Peter Attia: Longevity, Diet, and Finding the Drive

I head to San Diego, via Mexico (relevant shortly) to catch up with one of the great health leaders of the planet, Dr. Peter Attia.

Peter is a prominent longevity physician, ketogenic diet expert, ultra-endurance athlete, crazy self-experimenter (always in the name of science!), and as of July 2018 launch, host of an outstanding new podcast called The Drive. His A-game is now all organized at PeterAttiaMD.com. Sign up for his newsletter, subscribe to The Drive podcast and digest the great “Nerd Safari” articles on his website.

Hang on for a wild ride with Peter and learn about the best way to live a long, healthy life, escape the trap of disease and dysfunction that have reached epidemic proportions today, and go off onto interesting tangents. As Peter describes on his Twitter bio, he is a man obsessed with living a passionate and intense life, whether in his career in health and medicine or his hobbies like auto racing, archery, well-chronicled dietary and fitness experiments, or trying to be a super dad to kids 10, 4 and 1.

Yes, Peter is a rare and exalted breed of chingón- Spanish for bad ass. Dropping Spanish here is appropriate because I had just returned from a Mexico vacation the night before our podcast, and with a only a couple minutes left in the interview, I suddenly became super dizzy and sweaty and had to collapse onto the couch of Peter’s guest house! After a recovery period under the watchful eye of a physician (that would be Peter) and a Nurse Practitioner (Peter's wife Jill, who arrived from the beach to discover this interesting situation), we finished the show with a perfectly-timed cameo from daughter Olivia. Now you have to listen to the whole show!

Anyway, Peter lives his life with passion and intensity – attributes sorely missing as we grow more affluent, screen-addicted, and lazy in modern society. You’ll pick up on Peter’s A-game when he goes off on motorists who mess with cyclists on the road. He relates how lost a friend from a cycling accident, so this issue understandably strikes a deep chord. I also picked up on this theme when he arrived at Peter’s house as he was having an extremely animated telephone conversation with the f-word getting lots of action. He explained that he was talking to a close business associate (Bob Kaplan, head research analyst for PeterAttiaMD.com) and how they benefit from venting to each other on occasion! In the next breath, he explained the importance of compartmentalizing and controlling emotions, relating that he would never want his kids to hear such a phone call because they are too young to understand the context.

Peter’s calling is to fight the epic battle to cure diabetes, heart disease, cancer, and neurodegenerative disease. As evolutionary health enthusiasts realize, this is truly a battle against the forces of flawed and dated conventional wisdom, and manipulative marketing from big food and big pharma entities. Watch Peter’s amazing TED MED talk where he breaks down at the end, apologizing for feeling judgmental about a diabetes patient, while suggesting that we may have the story of obesity and diabetes all wrong. As Gary Taubes wrote in his book, Why We Get Fat, “obesity and sloth are not causes of obesity, they are symptoms.” What this means is that getting fat is your body’s effort to mitigate the damage caused by the disease condition of insulin resistance.

Are you with me? People who put together the one-two punch of unlucky genes and high carbohydrate dietary patterns become insulin resistant and get fat. The high insulin-producing diet messes up their appetite and fat storage hormones so that they are hungry too often, more likely to end up storing ingested calories as fat, and feel too tired to be physically active. Commanding a human to not eat when they’re hungry or to get their ass off the couch to exercise when their bloodstream is literally starved of energy, is missing the mark. In his TED MED talk, Peter draws the analogy of doctors treating patients for bruises caused by repeated whacking shin on a coffee table, when you might instead just move the coffee table!

Peter’s reflections on this important matter started years ago when he was adding excess body fat despite doing literally hours of endurance training each day in preparation for his 2006 swim from Catalina Island to Los Angeles (21 miles!) He was diagnosed as pre-diabetic despite his athletic (but massively carbohydrate-dependent) lifestyle, which is as good a wakeup call as you can imagine to second guess the mainstream notions that portion control and vigorous exercise are the keys to staying trim and healthy.

The show gets rolling with Peter discussing how to avoid the most common disease conditions of modern life: heart disease, cancer, and neurodegenerative disease. Peter’s approach is to tackle the “low hanging fruit” and reach 80 percent of your longevity potential. While he’s been deep into study of diet, and himself remained in strict nutritional ketosis for three years from 2011 to 2014 (monitoring his glucose levels with a surgically implanted glucose monitor in his abdomen), he prefers to dispense the simple advice of eating wholesome natural foods and staying away from processed modern foods. Beyond optimizing your diet, implementing some sensible exercise habits and obtaining adequate sleep get you pretty darn far down the road to longevity. Simple as that, but Peter relates that many of us know what to do and simply don’t do it for myriad reasons.

Peter’s been on many podcasts with detailed scientific discussion of his longevity and scientific interests, so pursuant to the Get Over Yourself mission of emphasizing the unplugged, we go off on some tangents—all credit to Peter here—and cover some stuff you might not hear from his other show appearances. For example, he delivers some impassioned insights that may save the life of a road cyclist out there listening someday. No kidding.

Peter discusses how insulin AUC (area under the curve) is perhaps his favorite longevity marker. Impossible to measure practically, but the concept is that you produce an optimally minimal amount of insulin over your lifetime to get the job done (deliver nutrients to cells throughout the body) and how this goal might reconcile with the seemingly disparate idea of eating plenty of nutritious calories to fuel athletic performance and recovery. It gets a little sciency at times but you’ll get quickly brought back to some relevant takeaway points, especially if you do a little googling as needed. The show progressed into the science of athletic peak performance and genetics, with cameos here for Michael Phelps, Usain Bolt, and Tour de France champ Chris Froome.

You will pick up some great tips about being a peak performer because this guy is like no other; he just goes hard in every direction and lives by this fundamental principle of pursuing mastery in whatever you do. Be sure to subscribe to his newsletter and podcast at peterattiamd.com if you care about getting the very best health information. Here’s a great quote from his introductory website message to give you a further appreciation for what Peter is all about:  “If the title of an article starts with “8 Essential Foods for…,” or the like, chances are it’s not worth reading. To really learn something requires contemplation and thinking—even as the reader—and over time this leads to new insights, which is one of the most rewarding experiences I have come to know. It’s the reason why I get so excited when a patient asks me a question I don’t know the answer to. I want to learn more each day, ask better questions, create and connect more dots, and engage my curiosity.”

 

TIMESTAMPS:

Peter is working with an exciting research team of people from many different backgrounds always searching for answers to longevity. [08:04]

His medical practice is located in San Diego and New York City basically helping to implement a model into the patient's own individual needs. It differs greatly from regular medical practice. [00:11:25]

Peter’s recommendations to avoid disease. [00:13:32]

What about eating things in moderation? [00:18:04]

Depleted glycogen is not a problem for ketogenic athletes. [00:22:03]

How does Peter's current diet work when he is in and out of ketosis? [00:24:49]

Does he ever cheat? [00:29:00]

Can one get up and over one's previous fitness level by virtue of having better fat burning? [00:32:58]
Is the amount of insulin one produces affecting longevity? [00:33:46]

Peter has a quarterly eating system he describes here. (Ketosis, fasting, nutritional ketosis, time restricted feeding.)[00:37:49]

What you eat post workout makes a real difference in how one recovers. [00:39:42]

What is the psychology that comes into play when one gets emotional? [00:44:20]

Road biking is one of the most dangerous activities in the world. [00:49:10]

Peter trained and then swam from Catalina Island to San Pedro, California in 10 hours. Wasn't he worried about sharks? [00:54:54]

When you are a performing athlete, can you still have excess body weight? [00:58:22]

What would be the ideal physique of a good marathon runner? Aerodynamics are important. [01:00:10]

Swimming is different because of the density of the water. One wants to avoid drag. [01:07:50]

The disastrous effects of overtraining are underestimated. [01:10:22]

When you compare yourself with other accomplished athletes, you can learn a great deal. [01:12:11]

What are Peter's athletic goals? He talks about working to improve his skills in varied activities. [01:15:26]

 

LINKS:

• Peter Attia, M.D. focuses his medical practice to applying nutritional biochemistry, exercise physiology, sleep physiology and basically studying how to improve your longevity. He is a very accomplished athlete in many different fields that he talks about here.
• Usain Bolt: The world’s fastest man. He is playing soccer now.
• Breaking 2: Documentary from a 2017 race with three runners attempting to break the two-hour marathon barrier.
• Tom Dolan: Doesn’t look like a swimmer, but he has won many races.
• The Drive: Peter Attia has entered the world of podcasting. His new series up every Monday is hyperlinked and has lengthy show notes.
• Chris Froome: British cyclist winning the Tour de France in 2017, 2016, 2015, and 2013.
• TED MED Speaker: Dr. Peter Attia talks about the “Obesity Crisis”. Is it a disguise for a deeper problem?
• Phil Mickelson: a fine golfer, who under the shadow of other golfers, had many second places.
• Michael Phelps: By the time the Olympics were in Rio in 2016 Phelps had collected a total of 23 gold, three silvers, and two bronzes at the Olympics.
• RAAM (Race Across America): The World’s toughest bicycle race starts in Oceanside California and finishes at City Dock in Annapolis, Maryland. Get ready…Next one is in June 2019!
• Swimming the Catalina channel: Swimming about 30,000 strokes for 20.2 miles, he was the 120th person to do this. View the YouTube of this feat.

 

QUOTES:

• "The journey of getting better at something is very important."
• "The best outcomes are when you are cycling between periods of anabolism and catabolism."
• "Thrust and drag avoidance are everything in swimming."

 

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