Dr. Peter Attia: This Is What You Need to Do to Live Longer | Amanpour and Company
Summary
TLDRالدكتور 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
📚 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.
💪 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.
🥗 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.
😴 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.
Mindmap
Keywords
💡longevity
💡health span
💡preventative approaches
💡cardiorespiratory fitness
💡chronic disease
💡exercise
💡nutrition
💡caloric restriction
💡sleep
💡emotional health
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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