In this episode, we discuss: 0:01:17 - Overview of episode topics and structure 0:03:14 - How Peter defines longevity 0:12:18 - Why healthspan is a crucial component of longevity 0:17:04 - The evolution of medicine from medicine 1.0 to 2.0, and the emergence of medicine 3.0 0:28:33 - Overview of atherosclerotic diseases: the 3 pathways of ASCVD, preventative measures, and the impact of metabolic health 0:36:15 - Cancer: genetic and environmental factors, treatment options, and the importance of early and aggressive screening 0:43:15 - Neurodegenerative diseases: causes, prevention, and the role of genetics and metabolic health 0:47:20 - The spectrum of metabolic diseases 0:48:32 - Why it’s never too late to start thinking about longevity 0:51:16 - The 5 components of the longevity toolkit 0:52:36 - Peter’s framework for exercise-The Centenarian Decathlon 1:05:04 - Peter’s nutritional framework: energy balance, protein intake, and more 1:15:27 - Sleep: the vital role of sleep in longevity, and how to improve sleep habits 1:21:19 - Drugs and supplements: Peter’s framework for thinking about drugs and supplements as tools for enhancing longevity 1:24:59 - Why emotional health is a key component of longevity 1:28:06 - Advice for newcomers on where to start on their longevity journey
Goodness, really wish I knew all of this earlier. Started fasting light exercise building to resistance..all bets seem off 😢 that said, better to still try
As a 77 year old male, on 0 medication I have been working on my healthspan for the last 50+ years. Movement has been my religion and therefore fuel to maintain strong movement is also hugely important. As a former pro ski racer and coach, strength and conditioning was a crucial factor in competing in an arena where you are only as good as your ability to redirect forces like gravity centripetal force and momentum to a very small focus point, your inside edge of the skis, to allow you to carve circles on a surface of slick frozen water at speeds of up to 70 mph while enduring 3+ Gs of gravity. Now I mostly cycle, some skiing, and windsurfing. I also workout with weights 2-3 times a week. But the surges and increased blood flow from the form of training I now revere the most is from my latest work as a pedicab operator( bike taxi) non motorized, quads only, in SanFrancisco. The physical demands are enormous, but beyond that the randomness of events encountered is hugely associated with increased brain plasticity. I am the oldest pedaler out there by at least 2 decades but not the slowest😅
I am a 69 y/o paraplegic who was injured in 1997 @41 y/o. I was always was an outdoor hiker and skier (cause of injury), as well as running and lifting since in high school. I remain healthy in attitude as well as physically. No doubt it has been an extra challenge. It is not impossible. I shoot for 120-150 min/week on a hand cycle as well as 2 days of weight training per week. I accept I have additional risk factors which will impact me as I enter another decade but you can fight it. If I can work out you can do. Fix your nutrition, keep your weight down and I hate to use the Nike phase “Just do it”. Good luck. I can influence the quality of the years left on this planet.
As someone who recently turned 70 and on no meds, I do see the physical decline in many areas even though I have been a lifelong gym goer. However, my energy level and mental acuity remain sharp which has a lot to do with the fact I am still working at a job I love.
What areas are you seeing physical decline, and have you found some solution/remedy to it? Genuinely curious Im amazed that your 70 with no meds and still sharp!
If you see a decline and are on no meds, perhaps you should go on meds, that way the rate of your decline might be slower. For example, it has been shown that even for older people with "normal" range of lipids, lowering the ApoB lipids further has distinct healthspan benefits. That's just one example. In any case, it's worth considering, or at least exploring. YMMV.
I just turned 74. After working with a health span coach for two years I've come to believe That half to 3/4 of everything that happens to us as we age has nothing to do with age at all. It has to do with decades of no strenuous exercise, no interest in wellness, and abusing our bodies. We need to drop the paradigm that age kills us. It is all the things we know we should do but don't.
I am 69 on no prescription med. I am conscious of what I eat & make moving my body my top priority. Heathspan is feeling good mentally & physically. You need to be proactive in everything you do..every single day. Its not selfish if you want to live without medical intervention as long as possible.
In relation to sleep. A couple weeks ago I had a bad bout of insomnia. I was throwing up and had massive migraines. I slept like 5 hours in a 72 hour. I completely reset my sleep. I stayed up for 27 hours. Drugged myself into a deep sleep. Set an alarm for 7 hours later and did this 3 nights in a row. I don't recommend that way but it worked for me. I've been sleeping good and I fixed the anxiety related to sleep.
What you did somewhat aligns with sleep interventions for insomnia, which is to use sleep restriction to re-set and re-structure sleep patterns, so you force sleep pressure to build up and release it in a structured way by waking up at a fixed set time, and eventually your sleep cycle resets.Voila!
This was a perfect compliment to the regular content. Would like more like this building up systematically from the basics, and then always keeping whatever the special area is within the nested series of systems that wraps back up to this. Thanks both. Btw, contrary to apparently everyone else in the comments, who seem to be 50+ in better than average health, I am a relatively beat up 27. Good luck to all you old codgers out there 😊
Riding a bicycle is a great way to exercise. Ebikes are bringing many older adults back to cycling. Cities need to do more to encourage people to ride bicycles. Safe protected bike lanes and trails are needed so adults and children can ride safely. Speak up for bicycles in your community. Bicycles make life and cities better. Ask your local transportation planner and elected officials to support more protected bike lanes and trails. Children should be riding a bicycle to school and not be driven in a minivan. Be healthier and happier. Ride a bicycle regularly.
I think the ebikes are the new smoking. Not much exercise involved there. I've been a paramedic for over 20 years. I think bikes need a lane off the road, there is no "protected bike lane" that actually protects a cyclist. Between adults riding the wrong way down the street, not obeying the rules of the road, not wearing helmets and adults riding on the sidewalk (illegal in most places) this is a recipe for disaster. I'm the one that picks up the pieces. In my experience, most of the time it's the cyclists fault. I love cycling but would never ride on the streets anymore. I'll stick to the bike path on the lake or in the woods.
I’m 60 and mine is outdoor exercise, especially in nature when possible performing activities such as sprinting, occasional longer runs all done out in nature and natural surroundings, also calisthenics, primal movement, climbing, basic natural/primal parkour, ground and quadrupedal movement and it’s been a total game changer compared to typical standard gym workouts which I don’t bother with anymore but still do outdoor strength/power training using weights, weighted and unweighted body natural movements etc!
I think you answered this, but I want to make it clear. What is "better" health? To be specific, I am going to give an example of insulin sensitivity. Let's say a person is not diabetic. Their HOMA IR is around 2.5. They don't have any symptoms related to diabetes, and their blood sugar is in the reference range. Would their health be "better" if they improved their insulin sensitivity? If yes, why do almost all medical doctors only treat diseases, but not try to improve people's health and make it better? Not only that, they actively try to stop people from optimizing their biomarkers. And this is true, I guess, for the entire world. I have a friend of mine who studies medicine. When I showed him the cronometer app where I track my macronutrients, he said I am taking things too seriously. I think the opposite, I don't take things seriously enough, I am not following a good enough diet, etc. Most patients in hospitals end up there because they haven't paid enough attention to their problems early on. But the number one advice I hear from every doctor I know is not to be a hypochondriac. Why is that, and is it smart? Trying to make your health better, even if you are not ill or sick is bad somehow? I honestly don't understand. Or are they telling me (and everyone else) not to try, because it is too hard? It's not that hard to drastically improve your insulin sensitivity and lower your HOMA IR from say 2.5 to 1.5. A person can improve many markers of health if they try. But it seems to me that medicine 2.0 fights against medicine 3.0. Why?
The reason they are fighting you is because they are not taught to promote health in med school. They are taught to treat disease with drugs and surgery. You are correct as they don't get the concept of OPTIMAL health. It's all about the med school brainwashing.
I'm 83 and people guess my age as late 50's early 60's. People are shocked when I tell them my real age, including doctors and nurses. I live the life of a 30 year old and my body doesn't know I'm old. This is the result of eating whole foods exercise, and Saw Palmetto. Now I'm eating a high protein diet and working on building my lean muscle mass. Why am I very young for my age? I take care of myself.
Hi Peter,, I confess not until I was 56 , 2 years ago ,, did I consider aging ,, and preventing it , I was simply in a exercise daily mindset, people were commenting on how young I looked , but this was not aimed at , this happened,, I have to assume,, by exercise including HIIT and an athletes diet spread over 30 years . Basically I’m waiting to age , as I’m just as I was at 28 yrs .
I love Peter but if I could offer a suggestion. You guys need to have a 3 year old version of these chats. Meaning they should be in a language a 3 year old would understand. Peter is not the guy to do that IMHO but this info is so important it needs to be heard and UNDERSTOOD by everyone.
Training to avoid a life you don't want, that's my focus. Both parents lost their lives before 66 (1 cancer, 1 alive but disabled from a stroke with no real quality of life). Don't let others in your life hold you back, you can only control you.
71, chronic fatigue, broke femur and in the category of didn’t die, but no longer able to do what I used to, 7 knee operations. Do what I can but have had to accept this life and have gratitude for what I can do and the people in my life. Started rapamycin 3 months ago but so far no difference in how I feel.
I also suffered bodily injuries which had long recovery. I’ve started using a 7mg nicotine patch for pain which really works and helps with movement. However I became proactive in my medical decisions and after years of trying to get help for my problems I started telling my primary doctor what I needed and have gotten everything I’ve asked for. I started with physical therapy. The knowledge of body mechanics is phenomenal now and the success I had encouraged me to get a personal trainer. I’ve gained 4 pounds of muscle mass and have improved in all aspects. Things change but don’t give up.
@@diversifiedcollectibles9242 I do need to eat less carbs - don’t eat simple sugars but whole grain bread fruit and such. I really doubt it will help but will try it thanks.
@@jfjenterprises I tried a nicotine patch for a few weeks it was going around the CFS circles for awhile. Didn’t do anything but maybe will give it another shot. Doubt I could do rebounder with the knee/leg issue and am now paranoid re falling. I tried a personal trainer but am not well enough to make commitments for a certain time and hour too much. I might try the Pilates machines though at this gym. Still the issue of a certain time commitment but think it could be good for body. Do wish I could find a really good PT I’ve had plenty of sessions in past 4 years with the certain joints but need to ask around for one very good with overall body mechanics. I did buy a blood restriction cuff that Peter talks about and use quite regularly but just not coming back from the femur break. Guess I’m in the percentage of older folks who don’t die within a year but never can get back to pre fall. I do see subtle improvements with time though. Thanks for the suggestions appreciate your taking the time.
It’d be good to see more publications and discussions about Medicine 3.0…. It seems, as it stands now, “Medicine 3.0”is just like an evolution of some medicine specialties and practices, such as preventive medicine, geriatric medicine, physical rehabilitation medicine, psychiatry, even chiropractics, plus nutrition science, into a practice to address chronic disease and aging. Maybe it’s a new version of family medicine that incorporates some aspects of aforementioned medical specialties (and others) to (only) deal with chronic diseases and aging. Maybe it should be called “Chronic Disease and Longevity Medicine”. Then, as a major discipline and specialty, it can have residency programs, even fellowship programs, to train next general physicians.
28:24 on smoking- with the research on nicotine being a nonaddictive nutrient- the prmyrizines added to tobacco are addictive along with the 100s of other harmful chemicals. I use nicotine patches for pain mitigation successfully. Nicotine has been found to help with brain tumors, heart disease, memory disease, and many other diseases. I also am in my 70s and no meds.
Peter, you mentioned five buckets for longevity tactics. You also gave the analogy of us all driving towards the cliff of death. It’s a very good analogy. There’s a bucket which is often ignored but is very powerful. That is the spirituality bucket. The realization of the ‘Self’ as the one and only eternal, unchanging divinity that’s is omnipresent in the cosmos gives the power to overcome the fear of the death cliff. As long as we recognize that we are not this body/mind/intellect complex which is ephemeral and is bound to perish, we are better prepared to go beyond death. This is the essence of spirituality bucket. In fact I would take a step further. Instead of considering the spirituality bucket as another bucket I would call it as one gigantic bucket in which all the other buckets (exercise, nutrition, sleep, emotional health) exist in harmony. If we incorporate and integrate spirituality and righteousness (of the greater good) into every thought, word and deed, then longevity becomes eternal in the true sense of the word 🙏🏼
How do I remove stress before sleep if the stress is in me? It's an almost serious question. I know It's up to me to fix it, so platitudes are always welcome but treated accordingly. I LOVE your advice about diet and exercise, but the emotional health and how to relax stuff to me all jsut sounds like someone yelling, "RELAX, MAN!"
Cardiologist Dr Williams (previous American Society of Nuclear Cardiology) is famous for his quote “There are two kinds of cardiologists: vegans, and those who haven't read the data.”......seems like a pretty big statement to make when "very few things in this field that can be stated with a high degree of certainty". That aside. If you can't say based on key research X, Y, and Z we should be having 1.6g of protein per kg/day and either include a snapshot of the key studies or reference them below, then at this point in time you're still one of those people just speaking with conviction and talking about a subject like it is absolutely correct without showcasing your work and openly allowing us to assess your error bar.
When PA talks about 'inevitable decline' I think there is a possible case he misses... Someone who, when young, lead a very health suppressing life but then in more senior years turned things around. The result, for a time at least, is that the individual improves as they age....
Thank you for this info.! So, statins lower Apop "B." Statins, also, imcrease the risk for developing Type 2 Diabetes, as well.as, cognitive decline: so, how are those risks to be responsibly balanced, I wonder.
Attia's comment that obesity "is driving 2/3 of cancers" isn't correct, or is at least overstated. Apparently women with a BMI over 35, which is very obese, do have a 1.6 times greater chance of getting breast cancer but that increase isn't high enough to be a drive of cancer. Other cancers are associated with a 10% to 20% increase in risk if obese. Interestingly, the breast cancer case rate has been *flat* since 1990 despite a huge increase in obesity.
Consonant with this I have read that only about 40% of cancers are currently considered preventable. It seems wrong to give any unjustified encouragement to those who would hold cancer patients responsible for their illness.
What are your qualifications or what evidence do you have to make this statement? You said "apparently" which doesn't exactly scream data driven results.
The section about cognitive ‘decline’ could be quite depressing if we thought about it only as a normal descriptor of aging brain function. I prefer to call it ‘Cognitive Evolution’. I see it on a near-daily basis in myself but the one thing that brought it front and center was my weekly piano lessons. I began playing again at age 64, which was 50 years after my last lessons, and thought I had forgotten how to read music. Remarkably (to me) I had not. The WAY I learn has changed-decreased speed, retention, recall-but it still does happen. It’s simply Different now. The synaptic connections feel like they take a longer path to get the end result, but they do still reach the ultimate destination. Perhaps because I have been an RN for over 40 years I see this in a more ‘clinical’ way. I learned so much from your book and am in complete agreement with your about the next stage-Medicine 3.0. Our entire approach to health and how we achieve an optimal state must change drastically.
to maybe perfect your analogy @ 1:22:15 May I suggest, "....asking them to not use a level or power tools" as in, you can do it manually and without callibration, but, it works better with
Regarding Vo2 Max, I’ve been able to raise mine from over 15 points (from 42 to 58) via Zwift, especially the canned Vo2 interval workouts (30 minute workouts). Very encouraging
Regarding the notions of Medicine 2.x and Medicine 3.x: are there some writings on this subject? It seems to me that these two paradigms are actually in the same spectrum, especially in terms of medical science and the practice of medical doctors and healthcare professionals. The big difference is perhaps on the societal and governmental policy aspects. After all, doctors and scientists must continue treating existing diseases and discover new cures, while the populations, industries and governments must take more responsibilities and actions in the current and future medicine.
@@GregVining : it’d be good to see more publications and discussions about Medicine 3.0…. It seems that as it stands now, “Medicine 3.0”is just like an evolution pf some medicine specialties and practices, such as preventive medicine, geriatric medicine, physical rehabilitation medicine, psychiatry, even chiropractics, plus nutrition science, into a practice to address chronic disease and aging. Maybe it’s a new version of family medicine that incorporates some aspects of aforementioned medical specialties (and others) to (only) deal with chronic diseases and aging.
What he said of effect on judgement due to lack of sleep. This is a tell on the mindset of medicine 2.0. MD residents must make critical treatment decisions while being drastically but intentionally deprived on sleep. If we make truck driver drive 18 hours straight we'd call it insanity.
Thank you for, IMO, more useful comments on the topic of nutrition than I have heard from from you in the past. ! My instant question was: how does the research on nutrition compare to the research on some of the drugs that you are taking regularly (that supposedly support longevity)?
I've been listening to Attia since the start of his podcast and one of his blind spots is his fervent belief that there will be no medical/technological breakthroughs to significantly increase the health span of those over 60 for the next 30 years.
@@yamishogun6501 I don't think that's a blind spot. I don't think there's a compelling reason to expect major changes there - continued marginal improvements, absolutely - and I think it's also best to live as if that won't be the case given that we can't know what the benefits will be, if any, and can only reasonably act on the information we have.
I just want to be strong. I've always been strong, I'm now 43 and I'm still stronger than these kids coming into work today, but I', weaker than I ever was, and i just need to get stronger. My shoulders pop out and my back always hurts now, really it seems to be my hips/psoas.
Peter dislikes the longevity movement but he understands that is all people want to talk about right now. Good on him for providing this for his fans, because this episode is fucking phenomenal! Cheers.
What is your take on Dr David Sinclairs take on longevity, namely taking NMN, metformin,reverential, Bernadine etc which appear to be his main focus, he also emfisises nutrition and exercise but he does tend to gravitate towards the above supplements, would you recommend them? Or are the gains not significant enough to warrant the expense?
Dr David Sinclair himself acknowledges that his theories are speculative and on the cutting edge of research. There needs to be a lot more empirical evidence before his claims can be taken seriously by the scientific community.
Please provide your evidence that 2.2 g/kg of protein is required for longevity and health. Baum, Kim, and Wolfe (2016) does not support this claim. This is your only citation in your book. You need to provide evidence. Yes, you speak with a level of certainty on protein, without providing any evidence.
Peter doesn't seem to be as aware of research explaining emotions as a function of neurobiology. Basically, the concept is that mood is the result of energy/metabolic allocation (allostasis) so if one is depleted, e.g. because of stress which calls on a lot of cortisol etc, then one's mood is negatively affected. So it's no surprise that poor heart health and other chronic diseases are highly correlated with depression.
@@Tamarahope77 do you recommend any resources to learn more about neurobiology's affect on emotions? Or how I can make use of the knowledge to improve mood?
So much time was spent on verbose, foundational thinking with almost no payoff because you skip over exactly the tactics that necessitate explaining how Peter thinks. The episode is really about exercise, protein, and sleep, but it is wrapped in a blanket suggesting we needed to patiently listen to all these other deductive thoughts about longevity. 5 seconds are spent on what Peter's anti-cancer tactic is (42:55 "early, aggressive screening"). I would politely suggest that if that if further elaboration on that tactic was outside the scope of the video, then you should have made a PUNCHY video. This video could have been 5-10 seconds per tactic to say what that tactic is, and another 5-10 seconds to say an important caveat or it's relative importance.
