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Dr. Peter Attia

lines on the record: 125
first: 2023-03-15
most recent: 2023-03-15
sittings or episodes: 1
sources: podcast

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“Yeah, the reason the legs are dark is they have much more mitochondria. Those are their slow twitch muscles there that are heavily dependent on oxygen delivery and oxidative phosphorylation, whereas the white meat, the breast meat, is very fast twitch. Quick, quick, quick, quick flapping doesn't have the mitochondria, so that has far less of it. And therefore, that's kind of a less oxygen-rich muscle. When you dissect us, of course, you don't see that difference. Our type 1 and type 2 fibers are less clearly separated.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“So, you get the sense of the difference. Now, as we age, we lose power and explosiveness more than anything else, and we lose that the soonest, and that's due to the type 2 fiber, the atrophy of the type 2 fiber. This, again, this comes back down to strategy. So that's why if you want to live a longer, better life, you have to have a strategy in place for maintaining type 2 fibers. And you're not going to get that without resistance. You know, you can't say, look, I play tennis every day, I walk every day. Those things are great. They're not doing something for your type 2 fibers.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“So you can do things for a long period of time, and these things don't fatigue. Conversely, another subset of these fibers are type two fibers, and they're called fast twitch muscle fibers, and they're fast to fatigue. Now they're much more powerful. So when a type 2 fiber contracts, far more is happening, it's generating far more force. But it's doing so with a different metabolic strategy. So it's glycolytic. It's just using glucose or broken down glycogen. And it's going to fatigue quickly. So it's accumulating metabolic byproducts that are leading to fatigue. So there's a reason why if I say Tim.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Our muscles are made up of these fibers. They're very unique properties. So muscles are these multicellular things where the cells are these long sort of fibers that contract past each other. And that's what creates the contraction of a muscle. But if you dig a little bit deeper, you have different types of fibers. So you have type 1 fibers which are fueled mostly, if not entirely by an aerobic process so they can use fat, they can use glucose, but they do so in the presence of oxygen primarily. They're very slow to fatigue, which is mostly where the name comes from. But they don't generate that much force. So these are the muscle fibers that are mostly on display when you're walking or just carrying out activities of daily living.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Controlling APOB and rapamycin and metform and all these other things, all that stuff is pixie dust compared to what these things are. On the strength side, the same thing. Anyone who's got older parents knows this. If you really want to watch somebody suffer when they're aging, you watch them losing their cognition and you watch them losing their physical body, you watch them lose the ability to move around with ease, to have balance, to be pain free, all of these things. Well, a big part of that is being strong. Strength is something we can actually hang on to as we age. You know, we lose quickness long before we lose strength. That's the good news. The bad news is you have to be very deliberate in how you train it. I'm sure on the podcast you've discussed type one and type two muscle fibers, so people are probably familiar with that.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“You might say, well, okay, how many people can become very, very strong or have a very high VO2 max? And the answer is I don't know. Like I don't know, especially on the VO2 max side, you know, to get into that top 2.5% of the population where you really start to see an enormous gap between you and everybody else in terms of lifespan, maybe only a quarter of the population has the potential to get there. But the point is everybody has the potential to be more fit than they are outside of people who are already doing everything they can. And so just going from being in the bottom 25% of the population to the 25th to 50th percentile of the population cuts your risk of all cosmetality in half at any point in time. There's nothing that compares to that. Like there's no drug out there that's going to do that. So again, I think you can talk about drugs all day long and how I think they're really important and how we could think about.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“If we're going to just talk in magnitude VO2 max and muscular strength stand in a league of their own. So there's really nothing that's within the zip code of those two metrics. So having very, very high VO2 max for your age and sex and being very strong, they have more of a positive impact than any single thing we can think of has a negative impact. And that includes having end stage renal disease like being on the wait list for a kidney while you get dialysis, being a smoker, having high blood pressure, having type 2 diabetes, being obese. The downside of those things is relatively small compared to the upside of having a high VO2 max and being very strong. So we almost shouldn't even talk about things until people are willing to accept that fact and take the steps necessary to address them.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“No, I mean, I think there are some patients of ours who actually want to utilize the Hawthorne effect. And if we agree mutually to do so, we can see all their data. So they can just say, look, I want you to be looking at my CGM data every day, and you're an accountability partner for me. So I'm going to eat less junk food.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Just have to understand that it's one of many tools that we can look at. And the CGM, again, do I think this is like necessary to live a longer, healthier life? Of course not. It's simply one tool that we have to help us understand how to regulate one of the four macronutrients.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Which is a fair argument, if you only index on blood glucose, you could still end up doing a bunch of things that aren't healthy. If you ate bacon for every meal every day, your blood glucose would not go that high. But it's probably not the healthiest choice. And I would agree with that. But by that logic, we shouldn't look at body weight either. Because by smoking cigarettes, your body weight will go down. So, does that mean body weight is a lousy measurement? No, it just means that any measurement in isolation can be ridiculous and can be gain. So we shouldn't ignore blood glucose any more than we should ignore body weight or body fat or body composition.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“I think CGM becomes a really helpful tool for compliance. It becomes a behavioral tool. We tend to gamify it a little bit. I know that when I'm wearing CGM, which I just happen to be right now, by the way, I'm going to think twice before eating something stupid. And again, it's purely just because my personality likes to gamify things. It's like, yeah, I'm tempted to go and eat all the leftover waffles on my kid's plate, but I just know it's like, eh, it's going to shoot my blood glucose up and I like not doing that where I think people get into trouble and where the”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“I mean, like, if I remember the first time I had raisinettes, I was like, it's not like I didn't expect it to go up. I didn't expect it to go up like that. Exercise certain forms of exercise. And by the way, I'm not saying this is pathologic. There's nothing wrong when you're exercising for your glucose to skyrocket if you're doing tabatas or you're doing hit workouts. Again, it's not pathological, but it's super interesting. And other things that I think are pathological is how much your blood glucose goes up if you had a poor night of sleep. If you have a horrible night of sleep, your insulin sensitivity gets crushed the next day and your glucose levels go up. Well, that's actually very interesting. Maybe you could argue that adds too much stress to the fire, but it's an insight nevertheless that can help drive a behavior change. I think in the book I cover my 10 best insights from years of CGM and myself and patients. It's about different foods and foods high in fiber are going to have one effect. Lean sources of protein versus fatty sources of protein, all those sorts of things.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“It's very dependent on red blood cell turnover. So the more rapidly red blood cells turnover, the more artificially low the hemoglobin A one C will be, and conversely, the longer the red blood cell sticks around, the higher artificially the hemoglobin A one C will be. CGM to actually get true measurements of average blood glucose. When a patient who doesn't have diabetes puts on a CGM for the first time, they're invariably surprised. There's this real learning phase that comes. You've done this, Tim. You were doing this probably 10 years ago. You were your first one. Everybody goes through this. I remember, you know, for me, it's been about eight years since I started. At first you simply cannot believe the things that drive your blood glucose up. You can't. I mean, it sounds, some of it sounds dumb.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“The answer here is actually pretty clear. It is that there is a difference. In fact, for a non-diabetic population, the lower the average blood glucose, as estimated by hemoglobin A1C, the lower the all-cause mortality. Okay, so what's the implication now? Well, if the implication is if you take a group of people who don't have diabetes but want to live longer, i.e. they want to lower their risk of cancer, they want to lower their risk of cardiovascular disease, they want to lower the risk of neurodegenerative disease, I think we can make a pretty reasonable leap of faith that having a lower average blood glucose is better than having a higher average blood glucose, even if that higher average does not put you in the range of a diabetic. So now the question becomes, are there tools to help us manage that? Because the one tool would just be the A1C. You could say, well, I'm just going to get my hemoglobin A1C measured every six months. The problem with that, as we know, is that hemoglobin A1C is very easy to mislead.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“So the question then would be if you take two people who don't have diabetes, one of whom has a hemoglobin A1C of 5.0 and one of whom has a hemoglobin A1C of 6.0. Neither of them are diabetic. Is there any difference in their outcomes? So, to put that in perspective, the guy at 5.0 has an average blood glucose of about 100 milligrams per deciliter. The person at 6.0 has an average blood glucose of about 120 milligrams per deciliter. So they're both outside that diabetes range.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“But now we have to get into the leap of faith that one takes when you start triangulating between other pieces of data. So we want to start with one, which is in a population of non-diabetics, is there any evidence that glucose levels matter? So type 2 diabetes is defined as having a hemoglobin A oneC above six point five percent. Hemoglobin A oneC is just a way to measure how much glucose is stuck to hemoglobin. And by knowing what that number is, you can impute what the average blood glucose is in that individual over the preceding three months. So 6.5, which is the cutoff, translates to an average blood glucose of one hundred forty milligrams per deciliter.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“To caloric restriction has greater efficacy than other methods. Once we now talk about people without diabetes, medicine 2.0 would argue a CGM plays no role. Okay, is there a randomized control trial demonstrating the efficacy of CGM in anything outside of patients with diabetes? There is not.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Given people with type 2 diabetes abjectly horrible news and insight with regard to what to eat. We just haven't really helped them think through this problem. So the CGM makes it pretty clear that not all foods are created equal when it comes to managing glucose homeostasis. Everything I've said so far is relatively straightforward. I think where we now, and this is a great example, by the way, of medicine 3.0 versus medicine 2.0. So everything I've said so far more or less makes sense if you're in medicine 2.0. In fact, I think we're finally at the point where even medicine 2.0 is starting to accept the fact that carbohydrate restriction is a really good idea for people with type 2 diabetes. It's not the only way, by the way. So caloric restriction in general will work to improve insulin sensitivity, which therefore improves glucose regulation. But it does seem that carbohydrate restriction as a form or a gateway”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“And the pancreas, of course, is like this brilliant organ where it's the one that's auto regulating glucose via insulin. And when that goes away, they have to be the one to do it. So now they have this device that is at least giving them real-time glucose information and they can adjust insulin injections as needed. It obviously didn't take long for that to expand into a much, much larger market, i.e. ten times the size, which is people with type two diabetes, some of whom do require exogenous insulin, some of whom do not, but all of whom by definition have a carbohydrate and glucose tolerance disorder, the very definition of type two diabetes is based around unregulated peripheral glucose. And this tool is therefore helpful, right? It's helpful in first and foremost, I think, knowing what to eat. I think historically we have”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“A continuous glucose monitor, as its name suggests, is a way to give you real time information about what your blood glucose is. You said for people with type 1 diabetes, which was the first use case, this is a very important innovation because people with type 1 diabetes are by definition dependent on insulin. So they are using insulin exogenously to do the job of their pancreas, which is no longer working.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“So, continuous glucose monitor is a device. There are really two big ones on the market right now. One is made by a company called Dexcom and one is made by a company called Abbott. And the latter is called the Freestyle Libre. So I think it's a company that Abbott acquired many years ago. These are devices that are worn usually on the tricep. They can also be on the abdomen. And they have a little tiny filament that is quickly shot in with a needle into the subcutaneous space. The filament remains after the needle comes out and the filament sits in a part of the body where it can sample something called interstitial fluid. This is basically the fluid between cells. To be clear, it's not sampling the blood. So it samples the interstitial fluid and it measures glucose level there. And it's basically calibrated to know based on what the reading is there, what the glucose level is in the blood.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“I don't know the last time I had one, but oh my God. Now that you reminded me of that, that's horrible of you to do that.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“As a type of alcohol, you know, I think people, I think, love to. This isn't again an example of something I think we tend to over index to. Oh, you know, I drink a lot, but let me tell you, it's just vodka and tequila. So it's got to be good for me, right? It's like, no, alcohol's alcohol, right? So I love tequila. I love Mescal. I love really good wine and I love really dark Belgian beer. I'm not deluded to think that any of those are healthy. And I know that there are some people who have a horrible reaction to certain types of alcohol. Well, I would put that in the same category as people who have a horrible reaction to certain types of foods. Don't consume them. But I think mostly where I focused him is on how much am I going to drink? How close is it going to be to bed? And what's the total tally per week and never exceed a certain tally in a given day?”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Second thing is, I really have to make sure that that drinking is a good three hours away from sleep. Again, when I say these things, people say, Peter, you must be a robot. No, I'm just saying these are general principles. There are going to be times when I violate that. I think I posted something on Instagram a little while ago, which was like the most rancid night of sleep. When I sleep data were comically bad. And the reason was we had friends over. It was very late. We drank, we ate. I basically went to bed. By the time they left at like 1030, I went to bed and we had just finished eating sort of thing. And not surprisingly, my sleep sucked. The point I made in the post was I'd do it again. It was a fantastic night. The four of us had dinner together in a long time. So you just have to be very thoughtful and deliberate about the choices and trade offs that you make.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“I'll start with kind of quantity. Yeah, so I would personally just say there's going to be an insane reason to have more than two drinks in a day. So it's sort of somewhere between zero and two. And it's got to be a really good reason to drink on more than three days a week. So in the back of my mind, I'm keeping a tally, which is I really shouldn't be having more than about seven drinks in a week. Again, seven drinks in one day is very different than one drink a day for seven days, so it's the frequency and it's the dose, and that defines the poison.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“And despite what a lot of the epidemiology will tell people, alcohol is not good for you in any dose. Doesn't mean we shouldn't drink it at all, but let's not delude ourselves into thinking it's actually healthy at some low dose. It's not. So understanding that it's a toxin, I think help you have a more measured response. My response to alcohol while we're on that topic is if I drink something that doesn't taste incredible, I pour it out. I'm never going to tolerate a bad glass of wine ever. It's just not worth it.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“A couple of years ago, I would have just said more data is always the answer. And now I think I'm a bit more measured and I say, look, sometimes more data is not always the answer. Now, the flip side of that is there's nothing that will demonstrate to a person how much late night food and alcohol are ruining their sleep than a sleep tracker. So I do think it's really valuable to see that. And for many of my patients, that has been the most decisive thing that has reduced their alcohol intake.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Completely fix that and completely toggle on the basic blocking and tackling aspects of sleep hygiene which have to do with food, alcohol, light, temperature, noise, etc, you're going to be okay. And I don't really need to know what your sleep score is and how many minutes of this sleep versus that sleep you had. So, you know, I personally go through this myself. I'll go through phases of time where I'm not looking at any sleep tracking device. If I know I'm going to be in an environment where sleep is compromised, which is basically a lot of the time if I'm traveling, I don't even take a sleep tracker with me. Because why do I need something to remind me of what's probably happening? How about I just do the best job I can and be a little less data focused? So that's an example of where I feel like.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“We could probably talk about different things within different buckets. So starting with sleep, I think that with sleep, I kind of like to simplify things a little bit sometimes. So one thing that I think is happening a lot right now is people are getting probably at least some people overly anxious about what their sleep trackers are telling them. And so, you know, we've got a problem where the pendulum has sort of swung a little too far to the other side where maybe 10 years ago nobody thought at all about sleep. And now you've got a class of people, me among them, who maybe think too much about sleep. And all of a sudden, it becomes a little bit counterproductive. And we see this in a subset of our patients. And the first and most important prescription for those people is stop tracking. Take the tracker off. Let's just focus on the fundamentals. What time are you getting into bed and what time are you getting out of bed? If we can, within fifteen to thirty minutes on either one of those.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Says twelve hazelnuts will reduce your risk of death. Twelve hazelnuts a day and consumption reduces risk of death by 10%. I can look at that and say total nonsense. That's just epidemiologic nonsense. Conversely, when I look at epidemiologic data that say people who are really, really strong live longer than people who are really, really weak, by going through those nine criteria, I can be much more confident that that is actually causal.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Causing those people to get more skin cancer than the people with brown hair. And the answer is probably not, right? The answer is probably that red hair is associated with fairer skin and that that's the issue. Because if you really wanted to know if red hair was causal, you would randomize people to different groups and you would actually dye the pair in one group, one color, and dye the hair in the other group another color, and then you would follow them. So what Bradford Hill's criteria allow us to do is look at nine factors such as the strength of the observation. So what's the actual magnitude of the observation? What's the reproducibility of it? What's the biological plausibility of it? Is there an analogy to it? Is there a dose effect to it? And as you go through these nine criteria, which I think actually do this a couple of times in the book because so much of the data we look at around nutrition and exercise are unfortunately epidemiological. We can't do the controlled experiments. But it's what allows us to say when I read a study that's”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Just as an anchor. So, an observational study doesn't have an intervention. So you can observe things either looking backwards, so things that already happen, you can go back and look at what happened. You can even observe things prospectively but without intervening. So saying, hey, we noticed that, you know, there are a group of redheads over here and there are a group of brunettes over here, and we're just going to follow them for the next 10 years and see if the color of their hair predicts their life satisfaction, you know, making this up, of course. And so you might get an answer from that and say, oh my God, the people with red hair were so much more likely to get melanoma. I mean, this is devastating and it must be that something about red hair is causing skin cancer. And it must be that brown hair must be reflecting the sun and those people aren't getting skin cancer. There's a correlation. So another question is, do we know if there's a cause there? Do we know if the red hair is?”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“One thing I'll add to this, Tim, before we leave this topic is also for folks to look up Austin Bradford Hill. So Austin Bradford Hill, scientist of the kind of middle part of the 20th century, to him we owe the Bradford Hill criteria. So there are, I believe, nine Bradford Hill criteria, which are the criteria that we use to scrutinize observational data. So when you have epidemiologic data, how can you scrutinize them to understand and change your confidence in the likelihood that these data are causal? I mean, causality is one of the most important concepts in science.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“that truthfully maybe there is a great book out there and I'm just ignorant of what that book is that kind of goes through this but that's the kind of stuff that I think you learn with with practice and unfortunately if you're not doing experiments I mean again I think I learned most of this stuff not in medicine but in the two years that I spent at the NIH where you know as a fellow but doing research so I was like a research fellow not a clinician that's probably where I learned more than anything about how to do science. And so I think anybody who's been in a lab is just learning that, but it's very informal. At least for me, it wasn't a structured thing.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“I don't off the top of my head have a resource that I can point to, I agree with you that there's so much more nuance to it than just understanding kind of the caricatured version that I explained earlier. For example, how you design an experiment is essential. So even if you have a hypothesis that can be falsified, if you design the wrong experiment to test it, you can miss out. This becomes very important, by the way, as you start to look at studies. If a study is quote-unquote negative, how do you know if it's negative because it was too small in size and what we would describe as underpowered versus it was adequately powered, but there was no effect. At the other end of that spectrum, sometimes a study will find a statistical significance, but it was overpowered and that difference while statistically significant is clinically irrelevant. Now that kind of stuff we do cover in the studying studies stuff, but I think what you're describing are these more important.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“But I can't remember what reps stands for, but it's basically a scientific literacy course in how to read studies about nutrition. In his case, it's about exercise and nutrition. Again, we try to cover everything in our newsletter that, you know, we'll talk about a drug study. We'll talk about a supplement study, an exercise study, all those sorts of things. So those, to me, are the ways you go about doing this. You just have to dive into it and kind of a little bit overcome the fear of it. I suspect it's not unlike what you would say if I was asking you, Tim, I really want to learn Japanese. Is there a particular app that I should look at or this? I think at the end of the day, you'd say, look, man, you got to like learn it. Here's the way to get the foundational skills and then go and find people to speak Japanese with.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Such and such a study is published, and the news picks it up and writes a take on it that we think is demonstrably wrong, or a paper gets published that gets a lot of attention that says this, and we think it's an important paper and we want to highlight it. So we kind of try to use those things as case studies. And I honestly think that's the most efficient way to go about learning this. Now, we did write a series six years ago, I think, called Studying Studies, which is I think a five-part blog series that Bob Kaplan and I wrote. And I think it's probably a great foundation to just get the basics. What is a case cohort study? What is observational epidemiology? What types of bias exist? And how do you look for them? Consider that sort of your basic foundational knowledge set thereafter it becomes reps. And the more you can do this, I think Lane Norton also has a course that he just launched, and I think it's actually called reps.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Hot shots that just graduated the first year class in college, you have an average vocabulary of X words. And X was like whatever number. I honestly don't remember it was. Call it 20,000 words. So in the next two years, i.e. just in the first, in the preclinical phase of medical school, we are going to add Y words to your vocabulary and Y was bigger than X by like 20%. And those are mostly going to be Latin, Greek words, by the way. And he was right. I mean, it was like learning a new language. So part of it is just the semantic problem. Now, do you have to know all of that? Of course not. But what's proximal? What's distal? All of these things kind of factor into this stuff. By far the biggest issue, though, and this is the one that we try to solve the most for on a weekly basis. There's a reason that we go to great lengths to write a newsletter every single Sunday. It's basically a class. A lot of times it's like.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“I think you and I have even talked about this once before, Tim, and I don't think I had a great answer for you then. And I don't know that I have a great answer for you now. It's really not a simple thing to do. Let's just start with the nomenclature. My first day of medical school, I still remember one of the professors saying, and I don't remember the numbers, so the story is not as cool because I don't remember the actual numbers. But I'm making the numbers up, but not the point, okay? He said, well, all of you are smart.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“And it's tempting at this point to say, well, pharmacology is either good or bad. No, it's both. Pharmacology is good and it's really valuable, but over indexing it is bad and ignoring all those other things is problematic. Those other things turn out to be far more efficient tools of prevention. If no doctor learned about them, then why are we surprised that medicine two point zero is unable to cope with that? So one, we have to understand prevention and we have to understand the timeline.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“The first is in its timeline. So medicine two point zero is largely focused on treating disease. And it's really interesting when I think about it because it's so obvious that I can't believe I didn't notice it earlier. But when you're in medicine, when you're in medical school, when you're in residency, when you're in practice, you sort of need a code for a disease. You need a code for a disease that you bill for and you treat. Prevention doesn't really fit into that. So when I went to medical school, I didn't learn a single thing about nutrition or exercise or sleep or stress management or emotional health. I learned a lot about pharmacology.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“A hundred to one hundred and twenty million people in the United States are metabolically sick, meaning have metabolic syndrome or prediabetes or type 2 diabetes outright. So something's not working and the current system of medicine 2.0 doesn't really seem equipped to address it. It intervenes late, and by the time it's intervening, it's not really fixing. This thing I'm proposing, this idea that, of course, I'm not the first person to suggest, maybe I'm the first person to talk about it this way, is we want to kind of pivot to this newer way of thinking about things, which deviates from medicine 2.0 in a couple of really important areas.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Secure these people. We have barely a few things that can slow the progression of their diseases. But we've made paltry steps against chronic diseases. When you and I were born, the prevalence of type 2 diabetes was less than one percent. Today it's 10% effectively, right? So we've seen a log fold increase in type 2 diabetes.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Now counter that with what we've done against cancer When Richard Nixon declared the war on cancer before you and I were born was more than fifty years ago, the goal was to eradicate this disease by the bicentennial in nineteen seventy six. Well, not only that not happened, but here we are more than fifty years later and survival for cancer is barely five percent greater than it was in nineteen seventy. I could go on and on, but let's just look at neurodegenerative disease. So you were talking about six million people with Alzheimer's disease in this country. If you add up those with Lewy body, dementia and Parkinson's disease, we're talking about, gosh, another four and a half million. So we're looking at more than 10 million people in this country with very, very significant neurodegenerative diseases. And that says nothing about, you know, ALS and Huntington's and things like that. We don't have a single thing that we can do.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Medicine 2.0. We saw these other amazing success stories. I think the two most notable by far would be Hepatitis C and HIV. I mean, to think that we're at a point now where a virus that is as tricky as HIV can basically be rendered a chronic disease on the back of highly active antiretroviral therapy is nothing short of amazing. When I was in medical school, Tim, we're not talking like a long time ago. This is 25 years ago. We were told Hepsy will never be cured and it will break the back of the US and global transplant infrastructure, meaning we're going to need so many livers to put into all these people with Hep C that by 2030 the system will break. And lo and behold, we have a drug that within a manner of weeks will eradicate this thing. So again, huge successes.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“That it basically propelled us into medicine two point zero, and the place where that shone greatest was unquestionably in the world of microscopic organism, so viruses and bacteria. And so it's a brutal, bloody slog to go from Semelweiss to Coke to Lister, but that transition effectively brought us into the modern era where, hey, all of a sudden doctors were washing their hands and not operating on people with dirty hands, and of course eventually we had antibiotics, and eventually we had vaccines. And taking smallpox and polio off the table and reducing the mortality of influenza and having any antibiotics, all of that stuff had such a profound impact on human health that it cut mortality rate down by a half and doubled our life expectancy. So now we're into the maturation of”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“And not the gods. That was truly remarkable insight. Now, beyond that, he had no clue what was going on. But that was a remarkable insight, and that was probably the apex of medicine one point zero. With Francis Bacon in the seventeenth century, we had basically the first push towards the scientific method. This became really important, and no one has done a better job explaining this than our mutual hero Richard Feynman. There's a great video, which I'm sure you guys can find for the show notes, where it's an old grainy black and white where Feynman is talking about the scientific method, and he's saying, look, you make a guess, you design an experiment. The guess is called a hypothesis, by the way. It's just a fancy word for a guess. that hypothesis you do the experiment you compare the results of the experiment to your guess and then you decide to either discard or update your hypothesis This was such a profound concept”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“So it's probably easiest for the completeness to start with medicine 1.0. Medicine 1.0 was basically everything that occurred prior to the transition period of the late 17th century into the late 19th century. So that 200-year period marks the transition from when medicine had absolutely no basis of science whatsoever. I mean, we can mock it now, but truthfully, they didn't have a scientific method or a scientific tool, so all they could do was sort of think about the gods, think about bad humors, come up with the best rationalization they had for what was going on. In fact, arguably the most insightful thought that occurred in medicine one point zero was thousands of years ago on the part of Hippocrates, who was the first to believe that diseases were somehow caused by nature.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“So, you do this very simple analysis, which is okay, let's go back to 1900 and march forward. But when we go through the mortality tables, just strip out the top eight leading infectious disease causes of death. And what you see is exactly what you describe. There is now no change in mortality from then until now, effectively. There's a little bit. It's been a little bit better. And I think what it speaks to is Two things one is the remarkable success of Medicine two point zero in solving acute care and infectious diseases. remarkable failure of Medicine two point zero in addressing the chronic diseases that sat under the surface of the water waiting for the tide to go down.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, so you're absolutely right. So, life expectancy since 1900 to today has increased by twofold. It's remarkable. It's gone from about 40 to about 80, plus or minus. But that's directionally the change we've seen in call it 120 years. And I do think that understandably it's tempting to tout that as the marvels of modern medicine. And you're thinking, well, oh my God, we went from 40 to 80 in 120 years. The next 40 just based on Moore's law, that's got to get us to like 160, right? Okay, maybe, but let's take a closer look at the data.”
2023-03-15 · The Tim Ferriss Show · #661: Dr. Peter Attia — The Science and Art of Longevity, Optimizing Protein, Alcohol Rules, Lessons from Glucose Monitoring with CGMs, Boosting Your VO2 Max, Preventing Alzheimer's Disease, Early Cancer Detection, How to Use DEXA Scans, Nature’s Longevity Drug, and More · IDENTIFIED FROM THE TRANSCRIPT