of what causes it 7:37 but it is known that people who carry 7:39 the Apple E4 gen are at higher risk of 7:42 developing Alzheimer's disease than 7:43 those who don't nonetheless people who 7:46 carry the gene are not necessarily 7:47 destined to get the disease especially 7:49 if they also carry the foxo3 gene a gene 7:53 that can help prevent the development of 7:54 diseases but there are still many people 7:57 who carry the Apple E4 genes that don't 7:59 carry the foxo3 genes that never get the 8:01 disease so regardless of your genetics 8:04 Don't Panic for the time being 8:06 neurodegeneration unfortunately can't be 8:08 cured and there is no known way to stop 8:10 the disease from advancing once the 8:12 symptoms start usually at around age 65 8:15 for most people but there are quite a 8:17 few things one can do to prevent it 8:21 I already talked about the heart and 8:23 brain benefits of using dry saunas 8:25 flossing omega-3 fatty acids ketones 8:29 monounsaturated fats and exercise it is 8:32 no coincidence that a lot of the things 8:33 that are good for the heart are also 8:35 good for the brain plain and simple 8:37 what's good for the heart is good for 8:39 the brain although there are a few 8:40 things that I haven't mentioned there 8:42 are at least for the most part good for 8:44 the brain B vitamins and vitamin D could 8:46 both potentially help prevent dementia 8:49 and Alzheimer's disease also grip 8:51 strength is correlated with better 8:52 cognitive function for some strange 8:54 reason and could also help prevent 8:56 neurodegeneration and as you would 8:58 expect getting good and sufficient sleep Sleep 9:00 six to nine hours per night is good for 9:03 the brain and pretty much everything 9:04 else but especially the brain as it can 9:07 help clear the brain of Tau and amyloid 9:09 beta Peter wrote an entire chapter on 9:12 the importance of sleep and she 9:14 basically explains how it can help 9:15 prevent neurodegeneration and heart 9:18 disease and even prevent depression and 9:20 car accidents in the end a Sleepless 9:22 state is like being drunk studies show 9:25 that poor quality sleep can increase the 9:27 risk of heart attack type 2 diabetes 9:29 Alzheimer's disease Elevate 9:31 triglycerides lower testosterone and 9:34 weaken the immune system on the other 9:36 hand after a good night's sleep you have 9:39 better endurance stronger muscles a 9:42 higher VO2 max and you're less likely to 9:44 get injured to quote Peter good sleep is 9:47 like a performance-enhancing drug these 9:50 are a few things you can do to sleep 9:52 better every night sleep in a dark room 9:54 the darker the better sleep in a cold 9:57 room avoid alcohol Peter recommends 9:59 avoiding alcohol as much as possible he 10:02 doesn't think it's healthy not even an 10:04 occasional glass of red wine although a 10:06 drink every now and then won't 10:08 your health but drinking at night is 10:10 especially bad because it will ruin your 10:12 sleep alcohol might help you fall asleep 10:14 faster but it isn't good quality sleep 10:17 avoid drinking coffee late during the 10:19 day and especially at night this one 10:21 actually depends on your caffeine 10:23 tolerance as some people can drink 10:25 coffee with no negative impact on their 10:27 sleep but nonetheless my guess is that 10:29 caffeine will ruin a lot of people's 10:31 sleep so it's worth mentioning abstain 10:34 from stimulating Electronics late at 10:36 night don't spend time on social media 10:38 or playing video games at least two 10:40 hours before going to bed but 10:42 non-stimulating ones such as TV might 10:44 not be as bad some sleep experts 10:47 recommend turning off all screens a few 10:49 hours before going to bed but according 10:51 to Peter this might not be absolutely 10:53 necessary for more information on sleep 10:56 and how to improve it I recommend you 10:58 read why we sleep by Matthew Walker 11:01 I now want to talk about cancer there's Cancer 11:04 an entire chapter on cancer in outlive 11:06 but unlike heart disease and 11:08 neurodegenerative diseases Peter 11:10 unfortunately doesn't give us a list of 11:12 medicines or precise ways to prevent it 11:14 and that's because cancer is a 11:16 complicated disease all diseases are 11:18 don't get me wrong but one type of 11:21 cancer can be very different from 11:22 another some treatments work on certain 11:24 cancers but not on others and some 11:27 cancers are easier to detect in early 11:29 stages than others cancer is the second 11:31 leading cause of death in the United 11:33 States and even after Decades of 11:35 researching it survival rates haven't 11:37 improved very much and it isn't because 11:40 killing cancer cells is super 11:42 complicated in fact killing them is not 11:44 as hard as many people think the problem 11:46 is that killing malevolent cells 11:48 involves killing benevolent ones as well 11:51 and if you kill enough benevolent cells 11:53 you kill the patient what researchers 11:55 want to figure out is how to spare 11:57 normal salt and only kill the cancerous 11:59 ones nonetheless hero a few things Peter 12:03 says one can do to help prevent cancer 12:05 exercise as I already said this is 12:08 probably the best longevity drug and it 12:10 could help prevent cancer and other 12:12 age-related diseases moving on calorie 12:15 restriction there appears to be a strong 12:17 link between calories and cancer in one 12:20 very long study conducted by the 12:21 University of Wisconsin the researchers 12:24 separated a group of Reese's monkeys 12:26 into two groups one of them was allowed 12:28 to eat as much food as they wanted while 12:30 the other was calorie restricted and fed 12:32 about 25 percent fewer calories the 12:35 calorie restricted group lived longer 12:37 and they had much less cancer than the 12:39 ad libidum group of monkeys the group 12:41 that was allowed to eat as much as they 12:43 wanted the calorie restricted group had 12:46 a 50 percent lower incidence of cancer 12:48 you should also not smoke don't become 12:50 obese and don't become insulin resistant 12:53 these last three really shouldn't come 12:55 as a surprise 12:56 nonetheless cancer is much harder to 12:59 prevent than other age-related diseases 13:01 there might be evidence showing that one 13:03 could somehow starve cancer but Peter 13:05 doesn't think so cancer cells always 13:08 seem to be able to obtain the energy 13:10 Supply they need which is why he 13:12 recommends getting screened for cancer 13:14 often every two or three years or so 13:16 depending on your age in order to 13:18 intervene early when there is a chance 13:20 of controlling or even eliminating the 13:22 cancer rather than the way it is 13:24 typically done now coming in at a late 13:26 stage when the odds are already stacked 13:28 against the patient and hoping for a 13:30 miracle with that said some cancers are 13:33 trickier to detect in the early stages 13:35 than others and no single diagnostic 13:38 test is 100 percent accurate so it is 13:41 advisable to get more than one test 13:43 ultrasound MRI scans and 4K blood tests 13:47 when screening for prostate cancer for 13:49 example Fasting with Cancer 13:50 with all that said those who already 13:52 have cancer and are being treated with 13:55 chemotherapy there is one thing you can 13:57 do to make it work better fasting or 13:59 following a fasting mimicking diet a 14:02 diet that restricts calories for a set 14:04 period of time in order to trick the 14:06 body and cells into thinking that they 14:08 aren't being fed fasting with cancer 14:10 might not seem like a good idea but it 14:12 probably is when chemotherapy is given 14:15 to patients that are fasting or on a 14:17 fasting mimicking diet they respond 14:19 better to the treatment cancerous cells 14:22 become more vulnerable and normal cells 14:24 become more resistant one very promising Immunotherapy 14:27 cancer treatment that Peter talks about 14:29 is immunotherapy but it unfortunately 14:31 currently only works sometimes and only 14:34 for certain types of cancer pancreatic 14:36 cancer being one of them which is great 14:38 because it has one of the worst survival 14:40 rates Peter talks about a friend of his 14:43 who was diagnosed with pancreatic cancer 14:45 after surviving colon cancer and was 14:47 given a few months to live but he was 14:49 treated with immune no therapy and 14:51 although he lost his pancreas he beat 14:54 cancer a second time and is fortunately 14:56 still alive whoever this guy is I really 14:59 hope he never has to go through anything 15:01 like this ever again he's been through 15:03 enough already anyways back to 15:05 immunotherapy immunotherapy plain and 15:08 simple consists of helping the immune 15:10 system recognize and attack cancer cells 15:13 when a person is infected with a virus 15:15 the immune system will attack it because 15:18 it can tell that the virus doesn't 15:19 belong in this specific case this is a 15:22 very good thing because you don't want a 15:24 virus doing its thing inside your body 15:26 but sadly the immune system can often 15:29 work against the benefit of the person 15:30 for example organ transplant patients 15:33 will need to take rapamycin and 15:35 immunosuppressant Drug because without 15:37 it the immune system will come to 15:40 realize that the transplanted organ 15:41 doesn't belong and will attack it the 15:43 same way it would a virus the point is 15:46 that to the immune system whether 15:48 something is good or bad is often 15:50 irrelevant if it's good but foreign like 15:52 a transplanted organ it will attack it 15:54 and if it's bad but native it 15:56 unfortunately often won't in the case of 15:59 cancer cells they might be bad but they 16:01 are nonetheless native cells and 16:03 therefore they belong we do have 16:05 something called t cells that fight 16:07 against cancer cells but it all becomes 16:09 a problem when the cancer grows and 16:11 learns to hide from T cells and avoid 16:13 detection 16:15 researchers have been working on 16:18 immunotherapy-based Cancer drugs and 16:19 treatments that can teach the immune 16:21 system to recognize cancer cells and 16:23 attack them and a few of them have 16:25 already been approved adoptive cell 16:27 therapy for example as well as a class 16:30 of drugs called checkpoint Inhibitors 16:32 much more work is needed to improve the 16:34 efficacy and availability of 16:36 immunotherapy treatments but it looks 16:38 very promising and what's great about it 16:40 is that when immunotherapy works it 16:43 really works when the cancer dies it 16:45 will almost certainly not come back Continuous Glucose Monitoring 16:48 I want to talk a little bit about 16:49 continuous glucose monitoring and why 16:52 Peter thinks it's important there are 16:54 devices that can be implanted in your 16:56 upper arm that monitor and show you your 16:58 blood glucose in real time on your phone 17:00 which is great for those who want to 17:02 maintain their glucose levels on the 17:04 Lower Side having high glucose levels 17:06 can cause all sorts of health problems 17:08 and if you can see for yourself what 17:10 effect the foods that you're eating or 17:12 having on your blood glucose you will 17:13 think twice before you eat a bowl of 17:15 breakfast cereal or an apple pie 17:17 watching your blood glucose Spike can 17:19 certainly discourage you from eating 17:21 high sugar foods or maybe encourage you 17:23 to do a decent amount of exercise before 17:25 you do to compensate for what you're 17:27 going to eat which is great the problem 17:30 is that continuous glucose monitors are 17:32 not available for people without 17:34 diabetes for the time being you 17:36 unfortunately require a prescription to 17:38 buy one but that will hopefully change 17:40 sooner rather than later you can however 17:43 buy a glucose meter without a 17:45 prescription and although it won't show 17:47 you your blood glue glucose in real time 17:49 you can still see what effects the foods 17:51 that you're eating or having on your 17:53 blood glucose just not as precisely but 17:55 either way you will still learn to make 17:57 better choices so a glucose meter is a 18:00 very decent Plan B nonetheless remember 18:03 that glucose is just one Health marker 18:05 an important one for sure but it isn't 18:07 the only Health marker that matters you 18:09 can eat a bunch of unhealthy fats that 18:11 won't spike your blood glucose levels 18:13 but that doesn't mean you should Stability 18:16 a minute ago I talked about the benefits 18:18 of exercising I now want to talk about 18:20 the benefits of working on your 18:22 stability whatever sport or exercise you 18:25 enjoy doing stability is what will allow 18:27 you to keep doing it well into old age 18:30 even if you don't like doing sports or 18:32 exercising it's still important because 18:34 the more stable you are the less likely 18:36 you are to fall and injure yourself 18:38 Peter talks about different stability 18:40 exercises in his book but I won't be 18:43 explaining them here I think it's easier 18:45 to watch Peter doing these exercises as 18:48 he explains them I'll put a link to 18:50 these videos in the description Rapamycin and mTOR 18:52 I now want to talk about a drug I 18:54 mentioned a minute ago rapamycin 18:57 rapamycin is the longevity molecule 18:59 Peter is probably most optimistic about 19:02 it's an immunosuppressant drug that was 19:04 discovered in Easter Island and although 19:06 it's only prescribed to organ transplant 19:09 patients in order to prevent their 19:10 bodies from destroying the transplanted 19:13 organ it has also proven to prolong the 19:15 life of different organisms such as 19:17 yeast cells and mice but someday it 19:20 could potentially be used as an 19:21 anti-aging drug rapamycin works by 19:24 inhibiting mtor a nutrient-sensing 19:26 pathway that is activated or suppressed 19:29 depending on the availability of 19:30 nutrients and it tells the body if 19:32 conditions are right to produce proteins 19:34 and for cells to divide when mtor is 19:37 inhibited the body is instructed to 19:39 conserve energy so cells divide more 19:41 slowly or stop completely and the body 19:44 recycles damaged proteins a process 19:46 known as autophagy both calorie 19:49 restriction and fasting have proven to 19:51 prolong the lives of different organisms 19:53 and like rapamycin they inhibit mtor and 19:56 activate autophagy so a molecule that 19:58 can do that without us having to fast or 20:01 restrict calories is nothing short of 20:03 fascinating with that said 20:05 immunosuppression is a big downside that 20:08 comes from taking rapamycin on a daily 20:10 basis the way organ transplant patients 20:13 do but studies suggest that there's a 20:15 way to evade this downside when 20:17 rapamycin or arapomycin analog like 20:19 everolymus is taken intermittently say 20:22 once a week at a high dose rather than 20:24 taking it every day at a low dose one 20:27 can get the longevity benefits of it 20:29 without affecting the immune system mtor 20:31 is composed of mtor complex 1 and mtor 20:34 complex 2 and taking rapamycin daily 20:37 inhibits both complexes while taking it 20:40 once a week or so only inhibits mtor 20:42 complex one exactly the one you want to 20:45 suppress for a longer and healthier life 20:47 another longevity molecule Peter Metformin 20:50 mentions is a type 2 diabetes medication 20:52 called metformin metformin helps 20:55 regulate blood sugar by helping the body 20:57 better respond to the insulin it 20:59 naturally produces and by reducing the 21:01 amount of sugar the liver makes and that 21:03 other organs absorb researchers have 21:05 noticed the type 2 diabetics that take 21:08 Metformin get less cancer and usually 21:10 live longer than non-diabetics a 21:12 clinical trial called a tame targeting 21:15 aging with metformin will attempt to 21:17 prove if metformin can indeed delay the 21:19 onset of age-related diseases like 21:21 cancer heart disease and Dementia by 21:24 giving it to healthy individuals between 21:26 the ages of 65 and 79 for a period of 21:29 six years 21:30 the last thing I want to talk about is Fasting and Protein 21:33 fasting in the book Peter briefly 21:35 mentions that he practices prolonged 21:37 fasting which is something I knew before 21:39 reading his book and although he doesn't 21:41 mention how long or how often he fasts 21:44 last I checked he was doing a three-day 21:47 water fast once a month and used to do a 21:49 seven day water fast every quarter 21:51 nonetheless he says he no longer 21:54 recommends prolonged fasting or even 21:56 intermittent fasting to most of his 21:58 patients going without food for long 22:01 periods of time can lead to a loss of 22:03 muscle mass and he doesn't think it's 22:05 worth it he goes on to say that protein 22:08 is the most important macronutrient and 22:10 one should be consuming enough of it 22:12 every day and throughout the day if 22:14 possible to grow and maintain muscle 22:16 mass something that is hard to do in a 22:19 short eating window don't get me wrong 22:21 Peter does say that fasting can do a lot 22:24 of good things such as lowering insulin 22:26 emptying the liver of fat suppressing 22:29 mtor and activating fog so but there are 22:32 also a few negatives such as the loss of 22:34 muscle mass and also that a lot of 22:36 people think that they can eat whatever 22:38 they want as long as they're fasting 16 22:40 hours a day and only eating within an 22:42 eight-hour window but you can for sure 22:44 gain fat and destroy your body in that 22:47 time so keep that in mind I trust Peter 22:50 attia he seems like a very trustworthy 22:52 and likable guy in my opinion but I have 22:55 to admit that this sounds a little 22:56 bizarre to me I am no expert but most 22:59 longevity researchers that I listen to 23:01 and Trust would probably disagree with 23:03 this both David Sinclair Harvard 23:06 professor of genetics and author of the 23:08 book lifespan and Dr Steven gundry heart 23:11 surgeon and author of the plant Paradox 23:13 and the longevity Paradox would disagree 23:15 with this they both believe that a lot 23:17 of protein especially animal protein can 23:20 be problematic and they both believe 23:22 fasting is one of the healthiest things 23:24 one can do some people have even cured 23:26 themselves of cancer without 23:28 chemotherapy by fasting for long period 23:30 periods of time for example in the book 23:33 my battle against cancer guy Tenenbaum 23:36 explains how he survived stage 4 23:38 prostate cancer by doing several 23:40 prolonged fasts fasts of up to 20 days 23:43 and although he indeed lost most of his 23:46 muscle and his testosterone levels went 23:48 down to zero he survived but then again 23:51 this wasn't a clinical trial I don't 23:53 know all that I'm saying is that both 23:55 his fasting and protein arguments left 23:57 me feeling a little confused not only 24:00 because of what David Sinclair and 24:01 Stephen gundry say but also because in 24:04 the blue zones the regions with the 24:06 longest living people people don't 24:08 consume that much protein and in at 24:10 least one of them they fast relatively 24:13 often but in outlive Peter doesn't talk 24:15 about the blue zones that also left me 24:18 feeling a little confused either way I 24:21 learned a lot from the book and I really 24:22 enjoyed it and I highly recommend it to 24:25 anyone who is interested in longevity 24:27 and Peter attia if you're watching this 24:29 thank you so much for your work 24:32 as always thank you so much for watching 24:34 let me know your thoughts in the 24:36 comments section below leave a like and 24:38 don't forget to subscribe until next 24:41 time 24:47 foreign For Seniors Non-stop action Skip navigation Search 9+ Avatar image 2:07 / 1:38:33 Peter Attia on Lifespan, Healthspan, and Outlive 9/25/23 EconTalk 18.9K subscribers Subscribe 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 Share Download Clip Save 2,190 views Sep 25, 2023 We spend too much of our health care focus on lifespan and not enough on healthspan--the quality of our life as we get older. So argues Dr. Peter Attia, author of Outlive: The Science and Art of Longevity. Attia speaks with EconTalk's Russ Roberts about what kills us, what slows us down as we age, and the weapons we have to allow us to live better and longer. Links, transcript, and more information: https://www.econtalk.org/peter-attia-... Subscribe to EconTalk on YouTube: / @econtalkwithruss Apple Podcasts: https://podcasts.apple.com/us/podcast... Stitcher: https://www.stitcher.com/podcast/econ... Spotify: https://open.spotify.com/show/4M5Gb71... and wherever you listen to podcasts. Transcript Follow along using the transcript. Show transcript EconTalk 18.9K subscribers Videos About EconTalk Podcast Archive - Econlib Discover more at EconTalk.org 7 Comments rongmaw lin Add a comment... @ShalomFreedman @ShalomFreedman 1 month ago The last part of this conversation was very surprising. In all the conversations of Econtalk that i have listened to Russ Roberts has been friendly, considerate and generous. Each person he speaks to is spoken to with respect. And there is praise for the work or thought discussed which may in fact seem more than it deserves. It is very difficult to see the self-described angry Russ Roberts in this conversation. The Russ Roberts I have witnessed interacting with many people is a smiling warm and shining countenance. I have never witnessed anyone so welcoming of so many others. And I have often admired and envied his ability to communicate so warmly with so many others. So where is the angry Russ Roberts hiding? 1 Reply @c5jp904 @c5jp904 1 month ago Great discussion! A lot of this was discussed by Dr. Dean Edell on his radio show and his two books Eat Drink and Be Merry and Life Liberty and the Pursuit of Healthyness well over 20 years ago. 1 Reply @marcbolan1818 @marcbolan1818 1 month ago Healthcare is holisitic and numbers are meaningless without actionable insights that are easy to translate to patients. Most humans will not begin to engage in healthcare until 40+ A lot of great talk on fine tuning here for those who are focused on their health (more likely to be motivated by actionable insights), but the majority of chronic cases consuming healthcare spend today are not taking the responsible steps to be their own stewards of their own healthcare: fast food multiple times a week, high sugar intake; high fat; processed foods; alcohol intake; smoking; abusing drugs. Reply @robinmcbride4057 @robinmcbride4057 1 month ago Interesting that you picked out emotional health as the key issue, a theory of moral and emotional sentiment. The real 'wealth' of nations is the quality of emotional transactions with others. 1 Reply @bennguyen1313 1 month ago Regarding the 30m-46m mark on colon-cancer screening.. aside from asking your endoscopist’s adenoma detection rate (ADR) , Cecal intubation rate , number of perforations they caused, major intestinal bleeding episodes during routine screening, and their withdrawal time... why is that some clinics give you the OPTION to be asleep and others let you watch on screen? I would think that if you can manage some discomfort, the latter would be much safer than induced-coma. BTW, would love to hear Peter discuss screenings with Vinay Prasad! Regarding the 1h5m on a prostate app (name?) and how the risk is better estimated using PSA velocity (should be less than .45) and PSA density (should be less than .1), any thoughts on Andrew Vickers' 4Kscore vs Prostate Health Index (PHI)? On the MedCram episode, Peter talks more about the prostate (48m), but doesn't mention the name of the app! Reply @FlamingBasketballClub 1 month ago 11:00-12:00 I like the question that Russ asked in today's podcast episode. Reply @HoobaBros 1 month ago excellent 1 Reply Transcript Search in video 0:02 today is September 5th 2023 and my guest is Dr Peter attia his podcast is the 0:09 drive and he is the author with Bill Gifford of outlive the science and art of longevity which is our topic for 0:15 today Peter welcome to econ talk thanks for having me now the book's a combination of advice 0:21 for the reader how to live in a different way it also is a critique of the advice for the field of medicine and 0:28 I'm sure we'll bounce back and forth uh between those I want to start with an early part of the book which is a dream 0:34 you had maybe more of a nightmare that involved eggs tell us what that was about 0:40 yeah so in this dream I was uh sort of tasked with catching eggs before they uh 0:47 hit the ground and so there's a tall building not that tall maybe two or three stories tall and there's a guy on 0:54 the top and he's tossing eggs out of a basket and I have a padded basket beneath him on the street level and I'm 1:01 running around trying to catch them all and you know truthfully I'm not doing that well I'm catching some but many of 1:09 them I miss and they Splat all over the uh all over the pavement 1:15 um and of course this dream I realized many years later I mean probably a decade later uh probably uh spoke to how 1:23 I felt in my medical training I had this dream during residency and uh it 1:28 probably spoke to the the feeling that we were doing so much at the last minute to try to save lives and of course we 1:37 could we had some remarkably heroic things that we could do But ultimately 1:42 they were they were they were typically futile and they merely extended lifespan slightly Without Really meaningfully 1:48 impacting Health span and of course in the dream I come to realize that the 1:54 only way to stop this is to go to the top of the building and take the basket of eggs from the guy who's tossing them 2:01 explain the difference between uh lifespan and health span so lifespan I think is the easier of 2:07 these two to understand it's certainly the easier to measure because it is binary it's discrete uh and it's the 2:14 period of life in which you are alive you're respiring uh and so we measure 2:19 lifespan and most of the data that is collected with respect to health is 2:24 lifespan based and you think about it this way Russ everybody says well median lifespan or maximal lifespan has 2:30 extended by such and such amount over the past hundred years and if we look at those metrics we can clearly see 2:37 successes so if you look 150 years ago versus today we have indeed doubled the 2:43 expected lifespan of a person living in the developed World from approximately 40 to 80. 2:48 we can talk a little bit about why that's happened um Health span however is is the analog 2:55 measure it's uh it really speaks to quality of life now I tend to have a 3:00 more nuanced definition to this than the medical establishment would today the medical definition of healthspan is the 3:07 period of time in which you are free from disability and disease 3:12 um I don't find that to be a particularly helpful definition um it maybe lends itself to slightly 3:19 better measurement than my definition but I don't think it truly captures what people care about I think what healthspan really comes down to is the 3:25 quality of your physical life so your ability to move around do things be free of pain uh 3:33 you know it's the difference between the 80 year old and the 30 year old from a physical activity level standpoint 3:38 there's a cognitive component to health span and this is absent disease so we're not talking about dementia but we're 3:44 still talking about executive power processing speed memory those things and then there's an emotional component and 3:51 this is the more interesting one in a sense because it's the only one that doesn't decline with age it doesn't necessarily have to decline I think 3:58 unless you're living in sort of a Sci-Fi land we have to accept that our physical and cognitive Health span is inevitably 4:05 going to decline as we age this does not have to be true with our emotional health which includes everything from 4:12 our sense of purpose our our the quality of our relationships with others with ourselves our happiness joy spontaneity 4:19 all these things and so to me those are a basket of things that Encompass Health 4:24 span and and I will say this Russ when patients come to me virtually without exception because I 4:31 always ask my patients on the first day what is your goal for the last decade of your life this marginal decade they 4:38 virtually never talk about lifespan they only talk about health span and I think 4:44 therein lies one of the biggest problems with our Health Care system today is the Relentless focus on lifespan 4:51 by the way we're not even doing that well so we can talk about that but to the exclusion of healthspin 4:57 yeah I love the uh the fundamental idea behind this book is that 5:03 of course we don't want to live we don't want to just live long we want to live 5:08 in a meaningful way as you say we want to live in a way that brings delight and that is maybe diminished relative to our 5:15 youth but is still uh at least reminds us of some of the aspects of our youth 5:20 in terms of what we care about doing and how we spend our time and so much of our focus is on saving lives and not on the 5:29 quality of life and you make the distinction between two point medicine 2.0 and Medicine 3.0 and you also add 5:36 you can also start with medicine 1.0 so give us those three those three eras 5:42 so medicine 1.0 represents the longest in in terms of time because it's 5:47 basically medicine for all of human history until about uh the transition 5:53 that occurred from say Francis Bacon to germ Theory that's really the transition to Medicine 2.0 so in medicine 1.0 we 6:00 didn't understand the natural Universe right so so the scientific method had not been created and while we can look 6:06 back at what people thought at the time and laugh I think we have to be a little bit Kinder and realize that you can't 6:13 use a tool that doesn't exist and so if a person was Ill you had to assume this 6:19 was the gods or there were bad humors in the air that were causing this all of this changed of course in the uh 17th 6:27 century when Francis Bacon uh began the work that I think led to the elucidation of a scientific method there were also 6:34 some really big technological breakthroughs I'm sure you've read Sid mukherjee's book the cell and I think he 6:39 does perhaps the best job of anyone in kind of explaining what really took place in this cellular Revolution where 6:46 we finally began to understand that there were microscopic organisms that played a role in our illness and so the 6:53 development of the light microscope and ultimately the discovery of antimicrobial agents completely changed 6:59 the face of medicine and that is where I really think medicine 2.0 took hold in 7:04 the late 19th century and by the way that is really the thing that is accounting for the doubling of human 7:13 lifespan in the past 120 to 140 years there is of course another very 7:19 important tool in medicine 2.0 that was not introduced until about the 1940s and 7:25 that was the statistical and conceptual tool of the randomized controlled trial this is what really allowed medicine 2.0 7:33 to take off and to continue to make advances in other areas such as oncology 7:39 and in particular I would say the poster child for medicine 2.0 beyond the 7:44 obvious which is communicable and infectious diseases is in cardiovascular disease so we have medicine 2.0 which is 7:51 currently the system that we're in it does very well again for infectious and communicable diseases and it also does 7:57 very well for acute injuries so our ability to actually deal with a heart 8:03 attack when it's happening today is remarkable compared to 50 years ago our ability to take care of trauma patients 8:10 to take care of patients in sepsis it's unparalleled however what this has all 8:17 shown us is that medicine 2.0 has an enormous blind spot and that is to the 8:23 treatment of chronic diseases we've made virtually no progress in the management 8:28 of chronic diseases and that's why today we see that the majority of people 8:33 living in the developed world are going to die indeed from chronic diseases 8:39 yeah it's um when we think about that expansion that doubling of lifespan it's 8:45 overwhelmingly two factors uh the incredible Improvement in childbirth 8:52 uh you talk about seminal wise we've talked about some ice many times in this program a tragic figure uh incredibly poignant who understood 8:59 that it was washing your hands after you went to the morgue uh and no one 9:05 believed him and the tragedy for me has always been he was kind of careless about his study 9:10 because he was so confident he was right so people were it made it easier for people to dismiss it along with his 9:15 personality and of course that led to the deaths of thousands of women prematurely uh such such a sad story 9:23 but we have the death Improvement in childbirth and and in childhood death death before the age of five so once you 9:31 reached a certain age 6 10 15 whatever it was that in the date I'm not sure but five is a good round 9:37 starting point uh the Improvement isn't anything close to doubling much once in 9:43 1900 you reached Sage of our many people live to be 70 and 80 years old it wasn't uh everybody died at 40 even though that 9:49 was the average that's because you had a lot of zeros and point fours for the people who died as in as choked as 9:56 infants the second improvement though that I I knew that before uh but what I learned from your book which I was I didn't 10:03 realize or appreciate is that mostly improvements since then is in fighting sepsis disease uh 10:09 infection and the use of antibiotics which is a miracle an extraordinary Revolution human creativity 10:16 but the other things very very very very very slow progress and or none and uh 10:24 it's easy to forget that we hear lots of statistics about improve mortality from certain 10:31 conditions they're somewhat misleading in that sometimes it's due to earlier detection rather than actual Improvement 10:38 and outcome uh and mortality outcome and then there's the question that you focus on in the book which I find uh really uh 10:46 a totally different perspective which is that our goal isn't to keep people alive I mean it's it's a cliche but it's so 10:53 easy to forget it it's to have a good life and it's not just oh take risks 10:59 enjoy things because of course you're not going to live forever it's that we may have the potential and Medicine 11:06 could focus instead on making sure that you maintain function 11:11 farther and farther into further and further excuse me into your lifespan and I it's a beautiful idea 11:19 yeah and I think I want to reiterate a point I made very quickly but it's I think it's the jugular issue here which 11:25 is the old cliche what gets measured gets managed could not be more true and 11:30 in medicine 2.0 understandably The Benchmark is lifespan and therefore 11:36 everything works towards the management of lifespan if we instead chose to focus more on 11:43 health span I believe we could be more effective but it's also understandable why we're not focusing on healthspan it 11:49 is much harder to measure and therefore I think it's easy to understand why we as doctors will instead focus on the the 11:57 metric that we can measure and we've had recent episodes uh 12:02 with a number of folks who are linked to pointing out that a lot of end-of-life 12:07 care it isn't just that it extends your life a small amount is extends it in 12:13 unpleasant ways often that take out the opportunity to do the things we love and 12:19 um maybe we'll talk more about that later but what what are The Four Horsemen of the Apocalypse what are the 12:25 four things that kill us slowly so if you're a non-smoker and that's an 12:31 important distinction because if you're a smoker there's a fifth really big bucket here which is chronic lung 12:36 disease but if you take out uh lung disease aside from lung cancer uh The 12:42 Four Horsemen in order are cardiovascular disease or the diseases of atherosclerosis so that includes 12:48 cerebrovascular disease Strokes heart attacks heart failure all of those things that's that's hands down number 12:54 one uh Russ and it's funny how little attention it gets uh at least in America 12:59 I think cancer gets a lot more attention perhaps because it's scarier but the truth of it is 13:04 um heart disease has always been number one and by the way globally that Gap is even larger so globally that Gap is 13:12 about 19 million versus 13 million so it's that's deaths per year 13:18 um disease number two is cancer and again we have to be careful when we talk about cancer it's not a disease right 13:24 cancer is a very very heterogeneous set of diseases that only have two things in 13:30 common which we can talk about but aside from that it completely different process right so breast cancer and colon 13:37 cancer are so different that to compare them to say that they're one disease called cancer is a little bit misleading 13:44 the third pillar or the third Horseman would be all of the neurodegenerative 13:49 diseases and all of the diseases of dementia this is a bit of a a two bucket if you will because not all forms of 13:56 dementia are neurodegenerative for example vascular dementia which is a significant driver of dementia is not 14:03 neurodegenerative the way Alzheimer's is and of course Parkinson's disease is not typically a dementing disease in the way 14:10 that Lewy Body Dementia or Alzheimer's is but collectively taken together this would be the third Horseman the fourth 14:17 and final courseman is one that doesn't really directly kill an enormous number 14:23 of people but indirectly I would argue is the gasoline that is poured on the 14:28 fire of all of them and it's the it's the cluster of metabolic diseases or maybe a better way to think about it is 14:34 the Continuum of metabolic diseases that ranges from insulin resistance all the 14:39 way to type 2 diabetes Now type 2 diabetes is indeed an epidemic in the United States I apologize I can't quote 14:46 worldwide statistics but if you just go back in time 50 years to when I was born the prevalence of this condition was 14:52 less than one percent in the United States today it's over 10 percent so it's you know when you have a log fold 14:58 increase in a disease in a decade and that is not a diagnostic difference I mean it's Crystal Clear that using the 15:05 same diagnostic criteria we have this log fold increase uh it's clear that there's a problem and that problem while 15:11 it does kill people directly people do die directly from type 2 diabetes far more likely they're dying as a result of 15:18 its doubling of risk of these other horsemen that's a fascinating point 15:25 I have to say when I start your book and it's very entertaining it's very well written it 15:30 it besides the medical insights uh and advice you give there's a great deal of 15:36 you in the book which is uh riveting uh I have to say when I started it I had 15:42 a lot of skepticism because uh if you asked me before I read your 15:48 book you know these four things we want to we want to avoid them and we want to uh do better I would say you know 15:57 other than maybe obesity which we're going to talk a lot about and diet 16:02 nutrition uh these things are overwhelmingly driven by genetics and I 16:09 can't change right now I can't change my genetics at least in our current medical knowledge scientific knowledge 16:15 but you know I can be kind of cavalier about these risks because it's already written into my into my DNA 16:21 and uh in fact ironically uh you start with us with a an analysis 16:28 after after the introductory parts of the book you start with analysis of people who live very very long 16:34 uh they live over a hundred uh centenarians and they they smoke they 16:39 drink say uh you know there doesn't seem to be 16:45 anything they have in common behaviorally uh so it kind of reinforces my bias uh 16:51 and yet you come up with a very clever insight about those folks and use that 16:57 as an example of why my initial skepticism might be misplaced uh so while it's true the genetics have a lot 17:04 to do with our risk of heart attack cancer Alzheimer's Etc it's not the 17:09 whole story yeah so I this is an area where you know Russ I had no idea what the answer was 17:16 going to be 10 years ago so I was I didn't start writing this book until seven years ago but of course the topic 17:21 was my life's work and so 10 years ago I was really digging into this particular question around centenarians so these 17:28 are the people who as you point out these people live to be a hundred and Beyond and there's something very special about them and understandably 17:34 there are no shortage of studies being gone on them but the but the two people who have done the Lion's Share of this 17:40 work are Tom Pearls at Boston University and near barcelai at Albert Einstein 17:46 and I I'll never forget the day when I finally you know in Neo in The Matrix 17:51 finally sort of sees the connection and everything I never forget my Neo in The Matrix moment which was literally I 17:57 don't know Circa 2011. and up until that point there was a very important question I wanted to 18:03 understand which was did centenarians somehow have immunity from chronic 18:09 disease and therefore it was just a matter of time before something else 18:14 killed them that was not part of the chronic disease Playbook or did they just delay the onset and it became 18:21 really clear again just through putting all this work together uh 10 12 years ago that the answer was no they're 18:27 actually not immune to chronic disease they just have a phase shift in time 18:32 of 20 to 30 years but then they basically die in the exact same 18:37 distribution as the rest of us with a slight difference they get slightly more 18:42 cardiovascular disease and slightly less cancer but and I talk about all this in 18:47 the book you know when they get a heart attack they get their first heart attack it's about 20 to 25 years later but then 18:53 they go down the exact same path to demise of cardiovascular disease when 18:59 they get cancer they just get diagnosed 20 to 25 years later but then their path towards death is the exact same 19:05 so the inside here the first Insight was centenarians uh gift is indeed delaying 19:13 the onset of chronic disease not avoiding it indefinitely simply delaying it the second insight and this is the 19:19 second part that the chapter focuses on is you you led with this it's not due to any Behavior it truly is 19:28 a genetic Lottery contrary to popular belief however it's very polygenic it is not like there is a 19:36 longevity Gene now there are some that show up more frequently when I talk about the top four or five in that 19:43 chapter but I talk about them not because you and I can do anything about them right like you and I are not going 19:49 to go change our APO ERC type Gene our foxo gene or any of those genes however 19:54 what we can do is copy the phenotype we can't change the genotype we can't 20:00 change the actual Gene to match theirs but we can learn what that Gene is doing 20:05 so for example a gene a mutation in a gene or a snip in a gene a difference in 20:11 a gene that changes or lowers the burden of their lipoproteins the the causative driver of 20:19 atherosclerosis is going to lead to a delay in the onset of atherosclerosis 20:25 that's something we can mimic so um the other thing that came out of this 20:31 study for me was the understanding of where and when genetics play a role in lifespan and it turns out that up until 20:38 about the eighth decade of Life genes play virtually no role you can never say 20:45 no role because there are examples I could give where genes do indeed are almost deterministic in lifespan but 20:52 those are absolutely marginal cases for the most part into your eighth decade 20:58 genes don't play any impact on lifespan however as you get into the 9th 10th and 21:05 11th decade genes start to matter um all of this comes back to those so 21:11 what why does this matter well I'm not here to suggest you or I I don't know your family history Russ but let's just 21:17 assume you don't have centenarian parents or grandparents or siblings well you wouldn't have siblings but you know 21:22 brothers are uh um parents or grandparents aunts and uncles and I certainly don't I have very little 21:29 belief that anything I'm going to do is going to get me to live to be a hundred but that doesn't mean I can't live say 21:36 five six seven years longer than my quote unquote genetic predisposition and 21:41 again and more importantly it's what can I do for my health span what can I do 21:46 such that at 80 instead of looking and functioning like the average 80 year old I could look and function like the 21:53 average 65 year old that's the really important thing to consider 21:58 and that's very inspiring and very moving I want to raise a question you don't talk about in the book 22:05 uh it feels to me that my mom is 90. uh 22:10 she my dad died at 89 and he was a smoker and he had about five horrible 22:18 cancers over the last 15 years was alive that they didn't eliminate his ability to play tennis Rod his bicycle spend 22:24 time with his grandchildren but took a lot of the fun out of it it was a tough you know he hated the phrase uh he 22:31 battled cancer like it was a a military campaign in his view it was just you 22:37 were stuck with it and you know you did what you could and he was lucky in a 22:42 sense that he overcame them for a while but while he was overcoming them was really unpleasant so that part of your 22:49 book that themey book really resonates really resonated with me but let's think of my mom my mom's 90. she lives on her 22:55 own she until about a month ago she drove until she Dr uh you know side mirror off or you know 23:02 Excel her car misbehaved it accelerated suddenly when she put her foot on the brake and she decided it was a design uh 23:11 malfunction her children thought otherwise but she's Lucid she takes walks every day she 23:19 lives a very good life doing the things that she still enjoys at 90. uh my wife's mother 23:26 just turned to 80. and she's also very active it feels to me that 90s the new 80s and 80s the the new 70 is that a 23:35 misperception on my part because when I was younger old people just looked really old and a 70 year old seemed to 23:41 crepit and and hopelessly uh having a hard life or have have we made some 23:48 improvement in health span already no I I wish you were right Russ I think 23:53 that's a sampling bias I think you have a couple of really great examples yeah I think I think you have a couple of 23:59 wonderful examples in front of you but sadly I don't think that's the case 24:04 um I think we've done the opposite actually um I think so so there's two things going on actually let's go back to the 24:10 example that you gave believe it or not if in the 19 40s someone managed to escape you know 24:18 childhood mortality manage to escape all of the infections that probably would have killed him along the way managed to 24:25 not get a heart attack I.E managed not to die by the time they were 85 they 24:30 were on balance far more robust than the 85 year old today in large part because of their lifestyle right they were a far 24:37 more active person they were sleeping better they were probably under far less stress there's a lot of things that they 24:42 had going for them um whereas I think today yes we do have 24:47 more people living to that age but they're living at a probably a much 24:53 lower quality of life so um I think the two women in your life 24:58 are are excellent examples of what we would aspire to yeah and I I'm of course 25:05 well aware that they just could be lucky and I may not be or maybe no way of knowing in advance now you talk about 25:11 five tactics that we're going to talk about uh exercise nutritional biochemistry sleep emotional health 25:19 exogenous molecules and you have interesting things to say about all of 25:25 them uh and we'll get to that but before we do I want to talk about screening because you make a case for uh you know 25:33 one of the four horsemen is cancer obviously we've made tragically little progress in quote curing it or with a 25:40 couple exceptions we've made very little progress in in reducing mortality dramatically 25:46 um then I Prasad recently on the program very skeptical of the uh 25:52 all mortality impact of screening for um breast cancer and and colon cancer we 25:59 didn't talk about many other things but he certainly uh skeptical of those I think you're less skeptical on the colon 26:04 cancer front you have a different interpretation of the Nordic experiment Nordic trials on it well I'm going to 26:10 give you a chance to talk about that I have a thought on in response but talk about your view of screening and in 26:16 fighting cancer and then we'll turn to this yeah the question of tactics uh for for Better 26:22 Health span yeah I think I I think my my thinking on screening has really changed so much 26:28 over the past decade um I I trained in you know cancer so I did my fellowship with the National 26:34 Cancer Institute in immunotherapy and got to see firsthand what I think and 26:39 what I believe is the most promising therapy we have for cancer going forward so uh everything you said about the lack 26:47 of progress in cancer so far uh is true and I'll put some statistics to that in a moment but when I think about the next 26:53 decade I'm actually much more optimistic um and we can talk about why but let's let's talk about some facts so 50 years 26:59 ago a little over 50 years ago Richard Nixon declared a war on cancer the goal if you recall this is coming on the 27:05 heels of the success of the Space Project where you know Kennedy declares we're going to go to the moon in 61 and 27:11 in 69 we're there and let's be clear it was a very reasonable although naive a 27:16 thing to assume that we could do the same thing with cancer well in the early 1970s if you had metastatic solid organ 27:24 cancer so epithelial cancers mean cancers of you know breast prostate colon pancreas lung brain all those 27:30 things if you had metastatic solid organ tumor the probability you would be alive in 10 27:38 years was Zero that's the metric that matters not median survival median survival might 27:45 have been 12 months today it's longer but overall survival zero 27:50 what is it today it's slightly better than zero but its 27:56 own in solid organ tumor there's only two solid organ cancers that are being cured today testicular cancer which was 28:02 not cured back then and a very rare type of stomach cancer called GI stromal 28:08 tumors this is not the stomach cancer that killed most people this is a rare cancer because it happens to arise from 28:14 one mutation for which there's a beautiful targeted drug so we'll make the math easy and say 50 28:20 years ago a hundred percent of people with metastatic cancer died in 10 years or were still alive in 10 years and 28:26 today uh you know one percent of those people might be alive so that's that's really low progress now median survival 28:33 has increased significantly it's probably more than doubled and some non-solid organ tumors have 28:40 become cured so the success against leukemias and lymphomas has also been remarkable again I think for the space 28:47 of time we don't need to go into all those but I just want to make sure people understand that look overall survival for cancer overall survival is 28:56 probably up by eight to ten percent from 50 years ago but why so little 29:03 well I would say that there are a couple of things going on but one of them is 29:10 I don't think I mean the obvious is we don't have great treatments right so we don't have great treatments once cancers 29:16 reach a certain size and a certain mutagenic burden the cancers seem very 29:23 good at out maneuvering Therapies but the other thing I would argue is 29:30 we're intervening very late because we intervene at a time 29:37 when the cancer is quite visible now if you if you consider like I don't know a lump in a breast if it 29:43 turns out to be cancerous it's already even just at that one lump well over a billion cells 29:52 now the question is what's the probability in a billion cells that you're going to have 29:58 heterogeneous pools of cells that are not going to respond to the same therapy 30:04 it's actually pretty pretty high it's much higher when that number is a hundred billion cells 30:11 so enter the discussion of screening which is something I used to really be a a 30:16 stronger skeptic of I really used to think that screening wasn't doing much in fact I even worked on a lengthy 30:23 project on this when I was in medical school and I used to think that most of the effective screening was lead time bias so you kind of alluded to this 30:30 actually a few minutes ago Russ when you said if you if you catch a cancer two 30:36 years earlier it could look like you're living two years longer when in fact you're not 30:42 I think a couple of things now I feel I feel different about this so the first is the following 30:49 if you look at colon cancer and breast cancer which are two easy examples to look at and I write about 30:54 this in the book We compare the success of adjuvant treatment versus metastatic treatment so 31:01 I'll Define those terms in a second you see an important pattern adjuvant treatment is the treatment you give a 31:07 patient after you have removed all visible cancer so this is what's done in 31:12 stage two stage three colon cancer so a stage three colon cancer let's use that as an example a person has a colonoscopy 31:19 and you see a tumor they sample what they biopsy yep they know it's cancer that person goes to the 31:25 operating room they have a section of their colon removed and a section of the adjacent tissue and you actually see 31:30 that the cancer even went to the lymph nodes so that's that's a that's a pretty aggressive cancer 31:35 but on during the surgical exploration the surgeon looks there's no visible tumor in the liver you can't you can see 31:43 that you do a scan of that person there's no visible tumor anywhere in the body so the term in oncology because 31:48 that person is NAD no evidence of disease do we just leave that person alone no we 31:54 don't we give them a cocktail of chemotherapy what's the survival of that person five 32:01 or ten years later call it 10 years later it's a little over 50 percent meaning half those people are alive 32:07 little over half those people are alive but half those people had a recurrence typically in the liver or in the lung 32:14 and they don't survive now what about the patients who have 32:19 metastatic cancer on that same day that these persons had their surgical resection it turns out we give them the 32:25 exact same chemotherapy how many of those people are alive explain what metastatic cancer is in other words it's 32:32 not the first one was no visible tumors but the cells nearby have some have 32:38 cancer that's right in the metastatic case it's visible to the naked eye either at the 32:44 time that the surgeon removes the colon he or she can actually see cancer in the liver or even just doing a scan on the 32:50 person you see that the cancer has spread of the liver lungs where else we give those people the exact same 32:56 therapy zero of those people are alive so what's the diff five five to ten 33:03 years later you said that's correct yeah that's correct yeah what's the difference why is it that the people who present 33:10 with metastatic disease cannot survive for 10 years where those 33:16 that survive that those that present with stage three disease and you give them the exact same therapy you could 33:22 save half of those people permanently that's a cure by the way I believe in many others as well uh 33:29 believe that the difference is in tumor burden the difference is that when you're 33:35 treating that patient with adjuvant therapy I.E when you don't have visible tumor you probably only have a few 33:41 billion cells scattered throughout the body when you're treating that patient with abject metastatic disease there are 33:47 hundreds of billions of cells throughout the body it's it's a numbers game and the numbers are not in your favor 33:54 the same example by the way is true with breast cancer so if you go hormone receptor for hormone receptor and do the 34:00 same exercise when you treat women for adjuvant therapy versus treat women for metastatic therapy using similar 34:06 regimens you're going to get similar outcomes all of this leads me to the 34:11 inevitable conclusion that the earlier one can detect a Cancer 34:17 and treat it the better your odds are does it mean that there's a guarantee absolutely not the biology of this is 34:23 very complicated and and by the way we use we I think you know if we want to talk about breast and colon those are 34:30 two great examples because they have very different biology so colon cancer develops in a halsteadian manner so 34:37 William Stewart Halstead sort of the the modern architect of you know American surgery proposed this idea which is not 34:46 true for all cancers but is true for colon cancer and that is the stepwise 34:52 progression from adenoma to cancer to distance spread so every single colon 34:59 cancer comes from a polyp though most polyps do not become cancer this is not true in breast cancer and 35:06 this is why I believe breast cancer is a much more complicated cancer right we don't fully understand not every breast 35:13 cancer comes from a ductal carcinoma inside you so there's something going on in the biology of breast cancer that 35:19 makes it more complicated but the reason I do feel very strongly about colonoscopy is it's also one of the few 35:25 cancers you can look directly at you can't look at breast cancer you have to 35:30 infer it from a mammogram an ultrasound an MRI those are all flawed they all 35:38 have limitations in sensitivity and specificity the way a colonoscopy does not so with colonoscopy I think what we 35:45 really need to be considering is at what frequency would you need to do this given that you know every Cancer came 35:52 from an adenoma to justify the risk because we'll have to talk about the three risks of colonoscopy and it is a 35:59 it's it's it's it's not a benign procedure unlike a mammogram which has a trip real amount of radiation and is 36:05 effectively a benign procedure so I don't want to suggest that this is an easy problem to solve and that's why I write about it at length but it is um 36:14 there's you know again I I have yet to see evidence that suggests that treating 36:19 Advanced cancer is better than treating early cancer or treating you know 100 36:25 billion cells is better than treating a billion cells or as good as let's put it that way 36:30 and so the question is you know as we talked about in the episode with finite Prasad they all cause mortality 36:37 which I Mis spoke a minute ago all cause mortality uh for colonoscopy it seems to 36:44 be relatively unchanged by by the procedure either 36:49 because it doesn't matter or be meaning it's not that important to get it early probably not the reason there are side 36:57 effects that you alluded to the three things there's perforation there's infection I assume there are other 37:02 things um and while you're skeptical I know of 37:07 some of those all-cause mortality results they are discouraging uh in 37:12 attempts to it does call into question the it's complicated but well let's 37:18 let's talk about the Nordic trial because I think that's the that's the that's the trial that would be looked at 37:23 as the the case against uh colonoscopy from an all-cause mortality standpoint 37:29 so the Nordic trial just for folks listening is a an enormous trial that was done in Europe published recently I 37:34 was about a year ago I think it was published Last Summer and it looked at uh two groups of people 37:40 half the group was randomized to usual care which meant not doing anything uh the other half was randomized to a 37:48 recommended colonoscopy in a 10-year window of time well let's pause for a moment and make 37:54 sure people understand the difference between Effectiveness trials and efficacy trials so an efficacy trial says let's use a 38:04 different example to make this easier let's say uh Russ we wanted to study the effect of a certain diet on weight okay 38:12 so we we get our people we randomize them and we tell one group look you're going to have to eat uh lettuce and 38:21 carrots and lima beans and Fiber One cereal for the next five years that's 38:27 all you're allowed to eat and the other group you can eat whatever you want and five years later we go and see how 38:34 they're doing well the efficacy of that is only determined if the people are able to 38:40 adhere to the right diet and the notorious challenge of dietary studies 38:47 is it's almost impossible to do efficacy studies if the intervention is quite extreme and for the most part we give up 38:53 on doing that and we only focus on Effectiveness studies which is how effective is this intervention in the 38:59 real world I.E how effectively can people follow the advice that is given so again when you tell people go on a 39:06 low-fat diet go on a Mediterranean diet you know they're going to adhere to it at some level but it's nowhere near the 39:12 prescribed level so this was a uh this was an Effectiveness trial of colonoscopy we're 39:20 going to recommend that you guys get a colonoscopy once in 10 years 40 of them did 39:26 a I'm not convinced that every 10 years is nearly sufficient enough there's literature showing that people can 39:32 develop colon cancer as little as one to two years after a completely normal colonoscopy again we could argue maybe 39:40 in those cases the adenoma was missed a year earlier it's hard to say but what I 39:45 would say is 10 years is far too infrequent and furthermore we didn't have very good compliance despite a 39:52 statistical analysis that suggested that didn't matter I don't buy it because I also don't think that the 10 years was 39:57 sufficient so I think that what we really ought to be doing is asking what 40:02 is the probability of one of those three risks so what are the three risks of colonoscopy there's the risk of the bowel prep which for people like you and 40:09 I is not an issue Russ but it would be for your mom and by the way I'd have reservations about your mom doing a 40:15 colonoscopy because of the preparation she could get so dehydrated that she could fall and knock her head right if 40:21 the bowel prep is a big deal but that's risk number one risk number two is the 40:27 risk of the sedation the ACT it's a low risk but it's not zero and then risk 40:32 number three is the procedural risk of bleeding and perforation and I always advise people when you're 40:39 getting a colonoscopy you must ask the endoscopist what his or her risk is of 40:46 perforation I'm sorry for laughing I apologize because I think I recently in the in the Prasad episode I don't know 40:52 if it was in that episode or not but you know a friend of mine was recently encouraged to do a particular procedure 40:57 and and I was worried about it about the a bad outcome and I said should ask 41:04 about it and the guy said well you know the odds of it are only blah blah blah and I said you don't want the national odds you want his or her odds the person 41:13 doing right and I assume they're not so eager to tell you sometimes yeah but you know what look I we were 41:19 encouraged in my surgical training to be very open about that and if even for the simplest procedure like putting a 41:25 central line into somebody I could quote the national average but I could also tell you that in the last 300 of these I 41:31 punctured one lung uh in the last you know 100 times you take out somebody's gallbladder you accidentally nicked the 41:37 common bile duct whatever the number might be so I'm I don't want to downplay any of those risks and they must be 41:44 taken seriously but what we really need to do is ask the question what is the 41:49 cost of those versus the cost of missing a colon cancer so here's the thought experiment so let's this you know as an 41:55 economist you'll appreciate this because the only way you can do this thought experiment is to throw money out the door for a minute so we're not going to 42:01 talk about the economics of this here's the thought experiment if you did a colonoscopy every three 42:08 months on a person could they ever die of colon cancer if you did a proper 42:13 bowel prep and did a colonoscopy the answer is no right you could there's no chance that in three months an adenoma 42:20 could be could develop and become cancerous in three months so the question then is okay so so you 42:26 take the 53 000 people a year in the U.S who die of colon cancer you took that number down to zero you have to because 42:33 it's a halsteady in cancer now the question is how many more people did you kill from the bowel prep the sedation 42:41 and the perforation by the way I did this calculation on the back of my napkin one day I got about five thousand 42:47 you would kill about 5 000 people doing the procedures 42:53 should we make that change I'm not suggesting that at all I'm suggesting that's an extreme way to think about it 42:58 right yes and then you take yeah there's also the stress which is 43:06 not sure how that factors in how important it is um issue with some of the other cancers 43:13 Russ I think I think that's less of an issue with the colon cancer because you get the answer right away but I think 43:20 your point about stress is significant when it comes to the more vague Imaging 43:26 modalities you get false positives I'm thinking 43:31 more of the stress of the of the procedure a lot of people because of our cultural taboos the idea of a 43:39 colonoscopy is so unpleasant that some of the 60 who didn't get that even though it was recommended in the Nordic 43:45 trial just didn't want to think about it uh and if you force them to have it or in some measure or incentivize them it 43:52 would come with an additional um burden but it's probably pretty small uh so I think vinay disagrees with you 43:59 but I'm not sure why you know he he is he reported well I think I I'll tell you 44:04 why I think having not spoken about this with vinay though I'd be happy to I think vinay and Peter come at this 44:10 through totally different lenses and neither is right and neither is wrong right vinay is coming at this through 44:15 the lens of policy he's coming at this through the lens of what is the recommendation to all I'm 44:22 coming at this through the lens of the individual I'm giving you as a person the way to 44:28 think about this for your decision around colon cancer I'm going to get a colonoscopy every three to four years 44:35 because I am comfortable with the additional risk that I'm taking of the 44:41 procedure by the way the additional cost I'm bearing because my insurance will not pay for it more than every five 44:46 years so I'm personally on the hook and it's not cheap I mean I just paid for my last colonoscopy I think it was about 44:53 two thousand dollars so that's that's a big sum of money um but at the individual level I can do 45:00 the math and make that determination I think vinay is saying we're trying to 45:06 make recommendations to millions of people here it can't be that nuanced it has to be based on Effectiveness trials 45:14 not efficacy he claims they're the same that after a statistical analysis those that 40 60 45:21 difference wasn't important but uh I that's a separate 45:26 statistical question reasonable uh economists and and data analysts can disagree on it I'm 45:32 sure but I think it's important for our listeners who may have after the previous episode said well I never do 45:38 that again I should think twice and I appreciate your your view on this I want 45:44 to turn to nutrition which is uh one of the tactics you talk about uh first 45:50 let's get get uh get it off the table you're not a big fan of epidemiology and 45:55 you and I share a deep I think Brotherhood there yeah I um I used to be far more 46:04 outspoken about it although I do devote some real estate in this book to talking about how we need to be very skeptical 46:10 of nutritional epidemiology I think epidemiology has had some enormous wins and I always try to point those out to 46:17 to sort of say look the field in and of itself has done some good um you know I mean we can point to 46:22 cholera and and other things like that and certainly smoking by the way we were never going to do the definitive 46:28 randomized control trial to demonstrate the harm of tobacco smoke but you know I also have to explain the 46:34 Bradford Hill criteria to make sense of when can you increase your confidence in 46:41 the causal nature of an observation and I think it is very safe to say Russ 46:47 that the ability to infer cause from nutritional epidemiology is somewhere 46:55 between zero and Epsilon where Epsilon is a very very very small number 47:00 yeah yeah so but that does not mean we have nothing to learn about nutrition and and 47:06 I want to give you my takeaways uh your from your book and and let you uh 47:12 elaborate on them so I would say a huge theme of of the Tactical part of your book that what we 47:18 would call advice and it's wonderful because you don't say uh go paleo 47:24 lift weights do this with kettlebells your your wise man you understand that 47:30 everybody's different uh and a lot of those things uh those disputes about various diets and exercise regimes are 47:38 as you say in the book religious resident intellectual and it's a wonderful Insight very important 47:45 um but you spend a lot of time on exercising nutrition without giving explicit without joining a church which 47:52 I which I really appreciate it but they're quite complicated a lot of your your your suggestions and I want to 47:59 start with the simplest recommendation I would take away from your nutrition and then see if you can make me go a little 48:04 a little further so um kind of simple actually 48:09 uh don't be obese take in fewer calories uh stay away from 48:15 sugar and junk food and uh you've gone a long way toward 48:20 what nutritionally you can do there's more to say and I want to let you say it but uh I think that's an enormously big 48:28 step for most people and I would say as a person on a diet right now I've been deeply inspired by your new 48:35 section of your broken calorie reduction to stick with it and so I'm uh I'm 48:40 guardedly optimistic you've had a uh a powerful impact on my beliefs it may be 48:46 a placebo effect that works too so I'm okay with it 48:51 well I'm glad to hear that Russ I I think the easiest way to talk about nutrition is to maybe do it through the 48:59 clinical lens in which I will look at a patient so every time I interact a patient I'm asking myself three 49:07 questions I mean I'm asking myself hundreds of questions but these are the three questions that factor into the 49:13 thinking around a nutritional strategy the first question is is this person 49:18 overnourished or adequately nourished that's a way of saying are they storing 49:25 excess energy or not let's understand something here which is up until about 49:30 150 years ago I.E from 250 000 years ago until 150 years ago 49:39 the ability to store excess energy was very good right this is this 49:45 was our darwinian superpower this is what allowed us to Leap Forward 49:51 our brains which weigh 2 percent of our body weight consume 20 to 25 49:57 percent of our metabolic demand there is no way our species could have 50:02 evolved to where it did did we not have the capacity to store enormous amounts 50:08 of energy so this was a very good thing until very recently when we entered such 50:14 an energy dense environment so question one is are you storing 50:20 excess energy or not question two is are you adequately muscled or not 50:27 and question three which is often related to the first two is are you 50:32 metabolically healthy or not now the good news is all three of those questions have objective answers there's 50:39 nothing subjective about this now you can't measure them on a bathroom scale you do need more complicated testing 50:46 called dexa testing but that's readily available it's about a hundred dollar test everybody can get a dexa scan and 50:52 understand the extent to which they are overnourished undernourished adequately muscled under muscle then I explain all 50:58 the parameters for these things and if they're metabolically healthy or not which can be done with blood testing 51:03 when you know the answer that question you basically now can draft out an algorithm which says do you need to 51:09 maintain caloric intake or decrease it and by the way in some cases increase it do you need to maintain protein intake 51:17 specifically or increase it and do you need to undertake additional tools to 51:23 improve your metabolic health and that's where exercise fits in by the way it also fits into the muscle balance now 51:29 most people listening to this if they go through this exercise more than 50 51:34 percent of people are going to wind up in the over nourished camp so if you're in the overnourished camp 51:40 the strategy must be some form of energy reduction and what I outline in the book 51:46 is there's only three strategies to reduce energy and others only three ways to go about 51:52 reducing intake one is directly we call that caloric restriction you directly reduce caloric intake without 51:59 necessarily paying attention to what you're eating and when you're eating you just say total pool of energy must go 52:04 down so if I'm eating 3000 calories a day it's got to be 2400 calories per day but if you're willing to track that and 52:11 that's the challenge of this approach you have great flexibility in what you eat and when you eat 52:16 the second approach is time restriction this has become very popular lately and also very cult-like but this says the 52:24 key is just fasting throughout the day so Russ you might say well okay the way 52:29 I'm going to do this is I'm only going to eat between two o'clock and seven o'clock in the afternoon so two o'clock in the afternoon seven o'clock in the 52:35 evening and by you know starving myself for 19 hours a day it's going to induce 52:41 indirectly a state of caloric restriction and that's fine uh the data on this by the way are crystal clear there's nothing magical about time 52:48 restriction metabolically or from a health perspective all of the benefits that are accrued through time restriction are through the Direct 52:54 effects on calorie restriction the third and most contentious of this and I say most contentious because it's 53:01 the one where most of the attention is it's the one where most of the books are written is called dietary restriction so 53:06 you pick a boogeyman in the diet and you take it out and the more restrictive the 53:12 the the boogeyman the more calorically dense it is the more ubiquitous it is the more restrictive you'll be so again 53:18 I use this example but if you if you go on the all lettuce diet uh you're gonna lose a lot of weight if 53:23 you go on the no lettuce diet you're going to lose no weight but that's where paleo and vegan and low carb and South 53:31 Beach and all those things come in they're restrictive diets and the more you restrict the more you will lose none 53:37 of these in my opinion are really superior to the other the data just doesn't bear it out what what the data 53:43 suggests is the one that you can adhere to is the best one yeah that's that's 53:49 again it's not a very satisfying answer because I think people want to believe that there is one true answer here but 53:56 at the level of our capacity to measure these things that doesn't seem to be the 54:02 case so thing to me and let's move away from the 54:07 individual for a minute and talk about the practice of medicine and I want your take um 54:13 past Dr mine in a different city different country where I am now I liked him a lot it's 54:20 thoughtful sensible clearly well educated understood a lot of things I 54:25 would get a physical uh the physical would go something like this um I would say I don't want a PSA test 54:34 because I know there's a lot of false positives and he'd say oh okay 54:39 um and then he would do the rest of the what do we call it work up and I'd get a 54:45 PSA test anyway even though I told not to they'd throw it in for free and I say I I didn't want that oh yeah sorry about 54:51 that fortunately it was always a relatively low number didn't lead to anything bad then we look at all the the 54:56 60 40 28 things that came back and there's a range 55:02 called healthy abnormal if you stayed within the range nothing else happened 55:07 we never had a conversation again smart man uh this was a while ago so maybe 55:13 things have improved but in general the doctors that I've encountered and talked to tend to just view it as a 55:20 binary thing your HDL is okay your such and such is okay and they go down the 55:27 list and if that and if something's not okay they might say oh yeah maybe your glucose a little high your sugar's a 55:33 little high you should probably cut out candy bars or eat less dessert that would be the that's the most radical 55:39 thing I've ever learned from a physical except for the occasional the last time 55:44 because I'm getting older now and I get more things outside the range if they say things like well yeah keep an eye on it but it's 55:50 probably okay you have a different approach so talk about that and why your approach 55:57 isn't everybody's approach what's going on well 56:03 um I guess there's a couple of things I'd like to spend the whole rest of the time on your approach not the rest time you spent three four hours on it a 56:09 lifetime so try to summarize give us a thumbnail of why you look at that number differently from then than I just 56:15 described it so I think a couple things one one is let's talk about what that range means 56:20 so when you when you go to a doctor and the doctor does a blood test on you and you look at the range 56:26 um it's very misleading to editorialize that the way we do by saying this is normal this is not normal we should be 56:33 more accurate and simply talk about what it is which is this is the interquartile 56:38 range this is you know for example if you look at your liver function tests your AST and your alt it might say less 56:45 than 40 less than 40. that doesn't mean less than 40 is normal and that 39 is good and 41 is bad it 56:52 simply means that in that case less than 80 percent of the or 80 of the people 56:57 are below 40. right or if you look at your testosterone level and it says 300 57:03 to 1200 is quote unquote normal no it means that 57:08 five percent of people are at 395 or the 95th percentile is at 1200 so the fifth 57:14 to 95th percentile is between 300 and 1200. and so again I think the problem 57:20 starts when we take a binary look at any of these metrics again let's I'll use 57:25 one more example which is the hemoglobin A1c which everybody I'm sure is familiar with that's the test that's used to 57:30 diagnose type 2 diabetes so the diagnosis of type 2 diabetes is made today this is not the way it used to be 57:37 done um but it's made today when you have that number exceed 6.5 percent 57:44 uh because that number is an estimate of your average blood glucose so 6.5 57:49 percent represents or estimates an average blood glucose of 140 milligrams 57:55 per deciliter that so we would all agree today if you have that number or greater 6.5 or above you have type 2 diabetes 58:02 but does that mean that if you're at 5.7 percent versus five percent that it's 58:08 the same no not at all this is a Continuum and We Know by the way that there is a monotonic Improvement in 58:14 health outcomes as that number gets lower so five is better than 5.5 is 58:19 better than six even though none of those have diabetes so that's that's problem one problem two 58:27 is and I went to a good medical school in your backyard Stanford and I think I 58:33 had a very good medical education I mean I I had amazing professors and we I thought it was just a it was amazing to 58:40 be lectured by Nobel laureates and all of that stuff you talked at the outside about five 58:45 tactics what in the four years of my medical school Russ I want you to estimate for 58:52 me how much time did I receive training in nutrition exercise emotional health and 59:00 sleep which were four of the five tactics and just just round it to the nearest hour that's zero one maybe 59:08 it's exactly right I I would give you a confidence interval of 95 if you said 59:14 zero to one now this is a problem and I want to juxtapose this with the problem I stated 59:20 at the outset of our discussion what gets measured gets managed and all we're measuring is lifespan and that's all 59:26 we're managing and then we're educating people in one-fifth of the tools we have 59:31 at our disposal to impact these things which is the exogenous molecules piece 59:36 and and again I I don't want to suggest that medications aren't valuable I can talk 59:43 for hours about all the places where medications are valuable but the truth of it is and this is borne out by data 59:50 it's not as valuable as exercise exercise is far more potent at extending 59:56 lifespan and improving Health span than any medication 1:00:03 um I misremembered my doctor I was mentioning I remember I had a vitamin D 1:00:09 deficiency which of course I suspect an enormous part of the American population does 1:00:15 because they work indoors and don't play outside much and so he prescribes like a mega dose of vitamin D and I thought I'm 1:00:23 not sure taking vitamin D is the same does the same thing to my body as Sunshine does in terms of reducing my 1:00:29 risk of I think it was shingles and it looks like it's correlated with kidney stones and I really don't want to get a 1:00:35 kidney stone so I remain I am sure very vitamin D deficient although now that I live in Jerusalem and walk to work every 1:00:42 day I think I'm I'm probably up a bit I hope I'm into a into quote a healthy range but I think the point you're 1:00:48 making about I mean there's two things you did mention the other one the one is well some of these even if they're in 1:00:54 the range there's a big difference so what piece of the range you're in second is you should be looking at them over time 1:01:00 because they tell you things about how your body is aging and I've never had a 1:01:05 doctor do that so I think it's a fascinating example about the training 1:01:10 and the mindset of medicine this that what you call the 2.0 mindset that and I'm not sure why I think it's a 1:01:16 hard question to answer why it's so I would call it 1:01:22 algorithmically driven rather than craft or art driven you have the word 1:01:27 art in your title and I think the part that's in it's incredibly important but 1:01:33 it can't be measured precisely so I think it gets ignored 1:01:39 I think that's fair um I I don't I you know you've said this 1:01:45 I'm sure in the past and and I and I want to make sure it's clear I think most doctors desperately want to 1:01:52 practice medicine 3.0 and again the title The the term is meaningless it's just a dumb idea I came up with but I 1:01:59 think everybody understands the ethos of it right everybody understands that they 1:02:04 want to prevent their patients from getting ill they want to keep people not 1:02:11 just living longer but more importantly living better I think another point which can't be 1:02:17 ignored here is the structural system of reimbursement now again this is a very 1:02:23 U.S Centric uh discussion but unfortunately the US and Canada are the two systems I 1:02:29 understand best because I grew up in Canada but I you know I've lived over half my life now in the U.S both of them 1:02:35 are completely inappropriate to solve this problem for completely separate reasons but in the U.S 1:02:42 because it is mostly a for-profit system which is not always a bad thing but in 1:02:49 this case it requires a system of diagnosis and billing code 1:02:54 and there this gets into a lot of problems which is you couldn't fix the system today because you don't have a 1:03:01 diagnostic code to bill for True preventive work so uh again we I don't 1:03:09 need to tell an economist what incentives do and there's nothing wrong with people who follow the incentive but 1:03:16 if the ins if if you're going to say to a physician you have to see X number of patients in 1:03:23 a day because that's the nature of the job and that affords you 15 minutes per 1:03:28 patient per day well in that 15 minutes you have to see how many billing codes you can come up 1:03:34 with and they have to be in line with the tools you have to treat so when you look at hypertension which 1:03:41 is a very important problem that's a that's a diagnosis um it's a lot easier to give somebody a 1:03:48 medication for hypertension than to explain to them how to exercise and change their 1:03:55 nutrition which could also be very effective there and by the way address their stress so and by the way I don't want to suggest I could do a better job 1:04:01 there's zero chance I would be doing a better job Russ no chance at all so it's 1:04:08 I have nothing but empathy for the doctors that are in that system and unfortunately the doctors those of us 1:04:14 who practice differently have to do so outside of the reimbursement system and 1:04:19 yeah I don't I don't want to go any deeper into this although my first thought is that it would be nice to have an app where I could enter my uh results 1:04:25 of my blood tests and and then it would help me track them over time in a thoughtful way I don't think that's very 1:04:31 hard to do I think there's some obvious things you could learn from that um it's shocking to me now that I think 1:04:37 about that I've never seen that done by a doctor I understand no incentive to do it or limited incentive but well but I'm 1:04:44 actually surprised I mean that that seems I mean I don't even think that that's the massive Insight the massive 1:04:49 Insight shouldn't be tracking it over time it's really knowing what to do with it so so for example like let's use your 1:04:56 PSA example so so I think that the the PSA I think has been demonized for the 1:05:01 wrong reasons um it's a very very low specificity test there's no doubt about it uh it's a high 1:05:08 sensitivity low specificity test which means taken on face value it's not helpful for making the diagnosis of 1:05:13 prostate cancer but again a very good doctor understands that it's not PSA that matters it's PSA 1:05:21 velocity which we calculate so there's an app for that by the way there's literally an app online where you plug 1:05:27 in all your PSA values and time and it calculates PSA velocity and if PSA 1:05:32 velocity exceeds 0.45 meaning if it's changing at 0.45 units per year or 1:05:38 greater that's a problem we also calculate PSA density so you take the 1:05:43 PSA and you divide it by prostate size which can be determined easily from an ultrasound that costs about 10 cents if 1:05:49 the PSA density exceeds 0.1 that's also of concern so by looking at PSA velocity and PSA 1:05:56 density you can very easily catch us and I'll tell you a very interesting story a very close friend of mine 1:06:02 um was paying attention to his father's Health he's not a physician by the way but he works with me he noticed that his 1:06:08 dad had a PSA test and the number wasn't that high right people don't get alarmed 1:06:13 until it's above three it was below three but he did the calculation because 1:06:19 he works with me and he saw that the PSA velocity was over 0.45 and so they went 1:06:24 he told his dad hey you got to tell your doctor this is a problem you need to get an MRI to look at this and the doctor 1:06:30 said no no there's nothing wrong with this and to make a long story short we went around the doctor got the MRI he 1:06:35 ended up having prostate cancer um and so you know his son who's not a 1:06:41 doctor made the diagnosis by looking at the rate of change of PSA which again is just time series data so 1:06:47 um I would I it upsets me to greatly to think that that patients don't have access to that information well Nicholas 1:06:55 Talib says when you go to a casino you don't take gambling 1:07:01 advice from the carpenter who built the roulette wheel even though in theory he's an expert on roulette because he built the wheel and doctors are not 1:07:09 trained sufficiently in my view in risk or this craft and art we're talking about and of course individuals who are 1:07:17 not doctors can often give thoughtful advice a friend of mine said 1:07:22 he had a vitamin D deficiency he was going to take this vitamin D supplement and I said 1:07:27 well you might worry about blah blah and he said he looked he looked at me like I was insane he said you don't understand 1:07:33 a doctor told me to take it and I wanted to say um okay whatever I am a doctor just not 1:07:40 the kind that helps people but maybe an economist but maybe in this case it 1:07:45 could be helpful anyway um a couple other issues we don't have time to talk about I just want to mention them and let you say a few 1:07:51 things about them if you'd like a couple things in here that were helpful to me you argue for the importance of protein 1:07:57 you order for the importance of sleep and you argue for the importance of exercise and the exercise 1:08:03 uh chapter is hard for me because I don't have the devotion that it sounds 1:08:09 like I need to go to the level of of uh customization that you're worrying about 1:08:16 so first for me who sits at a desk and loves sitting at a desk or a comfortable 1:08:21 chair even better or lying in bed uh and would do it for you know 16 hours a day 1:08:27 I now walk to and from work so my step count in Israel is ten thousand plus and 1:08:34 sometimes 20. uh when we go out at night because I don't own a car versus the 1:08:39 four or five thousand I had in Suburban Maryland I assume that's a good thing but I had some guilt reading that 1:08:45 chapter on exercise because I think I'm not doing enough and I'm worried I don't know how to get there from here 1:08:50 so give me some thoughts on exercise that if you want to throw in some protein and sleep all right I'll start with a specific 1:08:57 piece of advice for you that you could without adding any more time to your day could get you more benefit provided you 1:09:04 have a place to shower at your office which is you could instead of just walking to and from work you could Rock 1:09:10 to and from work I talk a little bit about rucking in the book which is just putting a weighted backpack on so if you 1:09:15 were carrying 30 pounds with you everywhere you went um again it wouldn't take any more time 1:09:22 but what it's going to do is give you more compressive load right because one of the things we have to think about here is we have to make sure you have 1:09:28 strong bones strong muscles as you age um once you hit the age of 65 if you 1:09:35 fall and break your femur or your hip your one-year mortality is anywhere from 1:09:43 15 to 30 percent that's all cause mortality because what happens when a person breaks their hip they don't just 1:09:50 die immediately from blood loss or from a fat embolism or a blood clot those things can happen but it says them on a 1:09:56 trajectory towards all sorts of bad things happening so even if you take the 1:10:01 low end of that estimate 15 percent of people age 65 are over fall and break their hip they're going to be dead in a year and 1:10:09 of the remaining survivors 50 of them will see a full reduction in 1:10:14 functionality uh meaning people who walked unassisted will now require a cane people who were on a cane will 1:10:21 require a walker people who were on a walker will be in a wheelchair so how do we avoid those things well we avoid those things by working we avoid those 1:10:28 things by having strong muscles strong bones and improving our balance which you get by practicing so again that's 1:10:33 just a very simple thing that says look if you don't want to be in the gym doing all these other things put that rucksack on your back when you make that walking 1:10:40 you'll get more bang for your buck okay now why do I harp on this so much because I think the data are 1:10:45 unambiguously clear that exercise is hands down the 1:10:51 heavyweight champion of interventions um and here's where the statistical tool 1:10:56 of a Cox proportional Hazard makes this case very clearly so uh I won't go into 1:11:02 the explanation of it I assume your listeners understand what a hazard ratio is sort of okay A Hazard ratio is uh is an 1:11:11 indication of relative risk so let's start with things that are very obvious is smoking bad for people yes how can we 1:11:19 measure this well when we look at all cause mortality if we compare a smoker 1:11:26 to a non-smoker at any point in time the smoker has a 40 percent increase in 1:11:35 all-cause mortality in the coming year relative to the non-smoker so that's a hazard ratio of 1:11:40 1.40 that's a very big Hazard ratio and it's not surprising right I mean it's 1:11:46 not just that smokers are more elected to die lung cancer they're more likely to die of all cancer they're more likely to die of heart disease all of these 1:11:52 things okay if you look at the hazard ratio for high blood pressure it's about 1:11:57 1.29 1.3 so 29 to 30 percent chance greater death in the following year than 1:12:05 the non-smoker at the very extreme levels for us we look at people who have end-stage kidney 1:12:10 disease so someone who's on dialysis compared to someone who's not on dialysis that Hazard ratio is about 2.75 1:12:17 that's enormous that's 175 difference in all cause mortality 1:12:22 over the coming year now let's talk about the difference between being very fit and not being 1:12:28 very fit when you compare so let's do there's a test called a VO2 max test which is uh it's a it's a test you do on 1:12:36 a treadmill or on a bike where you have a mask on your face and you're pushed to exertion to failure actually and what's 1:12:43 measured is the maximum amount of oxygen you can consume and the higher the amount of oxygen can you can consume the 1:12:49 thinner you are when we look at when we divide people into quartiles and we compare the top to 1:12:56 the bottom Etc you see Hazard ratios that look as follows if you compare people at the very bottom the the bot 1:13:03 and this is bisex and by age so if you take 60 year old men in the bottom 25 1:13:09 and you compare them to 60 year old men in the top two and a half percent the 1:13:14 hazard ratio is five that's 400 percent difference 1:13:20 if you just compare the bottom 25 to the second quartile these people are both 1:13:26 still below average the hazard ratio is 1.5 it's a 50 difference I could do the same 1:13:34 exercise with muscle mass and strength and while the numbers aren't quite as big they're still in the two to three x 1:13:40 Delta and the reason for this is that VO2 max strengthen muscle mass are 1:13:46 amazing integrals of work like you can't just decide tomorrow you 1:13:52 want to be strong and have a high VO2 max the way you could fix your vitamin D like if you took enough vitamin D in two 1:13:58 weeks you'd normalize your level the reason I don't think that has much of an impact is that you know it's it's not a 1:14:05 real change in your physiology the way if if we improved your VO2 max by 25 1:14:12 which we could do in two years it would have a bigger impact on your 1:14:17 lifespan and the quality of your life than any other intervention but it would 1:14:22 require work so this is the two-edged sort of exercise which is it does require the most work by far but it has 1:14:30 the most bang for the buck I just want to say the other perspective you bring which I love is that you tend 1:14:37 to think about well lift some weights I'll get stronger or I'll just work out in the gym I'll get stronger it's really an investment in those next 1:14:43 20 to 30 years for somebody in my situation at 68 because as you point out and you don't think about this and I 1:14:49 didn't think about it enough you're going to start declining actually pretty young and there's an inevitable Decline 1:14:56 and what you're trying to do is slow it down and it's not about today it's about 10 20 years from now and having the 1:15:02 again the ability to to live a healthy life uh you said if I carried a 30 pound uh rucksack I would it wouldn't take any 1:15:09 more time that would not be true tomorrow um I would have trouble getting to work in my 35 minute walk with 30 pounds on 1:15:17 my back I'd rest more uh even if I had I do have a shower here so there's hope but but I think the 1:15:25 the basic idea that there's some somewhat simple things we can do to to 1:15:30 improve our um our health and and health span and lifespan is interesting my only 1:15:36 problem with uh claims about exercise is that I thought you were a lot more skeptical of the nutritional literature 1:15:43 than you were of the exercise literature so let's take the the uh VO2 example somebody in the 1:15:49 bottom quartile um has a lot of things different about them than the people in the top two and 1:15:56 a half percent uh income education there's a lot of other stuff which you know are called co 1:16:02 uh confounders uh that's right third effect third um 1:16:08 third things that that interfere with the causal relationship so I'm curious why you're so confident in the in the 1:16:16 exercise for example the most obvious thing is that people with low VO2 or obvious I assume are on average more 1:16:23 obese so if you if you control for weight so if it's 260 year old men uh of 1:16:30 similar weight and height uh meaning BMI body mass index is it still going to be 1:16:37 true that that Hazard ratio is that large what if you control for Education what if you control for income are we 1:16:42 still going to get those impacts yeah a couple thoughts on that again great point I'm glad you brought it up 1:16:48 um so VO2 max already controls for weight because it's normalized by weight so VO2 max uh is is measured in liters 1:16:55 per kilogram per minute so that takes care of that issue um but you're right that there is 1:17:02 something fundamentally different about a person whose VO2 max is in the top five percent versus the bottom five 1:17:07 percent in other words VO2 max is a proxy for health like that's at the end of the day that's 1:17:13 the biggest difference so it's a bit of a circular argument but here's what I would say the same argument is true when 1:17:19 we look at the smoking when we look at the diabetes and we look at the end stage renal disease examples so really 1:17:25 the only thing I can say is not that the hazard ratio is 2.8 for this group of Fitness versus 1:17:32 that group of Fitness because you're right that has confounders in it but those same confounders will exist when 1:17:39 I'm looking at the person without diabetes to the person with diabetes having diabetes is a proxy for unhealthy 1:17:46 behaviors so it's a relative change the other point I would make and actually devote a bit of space in the book to 1:17:52 explain this because I understand that this is an obvious point is that when you go back and you look at 1:17:58 those Bradford Hill criteria of epidemiology and you run it through you 1:18:03 run the exercise epidemiology through the Bradford Hill criteria versus the way we did on the nutrition everything 1:18:10 points in the right direction so with nutritional epidemiology there are a lot of problems statistically the hazard 1:18:17 ratios are tiny right they're like 1.1 1.12 they never go in the same direction 1:18:23 twice one day red meat causes cancer the next week it doesn't one week coffee is 1:18:30 bad for you the next week it's good for you there's no dose effect it appears there's no biologic plausibility you 1:18:37 don't have the data to support this in you know you can't reproduce these results in randomized control trials all 1:18:43 of that goes out the window when you look at the exercise rust so in the exercise stuff all the data point in the 1:18:48 same direction the magnitudes change a little bit from study to study so the two biggest studies looking at VO2 max 1:18:54 ever and these are studies that involve over a million people you might have the difference one study 1:19:01 might have the highest Hazard ratio of four while the other one is at five but you see a dose effect for all levels of 1:19:07 VO2 max you also see the biologic plausibility when you study these in a 1:19:13 controlled setting in other words when you take individuals and you randomize them to treatment arms of different 1:19:20 training for a period of six months or nine months you see all of the health benefits come in line with the 1:19:26 intervention directly though they started without it so all of this is to say that the epidemiology is far from 1:19:32 perfect but in the exercise literature it's consistent and in the nutrition 1:19:39 in the nutrition world it is not and the magnitudes I think give you much more of 1:19:44 a buffer in you know you could put confidence intervals on those things and still know you're moving in the right 1:19:49 direction so none of this is to suggest that if you're if you doubled your VO2 max you'd live 20 years longer that 1:19:55 can't be imputed from the data and I've often said if all the exercise I did did 1:20:01 not lengthen My Life by one day it would still be worth it because I want to be 1:20:07 able to move freely and be active in the final decade of my life and it's there's 1:20:13 no question that exercise is doing that I I do want to say that although I think 1:20:20 it's unlikely that I'm going to add 30 pounds to my backpack I do often carry my laptop back 1:20:25 and forth and I I have a small MacBook Air I think I need to go to an older IBM 1:20:32 machine uh and thereby feel better about it anyway just a bad joke but uh let's 1:20:39 start start with ten start with 10 pounds so okay I'll try more books I 1:20:44 need to bring more books back and forth uh and and I'm gonna like this because I think I need a special rocking backpack 1:20:51 and I have a small obsession with luggage backpacks and bags so it'll feed that in a nice way 1:20:58 um there are a lot of interesting things in the book about sleep we didn't have a 1:21:03 chance to talk to about protein about exercising more detail certainly about uh calories and nutrition that we've 1:21:10 touched on but I want to talk uh about the last part of the book 1:21:16 which is totally different the fifth tactic of your book is emotional health 1:21:21 and I thought yeah yeah yeah okay yeah it's good to have less stress in your life and that's that's lovely and 1:21:29 um and I found the last part of the book about emotional health quite 1:21:34 overwhelming and quite powerful uh it's it's worth the price of the book Alone 1:21:40 um I'm not encouraging readers to buy the book and skip to the last part but it is a very very powerful part of the 1:21:46 book and I don't really care whether emotional health helps my physical health I'm willing to accept the 1:21:52 possibility that's true you can elaborate at that on that if if you'd like 1:21:58 um but I I want to talk about the tricks you've been playing on your 1:22:04 brain as you got older to be a more emotionally mentally health healthy 1:22:10 person I want to read an excerpt and let you expand on you write the following quote 1:22:16 another way in which mindfulness helps is by reminding us that when we are suffering it is rarely because of some 1:22:22 direct cause like a rock that is crushing our leg at this very moment much more often it's because we're 1:22:28 thinking about some painful event that occurred in the past or worrying about something bad that may occur in the 1:22:33 future this too was an enormous Revelation to me simply put I experience less pain because I'm able to recognize 1:22:39 when the source of that pain is inside my own head so it's not an original Insight it was done nevertheless profound I was about 1:22:47 2500 years behind the Buddha who said that your worst enemy cannot harm you as 1:22:52 much as your own unguarded thoughts Seneca improved on that in the first Century A.D observing that we suffer 1:22:59 more often in imagination than in reality and later in the 16th century Shakespeare's Hamlet noted there is 1:23:05 nothing either good or bad but thinking makes it so and if if you could in a 1:23:11 quote if you could talk about why this wasn't just oh you know I have these thoughts and they do 1:23:17 things to me but how they change their life and saved your life 1:23:23 well I'll never be able to explain it fully in just a few minutes but I think to that very specific point one of the 1:23:29 therapeutic modalities that I have found really powerful is something called 1:23:35 dialectical behavioral therapy DBT and DBT is a form of therapy developed 1:23:42 by a woman named Marsha linhan that really teaches you to understand 1:23:48 the relationship between thoughts and emotions um but to do that you have to create 1:23:56 space between the emotion and the impulse or the 1:24:01 reaction so if there's an event that triggers you for example if my child 1:24:08 does something which triggers me I must create a pause between that stimulus and 1:24:15 the response for me to then process the emotion and the thought and ultimately 1:24:21 the action and the only way to do that is to 1:24:27 understand uh the things that I know you're a lifelong meditator Russ so uh 1:24:32 or not lifelong but I know that it's an enormous part of your practice the only way to do that is to basically have the 1:24:38 tool that allows you to hit pause and I think that tool is you know Dan Harris describes this as kind of the 1:24:46 bicep curl for the mind is what you're learning when you do that so by the way that's actually one of the things I 1:24:52 really enjoy doing when I rock right so if I'm carrying that heavy backpack and walking around the neighborhood one of 1:24:58 the things I really enjoy doing is focusing on a sensation so I never take a phone with me so even though I have 1:25:04 lots of podcasts and audiobooks I'd like to listen to that's one hour you know three or four times a week when I have 1:25:11 to be in total silence because it allows me to for example focus on the way the wind hits the edge of my hand as my arm 1:25:19 swings and that's a sensation that is very difficult to notice normally so you 1:25:26 have to really focus on it and that's just that's just one little example obviously meditators will very 1:25:31 frequently use the breath as the object of meditation whether it be the movement of the abdomen or the air moving in and 1:25:36 out of the nose so um again I think of meditation for me 1:25:41 not as a tool that in and of itself fixes the problems but it's a skill that 1:25:47 allows me to work on these these other tools that in the case of DBT allows me 1:25:53 to ask myself a series of questions why am I feeling this way what is the purpose of this emotion what is it 1:25:58 trying to do for me is there a different emotion that's really underpinning the one that I think is going on right now 1:26:07 to be thoughtful in responding to the events of the world around us but it's much more profound and again I obviously 1:26:14 we don't have time to go into it in the depth but I want to give you a paradox that I think you have insight into that 1:26:21 most people would find puzzling in your book you describe 1:26:26 it's a powerful tragic story you get obsessed with your work uh you struggle 1:26:34 to spend time with your family you're struggling when you're married you're struggling as a parent 1:26:39 as a father and uh you're angry and you you recognize that and I have 1:26:48 been angry many different phases of my life and of course when you're in that mode 1:26:55 um it's a strange addictive drug you'd 1:27:01 think you would say well I don't like being angry I'll who would want that I mean what could be there's nothing good 1:27:06 about it it could ruin your marriage you could end up in jail because you get to 1:27:11 fight anger and rage are seems so destructive and yet they have an addictive quality 1:27:17 and what you suggest in your passage along in this section of the book is that you were having trouble 1:27:25 forgiving yourself so your anger at the outside world was not at the outside world it was it 1:27:31 yourself and this leads to a this is a paradox that that I think is incredibly 1:27:38 important which is people will tell you you know you have to forgive yourself and love yourself 1:27:44 before you can forgive and love others growing up as a so-called rational 1:27:51 person I always found that argument offensive no no you don't understand I'm 1:27:56 judging myself because I need to get better and when I judge you I'm just judging 1:28:02 you the way I judge myself and and this claim oh you need to forgive yourself 1:28:07 well wait a minute doesn't that mean that I'm gonna excuse all the things 1:28:13 that I do imperfectly no I have high standards I'm not going to do that I'm 1:28:18 going to live up to my expectations and and yet I think that's false and I 1:28:24 think it's destructive and I'll just mention one one thing we have we have the Jewish holiday of Yom Kippur coming 1:28:30 up soon which is about repentance and atonement and there's a a strong flavor 1:28:37 in Judaism that I have to I have to berate myself and yet at the same time there's a TR 1:28:43 there's a a theology in Judaism there's a there's a trend a track of Jewish 1:28:49 thought that says actually no if you beat yourself up all the time you'll actually become a worse person so I want 1:28:55 you to talk about not the Jewish part but about this this seeming Paradox that 1:29:01 by forgiving yourself you can then forgive others by loving yourself you can love others that seems 1:29:07 that seems like that seems like cheating and is an economist it seems oh I'm 1:29:12 going to ruin all the incentives I have to be a better person if I could always say oh well I'm going to forgive myself 1:29:19 what have you learned about that oh boy 1:29:25 um sorry I've learned a lot the hard way I'll say that right I've learned a lot the hard way which is 1:29:33 for different reasons we all kind of create different narratives and 1:29:41 um for whatever reason at least in my case and I should preface all of this by saying Russ I don't have a great answer 1:29:48 to the questions broadly right this is you know there's 16 chapters in this book that have bits of me weaved into 1:29:56 them but they are primarily me speaking as a quasi Authority on a subject matter 1:30:02 but this 17th and final chapter is not at all about that it is purely an 1:30:08 experiential uh chapter that is in the book if for no other reason than to 1:30:14 scratch or itch the scabs on the reader to then go and do this type of 1:30:19 exploration right it's a chapter that to be clear the publisher didn't even want in the book um their view was it doesn't make sense 1:30:26 go and write another book about this but let's let's end it here on sleep and exercise or whatever 1:30:33 um so so what I came to realize although it was not obvious at the time 1:30:39 because yeah you've I I can't imagine you're not familiar with David Foster Wallace's beautiful commencement speech 1:30:45 at Kenyon College this is water um he he talks about the ubiquity of 1:30:50 water around the fish and sometimes the most prevalent thoughts we have are the 1:30:56 ones we're unaware of because they are so constant and similarly I spent my 1:31:01 entire life completely blind oblivious to the self-talk 1:31:08 even though by the way at times it was audible like that's what's really remarkable is at times I could get so angry at myself I would be screaming at 1:31:16 myself as though there were another person there and yet somehow I just didn't register that that was happening 1:31:23 and what I learned through a very difficult uh stay in a in a in a in an 1:31:30 inpatient you know residential therapy uh facility was that until I got that 1:31:38 Bobby Knight which is what I called him because he screamed at me like the famous basketball coach Bobby Knight 1:31:44 until I got Bobby Knight out of the boardroom of my head I was never going 1:31:51 to be kind to myself and therefore I could never be kind to another human being and we the therapist came up with a 1:31:59 brilliant exercise that I think is I still don't know how she came up with this and I'm even more amazed that it 1:32:06 worked because I did it because I had no choice but I didn't think it could work uh but I'll share it 1:32:13 with you I know you've read the book so you know this but just so listeners understand so the the exercise was every 1:32:19 time you're about to scream at yourself either out loud or just in your head 1:32:25 take your phone out and record an alternative message as 1:32:31 though you were speaking to your best friend who had just committed whatever the egregious act you just committed was 1:32:37 I'm being facetious because it wasn't egregious clearly it was like I don't 1:32:42 know you overcooked a steak or you missed a shot yeah yeah yeah yeah yeah yeah you you weren't exceptional in 1:32:49 archery practice today or something something like that right or you know so 1:32:54 so sure enough three or four times a day because that's the frequency with which I would want to you know berate myself I 1:33:01 would I managed to do this I managed to take out my phone and dictate a note and instead of saying it to me I would 1:33:08 pretend I was talking to you as a dear friend and I would say and I would even say your name right I would say Hey Russ 1:33:16 I'm God I know I know how frustrating it is right now that you just uh you just 1:33:22 burnt that stake and it's embarrassing you have company over and they're here for dinner and you know you walked away 1:33:28 from it because you got distracted and now it's it's overcooked and um it's okay like you are distracted 1:33:36 right now you've got a lot on your mind and maybe when you heard you know your 1:33:41 son calling you and you went over there to see what was wrong you forgot to come back to the stake and I think people will understand and it's not the end of 1:33:48 the world and that was it and then I would have to send that voice memo to my therapist so this poor woman is getting three or 1:33:55 four of these messages a day but then something happened about four 1:34:01 or five months later which is I stopped hearing Bobby Knight's voice 1:34:06 and to this day uh Russ I I don't make any fewer mistakes than I did then I'm 1:34:13 no I'm no less likely to burn the stake miss a shot in archery spin my car on 1:34:19 the racetrack do any of the things that used to upset me um but I just don't hear coach night at 1:34:27 all and that has had a bigger impact on my life than probably all the exercise 1:34:36 nutrition sleep or drugs or cancer screening that I could do 1:34:41 yeah I have this fear that I'm hard on myself 1:34:49 so I'm Justified of being hard on others that's my fear this is the flip side of that 1:34:55 and and the argument is is that if I can be nice to myself maybe 1:35:00 it'll be easier to be understanding of other people everyone is in a battle so be kind is is 1:35:08 you know fabulous I think advice uh except for me of course uh I I win 1:35:14 all the battles I have to Triumph um and it is a fascinating aspect of human 1:35:21 behavior that confronting my imperfection and maybe it's a personality for certain kinds of 1:35:26 people but maybe it's every human being confronting my imperfection facing imposter syndrome that that this fear 1:35:33 that I'll be discovered that I'm that I'm a flawed human being and surely some of this anxiety and fear 1:35:40 comes from our the way we're raised our childhood or friends or Social Circle when we were four and six and ten 1:35:47 um but somehow if my fear of of imperfection 1:35:54 somehow makes it harder for me to be aware that other people are battle when I recognize it myself somehow it becomes 1:36:00 easier to see it in others uh and I think um beautiful thing it's great advice 1:36:07 um and I think it is the road to a much less stressful life which probably is 1:36:13 good for your health and it's a much better way to live not just in your last few decades but all 1:36:18 the way along yeah I think there's a lot there Russ I 1:36:24 think first of all I think of this the way I think of exercise which is even if exercise didn't increase my life a day 1:36:29 even if it's shortened my life by a year it would still be worth it because of the quality of the life I get to live 1:36:35 and truthfully I feel the same way about this which is it probably increases the 1:36:41 length of your life simply on the basis of the impact that stress has on disease 1:36:48 processes but even if it didn't it's really about the quality of life and going back to what I said at the outset 1:36:55 I I'm not delusional about the fact that my physical health is going to decline as I age despite what I do you know when 1:37:02 I'm your age Russ I am not going to be able to do what I do today I know that and a decade later when I'm 78 if I'm 1:37:09 still alive it's going to be even less but there's no reason I need to be 1:37:14 miserable throughout my life there's no reason that I need to be angry constantly 1:37:21 um and you know what I'm excited about frankly is this is I'm just at the beginning of this journey right I'm only 1:37:27 a few years into this fundamental change into this rewiring and so in many ways I 1:37:34 actually think I'm going to be I hope I'm going to be better off in a decade than I am today and that's something to 1:37:40 look forward to because in the other dimensions of my health I won't I likely won't be 1:37:46 my guess today has been Peter attia his book is out Live Peter thanks for being part of econ talk 1:37:52 thank you Russ [Music] 1:37:59 this is econ Talk part of the library of economics and liberty for more econ talk go to econtalk.org where you can also 1:38:06 comment on today's podcast and find links and readings related to today's conversation 1:38:12 sound engineer for econ talk is Rich goyet I'm your host Russ Roberts thanks 1:38:17 for listening talk to you on Monday [Music]