Dr. Peter Attia: This Is What You Need to Do to Live Longer | Amanpour and Company

Summary

الدكتور بيتر عطية في كتابه الجديد 'تعيش لفترة طويلة، العلوم والفن في الطول العمر' يطرح دليلًا لطول العمر والصحة، يركز على النهج الوقائي بدلاً من العلاج. يناقش في المقابلة مع هاري سرينivasan أفضل الممارسات لحياة أكثر صحة، ويشدد على الفرق بين العمر والعمر الصححي، ويناقش أهمية الرياضة والنوم والتوازن الغذائية في الحفاظ على الصحة وتحسين نوعية الحياة.

Takeaways

• 🌟 الفرق بين العمر الطبيعي (lifespan) والصحة ال术语 (healthspan): العمر الطبيعي هو مجرد طول حياة الشخص، بينما الصحة ال术语 تشير إلى نوعية الحياة وتشمل العقل والجسد والعاطفة.
• 🏥 نظام الرعاية الصحية الحالي يركز غالبًا على طول الحياة أكثر من نوعيتها، مما قد يؤدي إلى تجاهل نوعية الحياة.
• 👨‍⚕️ عند ممارسة الطب، يُطرح الأسئلة المناسبة لفهم رغبات المرضى وخططهم لحياة أطول وأكثر صحة.
• 🧬 ال百歳老人 يتمتعون بقدر طبيعي من تأخير ظهور الأمراض المزمنة، لكن ليس لديهم فرع خاص يمنحهم هذا القدر.
• 💪 الرياضة هي الأداة الأكثر فعالية لتحسين العمر الطبيعي والصحة ال術erm، وتساعد على الحفاظ على العقل والجسد.
• 🍽️ الnutrition يجب مراعاة كظاهرة biochemical، وتتضمن التوازن الенергético في الجسم، سواء كان الشخص يأكل أكثر من اللازم أو أقل.
• 🕒 النوم يلعب دورًا مهمًا في الصحة ال術erm، ويؤثر على الدماغ والذاكرة والتمثيل الmetabolismo.
• 💊 نظام الرعاية الصحية الحالي يواجه تحديات في التحول من المعالجة الفعلية للأمراض المزمنة إلى الوقاية والعلاج المبكر.
• 🧬 يجب على المرضى معرفة معدلات مثل APO B وLP little a وAPO e genotype لفهم مخاطرهم من الأمراض السرطانية والقلبية.
• ❤️ الصحة العاطفة هي جزء لا يتجزأ من الصحة ال術erm، ويجب على الأفراد العمل على تحسين العلاقات والهدف في الحياة لتحقيق حياة أطول وأكثر فرحًا.
• 📚 في كتاب 'outlive the science and art of longevity'، يناقش Dr. Peter Attia مجموعة واسعة من الأدوات التي يمكن استخدامها لتحسين العمر الطبيعي والصحة ال術erm.

Q & A

ما هي الفرق بين العمر الكامل وعمر الصحة؟

عمر الكامل هو مجرد طول حياة الشخص، وهو أمر ثنائي، إما أنك على قيد الحياة أم لا. أما عمر الصحة فهذا ما يتضمن نوعية الحياة، ويشمل ال组成部分 العقلية والجسدية والعاطفية.

لماذا يركز الطب التقليدي على عمر الكامل أكثر من عمر الصحة؟

لأن الأنظمة الطبية تركز عادة على طول الحياة لأن ما يُ量的 يُدار، لكن لا يولي الكثير من الاهتمام لنوعية الحياة التي تشمل جودة الحياة.

ما هي الأسئلة التي يسألها الأطباء لمرضىهم في ممارساتهم؟

يسألون عن ال諸 الطبية التي تؤثر على عمر الكامل مثل الأمراض السرطانية والأمراض العصبية والقلبية، ولكن في مجال عمر الصحة، يُخصص الوقت والجهد للتفكير في أشياء مثل ما الذي يريد المريض أن يستطيع فعله في العقود الأخيرة من حياته.

ما هي الشيء المشتركة لجميع ال百岁老人؟

ال百岁老人 يتمتعون بقوة تأخير ظهور الأمراض ال kronijyya مثل السرطان والأمراض القلب، مما يجعلهم يبدو أنهم أصغر بـ 20 إلى 25 عامًا من سنهم الفعلية.

هل ال百岁老人 يمارسون شيئًا ما يمنحهم هذه القوة الفائقة؟

للأسف، الإجابة لغيرهم منا الذين ليس لديهم تلك الجينات هو لا، وال百岁老人们 يتمتعون بعمر طويل بشكل طبيعي، لكن يمكننا أن نتعلم منهم بتطبيق أدوات أخرى مثل الnutrition، الexercise، الsleep والstress management.

لماذا يعتبر الرياضة هو أداة التأثير الأكثر قوة على عمر الكامل وعمر الصحة؟

الرياضة يؤثر بدرجة عالية على طول الحياة والعمر الصح، حيث أن القدرة الجسدية العالية والقوة هي أفضل مرشحين لطول حياة مفيدة، وتعد الرياضة أداة فريدة في الحفاظ على الصحة العصبية والجسدية.

ما هي ال態 الغذائية التي يجب علينا 考虑 في الcontext من الAGING؟

يجب أن نفكر في الnutrition كظاهرة كيميائية بيولوجية، وتدور حول التوازن الенергético في الجسم، سواء كان الشخص يغذي بكميات كبيرة أو قليلة.

ما هي الثلاثة الapproaches لتقليل الenergy intake؟

تتضمن الثلاثة الapproaches التقليل المباشر للسعرات الغذائية، والتقليل ال間接 من خلال الreduced consumption، والتقليل ال间irect من خلال time restriction.

لماذا يكون النوم مهمًا للصحة؟

لأن التطور لم يغير أنماط النوم التي تجعلنا لا نكون على إعاقة من الوعي لثمانية ساعات يومياً، مما يشير إلى أن النوم يلعب دورًا بażen في الصحة العقلية والجسدية.

لماذا لا يدفع التأمين الصحي الأطباء على مكافحة الأمراض ال Kronijyya؟

لأن التأمين الصحي يدفع للأدوية والإجراءات الطبية بعد التشخيص، وليس لتغيير السلوكيات الغذائية أو المراقبة الصحية لمنع الأمراض.

ماذا يجب أن يفهم المرضى عن الاختبارات الطبية؟

يجب أن يعرف المرضى قيمة الاختبارات التي تحدد APO B، وLP little a، وAPO e genotype، التي تلعب دورًا كبيرًا في الأمراض ال Kronijyya.

لماذا يكون الصحة العاطفة مهمة للعمر ال طويل؟

لأن الصحة العاطفة هي العامل الأساسية للحياة السعيدة، وبدون الصحة العاطفة، قد يصبح الطول العمر عقوبة بدلاً من نعمة.

Outlines

00:00

📚 The Pursuit of Longevity and Health Span

Dr. Peter Attia, author of 'The Science and Art of Longevity', discusses the distinction between lifespan and health span, emphasizing the importance of not just living longer, but living healthily. He highlights the medical system's focus on lifespan and the need to consider the quality of life, including cognitive and emotional components. Attia stresses the importance of defining metrics for health span and shifting the focus from merely prolonging life to enhancing its quality. He also introduces the concept of centenarians' delayed onset of chronic diseases, suggesting that while genetics play a role, lifestyle choices such as nutrition, exercise, sleep, and stress management are crucial in achieving a healthy longevity.

05:01

💪 The Power of Exercise for Longevity

Dr. Attia explains the profound impact of exercise on both lifespan and health span. He states that high cardiorespiratory fitness, muscle mass, and strength significantly reduce all-cause mortality more than any other factors, outweighing the risks associated with smoking, high blood pressure, and diabetes. Exercise is also vital for neuroprotection and maintaining physical capabilities in old age. Attia discusses the importance of a balanced exercise regimen, including both low and high-intensity cardiorespiratory training, as well as strength training, and the need to tailor exercise routines based on individual willingness and time commitment.

10:03

🥗 Nutritional Strategies for a Healthier Life

The conversation shifts to nutrition, where Dr. Attia outlines the importance of energy balance and the evolution of human dietary needs. He discusses the transition from a history of undernourishment to the current state of overnourishment and the necessity of reducing energy intake. Attia presents three approaches to caloric restriction: direct caloric restriction, dietary restriction, and time restriction, each with its advantages and disadvantages. He emphasizes the need for mindfulness and understanding the potential pitfalls of each approach to make informed nutritional choices that support health and longevity.

15:05

😴 The Crucial Role of Sleep in Health and Longevity

Dr. Attia delves into the significance of sleep, questioning why evolution has maintained the need for such a long period of unconsciousness each day. He argues that sleep must offer substantial benefits to brain health, memory consolidation, and metabolism, which are essential for overall health and longevity. Poor sleep is linked to a range of health issues, including obesity, metabolic health, insulin resistance, and type 2 diabetes. Attia advocates for recognizing sleep as a critical component of a healthy lifestyle and the importance of addressing sleep quality to prevent and manage chronic diseases.

🤔 Rethinking Healthcare: Prevention Over Treatment

The discussion addresses the current state of healthcare, with Dr. Attia critiquing the system's focus on reactive rather than proactive measures. He points out the economic incentives that drive the healthcare industry to prioritize diagnosis and pharmacological treatment over prevention. Attia calls for a shift towards a model that incentivizes and educates both physicians and patients on the importance of preventive care. He suggests that this change is necessary to effectively manage and reduce the burden of chronic diseases, which the current model is failing to address adequately.

🧬 Understanding Biomarkers for Better Health

Dr. Attia advises patients to be aware of specific biomarkers that are indicative of their health risks, such as APO B, which measures cholesterol-carrying particles associated with atherosclerosis, and APO e genotype, which is linked to Alzheimer's and cardiovascular diseases. He emphasizes the importance of understanding these biomarkers as part of a comprehensive approach to health and disease prevention.

🌟 The Importance of Emotional Health for a Fulfilling Life

The final paragraph focuses on the significance of emotional health and the role of happiness and life satisfaction in achieving a meaningful longevity. Dr. Attia reflects on the question of why one would want to live longer if they are unhappy, highlighting the importance of emotional well-being as a critical component of a healthy life. He discusses the correlation between strong relationships, happiness, and life span, and the potential for individuals to improve their emotional health just as they can work on their physical health metrics.

Keywords

💡longevity

الطول في العمر هو القدرة على العيش لفترة طويلة من الزمن. في النص، يناقش الأخصائي بيتر أتيا كيف يمكن من خلال ال生活方式 والتقنيات الوقائية تحقيق الطول في العمر بطريقة تحافظ على الصحة والرفاهية. مثالاً من النص، يشدد على أن الهدف ليس فقط العيش لفترة أطول، بل العيش بصحة جيدة.

💡health span

العمر الصح هو القدرة على العيش لفترة طويلة من الزمن بصحة جيدة، مع القدرة على العيش بجودة وبدون أمراض مزمنة. في النص، يُعرف على أهمية تميز بين طول العمر والعمر الصح، مع التركيز على القدرة على العيش بجودة وعدم التعرض للأمراض الخطيرة.

💡preventative approaches

الطرق المنعية هي الخطوات التي تتخذها لتجنب الإصابة بالأمراض بدلاً من العلاج بعد حدوثها. في النص، يُناقش الأخصائي بيتر أتيا أن التركيز على ال生活方式 المنعية هو المفتاح لتحقيق الطول في العمر والعمر الصح.

💡cardiorespiratory fitness

التحمل التنفسي-نبضي هو القدرة على التحمل على النشاطات الرياضية التي تتطلب من الشخص التنفس السريع والنبض السريع. في النص، يُذكر أن التحمل التنفسي-نبضي هو أحد العوامل الرئيسية التي تؤثر على طول العمر والعمر الصح.

💡chronic disease

الأمراض المزمنة هي الأمراض التي لا ت徹底 تماماً وتستمر لفترة طويلة من الزمن. في النص، يُناقش كيف يمكن تأخير ظهور الأمراض المزمنة من خلال الifestyle الصح.

💡exercise

التمارين الرياضية هي النشاطات التي تتطلب من الجسد الحركة والجهد الجسدي. في النص، يُعتبر التمارين الرياضية作为一种最具影响力 وأكثرها فائدة في تحسين الطول في العمر والعمر الصح.

💡nutrition

الغذاء هو ما يؤكل أو يشربه الإنسان لضمان العيش والعمل الجسدي. في النص، يُناقش الأخصائي بيتر أتيا أهمية الnutrition في الحفاظ على الصحة والطول في العمر، مع التركيز على التوازن بين الطاقة المدخلة واللازمة.

💡caloric restriction

الحد من السعرات الحرارية هي تقنية تتضمن خفض كمية ال السعرات الحرارية التي ي摄موها الأفراد. في النص، يُناقش كيف يمكن أن تكون الحد من السعرات الحرارية أحد الأساليب لتحسين الصحة والعمر الصح.

💡sleep

النوم هو الحالة التي يدخلها الإنسان أو الحيوان ل得到 الراحة وال休憩. في النص، يُشدد على أهمية النوم في الحفاظ على الصحة والعمر الصح، مع التركيز على الدور الكبير الذي يلعب في الذاكرة والmetabolism.

💡emotional health

الصحة العاطفية هي القدرة على التعامل مع المشاعر والظروف العاطفية. في النص، يُناقش الأخصائي بيتر أتيا أهمية الصحة العاطفية في العيش لفترة أطول و拥有幸福感.

Highlights

Dr. Peter Attia discusses the distinction between lifespan and health span, emphasizing the importance of quality of life in addition to longevity.

Health span includes cognitive, physical, and emotional components, and metrics should be defined to manage these aspects effectively.

Centenarians typically experience chronic diseases 20-25 years later than average, suggesting a 'superpower' of delayed onset of chronic diseases.

Exercise is the most potent tool for affecting both lifespan and health span, with high cardiorespiratory fitness and strength being key predictors of longer life.

Neuroprotection and warding off neurodegeneration can be significantly fostered through exercise.

The importance of a balanced approach to exercise, including both low and high-intensity training, is highlighted.

Nutrition should be viewed through the lens of biochemistry, focusing on energy balance and avoiding overnourishment.

Three approaches to reducing energy intake are discussed: direct caloric restriction, dietary restriction, and time restriction.

Sleep is crucial for brain health, memory consolidation, and metabolism, with poor sleep linked to obesity and metabolic issues.

The healthcare system's focus on treatment rather than prevention is critiqued, with a call for a shift towards proactive health measures.

Economic incentives in medicine need to be realigned to promote prevention and early intervention.

Patients should be aware of their APO B levels, a key indicator of heart disease risk.

Understanding one's APO e genotype can inform prevention strategies for Alzheimer's and cardiovascular diseases.

Emotional health is paramount, with a focus on happiness and life satisfaction as essential components of a healthy life.

The correlation between strong relationships, happiness, and life span is emphasized, along with the importance of emotional well-being.

Dr. Attia's book 'Outlive' offers a comprehensive guide to longevity, integrating physical, mental, and emotional aspects of health.

Transcripts

well our next guest says that he has the

secret for living a long healthy and

happy life Dr Peter attia's new book

lays out a how-to guide for longevity

focusing on preventative approaches

rather than treatment and he is joining

Hari sreenivasan to discuss the best

habits for a healthier life

Diana thanks Dr Peter attia thanks so

much for joining us now in your new book

outlive the science and art of longevity

you're not just trying to help us live

longer but you're trying to get us to be

healthy as well I mean you you have you

kind of make a distinction between

lifespan and health span spell that out

yeah lifespan is probably the easier of

those two things to explain which is uh

you know obviously how long you live and

that in that sense is is kind of binary

it's all or none you're alive or you're

not alive

um and unfortunately I think our medical

system uh mostly fixates on that metric

and obviously what gets measured gets

managed as the old saying goes what I

think we're not paying nearly enough

attention to is the quality of life and

uh that's what's captured in health span

right so there's a there's a cognitive

component to that there's obviously a

very physical component to that and

there's an emotional component to that

and if you don't really Define metrics

around those things it's probably not

surprising that we're not managing those

things and therefore most of the

resources and attention go to Simply

prolonging life even at the expense of

quality so when a patient approaches you

in your practice I mean kind of what are

the questions that you're asking them so

that you're kind of on the same path

together

well obviously we want to talk about all

of the medical things and all of the

things that deal with prolonging life as

well so we certainly want to understand

all the risks coming in with respect to

you know what we talk about as the Four

Horsemen of death you know

cardiovascular disease neurodegenerative

disease cancer Etc

but on the health span side we spend

just as much time and energy thinking

about for example what do you want to be

able to do in the last decade of your

life this becomes a very important

framing question and the more detail

that a person can provide sometimes with

our prodding as to what they actually

want to be able to do right do you want

to be able to pick up a grandchild do

you want to be able to travel these

things require very deliberate planning

and most people can't do these things in

the last decade of their life unless

they train for it so you know you took a

look and studied

people who are 100 years old and

was there something

that they had in common that we can

apply in our lives so the one thing that

is common to all centenarians is that

from the standpoint of chronic disease

there are about 20 to 25 years younger

than their birth certificate age says

wow in other words their first brush

with cancer their first brush with heart

disease their first brush with any sort

of chronic ailment is about 20 to 30

years after you would expect based on

their you know birth certificate age so

they have a superpower and the

superpower is they delay the onset of

chronic disease now the question of

course the million dollar question is

are they doing something in in order to

get that superpower right is it is it

you know

is there some magic diet or something

like that yeah and unfortunately I say

unfortunately for the rest of us who

don't have those genes the answer is no

um and and it's actually more likely

your observation which is on average

believe it or not centenarians are more

likely to smoke more likely to drink

less likely to exercise and less likely

to eat well and yet despite those things

they have this Supernatural lifespan

but that doesn't mean we can't learn

from them what we learn is we have to

apply to ourselves other tools to get

their benefits in other words we have to

use nutrition exercise sleep stress all

those other things as tools to get what

they get for free genetically we have to

create a phase shift of time in the

onset of chronic disease let's first

talk about

um just exercise I mean you write a

tremendous amount that that is one of

the most beneficial things that we could

be doing earlier in our lives to prevent

a lot of ailments

yep exercise is hands down the most

potent tool slash intervention that we

have to affect both of the metrics we

care about lifespan and health span so

on the lifespan side of the equation

having a very high degree of

cardiorespiratory Fitness having high

muscle mass and high strength relative

to your sex and age

is a better predictor

of longer life meaning a greater

reduction of all cause mortality death

for many causes than anything else we

have positive or negative the benefit

bestowed on an individual from being

very high in those categories is greater

than the harm that comes from smoking

having high blood pressure having type 2

diabetes even having kidney disease

which would be the step right before

needing a transplant so as much as we

understand how harmful those things are

it's even more beneficial to be

incredibly fit and incredibly strong so

if you're just thinking about how do I

live longer that's the ticket

on the other side of the Ledger when we

think about the quality of life there

simply is no greater tool to Foster

neurodegenerate neuro neuro protection

and ward off neurodegeneration than

exercise and of course exercise is the

most important piece in maintaining your

physical body as you age so you can do

all those things you would want to do in

that last decade of your life is there

a combination of things that will help

your body prepare for aging better than

anything else

you know if there's one drawback to

exercise it's that it takes more time

than all of the other things that we

might think of as being beneficial few

things take as much time to reap the

full benefit uh from as exercise you

need to be doing strength training you

need to be doing cardio respiratory

training and that cardio training needs

to be at different levels of intensity

about 80 percent of it needs to be at

relatively low intensity the level of

intensity at which you could still carry

out a conversation albeit a strained one

and about 20 of it needs to be at a

higher level of intensity where you

couldn't carry out a conversation and I

think for the individual who says look

Peter I am not willing to spend more

than 90 minutes a week exercising yes I

would rather have them you know focus on

what's not necessarily what I think the

best approach to exercise is but doing

whatever they can to get some benefits

but the way I ask my patients is very

different I start in Reverse I say

tell me how many hours a week you're

willing to put into this and I've

already explained to them and shown them

all the data that explain why this is

going to have a greater impact on the

length and quality of their life than

anything they will ever do

let's talk a little bit about nutrition

you for a time being were a big fan of

Keto diets and and in the book you kind

of walk through why and how you changed

your mind about that

um explain to our audience

um how should we be thinking about

nutrition

in the context of Aging I go to Great

Lengths in the book to detach from diets

and really just talk about nutrition as

a biochemistry phenomenon let's just

talk about it through the lens of

biochemistry and molecules

the most important component of your

nutrition is basically the energy

balance it creates in your body in other

words is a person overnourished or

undernourished now for most of our

existence we have been undernourished

right for if you think about a thousand

years ago 500 years ago 200 years ago

most of us were barely getting enough

energy right and and our bodies of

course evolved remarkable ways to store

and hold on to energy this is what

basically allowed us to LeapFrog ahead

of all other species in terms of our

remarkable brains because our brains are

so energy hungry well that worked really

well until our you know modern

environment which basically created such

an abundance of food that now most of us

are on the other side of that we are

overnourished strategy number one is you

have to reduce energy intake

and there are basically three approaches

to that Each of which can work Each of

which has advantages and Each of which

has disadvantages so broadly speaking

they are direct caloric restriction

dietary restriction and time restriction

to say a bit more about them direct

caloric restriction as the name suggests

means

you just deliberately go about eating

less while paying attention to how much

you are eating not necessarily paying

attention to when you're eating or what

you're eating but just reducing the

total caloric burden

dietary restriction of which you

mentioned an example a ketogenic diet is

a form of dietary restriction but so are

most quote unquote diets this is when

you just restrict certain elements

within the diet and what that results in

is less overall consumption so it's an

indirect way to go about calorie

restriction

finally time restriction is also an

indirect way to go about calorie

restricting by creating a narrower and

narrower window in which you eat and if

you create a narrow enough window you

will end up reducing intake now

you know we don't have to go into the

details of how each of these has a

benefit and each of these has a risk but

none of these are you know things that

you should do mindlessly each of these

are things you have to be mindful of the

blind spots and pitfalls and work around

them

you spent a fair amount of time talking

about sleep why is it

as important I mean I'm somebody who

doesn't get enough sleep and I feel like

it's underrated but you know younger

points in my life I didn't really think

about how much I was getting maybe

because I was obviously younger and I

was fitter and I was able to rebound

faster but now if I don't get a good

night's rest it's really difficult to

perform at the same level every day in

the book I talk about a thought

experiment which is effectively like you

know Evolution didn't muck around right

Evolution

everything about evolution is is really

laser focused and if you think about it

no one disputes that we are optimized to

forage for food to reproduce to fend for

ourselves I mean these are the

characteristics that Evolution owned why

would Evolution have kept around this

behavior that rendered us unconscious

for eight hours a day it just doesn't

make any sense and the only way you

could really justify this is if that

eight hours I.E one third of our life

that is spent in unconsciousness must be

doing something so important we have

never figured out a way to out evolve it

we've never even figured out a way to

reduce it by half like it's basically

just stuck there at about seven to eight

hours

and

that's kind of what I think I talk a

little bit about in the book right is

like what are those features of sleep

why is that important to brain health

why is that important to memory

consolidation why does that play an ins

in a profound role in metabolism right

so many of the problems that I think we

have with obesity metabolic Health

insulin resistance type 2 diabetes can

actually be attributed to poor sleep

just as much as they can be attributed

to poor diet

you know a lot of the book also it takes

a critical look at our existing Health

Care System you write that both health

insurance companies won't pay a doctor

very much to tell a patient to change

the way he eats or to monitor his blood

glucose levels in order to help prevent

him from developing type 2 diabetes yet

insurance will pay for this same

patients very expensive insulin after

he's been diagnosed so is there a way to

turn what seems like the largest

industry in the country around to think

kind of proactively instead of

reactively

I mean there clearly is from a

conceptual standpoint from a structural

standpoint I don't want to be naive and

and suggest that it's going to be easy

but uh that example that you you read

the quote from I think illustrates kind

of the point right which is

everything follows the dollar and I

don't say that as a skeptical guy like

dollars are important I'm a capitalist

it's all about you know you have to set

the right economic incentives but right

now the economic incentives in medicine

are around diagnosis and pharmacologic

treatment and I'm not here to say

pharmacologic treatments don't matter

they're very important and we do rely on

them but the point here is we were

really only educated along one parameter

of Intervention which is procedural and

pharmacologic and if the entire system

of reimbursement is based on creating a

diagnosis and developing a treatment

plan along those metrics and by the way

go back to what I said at the outset and

the only metric of interest is length of

life

you you will create the machine we have

called medicine 2.0 and by the way

medicine 2.0 was very successful at

treating some things namely infectious

diseases and acute problems such as

trauma this is what has effectively

doubled the lifespan of humans in the

last 150 years it's the success of that

model medicine 2.0 applied in that way

which is wait till the problem happens

treat it with pharmacologic intervention

or procedural intervention

yeah what we're seeing is that Playbook

is not working with chronic diseases not

even close and the only way you're going

to treat chronic diseases is moving on

to an approach where you treat you where

you really enact prevention

and if you want to incentivize

Physicians to do that they have to be

educated in this way and you have to be

able to reimburse for these tools you

have to be able to reimburse Physicians

uh and you have to be able to

incentivize patients to take care of

themselves 30 years before they have

that heart attack if you were to advise

a patient that's heading to their doctor

what are the kinds of things that you

would tell them to kind of perk their

ears up on or listen close to this

number that are good guides for

healthfulness

I want patients to understand there are

some things that labs are really good at

there are a lot of things they're not

good at everybody should know their APO

B APO B is a number that measures the

total concentration of the cholesterol

carrying particles in the blood that

drive atherosclerosis which is the

dominant Force driving heart disease

again

can't say it enough right heart disease

is the leading killer globally about 19

million people per year die of

atherosclerotic cardiovascular disease

which dwarfs the number two Killer By

the way which is cancer at about 12 to

13 million so you've got to know this

APO B concentration everybody at least

once in their life needs to have their

LP little a measured that's it that's

genetically determined so once you've

measured it once you don't really need

to recheck it

um and we think everybody needs to know

their APO e genotype this is a gene that

plays an important role in Alzheimer's

disease and also in cardiovascular

disease and knowing that can help you

understand how aggressive you might need

to be in prevention so those are a

handful of the the things that you know

we just think are very important for

everybody to know you write in the book

about emotional health and why it's so

important and you you know there's a

line from your therapist I want to say

that kind of sums up the whole book I

mean why do you you want to live longer

if you're so unhappy it's just a pretty

simple question but pretty profound

yeah this is another one of those things

that doesn't show up anywhere in the

standard diagnostic list of criteria and

it's one of those things that probably

matters more than anything else because

if you don't have it nothing else

matters right so if if your life sucks

living longer is actually a curse not a

blessing regardless of the state of your

physical health so I do think that even

though it's probably not something as a

PR as a as a profession we spend enough

time talking about we do really want to

understand what a person's sense of

purpose is how strong their

relationships are I do think that

generally people understand that there's

a there's a reasonable correlation

between the the strength of your

relationships and your happiness yeah

and there's a reasonable correlation

between happiness and length of life and

I and I think that there's some

causality there too and I think the real

question becomes what can you do about

it right at the individual level if

you're you're sitting where I was

sitting six years ago which was to say

you know physically healthy but not

emotionally healthy can can you bend the

Arc of that curve in the same way that

you can bend the Arc of the curve of

your Fitness your muscle mass your

strength your lipid numbers your insulin

resistance numbers and the answer

unequivocally is yes

Dr Peter attia author of outlive the

science and art of longevity thanks so

much for joining us yeah thank you so

much for having me

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