#181 Peter Attia - The Science of Longevity, Nutrition Myths and Medicine 3.0

Shawn Ryan and Peter Attia discuss Attia's background and life experiences, shedding light on how personal choices and a unique set of interests shaped his life and career trajectory.

Attia, Egyptian by Heritage, Grew Up In Toronto

Attia confirms that he grew up in Toronto, Canada, to Egyptian immigrant parents. He shares insights into his childhood, including how his parents ran a restaurant together, with his dad managing the restaurant and his mom working alongside him after an earlier job at a grocery store checkout.

Disinterested In Academics, Attia Found Purpose in Boxing and Martial Arts

While Peter Attia touched on his love for hockey, he admits to losing interest in school during fourth or fifth grade after he was placed in a normal program following the defunding of a gifted program. Attia began clashing with teachers and reached a point in high school where he had zero interest in academics. Nevertheless, a math teacher named Woody Sparrow saw potential in him and encouraged him to consider university, recognizing his talent in mathematics.

From age 14, Attia devoted six hours a day to boxing, which he believes saved his life by keeping him focused and steering him clear of negative influences. This distraction away from socializing helped him avoid bad decisions, like engaging in crime or other dangerous behavior, which some of his peers succumbed to. The lethal game of playing chicken with subway trains that resulted in a death emphasized the dangerous paths from which boxing and martial arts withheld him. He credits the older, employed individuals he trained with for offering a good influence and a perspective different from that of his peers.

Though seriously considering professional boxing, Attia eventually decided against it due to the risk of injury and low chances of success. He remained connected to the sport even in university but had to face the harsh realities of injury and its long-term effects, a severity underscored by a severe concussion he sustained. Attia values the lessons boxing and combat sports teach about fear control and adversity but remains ambivalent about his children participating in contact aspects of the sports.

Attia Left Residency, Frustrated With Healthcare System Li ...

Peter Attia, founder of Early Medical, advocates for a new paradigm in healthcare known as "Medicine 3.0," which aims to enhance longevity by preventing chronic diseases through lifestyle changes and other methods.

Attia Promotes "Medicine 3.0" to Prevent Chronic Diseases

Attia analyses the history of medicine and explains his vision for its future.

Medicine 1.0: Traditional Beliefs; Medicine 2.0: Improved Care, Chronic Struggles

Medicine 1.0 spans human history up until the end of the 19th century, characterized by practices based on prevailing beliefs rather than science, often resulting in ineffective or harmful treatments like bloodletting. People succumbed to infectious diseases and complications such as during childbirth. In contrast, Medicine 2.0, which began around 140 years ago with the adoption of the scientific method, brought advances in sanitation, maternal and infant mortality, and infection treatment, effectively doubling the human lifespan.

Medicine 3.0 Focuses On Maximizing "Healthspan" and Preventing Disease

However, Attia emphasizes that while modern medicine is adept at treating acute conditions, it is not designed to effectively manage chronic diseases. He introduces Medicine 3.0, which aims not to just keep people alive longer with chronic disease, but to delay and prevent the onset of such diseases entirely. This approach values healthspan as much as lifespan and focuses on maximizing quality of life by managing physical, cognitive, emotional health, muscle mass, reaction time, and even strength of relationships. Attia underscores the importance of aggressive disease screening, undergoing comprehensive diagnostics like whole-body MRIs and seeking to understand one's personal risk factors.

Attia Believes Heart Disease, Cancer, and Dementia Are Preventable Through Lifestyle Changes

Attia identifies cardiovascular disease, cancer, dementing diseases, and metabolic diseases as the main culprits behind mortality and suggests that they can largely be prevented.

Attia Emphasizes Optimizing Key Risks: Weight, Blood Pressure, Cholesterol, Metabolic Health

The majority of people face ri ...

Peter Attia discusses the implications of the current American food culture, the rise of chronic metabolic diseases, and the need for individualized nutrition guidelines, while also advocating for minimizing exposures to potential toxins like microplastics and pesticides.

Attia: Us Food Scene Encourages Overeating and Poor Nutrition

Attia criticizes the American food system, which promotes overeating with a large amount of processed food and encourages an environment where poor nutritional choices are the norm. He observes that these lifestyle habits have led to doubling obesity rates and a tenfold increase in type 2 diabetes prevalence since his birth. Attia contrasts American overeating and processed foods with European habits of smaller portion sizes and less frequent consumption of calorie-dense foods.

Factors Contributing To Chronic Diseases

Attia explains that factors such as disrupted sleep, stress, boredom, and actual hunger influence our food choices and subsequently our health, contributing to chronic diseases such as obesity, type 2 diabetes, and dementia. For instance, a lack of proper sleep can increase unhealthy cravings and elevate cortisol levels, leading to poor eating patterns. He stresses that these lifestyle choices, coupled with an American culture that includes frequent intake of high-calorie foods, significantly drive the incidence of chronic diseases.

Attia Advocates for Individualized, Evidence-Based Nutrition Over Absolutes

Peter Attia emphasizes the importance of individualized nutrition that accounts for nuances rather than rigid absolutes. He dismisses simplistic health claims, such as those about the unusual harms caused by specific foods or nutrients. Attia decries one-size-fits-all dietary recommendations and suggests that people should focus on more critical, evidence-supported aspects of nutrition like exercise and sleep, rather than unduly worrying about particular foods.

Attia Critiques Simplistic Claims on Food or Nutrient Harms

Attia believes that nutritional advice should accommodate individual variation. He noted that while some diets may work for certain individuals, they aren't universally applicable. For example, while he personally had a positive experience on a ketogenic diet, he now prefers a balanced diet and constant health monitoring through biomarkers. Attia is organizing a moderated podcast debate on seed oils, striving for a factual discussion that could illustrate his dislike of simplistic and unfounded claims about nutrition.

Attia Advocates Minimizing Microplastic and Pesticide Exposure for Better Health

Attia counsels reducing exposure to harmful substances like microplastics, although he recognizes the challenge of completely avoiding them. He suggests practical steps like using glass instead of plastic containers, avoiding heating anything in pl ...

Dr. Peter Attia emphasizes the potent effects of exercise on health, particularly in reducing the risk of dementia and in maintaining muscle and aerobic fitness.

Attia On Maintaining Muscle and Aerobic Fitness With Age

Attia underlines the importance of managing healthspan by measuring physical qualities. These include muscle mass, strength, and VO2 max—a measure of maximal aerobic capacity.

Attia Suggests Assessing Capability With Lean Mass Index, Strength Tests, and Vo2 Max

Though not detailed in the provided transcript, Attia's approach implies that exercising has systemic benefits that can be measured through health markers. He discusses the importance of maintaining muscle mass relative to the population, aiming to be at or above the 75th percentile. Attia recommends using the Appendicular Lean Mass Index and Fat-Free Mass Index from a DEXA scan as one way to measure muscle mass.

Furthermore, Attia stresses the importance of strength, suggesting individuals should be capable of wall sits, which serve as a benchmark that adjusts with age and sex. When discussing VO2 max, he describes using a mask during exercise on a bike or treadmill to assess maximal aerobic capacity, setting a high standard relative to age and sex. Additionally, Attia refers to watt output relative to body weight for an hour as another benchmark for aerobic fitness, a metric he calls "zone 2" fitness.

Attia Tailors Exercise To Fit Individual's Schedule

Attia Advocates for Personalized, Sustainable Exercise Routines

Attia focuses on the sustainability of exercise routines, asking individuals how many hours per week they can cons ...

Alternative therapies are gaining traction as influential tools for promoting mental and emotional wellness. Peter Attia's experiences and insights shed light on the value and proper use of these unconventional interventions.

Attia Benefits From Psychedelic and Alternative Therapies

Peter Attia speaks from personal experience regarding the impact of psychedelic and alternative therapies on mental and emotional health.

Attia Warns Against Indiscriminate Use, Stressing Intentionality and Professional Guidance

Attia cautions against the indiscriminate use of psychedelics and emphasizes the necessity of intentionality and professional guidance. He has had profound experiences himself, particularly citing high doses of psilocybin that allowed him to dissociate and empathetically see the world through his father's eyes. Attia has found these experiences life-changing, fostering a newfound compassion within him.

He notes anecdotes about patients who have undergone psychedelic therapy, such as one who lost their craving for alcohol after attending a retreat, highlighting the profound impact these therapies can have. However, he hasn't used all forms of therapy, notably excluding iboga from his personal experiences despite talking about its benefits, particularly concerning alcohol and opioid dependency.

Attia: Mental and Emotional Health Crucial for Well-Being

Attia believes that mental and emotional health is pivotal for overall well-being, suggesting that alternative therapies can play a vital role in this domain.

Alternative Therapies, Sleep Optimization, Social Connection, Self-Reflection

Anecdotal evidence from individuals like Shawn Ryan, who sought treatment at a retreat for PTSD and traumatic brain injury, suggests that these therapies offer multifaceted benefits. Ryan observed a range of positive outcomes post-retreat, including giving up caffeine and alcohol, engaging more with his family, and a decreased sugar intake.

Attia emphasizes the concept of "altered traits over altered states," po ...