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Early prevention in medicine is crucial as evidenced by the change from medicine 1.0 to 2.0 where the focus shifted from managing fast death from trauma and infections to countering the decline in life expectancy caused by chronic diseases. Physicians require granular training in addressing lifestyle factors like nutrition, exercise, and stress, which play a significant role in determining lifespan and health span.
Exercise is highlighted as a potent longevity intervention, surpassing other factors like blood pressure and cholesterol in influencing lifespan and health span. Studies emphasize the substantial impact of cardiorespiratory fitness, muscle mass, and strength on reducing all-cause mortality significantly. Optimizing exercise routines tailored to individual fitness levels is crucial for enhancing longevity.
Distinguishing between health span and lifespan is essential for understanding longevity. Health span focuses on quality of life encompassing physical, cognitive, and emotional well-being, while lifespan denotes the duration a person lives. Managing the four horsemen of atherosclerosis, cancer, neurodegenerative diseases, and metabolic dysfunction contributes to dying 'with' disease rather than 'from' it.
Balancing the costs and benefits of health interventions is crucial in decision-making, whether it's focusing on biohacking trends, pharmacological treatments, or lifestyle modifications. Understanding the opportunity cost of time, potential trade-offs, and contextual nuances of health choices provides individuals with a clearer perspective on optimizing their health journey.
Knowing your non-HDL and LDL cholesterol levels is crucial for managing heart health. Non-HDL cholesterol includes LDL cholesterol and reflects the negative impact of high triglyceride levels. Elevated triglycerides pose a cardiovascular risk that is not fully captured by LDL cholesterol but is reflected in VLDL cholesterol. APOB, measuring atherogenic particles, provides a comprehensive assessment. Lifestyle interventions to lower triglycerides are essential, with carbohydrate restriction being effective, although it may increase cholesterol synthesis in susceptible individuals.
Monitoring blood pressure is vital for cardiovascular and kidney health. Elevated blood pressure impacts cardiovascular and cognitive health, emphasizing the need for regular monitoring, especially in older adults. Proper blood pressure measurement techniques are crucial for accurate readings. Consistent tracking using high-quality monitors and understanding individual variations can help in early intervention and improved outcomes.
CGM offers real-time insight into blood glucose levels and how lifestyle factors affect them. It provides a deeper understanding of how diet, exercise, sleep, and stress influence blood sugar levels. CGM use can offer behavioral cues to make healthier choices based on glucose responses. CGM's ability to show glucose variability assists in optimizing metabolic health and aligning with individualized health goals.
The speaker discusses his journey towards emotional growth, acknowledging his struggles with perfectionism and vulnerability. He reflects on personal experiences that led to self-awareness and the importance of seeking help and resources. Despite the discomfort of vulnerability, he values his progress and aims to pay it forward by sharing his story to help others.
The speaker emphasizes the significance of personalized self-care strategies to improve emotional health and well-being. He introduces the concept of a 'recovery contract' that outlines red, yellow, and green light behaviors. By focusing on specific behaviors and consistently applying tailored approaches, individuals can enhance emotional resilience and lead to long-term positive changes in their lives.
No one would argue that smoking is a killer. And no doctor would wait until a patient was showing early signs of cancer or heart disease before advising them to quit. Yet this is one of the few health scenarios where early prevention is given the evidence-based weight it deserves. Today’s guest believes that needs to change.
Dr Peter Attia is a medical doctor, a longevity expert and author of the brand new book Outlive: The Science and Art of Longevity. He gained his medical degree at Stanford University, trained in general surgery at Johns Hopkins Hospital, and was a surgical oncology fellow at the US National Cancer Institute. He’s also on the editorial board for the journal Aging and host of The Drive podcast, which covers health, medicine, and longevity.
Peter is not interested in reaching unheard-of age milestones or hitting birthdays in triple figures – unless he can do it with full vitality. He believes our focus needs to be on the quality of life we’re living; our healthspan rather than our lifespan.
We talk about the evolution of medicine and we discuss the limitations of current practice. Peter calls this ‘medicine 2.0’ and describes it as adept at dealing with ‘fast death' from trauma and infection. But it’s failing to counter our declining life expectancy or deal with the prevalence of chronic disease. Peter shares what he calls the ‘four horsemen’ of the health apocalypse – namely the 4 disease states, that will end up taking most of our lives: atherosclerosis, cancer, neurodegenerative diseases and metabolic dysfunction.
Our objective, he says, should be to die ‘with’ disease, not ‘of’ disease and a huge part of Peter’s philosophy is about aggressively taking action to delay the onset of these four horsemen. But, to do that, we will need to take a different approach, which Peter calls, ‘medicine 3.0’. In our wide-ranging conversation, Peter shares which investigations and tests he thinks we should all be doing and he explains why when it comes to longevity, exercise is the most important area to focus on.
We also discuss the vital importance of emotional health and, Peter talks openly about his own struggles with extreme perfectionism and shares some of the tools that he uses daily to help. I loved having the opportunity to connect with Peter during this in-depth and enlightening chat. I hope you enjoy listening.
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Show notes https://drchatterjee.com/356
DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.
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