Download my free Cognitive Enhancement Blueprint - packed with my specific protocols for boosting BDNF with heat stress, omega-3s, and exercise: bdnfprotocols.com/ Dr. Attia's book "Outlive: The Art and Science of Longevity": www.amazon.com/Outlive-Longevity-Peter-Attia-MD/dp/0593236599 CHAPTERS: (00:00:00) In this episode (00:04:29) Defining cardiovascular disease (00:06:36) Coronary plaque and fatality risk (00:08:02) What is cholesterol? (00:10:27) How ApoB predicts heart disease (00:18:27) Factors elevating ApoB (00:22:17) ApoB reference range explained (00:24:16) Does high ApoB cause cardiovascular disease (00:33:54) ApoB thresholds for ASCVD prevention (00:37:20) Dietary factors raising ApoB (00:36:26) Genetics of ApoB and LDL (00:50:17) Does low LDL increase cancer? (00:53:12) Cholesterol-lowering drugs (00:56:52) Statins, uses, and side effects (01:00:05) Are statins toxic to mitochondria? (01:06:49) Ubiquinol for statin-induced muscle soreness (01:08:02) How to train in zone 2 (01:14:02) Statins and neurodegenerative disease risk (01:18:47) Cholesterol synthesis in the brain (desmosterol role) (01:22:51) Statin alternatives - pros and cons (01:24:23) Ezetimibe (01:27:54) Bempedoic acid (01:33:42) Berberine for CVD Risk Reduction? (01:36:29) Muscle as a glucose sink (01:42:51) Chronic glucose toxicity and vascular impact (01:48:31) Hemoglobin A1C Levels and Mortality Data (01:52:28) 80/20 Zone 2/VO2 Max Training Protocol (01:59:05) Insights from VO2 max testing data (02:09:10) How obesity increases cancer risk (02:11:56) Cancer screening benefits and risks (02:17:40) Dr. Attia's recommended cancer screening age (02:25:47) Liquid biopsies for detecting cancer (02:31:41) CT scans, mammograms and radiation concerns (02:37:25) Menopause - hormonal shifts and health effects (02:42:06) Hormone replacement therapy (HRT) (02:55:50) Perimenopause diagnosis with hormone levels (02:58:57) HRT's impact on dementia, cancer, and heart disease risk (03:01:42) Estrogen's role in bone density (03:04:35) Vitamin D (03:13:17) Testosterone replacement for women's sexual function (03:15:40) HRT safety 10 years post-menopause (03:19:58) Treating low testosterone in men (03:26:46) TRT side effects and risks (03:29:26) Ways to reduce blood pressure (03:36:26) How to measure blood pressure (03:42:23) Peter's longevity optimization routines
@Dr Patrick - you are so brilliant, amazing, smart, and beautiful. Thank you for sharing your knowledge, suggestions, and insights with all of us. Appreciate you and Dr. Attia, Dr. Huberman, Dr. Walker, and the other ones whose names I can't remember off the top of my head. You're all amazing ❤
I’ve been a practicing physician for almost 30 years (Sports Medicine, nonsurgical orthopedics, and Regenerative medicine) Other than the discussion on bio-identical hormones, with which I am well trained and well-versed, this has been one of the most instructional and informative videos that I’ve seen in my entire career.
These two along with Doctors Panda and Lustig changed my life 10 years ago at 63. Changed what I eat, how I exercise, when I sleep etc. Thank you Rhonda for a life worth living.
I only listen to 4 podcasts, so it's fantastic when there are two of them together and then: it's four hours!! I love the long format. Huge thanks to both Doctors for sharing their passion and knowledge.
I really like the pace of Dr. Attias talking. He talks slow enough a layman like myself can process and mostly understand what he's saying even on complex topics.
@FoeverDirt I mean sure I suppose but I think Huberman, Delauer and Patrick (also perhaps Attia) would probably already have most bases covered from what he might have to add other than something that isn't a low- or no-cost supplement, practice or protocol but yes of course longevity is his specialization no question
We're lucky to have a Dr. Attia who is able and willing to spend 4 hours educating us on how we can increase our lifespan and healthspan. What a brilliant guy.
I'm that "one" person, 5' 7" 145 lbs (recently gained 20 lbs), sauna and cold plunge 4 x/week. Saw GYN 9/28/23, "normal" pelvic exam, normal PAP, I did c/o overactive bladder and 20 lb weight gain. 12/6/23 diagnosed with stage 4 cancer. Would love to see better screening for ovarian cancer. Also, would be nice if physicians actually listened to your symptom complaints. Just received first chemo tx and down 20 lbs, hoping it's all cancer weight I lost.
@@CrystallyLavender thank you! It is ovarian cancer. I understand a healthy lifestyle doesn't make you immune to disease, I'm just really frustrated my gyn blew off my complaints.
I've watched most of Dr. Attia's videos from way back & read his writings over a long time & not to be too critical but most of the information overload is difficult to follow for the average non medically educated person. I am 81 years of age, physically very fit & still reasonably mentally alert. If I was to worry about all the information Peter expounds I would probably lose my focus on just simply keeping active & eating well which enables me to remain "healthy". I listen to the advice from people like Peter because I am now vitally concened with longevity but in reality the "science" seems to be never ending in comlpexity & still there is no clear cut simple direction.
he drops so much biotechnical information to give you the impression he knows what he is talking about. Still, most of what he says about cardiovascular health and the cholesterol-saturated fat myth is sheer nonsense. He spreads the Ancel Keys disinformation and ignores the findings and insights of Joseph Kraft. Watch the interview with Joseph Kraft, the father of the insulin assay (ruclips.net/video/w0nV-_ddXoc/видео.html), and you will be surprised about the level of nonsense he waffles about...
I am 68. I’ve been on estrogen and testosterone natural pellets and oral progesterone since my mid forties and I have no intention of stopping, ever. I’m still working and I feel as good as I did in my 30’s.
Wow. I can so relate to this. My daughter was born 6 years ago and I'm in my mid 40s. My dad had 5 strokes and a heart attack starting at age 50. As a result I got into exercise at a very young age and even went on to get my degree in exercise physiology. I too am so fascinated by the topic of longevity and I love Dr. Attia. He really inspires me to keep digging though all of this and learning more and training smarter and eating better.
Dr. Patrick, you were my gateway into a healthier and more deliberate lifestyle. Thank you! I also bought Dr. Attia's book for my mother and she loves it!
I was wondering when she would have him on her show too, again. He had her on his episode 252, I think. Great to see both of these people discuss health together anytime, anywhere!
My two favourite podcasters together, what a treat and as always so informative and educative. I love how you both freely share your learning and knowledge and will happily say when you don't know the answer to something, or outline that you've changed your previous thoughts/position on topics. You are both shining examples. Thank you for continuing to share how we can live longer and healthier lives. Rhonda you should seriously consider writing a book! Peter Attia's book sits on my study desk as a constant reference and the audio version I find very consumable. Thank you Rhonda and Peter.
I recommend having Dr. Michael Greger on the podcast. His new book "How Not To Age" offers a different view point from Attia, but is well researched and science based. I think your viewers would appreciate his work on the subject of longevity. It would be interesting to hear Rhonda question him on the research he cites in the book.
I don’t say this often enough about certain lecturers on podcasts, but the fact that he hasn’t referred to Notes I’m almost 3 hours into this just shows how smart he is, even though he does still believe in calories and calories out
Truly admirable, unlike other famous doctors or physician recommending certain diet or supplements. Dr Attia really explain almost all his finding of scientific paper to backup any recommendations... As a Healthcare provider myself, i really admire his ability to cite papers left and right like it was nothing. Amazing stuff.
I listened, can’t say I understood any of this podcast on a science basis, but to summarize: lots of zone 2 mixed with HIIT, lower glucose by eating cleaner, no smoking, cancer screening regularly, live love….LIFE!
@@socrates1818I think it’s referring to perceived exertion. You should be working out a level that you feel a little difficulty speaking in complete sentences.
00:02 Nearly 50% of first symptoms of coronary artery disease result in sudden death. 02:08 Birth of daughter sparked interest in longevity 06:14 Coronary artery disease is the leading cause of sudden death, with over 50% of first symptoms being sudden death. 08:19 Cholesterol is essential for life and plays a vital role in the body. 12:33 Measuring the concentration of all the apob particles can predict risk. 14:48 Measuring LDL particle number predicts risk better than LDL cholesterol concentration 18:41 ApoB plays a crucial role in lipid recycling and LDL clearance. 20:35 LDL receptor presentation impacts risk factors 24:23 Eliminate causal factors of disease as soon as possible 26:27 Atherosclerosis is a disease that progresses over decades, and apop is a major driver of it. 30:27 LDL plays a major role in reverse cholesterol transport. 32:14 Low levels of APOB and LDL cholesterol are sufficient for normal functioning. 36:04 Four big factors driving ASBD risk 38:00 Lowering triglycerides is key to managing apob levels. 42:05 Dietary choices impact lipid levels 43:52 Nutrition should be used to address energy balance and protein needs, and let lipids fall where they may. 47:23 Genetic control of LDL cholesterol affects ASCVD risk 49:19 PCSK9 gene mutations impact LDL cholesterol and cardiovascular disease 53:05 Early lipid-lowering drug was ineffective and had adverse effects 54:50 Bile acid sequestrants are a class of drugs to lower cholesterol 58:31 Statin can lead to insulin resistance and increased transaminases 1:00:03 Statin's impact on mitochondrial function. 1:04:00 The longer a cell stays in the mitochondrial space, the better it is for ATP production and lactate accumulation. 1:06:11 Metformin may not be a great drug for non-diabetic individuals 1:09:46 Use rate of perceived exertion to exercise in Zone 2. 1:11:32 Heart rate guidance depends on fitness level and daily factors. 1:15:26 Statin use shows neutral to beneficial impact on dementia and Alzheimer's disease. 1:17:26 Statins and diabetes risk 1:21:29 Prefer using alternative tools like aetam, pcsk9 Inhibitors, bidic acid over taking unnecessary risks with Statin, especially for higher risk individuals. 1:23:27 PCSK9 inhibitors are highly effective but expensive. 1:27:15 Desol imbalance can impact health in both positive and negative ways 1:29:08 CT angiogram is a useful tool for assessing plaque accumulation. 1:32:34 Using CTA to determine treatment aggressiveness based on risk factors and test results 1:34:23 Berberine shows potential benefits in lowering LDL cholesterol. 1:37:57 Fasting blood glucose of 100 mg/dL is on the cusp of being too high. 1:39:57 Liver and muscles work as buffer system for glucose 1:44:18 Elevated levels of glucose and insulin can cause damage to small and large blood vessels. 1:46:16 Sleep disruptions significantly reduce insulin sensitivity 1:49:55 Maintaining an average blood glucose level of 100 is better than 115 for overall health. 1:52:03 Training in zone 2 pushes metabolic flexibility and expands mitochondrial capacity. 1:56:07 Optimal cardiorespiratory engine requires balance. 1:57:57 Optimal workout intensity for V2 Max power generation 2:01:18 Understanding the dynamics of a fitness test on a bike for health monitoring. 2:03:00 Respiratory quotient (RQ) indicates fat and glucose oxidation ratio. 2:07:03 High V2 Max reduces all-cause mortality risk significantly. 2:09:03 Smoking is still the number one modifiable risk factor for cancer. 2:12:50 Cancer is still a big black box in terms of understanding its different ways of occurrence. 2:14:49 Early detection reduces cancer burden. 2:18:39 Recommended cancer screenings may not be fully covered by insurance. 2:20:29 Mammography has limitations in cancer detection due to low pre-test probability and personal factors. 2:24:22 Regular screenings are important for early detection 2:26:12 Liquid biopsies can detect cancer using DNA in the blood 2:30:09 Grail test sensitivity is lower for indolent breast cancers 2:32:12 CT scans are not a good way to screen for cancer, except for former or current smokers. 2:36:15 Discussion on the confusion between mammogram and MBI tests. 2:38:01 Menopause causes a rapid decline in important hormones like estrogen, progesterone, and testosterone. 2:41:43 Menopause causes a harsh decline in bone mineral density for women 2:43:46 HRT does not increase the risk of dying of breast cancer 2:48:12 Estrogen did not drive the incidence of breast cancer or mortality associated with breast cancer. 2:50:06 Importance of bioidentical estrogens over synthetic estrogens 2:54:12 Options for taking estrogen and progesterone in hormone therapy. 2:56:03 Measuring hormone levels is key for understanding women's transition to perimenopause. 2:59:50 Initiating HRT at the time of menopause reduces the risk of heart disease and dementia. 3:01:54 Estrogen is crucial for bone density maintenance. 3:05:43 Sunlight-derived vitamin D versus supplementation 3:07:28 Vitamin D levels and toxicity 3:10:48 Importance of measuring vitamin D levels and avoiding deficiency 3:12:22 Estrogen's role in compensating for vitamin D deficiency. 3:15:56 HRT initiation handled on a case-by-case basis 3:17:51 Customized hormone replacement therapy is crucial for individual needs. 3:21:46 Challenges in accurately measuring testosterone levels 3:23:44 Threshold for testosterone levels and TRT initiation 3:27:12 Testosterone replacement therapy does not increase the risk of prostate cancer. 3:29:01 Testosterone may have a slight initial increase in cardiac risk but the effect disappeared over time. 3:32:31 Nutritional supplements and lifestyle changes impact health. 3:34:20 Cocoa flavanols decreased blood pressure 3:37:54 Regular blood pressure checks not valuable for most people. 3:39:53 Limited release of a health program, with positive reception 3:43:20 Dr. Peter Attia emphasizes the importance of sleep for optimal functioning. 3:45:09 Establishing a bedtime routine to optimize sleep quality. 3:48:53 Importance of exercise in maintaining overall health. 3:50:38 Peter Attia's book is a must-read on anti-aging 3:54:04 Dr. Attia and the host plan to continue their conversation in future podcasts due to their shared interests and the abundance of topics to cover.
So good to see the evolution of Peter Attia. He is fantastic but no one is aways perfect. Watch that first episode with Rhonda. Compare his personae. His was angry with his own humanity and perfection in those days. He’s a genius and a great academic.
A friend was being tested for MS amongst other things because she couldn’t grip properly etc ,it turned out her vit d levels were extremely low. She was given short term very high doses and after a few weeks everything returned to normal,she was due an MRI scan shortly before one clever doctor suggested to test for vit d.
It is normal that MS patients have bursts of symptoms and than pauses in between. She should take real medicine if it is real MS. Vit D is down regulated during disease. Therefore it seems to play a role in many diseases but is only downregulated by default during disease. Measure it when you are not in an active disease state.
FINALLY !! ... This has been the first time I've heard Peter talk about Maffetone heart rate numbers and associate them with lactate based Z2 heart rate numbers .. this clarified a lot ! Great podcast !!!
Always illuminating listening to these two. Key point for me on diet. Lower saturated fat to reduce apo-b. Tryglecerides are a proxy for insulin resistance.
Would've been nice if you'd pushed him on Berberine being a PCSK9 inhibitor and whether this would outweigh it being a Metformin analogue in regards to overall health.
I was a bit disappointed as well, but considering that he talks so highly of statins, which are some of the worst drugs you could possibly take -- it's pretty apparent he's pushing big pharma's agenda.
@@ShowMeWhatINeedToKnowthis disappoints me, too. My mom just started a statin and now has lower back pain and other side effects. Her LDL is 100, not even really out of range. I’m so frustrated with her doctor. My brother and I talk her out of taking it and then her doctor gets upset and talks her into taking it again. Each time she gets side effects.
@@stephanienewton6618 - Check out pantetheine -- I've been using it for sleep but apparently it is VERY GOOD at lowering cholesterol. Also red yeast rice is supposed to be very good too.
Except ... he's doing constant bloodwork to see what's working and I'm assuming you're not. I suspect you're falling for the "natural is better" fallacy.
@@houndofzoltan Bruce Lipton's book The Biology of Belief tells the history of the study of human biology. Every time we thought we had it figured out and then OOPS. Every time we thought a body part was vestigial, because we didn't understand what it did, only to discover it was actually doing something important. All the diet drugs that have been prescribed by Drs, only to be banned once the bodies started piling up. I think the GLP-1 drugs will be the same, the evidence is just now starting to come to light. Antibiotics? They save lives, right? Oh, except now we have super bugs and we know about the microbiome. Peter himself has changed his mind on various things over the years, any good scientist does.
Thank you so much for your investment into the sports science and associated factors. You have become my favourite go to source of information as well as inspiration to motivate alternative fitness pathways. Once again, thank you
Incredible episode - he is flat out amazing - and the information is so helpful - busted many mistaken beliefs I have had - facts beat chest pounding every time.
I don't see any videos on your channel about this topic, so I was wondering if you could do a review of blood pressure and how to lower it with lifestyle intervention. The reason I ask is because I feel like I do everything right, yet my blood pressure readings are always very high. - Gym 3x a week - HIIT 2x a week - Sauna use 3x a week - Diet high in nitrate-rich vegetables - Diet low in sodium, alcohol, and fried foods And I've been doing this for about 10 years now, and my blood pressure is still extremely high.
I've never seen vid annotations as robust as Rhondas. How suitable she joined with Peter who himself has remarkable strength in his shownotes (great for both).
Dbl up on JOCKO MÖLK (2 scoops) blended w/a cup of unsweetened vanilla almond milk! 44grams of protein and a bunch of other good stuff! I keep Molk in the freezer, put the blender jar w/the almond milk in the freezer for 15 mins before blending and it's basically a vanilla milkshake!
Great discussion! I respect and admire Dr. Ronda Patrick’s and Dr. Peter Attia’s work. I told my doctor about you. Could you please elaborate more about mitochondrial biogenesis, metabolic flexibility and how to optimize mitochondrial health? Thank you.
Attia doesn't really care about diets as long as you are getting enough protein and are in control of your calories ( not fat or too skinny ) because loss of muscle mass is increasing as we age , and is terrible for both health span and lifespan.
I've been listening to your podcast for years (maybe since 2015?) and I would absolutely be the first in line to buy your book!! I hope you consider writing one! ❤
Me too. She makes science accessible to the general public. Too many science communicators talk down or go into dogma to separate themselves. Rhonda just gives her opinion. That and a science communicator that reads the literature herself (my niche) makes her in the remarkable few in this space.
Mine too, alerted by pain, which is not the norm for breast cancer, but luckily for me was the case. No obvious lump and well hidden. The ultrasound looked suspicious and needle aspirations were needed. Early stage, and 6 years on, all good!
Rhonda you really need to speak with a Menopause expert. Peter gets some of what he's saying slightly off, specifically around symptoms not outcome. Louise Newson is a brilliant person to speak with. Thanks for doing these.
Vitamin D serum levels of 80 ng/mL put my autoimmune diseease into remission. 10 years of suffering gone (I also took vit. D co-factors such as magnesium, zinc, B vitamins, boron). Psst, best-kept secret
google lyme disease and check out the symptoms.@@yomain7227Advice to send your blood to Igenex Labs in California and get checked for it. Your body does not fight itself. It fights an unknown to you.
With the almost unnatural quantity of protein Peter has now adopted, I fear he’s taken the side of Lane Norton types too much. He’s even admitted it’s difficult to reach his protein goals, which intuitively doesn’t make sense it’s how we optimize health. I love Peter and find him brilliant. But he’s been wrong before too, as we all have.
An issue I have regarding protein intake is the units by which I hear it recommended; I've heard people say ~1g per kilogram body weight. I've heard people say ~1g per pound. A huge difference yet I've heard it reported both ways by seemingly credentialed people.
Why would we care about what's "natural" or "intuitive"? We care about what's optimal. 99% of our lives as humans right now are unnatural and unintuitive to our predecessors, but we are more healthy and live much longer than we ever did. The purpose of high protein intake combined with strength training is to battle the inevitable onset of sarcopenia. We're not mice in cages, we die frequently at old ages from accidents due to frailty. Also, healthspan is impacted tremendously by muscle mass in old age. People that have strong muscles, joints, and bones live more free and unencumbered lives in old age. Though you may be able to increase your lifespan marginally by lower protein intake (maybe), your healthspan will decrease significantly. Not everything is black and white, it's about trade-offs.
@@nichtsistkostenlos6565 what’s most natural is what drives optimal biology. That’s why your Venus fly trap lasts 2 weeks in your apartment. Excessive protein intake (I.e. forcing intake beyond satiety) is not natural. Our average lifespan is longer due to better infant mortality rates, cleaner water and better hygiene.
Be interested in Attia's take on the recent Lean Mass Hyper Responder study...his take on statins, ApoB and LDL is not popular with an awful lot of eminent people...!
3 questions for anyone: 1) if you have an optimal level of apoB (whatever that is according to Peter), will you ever have to worry about a cardiac event? 2) Who is a good candidate for a heart CT according to Peter? 3) re family history of ASCVD : what is the cut off age? A cardiac event in the 60s?
I can answer the first question 1) It would be extremely unlikely to suffer a cardiac event as a result of the development of arterial plaque if you had ApoB levels as low as Peter recommends in a normal human lifespan and that was maintained through your entire adult life. If you're talking about at the population level, some people still would, but it would be very rare. Current studies show that below 60 mg/dl, cardiac events are extremely sparse and the data we have even further below that they're essentially non-existent because people just die of some other cause before they even have an event.
@@porkpie2884 There are ways to estimate insulin resistance pretty accurately. HOMA-IR and LP-IR are probably the most practical. To the OP, you can calculate HOMA-IR yourself if you have your fasting glucose and fasting insulin from a basic blood test.
So many unanswered questions around women’s hormones 😭 I’m 29 and am experiencing jawline acne only around my cycle, otherwise my skin is wonderful. I have severe mood swings two days before I start my period (I swing from super angry and irritable one day to literally crying and suicidal the next day). My cycles are regular, meaning in time every month. I can’t sleep at all when I’m ovulating. I took 5mg melatonin, 400mg mag glyc and ashwagandha with rhidiola and doesn’t do shit during ovulation but I tried progesterone cream and that gave me the best night of sleep I’ve ever had AND I didn’t have any mood swings or breast tenderness this last period. What gives?! Aren’t I too young to be having to apply progesterone cream? I don’t want to give myself breast cancer but I can’t keep living like that every single month 😭 also my obgyn says my hormones are fine. This is such BS. Only think blood work says is that I have low vitamin D but I take 5,000IU Vit D + K2 consistently so none of this make sense lol I hate it
Getting enough molecular iodine (not iodide from food and salt) has been shown to be important regarding cyclic mastalgia. Progesterone probably helped because your hormones are dysregulated by insufficient iodine/selenium along with maybe a pathogenic environment/diet/mold exposure. Not gonna say it is 100% this because it's pretty common because of flame retardants like bromide blocking iodine from being used in the body. It's really worth looking into. 400mg of Magnesium Glycinate equals about 60mg of elemental magnesium (RDI is 400mg). It's not much if you actually need it. I take 1g of it morning then 1g night (total 290mg elemental Mg). I was deficient from taking Vitamin D for too long and initially got an ironic excitatory reaction from magnesium at night. I tried metatonin for years. Unless you're old or have some genetic disorder where you can't produce metatonin, it's useless and might actually keep you up at night through a couple different processes. Most melatonin supplements are too much and absorbed too fast. Hormones like that have a very delicate balance and supplements are like a sledgehammer. Only good for changing timezones. We need very little of it. Ashwagandha gave me a hyperthyroid experience (takes a month to fully breakdown ashwagandha). Thyroid is something to think about with that one. IMHO herbal supplements need to be avoided because they can just make it worse since they do way too many things we don't understand and are often contaminated with pesticides and heavy metals. Focus on molecular iodine, your adrenals and thyroid. Which would need to be worked on by mindfulness/acceptance, diet (eat enough fat) and relaxation (only easy exercise). Insomnia is hell and it took me years to realize that the desire for sleep is a catch-22. Unfortunately the more you want it, the less you get. Mindset is half of everything. idk if any of this helps or not. Hope you get some relief soon
Maybe try eating and exercising according to your cycle. Women have 3 hormones to support during different phases of her cycle. Estrogen, Testosterone, Progestrone. (start count from first day of bleeding) Day 1 - 10 - Estrogen (able to withstand lots of HIIT cardio, Intermittent fasting, low carbs diet, keeping blood sugar levels low) Day 11 - 15 - Testosterone will peak during ovulation (suitable for heavy lifting, resistance training, prolonged water fasts) Day 16 - 18 - Hormones will take a big dip or "crash" transitioning into Progestrone (start to introduce good carbs, needs higher blood sugar levels to prepare to shed your lining) Day 19 - 28 - Progestrone (stop fasting, higher carb diet, taper off cardio and do lighter workouts like pilates, yoga, zone 2, long walks, light weights, keeping cortisol low) Hope that helps!
Please talk about estrogen positive breast cancer and the hesitation to use hrt in survivors of triple positive BC when they reach menopause. Please.....
Dr Attia makes it sound like insulin resistance is a main driver of ApoB formation, and that saturated fat intake is less important - I was under the impression that saturated fat intake is more relevant from what research I've seen. Anyone else have research to show me on this?
Please, please get into the detail of sauna and HRT patches. Does excessive sweating like a 70 min sauna yoga session nullify the benefits of the patch thereafter?
I would also love to please hear more about HRT patches and sauna!! Also, Dr Patrick, do you have an opinion about whether sauna during a cold or flu is contraindicated?
I would really like if someone explain the 'french paradox' which is really more of an 'european paradox'. And it does seem that countries that eat more meat and saturated fat has less heart disease.
If I understood right, (and probably I didn’t) he said low fat works to lower cholesterol but it’s probably not a good idea because cutting back on fat can mean increasing intake of(processed) carbs as an energy source. He also said that monounsaturated fats tend to be benign so rule of thumb is cut out saturated fats where you can and add olive oil where you can. Of course all this is made a bit difficult because each person is different. Some people can eat 29 bacon sandwiches a day and be perfectly healthy. For me I found that by cutting down on carbs and especially sugar stuff like triglycerides and overall cholesterol and blood pressure all fell. So my interest is basically should I still aim to eat less saturated fat if my blood test results seem okay with my current diet? Regarding statins it’s not really a fashionable thing to say but it’s probably best to take them if prescribed. Heart disease is a massive killer and statins can help reduce the risk.
You have a lot of things the wrong way around. Statins increase risk of heart disease, not decrease it. Saturated fat is not unhealthy. Lowering cholesterol is bad for us. Blood sugar causes heart disease, not sat fat or cholesterol @@MrBlaxjax
@@porkpie2884 look I agree that blood sugar and also added fructose (which is processed into liver fat and not processed by the insulin system) are public enemy number one as far as metabolic health and heart disease go. But really you are being too dogmatic. Saturated fats and bad cholesterol are usually villains too and yes it’s generally a good idea to take statins if prescribed. Some people possibly me seem to get along okay with a high intake of saturated fat. But not everyone. My inference out of everything I understand (which isn’t a lot) is 1 deal with your added fructose intake. Reduce this to less than 30g/ day ( the uk nhs recommendation) 2 cut back on carbs generally and especially ultra processed food type carbs. For me this seems enough. But for others it won’t be. If you have done all the above and your blood test results are suboptimal then you have to reduce saturated fat and you would just be taking a silly risk by avoiding statins without a very good reason.
She has spoken of it favorably before. What the conversation missed for lack of time is that we have good hard endpoint data (favorable) for diabetics but very limited data on berberine.
I think the point is that they don't know for sure, but if you're concerned about things like mitochondrial inhibition and/or insulin resistance, then you should be just as worried about berberine as you would be about statins.
@@nichtsistkostenlos6565 I think you miss the point here. Berberine and metformin are used as treatments for type 2 diabetes and insulin resistance. It cannot cause insulin resistance. If berberine has CVD protective effect on top of analog effect like metformin, considering how popular metformin is, then berberine is a shoo in, unless there are other drawbacks with berberine and hence the interest in getting a more nuanced opinion from them
I found the comments regarding Metformin on Lactate to be really interesting. I've been taking Berberine to help with insulin sensitivity and gut health for the past year (I'm not diabetic, but have a family history). This along with other changes last year helped me to drop 40 lbs along with a lot of other benefits. I'm a very active cyclist, and so the lactate threshold comments were interesting to me. I don't feel like I've noticed issues for myself, but I also am not measuring it. Does anyone know if Berberine has similar issues with Lactate production as Metformin?
Download my free Cognitive Enhancement Blueprint - packed with my specific protocols for boosting BDNF with heat stress, omega-3s, and exercise: bdnfprotocols.com/
Dr. Attia's book "Outlive: The Art and Science of Longevity": www.amazon.com/Outlive-Longevity-Peter-Attia-MD/dp/0593236599
CHAPTERS:
(00:00:00) In this episode
(00:04:29) Defining cardiovascular disease
(00:06:36) Coronary plaque and fatality risk
(00:08:02) What is cholesterol?
(00:10:27) How ApoB predicts heart disease
(00:18:27) Factors elevating ApoB
(00:22:17) ApoB reference range explained
(00:24:16) Does high ApoB cause cardiovascular disease
(00:33:54) ApoB thresholds for ASCVD prevention
(00:37:20) Dietary factors raising ApoB
(00:36:26) Genetics of ApoB and LDL
(00:50:17) Does low LDL increase cancer?
(00:53:12) Cholesterol-lowering drugs
(00:56:52) Statins, uses, and side effects
(01:00:05) Are statins toxic to mitochondria?
(01:06:49) Ubiquinol for statin-induced muscle soreness
(01:08:02) How to train in zone 2
(01:14:02) Statins and neurodegenerative disease risk
(01:18:47) Cholesterol synthesis in the brain (desmosterol role)
(01:22:51) Statin alternatives - pros and cons
(01:24:23) Ezetimibe
(01:27:54) Bempedoic acid
(01:33:42) Berberine for CVD Risk Reduction?
(01:36:29) Muscle as a glucose sink
(01:42:51) Chronic glucose toxicity and vascular impact
(01:48:31) Hemoglobin A1C Levels and Mortality Data
(01:52:28) 80/20 Zone 2/VO2 Max Training Protocol
(01:59:05) Insights from VO2 max testing data
(02:09:10) How obesity increases cancer risk
(02:11:56) Cancer screening benefits and risks
(02:17:40) Dr. Attia's recommended cancer screening age
(02:25:47) Liquid biopsies for detecting cancer
(02:31:41) CT scans, mammograms and radiation concerns
(02:37:25) Menopause - hormonal shifts and health effects
(02:42:06) Hormone replacement therapy (HRT)
(02:55:50) Perimenopause diagnosis with hormone levels
(02:58:57) HRT's impact on dementia, cancer, and heart disease risk
(03:01:42) Estrogen's role in bone density
(03:04:35) Vitamin D
(03:13:17) Testosterone replacement for women's sexual function
(03:15:40) HRT safety 10 years post-menopause
(03:19:58) Treating low testosterone in men
(03:26:46) TRT side effects and risks
(03:29:26) Ways to reduce blood pressure
(03:36:26) How to measure blood pressure
(03:42:23) Peter's longevity optimization routines
Thanks for this Doc! The Norwegian 4x4s - OMG those are brutal, but gooooooood! Cheers!
I’m fry f
Question... I'd a person works outside in the heat do they get heat shock protein benefits?
@Dr Patrick - you are so brilliant, amazing, smart, and beautiful. Thank you for sharing your knowledge, suggestions, and insights with all of us. Appreciate you and Dr. Attia, Dr. Huberman, Dr. Walker, and the other ones whose names I can't remember off the top of my head. You're all amazing ❤
I’ve been a practicing physician for almost 30 years (Sports Medicine, nonsurgical orthopedics, and Regenerative medicine) Other than the discussion on bio-identical hormones, with which I am well trained and well-versed, this has been one of the most instructional and informative videos that I’ve seen in my entire career.
Rhonda Patrick x Peter Attia = LEGENDARY!
So excited for this!
I’m with you!!!
These two along with Doctors Panda and Lustig changed my life 10 years ago at 63. Changed what I eat, how I exercise, when I sleep etc. Thank you Rhonda for a life worth living.
Lustig loool
Same here , though Attia is new for me and I am 71
What have you changed if you don’t mind to share, thanks
I only listen to 4 podcasts, so it's fantastic when there are two of them together and then: it's four hours!! I love the long format. Huge thanks to both Doctors for sharing their passion and knowledge.
Out of the curiosity, what are the other 2? Because l follow these 2 as well.
@@zoranvujovic998 Sam Harris and Sean Carroll. Not the same area, though Dr Attia and Sam Harris have been on each others' podcasts.
I really like the pace of Dr. Attias talking. He talks slow enough a layman like myself can process and mostly understand what he's saying even on complex topics.
Is this the start of the longevity Avengers!? I had to do a triple take on my feed when I saw these two faces side by side. ❤
Roundtable with Rhonda Patrick, Peter Attia, Thomas Seyfried, Caldwell Esselstyn, Andrew Huberman, and Thomas Delauer would be good
I’d add Matt Kaeberlean to the table!
@@AnalyticalSentientmaybe with a side of David Sinclair?
@FoeverDirt I mean sure I suppose but I think Huberman, Delauer and Patrick (also perhaps Attia) would probably already have most bases covered from what he might have to add other than something that isn't a low- or no-cost supplement, practice or protocol but yes of course longevity is his specialization no question
Real life super hero’s for sure 👏
We're lucky to have a Dr. Attia who is able and willing to spend 4 hours educating us on how we can increase our lifespan and healthspan. What a brilliant guy.
I need to master longevity to make it through this episode.
lol
😭😭
Rip 😢
I know, it'd be a bit sedentary to watch it all! Have you got through it yet? I'm going to watch it at work today, and tomorrow.
At work? How do you have time?
I'm that "one" person, 5' 7" 145 lbs (recently gained 20 lbs), sauna and cold plunge 4 x/week. Saw GYN 9/28/23, "normal" pelvic exam, normal PAP, I did c/o overactive bladder and 20 lb weight gain. 12/6/23 diagnosed with stage 4 cancer. Would love to see better screening for ovarian cancer. Also, would be nice if physicians actually listened to your symptom complaints. Just received first chemo tx and down 20 lbs, hoping it's all cancer weight I lost.
❤ Wishing you great health.
I’m sorry, hope you’ll make a full recovery. Is it stage 4 ovarian cancer?
@@CrystallyLavender thank you! It is ovarian cancer. I understand a healthy lifestyle doesn't make you immune to disease, I'm just really frustrated my gyn blew off my complaints.
@@sazennonumber thank you!
I've watched most of Dr. Attia's videos from way back & read his writings over a long time & not to be too critical but most of the information overload is difficult to follow for the average non medically educated person. I am 81 years of age, physically very fit & still reasonably mentally alert. If I was to worry about all the information Peter expounds I would probably lose my focus on just simply keeping active & eating well which enables me to remain "healthy". I listen to the advice from people like Peter because I am now vitally concened with longevity but in reality the "science" seems to be never ending in comlpexity & still there is no clear cut simple direction.
he drops so much biotechnical information to give you the impression he knows what he is talking about. Still, most of what he says about cardiovascular health and the cholesterol-saturated fat myth is sheer nonsense.
He spreads the Ancel Keys disinformation and ignores the findings and insights of Joseph Kraft.
Watch the interview with Joseph Kraft, the father of the insulin assay (ruclips.net/video/w0nV-_ddXoc/видео.html), and you will be surprised about the level of nonsense he waffles about...
Just stay very active , don't smoke , don't drink too much , get enough sleep and try to avoid processed foods.
I am 68. I’ve been on estrogen and testosterone natural pellets and oral progesterone since my mid forties and I have no intention of stopping, ever. I’m still working and I feel as good as I did in my 30’s.
Do these have to be prescribed? Thank You for Sharing!🎉
These two are the Gold Standard! Thanks Rhonda and Peter.
Wow. I can so relate to this. My daughter was born 6 years ago and I'm in my mid 40s. My dad had 5 strokes and a heart attack starting at age 50. As a result I got into exercise at a very young age and even went on to get my degree in exercise physiology. I too am so fascinated by the topic of longevity and I love Dr. Attia. He really inspires me to keep digging though all of this and learning more and training smarter and eating better.
Dr. Patrick, you were my gateway into a healthier and more deliberate lifestyle. Thank you!
I also bought Dr. Attia's book for my mother and she loves it!
Damn I love the "in video" references with the highlights - just amazing!
I remember she interviewed him years ago while he was working I’m pretty sure given he was wearing scrubs. Epic to see how far this has came
I was wondering when she would have him on her show too, again. He had her on his episode 252, I think. Great to see both of these people discuss health together anytime, anywhere!
My two favourite podcasters together, what a treat and as always so informative and educative. I love how you both freely share your learning and knowledge and will happily say when you don't know the answer to something, or outline that you've changed your previous thoughts/position on topics. You are both shining examples. Thank you for continuing to share how we can live longer and healthier lives. Rhonda you should seriously consider writing a book! Peter Attia's book sits on my study desk as a constant reference and the audio version I find very consumable. Thank you Rhonda and Peter.
I recommend having Dr. Michael Greger on the podcast. His new book "How Not To Age" offers a different view point from Attia, but is well researched and science based. I think your viewers would appreciate his work on the subject of longevity. It would be interesting to hear Rhonda question him on the research he cites in the book.
Actually Dr. Attia recommends low protein
Sorry spell fixer
I believe Dr attia discovered rampamycin
More importantly mTor
Actually, Attia recommends 2 grams of protein per kilogram of body weight per day. That’s a very high protein diet.
Thanks Dr Rhonda, I have watched this numerous times and really appreciate the chapter headings. 🎉😊
I wish this was a regular thing. Like regular short 30 minute quick dives into topics.
Love that final part :” Yeah Peter! Tell her, tell her” You are so smart Ronda, give it a thought 💭💕
I don’t say this often enough about certain lecturers on podcasts, but the fact that he hasn’t referred to Notes I’m almost 3 hours into this just shows how smart he is, even though he does still believe in calories and calories out
Go for it Rhonda! Write that book!
Truly admirable, unlike other famous doctors or physician recommending certain diet or supplements. Dr Attia really explain almost all his finding of scientific paper to backup any recommendations...
As a Healthcare provider myself, i really admire his ability to cite papers left and right like it was nothing. Amazing stuff.
I listened, can’t say I understood any of this podcast on a science basis, but to summarize: lots of zone 2 mixed with HIIT, lower glucose by eating cleaner, no smoking, cancer screening regularly, live love….LIFE!
What’s Zone 2?
Way too complex and I read Kierkegaard for fun!
@@socrates1818I think it’s referring to perceived exertion. You should be working out a level that you feel a little difficulty speaking in complete sentences.
00:02 Nearly 50% of first symptoms of coronary artery disease result in sudden death.
02:08 Birth of daughter sparked interest in longevity
06:14 Coronary artery disease is the leading cause of sudden death, with over 50% of first symptoms being sudden death.
08:19 Cholesterol is essential for life and plays a vital role in the body.
12:33 Measuring the concentration of all the apob particles can predict risk.
14:48 Measuring LDL particle number predicts risk better than LDL cholesterol concentration
18:41 ApoB plays a crucial role in lipid recycling and LDL clearance.
20:35 LDL receptor presentation impacts risk factors
24:23 Eliminate causal factors of disease as soon as possible
26:27 Atherosclerosis is a disease that progresses over decades, and apop is a major driver of it.
30:27 LDL plays a major role in reverse cholesterol transport.
32:14 Low levels of APOB and LDL cholesterol are sufficient for normal functioning.
36:04 Four big factors driving ASBD risk
38:00 Lowering triglycerides is key to managing apob levels.
42:05 Dietary choices impact lipid levels
43:52 Nutrition should be used to address energy balance and protein needs, and let lipids fall where they may.
47:23 Genetic control of LDL cholesterol affects ASCVD risk
49:19 PCSK9 gene mutations impact LDL cholesterol and cardiovascular disease
53:05 Early lipid-lowering drug was ineffective and had adverse effects
54:50 Bile acid sequestrants are a class of drugs to lower cholesterol
58:31 Statin can lead to insulin resistance and increased transaminases
1:00:03 Statin's impact on mitochondrial function.
1:04:00 The longer a cell stays in the mitochondrial space, the better it is for ATP production and lactate accumulation.
1:06:11 Metformin may not be a great drug for non-diabetic individuals
1:09:46 Use rate of perceived exertion to exercise in Zone 2.
1:11:32 Heart rate guidance depends on fitness level and daily factors.
1:15:26 Statin use shows neutral to beneficial impact on dementia and Alzheimer's disease.
1:17:26 Statins and diabetes risk
1:21:29 Prefer using alternative tools like aetam, pcsk9 Inhibitors, bidic acid over taking unnecessary risks with Statin, especially for higher risk individuals.
1:23:27 PCSK9 inhibitors are highly effective but expensive.
1:27:15 Desol imbalance can impact health in both positive and negative ways
1:29:08 CT angiogram is a useful tool for assessing plaque accumulation.
1:32:34 Using CTA to determine treatment aggressiveness based on risk factors and test results
1:34:23 Berberine shows potential benefits in lowering LDL cholesterol.
1:37:57 Fasting blood glucose of 100 mg/dL is on the cusp of being too high.
1:39:57 Liver and muscles work as buffer system for glucose
1:44:18 Elevated levels of glucose and insulin can cause damage to small and large blood vessels.
1:46:16 Sleep disruptions significantly reduce insulin sensitivity
1:49:55 Maintaining an average blood glucose level of 100 is better than 115 for overall health.
1:52:03 Training in zone 2 pushes metabolic flexibility and expands mitochondrial capacity.
1:56:07 Optimal cardiorespiratory engine requires balance.
1:57:57 Optimal workout intensity for V2 Max power generation
2:01:18 Understanding the dynamics of a fitness test on a bike for health monitoring.
2:03:00 Respiratory quotient (RQ) indicates fat and glucose oxidation ratio.
2:07:03 High V2 Max reduces all-cause mortality risk significantly.
2:09:03 Smoking is still the number one modifiable risk factor for cancer.
2:12:50 Cancer is still a big black box in terms of understanding its different ways of occurrence.
2:14:49 Early detection reduces cancer burden.
2:18:39 Recommended cancer screenings may not be fully covered by insurance.
2:20:29 Mammography has limitations in cancer detection due to low pre-test probability and personal factors.
2:24:22 Regular screenings are important for early detection
2:26:12 Liquid biopsies can detect cancer using DNA in the blood
2:30:09 Grail test sensitivity is lower for indolent breast cancers
2:32:12 CT scans are not a good way to screen for cancer, except for former or current smokers.
2:36:15 Discussion on the confusion between mammogram and MBI tests.
2:38:01 Menopause causes a rapid decline in important hormones like estrogen, progesterone, and testosterone.
2:41:43 Menopause causes a harsh decline in bone mineral density for women
2:43:46 HRT does not increase the risk of dying of breast cancer
2:48:12 Estrogen did not drive the incidence of breast cancer or mortality associated with breast cancer.
2:50:06 Importance of bioidentical estrogens over synthetic estrogens
2:54:12 Options for taking estrogen and progesterone in hormone therapy.
2:56:03 Measuring hormone levels is key for understanding women's transition to perimenopause.
2:59:50 Initiating HRT at the time of menopause reduces the risk of heart disease and dementia.
3:01:54 Estrogen is crucial for bone density maintenance.
3:05:43 Sunlight-derived vitamin D versus supplementation
3:07:28 Vitamin D levels and toxicity
3:10:48 Importance of measuring vitamin D levels and avoiding deficiency
3:12:22 Estrogen's role in compensating for vitamin D deficiency.
3:15:56 HRT initiation handled on a case-by-case basis
3:17:51 Customized hormone replacement therapy is crucial for individual needs.
3:21:46 Challenges in accurately measuring testosterone levels
3:23:44 Threshold for testosterone levels and TRT initiation
3:27:12 Testosterone replacement therapy does not increase the risk of prostate cancer.
3:29:01 Testosterone may have a slight initial increase in cardiac risk but the effect disappeared over time.
3:32:31 Nutritional supplements and lifestyle changes impact health.
3:34:20 Cocoa flavanols decreased blood pressure
3:37:54 Regular blood pressure checks not valuable for most people.
3:39:53 Limited release of a health program, with positive reception
3:43:20 Dr. Peter Attia emphasizes the importance of sleep for optimal functioning.
3:45:09 Establishing a bedtime routine to optimize sleep quality.
3:48:53 Importance of exercise in maintaining overall health.
3:50:38 Peter Attia's book is a must-read on anti-aging
3:54:04 Dr. Attia and the host plan to continue their conversation in future podcasts due to their shared interests and the abundance of topics to cover.
Thank you for this public service Open.
Thank you so much for doing this
🙏
So good to see the evolution of Peter Attia. He is fantastic but no one is aways perfect. Watch that first episode with Rhonda. Compare his personae. His was angry with his own humanity and perfection in those days. He’s a genius and a great academic.
A friend was being tested for MS amongst other things because she couldn’t grip properly etc ,it turned out her vit d levels were extremely low. She was given short term very high doses and after a few weeks everything returned to normal,she was due an MRI scan shortly before one clever doctor suggested to test for vit d.
It is normal that MS patients have bursts of symptoms and than pauses in between. She should take real medicine if it is real MS. Vit D is down regulated during disease. Therefore it seems to play a role in many diseases but is only downregulated by default during disease. Measure it when you are not in an active disease state.
great guest
FINALLY !! ... This has been the first time I've heard Peter talk about Maffetone heart rate numbers and associate them with lactate based Z2 heart rate numbers .. this clarified a lot !
Great podcast !!!
Check out his podcast, there's lots about it on there
Always illuminating listening to these two. Key point for me on diet. Lower saturated fat to reduce apo-b. Tryglecerides are a proxy for insulin resistance.
Would've been nice if you'd pushed him on Berberine being a PCSK9 inhibitor and whether this would outweigh it being a Metformin analogue in regards to overall health.
I was a bit disappointed as well, but considering that he talks so highly of statins, which are some of the worst drugs you could possibly take -- it's pretty apparent he's pushing big pharma's agenda.
@@ShowMeWhatINeedToKnowthis disappoints me, too. My mom just started a statin and now has lower back pain and other side effects. Her LDL is 100, not even really out of range. I’m so frustrated with her doctor. My brother and I talk her out of taking it and then her doctor gets upset and talks her into taking it again. Each time she gets side effects.
@@stephanienewton6618 - Check out pantetheine -- I've been using it for sleep but apparently it is VERY GOOD at lowering cholesterol. Also red yeast rice is supposed to be very good too.
@@stephanienewton6618 - Check out pantethine and red yeast rice. Seriously.
@@stephanienewton6618 Look into red yeast rice and pantethine.
I think Peter is right about so many things. The use of pharmaceuticals over nutrition is one area that I think he's wrong.
Yes agree and unapologetic about it
One of you has the data on their side. Besides, I think his position is more accurately characterized as pharmaceuticals AND nutrition
He finally realized metformin was not good for him and stopped taking it. Also takes regenerative food more seriously
Except ... he's doing constant bloodwork to see what's working and I'm assuming you're not. I suspect you're falling for the "natural is better" fallacy.
@@houndofzoltan Bruce Lipton's book The Biology of Belief tells the history of the study of human biology. Every time we thought we had it figured out and then OOPS.
Every time we thought a body part was vestigial, because we didn't understand what it did, only to discover it was actually doing something important.
All the diet drugs that have been prescribed by Drs, only to be banned once the bodies started piling up. I think the GLP-1 drugs will be the same, the evidence is just now starting to come to light.
Antibiotics? They save lives, right? Oh, except now we have super bugs and we know about the microbiome.
Peter himself has changed his mind on various things over the years, any good scientist does.
Thank you so much for your investment into the sports science and associated factors. You have become my favourite go to source of information as well as inspiration to motivate alternative fitness pathways. Once again, thank you
Such incredible information
What an IMPACTFUL PODCAST!! Thank you!!❤
Glad you enjoyed it!
peter is just the best. thanks rhonda!
Yes ! please write a book !!! (just please make it much more layman friendly with practical suggestions and big picture of what is most important)
One of the most informative, excellent podcasts of them all- thank you, you two are phenomenal!!
Incredible episode - he is flat out amazing - and the information is so helpful - busted many mistaken beliefs I have had - facts beat chest pounding every time.
Indeed, these two are beacons of sanity in the precarious seas of RUclips information.
Fascinating… this is what podcasts are all about. Thank you
+1
I don't see any videos on your channel about this topic, so I was wondering if you could do a review of blood pressure and how to lower it with lifestyle intervention.
The reason I ask is because I feel like I do everything right, yet my blood pressure readings are always very high.
- Gym 3x a week
- HIIT 2x a week
- Sauna use 3x a week
- Diet high in nitrate-rich vegetables
- Diet low in sodium, alcohol, and fried foods
And I've been doing this for about 10 years now, and my blood pressure is still extremely high.
WHAT A DUO! 🙌🤩
Yeah
Love the long form interview and annotations. Great job all around and thankyou for sharing your knowledge.
I've never seen vid annotations as robust as Rhondas. How suitable she joined with Peter who himself has remarkable strength in his shownotes (great for both).
Thanks! Very helpful, thorough discussion.
Great podcast with Dr. Attia and great questions from Dr. Patrick!!
40 to 50 grams of protein 4 times per day, Pete? I can't eat 8 cans of sardines in a day. I just cannot.
How does anyone do this?
Whey protein in a shake
Don’t eat any carbs. Eat protein until you aren’t hungry anymore. Does it have to be sardines?
Dbl up on JOCKO MÖLK (2 scoops) blended w/a cup of unsweetened vanilla almond milk! 44grams of protein and a bunch of other good stuff! I keep Molk in the freezer, put the blender jar w/the almond milk in the freezer for 15 mins before blending and it's basically a vanilla milkshake!
There's no need for that much protein. Do some more research on the subject. He's just stuck in some old bs narratives.
- Morning shake 40g
- Lunch meat + yoghurt 40g
- Dinner chicken or fish 40g
- A snack during day of nuts + yoghurt + beef jerky 40g
Thank you guys for sharing your knowledge with us!
Great discussion! I respect and admire Dr. Ronda Patrick’s and Dr. Peter Attia’s work. I told my doctor about you. Could you please elaborate more about mitochondrial biogenesis, metabolic flexibility and how to optimize mitochondrial health? Thank you.
Thank you Doctors
I'm so glad I discovered these legends. So much great content in these four hours. I'll be sure to listen in to the podcasts, very excited
And I am over 10 year post menopause and still on HRT. And could not feel better.
HRT is not safe (cancer, CVD, stroke) there are more natural approches. Dr Greger have plenty of vid about it on his channel nutritionfacts
What a podcast, thanks to you both.
Please mention the whole food plant diet
Attia doesn't really care about diets as long as you are getting enough protein and are in control of your calories ( not fat or too skinny ) because loss of muscle mass is increasing as we age , and is terrible for both health span and lifespan.
Great to see Rhonda on this show! Excellent discussion with two powerhouses!
I've been listening to your podcast for years (maybe since 2015?) and I would absolutely be the first in line to buy your book!! I hope you consider writing one! ❤
Me too. She makes science accessible to the general public. Too many science communicators talk down or go into dogma to separate themselves. Rhonda just gives her opinion. That and a science communicator that reads the literature herself (my niche) makes her in the remarkable few in this space.
Thank you, no other words worth
So insightful. Thank you both.
Excellent. Thank You !!!
Strong open, Dr P!
than ylu both very much...
Love the deeper detail that is in this episode
Totally agree - first symptom was a ‘widow maker’. Life pivot done - eek
Just found your channel. Love it already. I’ve watched your JRE appearances and I’m glad to see you’re doing your thing here
Awesome information! Keep up the good work Rhonda and Peter 👍👍👍
3:35:32 Fascinating point for us men!
My breast cancer was NOT found on the mammogram, but was found on the Ultrasound
type breast cancer in nutritionfacts YT channel or website
Mine too, alerted by pain, which is not the norm for breast cancer, but luckily for me was the case. No obvious lump and well hidden. The ultrasound looked suspicious and needle aspirations were needed. Early stage, and 6 years on, all good!
42:20 love the little shot at Paul Saladino 😉
Listening from new Zealand 🇳🇿. Totally educational
Rhonda you really need to speak with a Menopause expert. Peter gets some of what he's saying slightly off, specifically around symptoms not outcome. Louise Newson is a brilliant person to speak with. Thanks for doing these.
Oh man a guide besides! Rhonda! You are so on point! Peter! You too! Love you guys. Thank you!
Dear Dr
The was amazing: so clearThank you so much
better than any college class.... by far.
Vitamin D serum levels of 80 ng/mL put my autoimmune diseease into remission. 10 years of suffering gone (I also took vit. D co-factors such as magnesium, zinc, B vitamins, boron). Psst, best-kept secret
What were the symptoms of your autoimmune disease? I'm just asking because I've been wondering if I developed an autoimmune disease
google lyme disease and check out the symptoms.@@yomain7227Advice to send your blood to Igenex Labs in California and get checked for it. Your body does not fight itself. It fights an unknown to you.
@@yomain7227take a blood test and find out what your ANA no’s are. ( anti nuclear antibodies are). Then take those results to a rheumatologist.
With the almost unnatural quantity of protein Peter has now adopted, I fear he’s taken the side of Lane Norton types too much. He’s even admitted it’s difficult to reach his protein goals, which intuitively doesn’t make sense it’s how we optimize health. I love Peter and find him brilliant. But he’s been wrong before too, as we all have.
Good point!!
An issue I have regarding protein intake is the units by which I hear it recommended;
I've heard people say ~1g per kilogram body weight.
I've heard people say ~1g per pound.
A huge difference yet I've heard it reported both ways by seemingly credentialed people.
Why would we care about what's "natural" or "intuitive"? We care about what's optimal. 99% of our lives as humans right now are unnatural and unintuitive to our predecessors, but we are more healthy and live much longer than we ever did. The purpose of high protein intake combined with strength training is to battle the inevitable onset of sarcopenia. We're not mice in cages, we die frequently at old ages from accidents due to frailty. Also, healthspan is impacted tremendously by muscle mass in old age. People that have strong muscles, joints, and bones live more free and unencumbered lives in old age. Though you may be able to increase your lifespan marginally by lower protein intake (maybe), your healthspan will decrease significantly. Not everything is black and white, it's about trade-offs.
@@nichtsistkostenlos6565 what’s most natural is what drives optimal biology. That’s why your Venus fly trap lasts 2 weeks in your apartment. Excessive protein intake (I.e. forcing intake beyond satiety) is not natural. Our average lifespan is longer due to better infant mortality rates, cleaner water and better hygiene.
I lean toward Dr Longo take on protein
Thank you so much for this episode! You two are awesome 🎉 your work is GREATLY appreciated 😎💯
Be interested in Attia's take on the recent Lean Mass Hyper Responder study...his take on statins, ApoB and LDL is not popular with an awful lot of eminent people...!
I'm sure he doesn't want to talk about that! His ego is too big.
Study was conducted by someone pedalling a high fat cookbook 😂 how about a study that doesn't have a massive conflict of interest.
Seriously.....!!@@PatrickMC
@@PatrickMC can you please clarify who you are speaking about what study and what cookbook? Thank you
@@LP-it9jy Yes exactly
summary of "how ApoB predicts heart disease" section
total cholesterol (worst);
LDL cholesterol via Friedewald Formula (good): LDL-C = (TC) - (HDL-C) - (TG/5);
LDL-C "direct" (better);
LDL particles (best) via NMR, or ion motility
ApoB (king)
Thanks!
3 questions for anyone:
1) if you have an optimal level of apoB (whatever that is according to Peter), will you ever have to worry about a cardiac event?
2) Who is a good candidate for a heart CT according to Peter?
3) re family history of ASCVD : what is the cut off age? A cardiac event in the 60s?
I can answer the first question
1) It would be extremely unlikely to suffer a cardiac event as a result of the development of arterial plaque if you had ApoB levels as low as Peter recommends in a normal human lifespan and that was maintained through your entire adult life. If you're talking about at the population level, some people still would, but it would be very rare. Current studies show that below 60 mg/dl, cardiac events are extremely sparse and the data we have even further below that they're essentially non-existent because people just die of some other cause before they even have an event.
You can't get most doctors to test for insulin resistance so how would you know if the statin is causing insulin resistance.
There is no test for insulin resistance
There is a test for how much insulin you have. Mine was 14 which is considered high. However my A1C and glucose were good levels.
That test for how mush insulin your pancreas is creating doesn't measure insulin resistance though @@cindypina4944
@@porkpie2884 There are ways to estimate insulin resistance pretty accurately. HOMA-IR and LP-IR are probably the most practical.
To the OP, you can calculate HOMA-IR yourself if you have your fasting glucose and fasting insulin from a basic blood test.
@@porkpie2884 have a look at the Kraft test...
Great interview👍
So many unanswered questions around women’s hormones 😭 I’m 29 and am experiencing jawline acne only around my cycle, otherwise my skin is wonderful. I have severe mood swings two days before I start my period (I swing from super angry and irritable one day to literally crying and suicidal the next day). My cycles are regular, meaning in time every month. I can’t sleep at all when I’m ovulating. I took 5mg melatonin, 400mg mag glyc and ashwagandha with rhidiola and doesn’t do shit during ovulation but I tried progesterone cream and that gave me the best night of sleep I’ve ever had AND I didn’t have any mood swings or breast tenderness this last period. What gives?! Aren’t I too young to be having to apply progesterone cream? I don’t want to give myself breast cancer but I can’t keep living like that every single month 😭 also my obgyn says my hormones are fine. This is such BS. Only think blood work says is that I have low vitamin D but I take 5,000IU Vit D + K2 consistently so none of this make sense lol I hate it
Getting enough molecular iodine (not iodide from food and salt) has been shown to be important regarding cyclic mastalgia. Progesterone probably helped because your hormones are dysregulated by insufficient iodine/selenium along with maybe a pathogenic environment/diet/mold exposure. Not gonna say it is 100% this because it's pretty common because of flame retardants like bromide blocking iodine from being used in the body. It's really worth looking into.
400mg of Magnesium Glycinate equals about 60mg of elemental magnesium (RDI is 400mg). It's not much if you actually need it. I take 1g of it morning then 1g night (total 290mg elemental Mg). I was deficient from taking Vitamin D for too long and initially got an ironic excitatory reaction from magnesium at night.
I tried metatonin for years. Unless you're old or have some genetic disorder where you can't produce metatonin, it's useless and might actually keep you up at night through a couple different processes. Most melatonin supplements are too much and absorbed too fast. Hormones like that have a very delicate balance and supplements are like a sledgehammer. Only good for changing timezones. We need very little of it. Ashwagandha gave me a hyperthyroid experience (takes a month to fully breakdown ashwagandha). Thyroid is something to think about with that one.
IMHO herbal supplements need to be avoided because they can just make it worse since they do way too many things we don't understand and are often contaminated with pesticides and heavy metals. Focus on molecular iodine, your adrenals and thyroid. Which would need to be worked on by mindfulness/acceptance, diet (eat enough fat) and relaxation (only easy exercise). Insomnia is hell and it took me years to realize that the desire for sleep is a catch-22. Unfortunately the more you want it, the less you get. Mindset is half of everything.
idk if any of this helps or not. Hope you get some relief soon
Maybe try eating and exercising according to your cycle. Women have 3 hormones to support during different phases of her cycle. Estrogen, Testosterone, Progestrone. (start count from first day of bleeding)
Day 1 - 10 - Estrogen (able to withstand lots of HIIT cardio, Intermittent fasting, low carbs diet, keeping blood sugar levels low)
Day 11 - 15 - Testosterone will peak during ovulation (suitable for heavy lifting, resistance training, prolonged water fasts)
Day 16 - 18 - Hormones will take a big dip or "crash" transitioning into Progestrone (start to introduce good carbs, needs higher blood sugar levels to prepare to shed your lining)
Day 19 - 28 - Progestrone (stop fasting, higher carb diet, taper off cardio and do lighter workouts like pilates, yoga, zone 2, long walks, light weights, keeping cortisol low)
Hope that helps!
Please talk about estrogen positive breast cancer and the hesitation to use hrt in survivors of triple positive BC when they reach menopause. Please.....
Recommend seeing a functional doctor.
You might be interested in the work of Ray Peat PhD to find answers to all those questions.
Dr Attia makes it sound like insulin resistance is a main driver of ApoB formation, and that saturated fat intake is less important - I was under the impression that saturated fat intake is more relevant from what research I've seen. Anyone else have research to show me on this?
Please, please get into the detail of sauna and HRT patches. Does excessive sweating like a 70 min sauna yoga session nullify the benefits of the patch thereafter?
I would also love to please hear more about HRT patches and sauna!! Also, Dr Patrick, do you have an opinion about whether sauna during a cold or flu is contraindicated?
You make such a lovely couple both with great minds x
That intro was wild!
Great podcast!
Wow! Amazing 👏
Good job😊
Can’t wait 🎉
I would really like if someone explain the 'french paradox' which is really more of an 'european paradox'. And it does seem that countries that eat more meat and saturated fat has less heart disease.
Dr. Attia stated that a low fat diet lowers blood cholesterol, but thinks that using Statin drugs is a better way to lower blood cholesterol.
Attia is a fraud. Lower cholesterol is not good for us, and statins are very toxic, and increase risk of the very diseases it's claimed they reduce
If I understood right, (and probably I didn’t) he said low fat works to lower cholesterol but it’s probably not a good idea because cutting back on fat can mean increasing intake of(processed) carbs as an energy source. He also said that monounsaturated fats tend to be benign so rule of thumb is cut out saturated fats where you can and add olive oil where you can. Of course all this is made a bit difficult because each person is different. Some people can eat 29 bacon sandwiches a day and be perfectly healthy. For me I found that by cutting down on carbs and especially sugar stuff like triglycerides and overall cholesterol and blood pressure all fell. So my interest is basically should I still aim to eat less saturated fat if my blood test results seem okay with my current diet? Regarding statins it’s not really a fashionable thing to say but it’s probably best to take them if prescribed. Heart disease is a massive killer and statins can help reduce the risk.
You have a lot of things the wrong way around.
Statins increase risk of heart disease, not decrease it.
Saturated fat is not unhealthy.
Lowering cholesterol is bad for us.
Blood sugar causes heart disease, not sat fat or cholesterol
@@MrBlaxjax
@@porkpie2884 look I agree that blood sugar and also added fructose (which is processed into liver fat and not processed by the insulin system) are public enemy number one as far as metabolic health and heart disease go. But really you are being too dogmatic. Saturated fats and bad cholesterol are usually villains too and yes it’s generally a good idea to take statins if prescribed. Some people possibly me seem to get along okay with a high intake of saturated fat. But not everyone. My inference out of everything I understand (which isn’t a lot) is 1 deal with your added fructose intake. Reduce this to less than 30g/ day ( the uk nhs recommendation) 2 cut back on carbs generally and especially ultra processed food type carbs. For me this seems enough.
But for others it won’t be. If you have done all the above and your blood test results are suboptimal then you have to reduce saturated fat and you would just be taking a silly risk by avoiding statins without a very good reason.
@@porkpie2884LOL, 🤡
4 hrs. Love it
An inspiration to me.
She did bring up berberine and he brought up the fact that it a metformin analog. However, there is no conclusion. Is it good or bad?
I wondered same thing
She has spoken of it favorably before. What the conversation missed for lack of time is that we have good hard endpoint data (favorable) for diabetics but very limited data on berberine.
Berberine has helped lower my numbers. I don’t want to take statins. Everyone I know on statins have body aches.
I think the point is that they don't know for sure, but if you're concerned about things like mitochondrial inhibition and/or insulin resistance, then you should be just as worried about berberine as you would be about statins.
@@nichtsistkostenlos6565 I think you miss the point here. Berberine and metformin are used as treatments for type 2 diabetes and insulin resistance. It cannot cause insulin resistance. If berberine has CVD protective effect on top of analog effect like metformin, considering how popular metformin is, then berberine is a shoo in, unless there are other drawbacks with berberine and hence the interest in getting a more nuanced opinion from them
I found the comments regarding Metformin on Lactate to be really interesting. I've been taking Berberine to help with insulin sensitivity and gut health for the past year (I'm not diabetic, but have a family history). This along with other changes last year helped me to drop 40 lbs along with a lot of other benefits. I'm a very active cyclist, and so the lactate threshold comments were interesting to me. I don't feel like I've noticed issues for myself, but I also am not measuring it. Does anyone know if Berberine has similar issues with Lactate production as Metformin?
Great update as usual. I have been reading about colchicine and its new therapeutic use in CAD. Any comments?
Longevity!!!!