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Dr. Peter Attia

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2023-03-15
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2023-03-15
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  1. “cancer, as one example, it's better to have your first heart attack very late in life than have it early in life and then be right on the verge of having another one as time goes on. Well, just by going through those very simple questions, all of a sudden you start to formulate a much clearer strategy for living longer that points you much more clearly towards this idea that I talked about in the book called Medicine 3.0 rather than medicine 2.0. And once you iron all that out, then you start to get into the tactics, oh, all right, okay, so how does nutrition layer onto this? How does pharmacology layer onto this? How does exercise layer onto this, et cetera?”

    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

  2. “Diseases such as type 2 diabetes and things like that. Probably I would include accidental death in there. So falling or automotive accidents. So that's an important insight because now you start to work backwards from there. So if you, so wait a minute, you think, oh, if I want to live longer, I have to avoid those things. Ah, okay, how do I avoid those things? Well, let's start with the chronic disease bucket. There's two ways to think about that. I love when things turn into somewhat binary decisions. Is one way to live longer to live longer with a chronic disease or live longer without a chronic disease? So it might not be entirely obvious which of those is true, but if we look at the data, it's pretty clear. The data unambiguously make it clear that you will live longer if you can extend the period of time that you live without a chronic disease rather than extend the period of time you have the chronic disease. So in other words, it's better to get cancer later in life than to live longer with you.”

    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

  3. “Well, I guess the question is how do you come up with the list, right? Like, how are you filtering on that list, right? So there's no shortage of tactics that one could think about because the world is rife with everybody offering their tactics. It's not like I'm not suggesting tactics. But what I really want people to do is say, look, let's anchor to a strategy. So for example, if one of your objectives is, okay, I'm going to live longer. It's like, no, no, let's deconstruct that. What does living longer mean? Well, to understand what it means to live longer, you have to understand what ends life. Well, what ends life is a very clear and easy to understand data set. So let's look at it. And let's look at it in great detail. We call this the death bars analysis. So what are the death bars? Well, it turns out if you're over forty, you don't smoke, we can really clearly tell you that there's about an 80% chance you're going to die from atherosclerotic cardiovascular disease, cancer, neurodegenerative disease, or medical.”

    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

  4. “And certainly not having that strategy piece in the middle makes life really complicated. So the first thing I think is to understand what's the difference. So objective is pretty straightforward. It needs to be stated. It should be very clear, though. So, for example, my objective might be to live longer. If you said, well, what are the tactics now? What should I eat? How should I exercise? Do I need to take this supplement or that supplement? The probability that you are going to come up with the right set of instructions is vanishingly small”

    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

  5. “I learned about this stuff about a decade ago when I was working on a problem that is irrelevant now, but I think the message was important, which was, I think I had a vague sense of what the objective was. My immediate tendency, which I think is normal, and I think we all do because I don't think anyone's hardwired to go through the middle step was to go from objective to tactics. In fact, I think most people just kind of go to tactics without even thinking about objective.”

    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

  6. “I didn't know that, Tim. Thank you. Because when you guys came over, he mentioned how much he was liking it. He had just picked it up, but I didn't realize he'd finished it and he enjoyed it. So thank you. That means a lot.”

    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

  7. “Doing and it's different with blogging, which I don't have a problem doing. But this strikes me as maybe what an actor feels like when they make a big film or a director or again, like an author like you. So I think there was a little bit of subconscious dragging my feet and, hey, maybe I can just keep working on this book forever, but it'll never actually come out.”

    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

  8. “And maybe you can relate to this, Tim. I don't know. We've never actually talked about this, but I think there's just a vulnerability that comes with writing in this manner that is unlike all the writing I've done in the past. So I've been blogging insanely for 12 years. That's different. You're not really putting yourself out there when you write a blog post. You don't have to read the comments that people write. You don't have to pay attention to any of that stuff. I think when you write a book, you are really saying to people like, here I am, tear me down. And I just think there's on some level, maybe it's embarrassing to say this, there's just been a little bit of a reluctance to, yeah, again, for lack of a better word, vulnerable, just to sort of say, okay, you know, I'm willing to say everything I have to say on a subject matter and now let the arrows come flying. And that's, again, I don't know that that makes sense, but I'm sure that anyone who does something very public feels that way. But it's different with podcasting, which I don't have a problem doing.”

    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

  9. “Yeah, yeah, yeah. Look, I think there are some people out there who can churn out a book a year and more power to them. But the way I viewed this book was that this is sort of the one and only book I ever want to write. Will I ever write another book? It's hard for me to ever imagine the answer to that question is yes, but again, maybe at the end of my life I'll have something else to say. But as I'm 50 years old now and I'm at the midpoint of my life or slightly past the midpoint of my life, I feel like everything I ever want to say on this particular topic is in this book. And therefore, it was just a very long book. The final version is probably 140,000 words. The version I ultimately submitted was two hundred thousand words. Like this has been chopped way down by thirty percent into what is still obviously a book that is quite long. So that's part of it. I also think part of it 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

  10. “I think there are probably several factors, some of which are related, some of which are not. I think on one level, my appetite for how good, quote unquote, I needed this book to be was very high.”

    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

  11. “Couple hours after the workout doesn't really seem to matter. Our window in which we can synthesize new muscle is sufficiently broad that even for an untrained individual who has a narrower window, it's totally reasonable to say, look, just make sure a couple hours after that workout, you get in your big protein meal. So instead today, I just use high quality whey protein post-workout, and I don't trouble myself with consuming any protein in workout.”

    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

  12. “I was. I used to always drink BCAAs during workouts, and for folks listening, there were three branch-chain amino acids, and leucine is hands down, the most relevant of them. And we know from work that our mutual friend David Sabatini has done in his lab that leucine is a very, very potent MTOR stimulator. In fact, it might be the single most potent stimulator of MTOR. Emtor, of course, acutely, you want that thing stimulated. It's promoting growth. You don't want it chronically stimulated, but you want it acutely stimulated. The problem with branch chain amino acids, and I got to tell you, Tim, I think it's largely fallen out of favor. So I don't even consume branched chain amino acids anymore. During a workout, I'm literally just consuming an electrolyte drink. That's it. The problem is, one, they don't stick around long enough in their free form. And two, you're just not getting enough of them. The third thing is the temporal nature of when you take them in, being in the workout.”

    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

  13. “It's called carbon. I have no affiliation with it, but a friend of mine, it's his app. I like it. I guess my affiliation is that it's my friends app”

    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

  14. “Rather than just fixating on the total number of grams of protein you need to eat, which you may have a hard time hitting, if you focus on the number of grams of leucine lysine and methionine you're getting in a given meal or a given day that will almost assuredly get your total protein quantity to the right place. So for me that really meant I just wanted to make sure I was getting gosh probably six to eight grams of leucine a day comparable amount of lysine at least two grams of methionine a day. And you know, I use an app to track what I'm eating just so that I can see where my protein is coming from and how much I'm getting and when and where and that tended to work out pretty well.”

    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

  15. “A quantity, mean plant protein. Now, you can get them, and it gets especially hard if you can't have dairy or eggs. So if someone says, look, I'm a vegetarian, I'm not going to eat beef or chicken, but I'm willing to have eggs and dairy, it gets a lot easier. You know, eggs, for example, are a very high source of methionine. So what we typically will tell patients is 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

  16. “So, the first decision I think everybody wants to make is am I getting this from plant or animal? And unfortunately, this has become sort of a contentious topic and it's got its sort of political religious overtones to it. But if you don't concern yourself with any of those things and you just think about biochemistry, there's really no ambiguity here. Protein derived from animal sources are more bioavailable. So you can overcome some of that by cooking the plant. So once you start to cook the plant and free it up from the fiber, you can liberate more of the plant protein. But you're still always going to be struggling with a bit of a bioavailability problem that can be anywhere from a 20 to 30 percent haircut you're taking just on the net consumption of the amino acid. The second issue comes down to amino acid quality. And if you're really concerning yourself with hypertrophy, I think the three most important amino acids would be leucine, lysine, and methionine. These are amino acids that also you don't tend to have as high.”

    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

  17. “At the same time, you don't want to have too much, and too much is a bit of an unclear limit, but my best reading of the literature is that you're starting to hit too much at about 50 grams in a serving”

    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

  18. “The next question though becomes timing, and this is something that until a couple years ago I wasn't really paying enough attention to. So it wasn't enough to just say, well, Peter, you've got to have 180 grams of protein in a day. Because, for example, 290 gram boluses of protein doesn't accomplish nearly the same thing as four forty-five gram servings spread out over the course of a day. So there is kind of a sweet spot with protein where you really need to be north of about 20 to 25 grams to ensure that those amino acids aren't just going into what's called a gluconeogenic pathway. So we can turn protein into glucose, but we don't really want to. Protein should be thought of as a structural nutrient, whereas we want to really think of carbohydrates and fats as energy nutrients. So you have to have enough protein in a given serving that you don't just have the liver take it and use its bit for glucose.”

    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

  19. “I'll start with that, and then we can talk about the training. So, the protein basically went to a very conscious and concerted effort to increase protein to one gram per pound of body weight. People are going to ask, is that one pound of actual body weight? Is that one pound of lean body weight? Is that one pound of target body weight? The answer is for someone my size and weight and my body fat percentage, I think at the time I was about 15% body fat, it really doesn't matter. It could be basically call it one gram per pound of current body weight is sufficient. So that's what I did.”

    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

  20. “So, in a span of, God, I'd have to go back and look at the exact data. I believe it was 13 or 14 pounds of lean mass in about 12 months, which is, again, that's not Herculean. These are not insane numbers. Not taking anabolic steroids. This is relatively doable for someone who is making it a high priority to eat the right amount of protein, the right kind of protein, and spacing it and consuming it at the right times, and then also focusing training on a little more hypertrophy.”

    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

  21. “The bar. I want to be considerably above the bar. So basically, I just change things around and said nutrition and exercise are going to change a little bit. So we can talk about those changes, but basically I made big changes with exercise and nutrition to make those corrections.”

    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

  22. “Probably quarterly. Yeah, probably every quarter. And while I certainly think there are some benefits from doing that, I think what I was sort of confronting was, wow, there's actually a pretty big cost as well. And I would go out of my way while fasting to still exercise. I was lifting weights every single day, which was difficult sometimes, but doing everything I could to sort of try to stimulate muscle protein synthesis. But at the end of the day, if you're not providing any nutrients, including amino acids, you're basically just tearing down muscle to try to rebuild with that muscle, but your net effect is a loss. So I just said, like, I got to fix this. I got to do something about this. And I want to have my ALMI be in the at least the 90th percentile, if not above the 97th percentile as I age. The data are pretty unambiguous that people live longer, better lives with an ALMI north of the 75th percentile. So not one to just clear.”

    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

  23. “Entire body and just subtracts out fat. That's also a good proxy for lean mass, but there are many other things like organs that are taking up some residence there. Anyway, when I looked at these metrics, I was shocked. I was shocked at how much less muscle I had than ten years earlier. Almost exactly ten years sooner. And, you know, I attribute it to several things, but I really thought that chief among them was just how much fasting I had been doing over the previous three years. I had really kind of taken fasting to a pretty extreme place, you know, doing up to ten days of water only and routinely just busting out seven day water only fasts, certainly doing three days every month would be something I would do without hesitation.”

    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

  24. “And when I get my Dexa skins, you know, I always plot the data, right? So I'm not just interested in body fat, but also bone mineral content and many other metrics. But one of them that's really important is something called appendicular lean mass index, or ALMI. Another one is called FFMI, fat free mass index. And it's probably worth explaining a little bit about what these are, but the ALMI takes what the Dexaskin imputes as the lean tissue in your arms and legs in kilograms divides that by your height in meters squared so it spits out a number like eight kilograms per meter squared this is a pretty accurate representation of how much muscle you have in your arms and legs because the dexascan can really only identify three things bone fat and other and since things in your arms that are not bone and fat tend to be muscle it's pretty good at identifying muscle whereas the fat free mass index looks at 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

  25. “The fall of 2021 I had sort of hit a relative low in weight that wasn't quite as low as where I was as a cyclist, which was probably about 165 pounds, but was still pretty low for me kind of in the low to mid 170s. And I did a Dexa scan, which I do periodically.”

    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