Dr. Peter Attia: Exercise, Nutrition, Hormones for Vitality & Longevity

I just can't get enough of the machinating and arguing about this supplement versus that supplement ... You shouldn't be having those arguments until you have your exercise house in order. You shouldn't be arguing about this nuance of your carnivore diet versus this nuance of your paleo diet versus this nuance of your vegan diet until you can deadlift your body weight for 10 reps.

ApoB, remember, is the concentration of LDL and vLDL particles. And what do they carry? Cholesterol and triglycerides. So, anything that reduces cholesterol and reduces triglycerides is going to reduce ApoB. Triglycerides are generally driven by carbohydrate intake. So, more insulin resistance, more carbohydrate intake, more triglycerides.

If you look at low muscle mass versus high muscle mass, what is the improvement? And it's pretty significant. It's about 3x. So, if you compare low muscle mass people to high muscle mass people as they age, the low muscle mass people have about a 3x hazard ratio, or 200% increase in all-cause mortality.

If you're over the age of 65, and you fall and break your hip, your 1-year morbidity is about 30-40% .... If you're 65 or older, you fall and break your hip, there's a 40% chance you're dead in a year.

If you tell me you want to live to be 100, you're going to need to keep your ApoB below 30 mg/dL.

You want ApoB to be as close to the level as it was when you were born. So, we start developing heart disease when we're born. That's just the way it is.

The single most prevalent genetic driver of atherosclerosis is Lp(a). Unfortunately, most physicians don't know what Lp(a) is, and somewhere between 8 and 12% of the population... have a high enough Lp(a) that it is contributing to atherosclerosis.

There's a group of people who think, 'If I could just fix my testosterone, everything will be better.' And it's sort of like, no, actually, that's not true at all. Really, the only purpose, in my mind, of fixing testosterone is to give you the capacity to work harder. It's really going to help you recover more from your workouts. This should just give you a greater ability to experience muscle protein synthesis.

What's the most prevalent cause of death globally? Cardiovascular disease ... If you go to 2019, 18.6 million people died of heart disease. Number two, cancer, 10 million. Nothing is in the zip code of atherosclerosis.

Strength training is such an essential part of our existence ... It's never too late to start, but you should never stop.

Smoking is, approximately, a 40% increase in the risk of ACM (all-cause mortality).

Testosterone improves glycemic control. Testosterone improves insulin signaling. This shouldn't be surprising, by the way, given the role muscles play as a glucose reservoir and glucose sink.

Dietary cholesterol plays no role in serum cholesterol. Again, it took the American Heart Association another 60 years to figure that out, but even now they acknowledge that dietary cholesterol has no bearing.

I only care about ApoB ... I care about the causative agent of atherosclerosis. ApoB is the thing that drives atherosclerosis.

Age is the biggest driver of risk ... If you take a 70-year-old with perfect lipids and perfect blood pressure and perfect everything, their 10-year risk of ASCVD is probably 4-5 times higher than the most unhealthy 30-year-old.

What gets in the way of lifespan is, essentially, the four horsemen of disease—so, atherosclerotic disease, cancer, neurodegenerative disease, and metabolic disease.

When it comes to cancer, blood testing in the sense of biomarkers is not particularly helpful outside of knowing that the second leading environmental or modifiable cause of cancer is metabolic ill-health after smoking.