By DJ Quinones
Dr. Peter Attia is a physician, researcher, and longevity expert who has dedicated his career to exploring the science of human health and longevity. His medical practice, Attia Medical, is focused on optimizing health span and lifespan. Dr. Attia is known for his evidence-based approach to health and nutrition, as well as his willingness to challenge conventional wisdom in these fields. His 5-day course, "Introduction to my Longevity Topics," is an in-depth exploration of the latest research and insights into the factors that contribute to a long and healthy life. In this article, we'll review the highlights of each day of the course and summarize the key takeaways.
Day 1: Nutritional Biochemistry
The first day of the course focuses on the role of nutrition and metabolism in promoting health and longevity. Attia emphasizes the importance of a low-carbohydrate (e.g. low-carb, Mediterranean, plant-based), high-fat diet for maintaining optimal metabolic health and reducing the risk of chronic diseases such as type 2 diabetes, cardiovascular disease and cancer. In the context of nutrition, the question of which diet works best is not the right question to ask. Instead, the focus should be on determining whether an individual is over-nourished or under-nourished, under-muscled or adequately muscled, and metabolically healthy or not. This creates a 2x2 framework (2 exercises done in 2 sets at a high effort) that informs the strategy and tactics used to work towards nutritional goals.
For instance, if an individual is over-nourished and under-muscled, the strategy would involve inducing an energy deficit while boosting protein intake and engaging in an exercise program aimed at building muscle (which is why programming is so important). Conversely, if an individual is over-nourished, regardless of muscle mass, the strategy would be to create an energy deficit to shed excess body fat.
There are three approaches to creating an energy deficit, namely calorie restriction (CR), dietary restriction (DR), and time restriction (TR). CR involves consistently restricting calorie intake and accurately tracking input, while DR excludes or limits certain foods or macronutrients from the diet. TR involves restricting the number of hours each day in which an individual consumes calories.
Reports of fat loss with a specific diet are common, but the fat loss promoted by any diet has much more to do with the calorie deficit created by restricting foods or macronutrients than with the food or macronutrient restriction itself. As a general rule, the more restrictive a DR strategy, the more likely it is to achieve its ultimate goal: fewer calories consumed.
To begin a longevity journey, one should identify which box they fall into in the 2x2 framework and create a nutrition protocol that propels them towards the goal of being adequately nourished and adequately muscled. By focusing on these aspects of nutritional biochemistry, individuals can develop an approach to nutrition that is tailored to their specific needs and goals.
Day 2: Exercise Physiology
On the second day of the course, Attia delves into the role of exercise and fitness in promoting health and longevity. He emphasizes the importance of both aerobic (training for endurance) and strength training exercises and recommends incorporating both into a well-rounded exercise program to improve overall fitness. He also stresses the importance of avoiding a sedentary lifestyle and maintaining a regular exercise routine. He discusses the importance of monitoring heart rate variability (HRV) as a marker of fitness and recovery. HRV is a measure of the variation in time between consecutive heartbeats and can provide insights into an individual's overall fitness and recovery status.
Dr. Attia defines the concept of longevity as a function of lifespan and health span. Lifespan is simply the number of years a person lives, while health span is about preserving cognitive, physical, and emotional elements of life for as long as possible. To explore the topic of physical function, Attia dives into exercise physiology and answers the question, “How should I exercise to improve my longevity?” Dr. Attia then advises that in order to know how to exercise, individuals must first clarify their objective. The type of exercise needed to break 40 minutes at a local 10K race versus the exercise needed to improve layup accuracy in a pick-up game is different from the exercise needed to be the best version of oneself as one ages. In clarifying his own objective with respect to exercise, Attia arrived at something he calls The Centenarian Decathlon™. In planning for The Centenarian Decathlon™, individuals should begin by identifying a set of activities they would like to be able to do at age 100, such as picking up a child from the ground or carrying groceries up four flights of stairs. To train for The Centenarian Decathlon™, Attia recommends four categories of exercise that he believes provide the most value. These include stability, strength, Zone 2 training (aerobic efficiency), and VO2 max (maximum aerobic output).
Stability is essential for safely transferring force from the body to the outside world and vice versa, and virtually any orthopedic injury can be traced back to some deficiency here. Strength, which means utilizing muscle to generate force, is important for living a long and healthy life and playing with great-grandkids someday. Zone 2 training, defined as the highest metabolic output/work that an individual can sustain while keeping their lactate level below two millimoles per liter, measures peak aerobic efficiency. Lastly, VO2 max is the maximum rate at which muscles can extract oxygen from the blood and put it to metabolic use to generate energy, and it is highly associated with the length of an individual's life.
Attia emphasizes that preserving physical function is critical for maintaining healthspan and living a long and healthy life. While exercise is not the only factor in longevity, it is an essential one. By identifying their goals and training accordingly, individuals can increase their chances of achieving The Centenarian Decathlon™ and preserving their physical function for as long as possible.
Below is a quote from Joe Fox (president and strength coach at TrainSMART Personal Fitness).
“Exercise is medicine, but like medicine, you need to make sure that you’re doing the right exercises in the right doses, and like medicine, your exercises should be prescribed by a professional in order to ensure optimal safety and efficiency. This ensures that you get the most out of your exercise without getting hurt. It may be challenging to find the proper professional. For example, someone who spent $300 to become a certified strength coach is not necessarily a professional.” ~ Joe Fox
Day 3: Sleep Physiology
Dr. Attia admits that he neglected the importance of sleep for many years (following the mindset “I’ll sleep when I’m dead”) until he realized its crucial role in his health. As a student and later in his medical residency, he used to prioritize exercise and studying over getting enough sleep. However, he experienced the negative consequences of sleep deprivation firsthand when he fell asleep twice in the operating room during his residency.
Attia explains that while the immediate and short-term consequences of sleep deprivation (such as falling asleep during an important task) are easy to imagine, chronic sleep deprivation can also contribute to chronic diseases and shorten lifespan. He refers to the "Four Horsemen", which is a metaphorical way of describing the four main drivers of chronic disease that he believes are responsible for most of the health problems we face today. These four horsemen are:
According to Dr. Attia, these four factors are interrelated and can feed off each other to create a vicious cycle of poor health. By addressing each of these factors through diet, lifestyle changes, and other interventions such as correctly applied exercise programming, he believes it's possible to improve health outcomes and prevent or reverse chronic disease.
He acknowledges that the optimal amount of sleep can vary among individuals, but the National Sleep Foundation recommends that adults aim for 7-9 hours of sleep per night. Dr. Attia also suggests that the quality of sleep is just as important as the quantity, and recommends implementing good sleep hygiene practices, such as keeping a consistent sleep schedule, creating a dark and quiet sleeping environment, avoiding caffeine and alcohol close to bedtime, and avoiding screens before sleep.
Dr. Attia also explains how poor sleep can increase the risk of Alzheimer's disease, negatively impact mental health, and impair memory consolidation. Attia also explains the various stages of sleep and the importance of each stage for overall health.
The 5-Day Course highlights the role of sleep in consolidating memories and the potential consequences of poor sleep on memory retention. Dr. Attia explains how sleep deprivation can impair cognitive function, including attention, decision-making, and reaction time, which can have significant consequences in professional and personal life.
Moreover, Dr. Attia discusses the relationship between sleep, hormones, and weight regulation. He explains how sleep deprivation can lead to increased levels of the hormone ghrelin, which stimulates appetite, and decreased levels of the hormone leptin, which suppresses appetite, leading to weight gain and obesity.
Finally, Dr. Attia provides practical recommendations for improving sleep hygiene, including setting a consistent sleep schedule, limiting caffeine and alcohol intake, reducing exposure to electronic devices before bedtime, and creating a comfortable sleep environment. He also discusses the potential benefits of supplements, such as melatonin and magnesium, and sleep-tracking devices to improve sleep quality.
Day 4: Mental And Emotional Health
The fourth day of the course delves into the role of hormones in aging and longevity. Dr. Attia emphasizes the importance of optimizing hormone levels for overall health and highlights the negative impact of hormone imbalances on health and longevity. Dr. Attia discusses the role of testosterone, estrogen, and growth hormone in promoting muscle mass, bone density, and overall health. He also highlights the importance of monitoring hormone levels and working with a qualified physician to optimize hormone levels for optimal health and longevity.
In Peter Attia's Longevity Toolkit, emotional health is a relatively new addition, as he admits that he used to spend little time considering it. However, an "aha moment" question from his therapist, Esther Perel, made him realize the importance of emotional health in living a long and fulfilling life.Perel's question was simple yet powerful: "Do you find it ironic that you spend so much time focused on how to live longer and no time at all trying to be less miserable?" Dr. Attia realized that there was no point in focusing solely on living longer if he and his loved ones were not happy. The quality of our emotional health is closely linked to the quality of our relationships. When we are emotionally struggling, we tend to inflict our misery on those around us. On the other hand, when we take care of our emotional well-being, we can show up for our loved ones in a more positive, meaningful way.
One of the biggest challenges in quantifying emotional health is that there are no scans or biomarkers to measure it. Dr. Attia suggests that the best way to track changes in emotional health is to ask ourselves two basic questions: "On average, how do I feel?" and "On average, how do I make the people around me feel?" Emotional health does not have to decline with age. In fact, Dr. Attia believes that it can even improve as we age. While he does not present himself as an expert on the topic, he invites readers to join him on this part of the journey as he continues to explore and learn about emotional health, as it is a crucial aspect of longevity that should not be overlooked. It is intimately tied to the quality of our relationships and that is why it is vital that we respect our mental and emotional health.
Day 5: Medications and Supplements
On the fifth and final day of his 5-day course on longevity, Dr. Peter Attia explores the topic of medications and supplements. He begins by acknowledging that many people search for a magic elixir or a one-size-fits-all medication or supplement that will cure any ailment or disease. However, he notes that no such elixir exists, and there is no single medication or supplement that is a panacea for all ailments.
Dr. Attia identifies three different perspectives when it comes to medications and supplements: those who will take any medication or supplement but refuse to change their diet or exercise habits; those who are willing to make changes to their diet and exercise habits but refuse to take any medications or supplements; and those who are willing to take over-the-counter (OTC) supplements but refuse to take prescription drugs.He emphasizes that to maximize healthspan and increase lifespan, individuals should be open to using all the tools available to them, including changes to nutrition and exercise habits, prescription drugs when necessary, and careful use of high-quality supplements when indicated.
Dr. Attia stresses that, unlike the other four tactics he has discussed in the course, medications and supplements are highly individualized. It is impossible to offer guidance on who should take what medication or supplement, what the proper dose is, when to take it, and when to stop without knowing the patient's medical history, family medical history, current health status, labs, age, sex, lifestyle factors, and objectives. However, Dr. Attia provides a series of questions to consider when evaluating medications and supplements. The first question is to define the objective clearly. By doing so, individuals can assess whether a particular medication or supplement is the right tool for accomplishing that objective. The second question is to ask whether there is a biomarker to monitor the effectiveness of the treatment over time. If there is no biomarker, it may be necessary to monitor results in other ways. The third question is to evaluate whether the risk outweighs the reward. Some factors to consider when weighing risk vs. reward include the mechanism of action, the patient's years of use, the short- and long-term risks of taking the medication or supplement, as well as the risks of not taking it.
Ultimately, Peter Attia's 5-day course is an invaluable resource for anyone interested in optimizing their health and longevity. Attia's approach is grounded in the latest scientific research and emphasizes a personalized, evidence-based approach to health and wellness. Throughout the course, Dr. Attia covers a wide range of topics, including nutrition, exercise, sleep, stress management, and why all these things are so important.
Some of the key takeaways from the course include the importance of a nutrient-dense, whole-food diet, the benefits of regular exercise, the impact of stress on health, and the role of sleep in overall well-being. Dr. Attia also emphasizes the importance of individualization, recognizing that there is no one-size-fits-all approach to health and wellness. Instead, he encourages each person to experiment and find what works best for them based on their unique needs and circumstances.
Overall, Dr. Attia's course provides a comprehensive and practical guide to optimizing health and longevity, based on the latest scientific evidence. By incorporating the principles and strategies outlined in the course, individuals can take steps to improve their health, prevent disease, and enhance their quality of life.
Below is a quote from Joe Fox (president strength coach at TrainSMART Personal Fitness):
“TrainSMART is all about helping people to move without limitations, stay strong for life, and continue to do the activities and sports they love. Whether it is tennis, golfing, pickleball, running, or being a weekend warrior on the softball diamond, TrainSMART is committed to helping its clients continue to live their best lives. It is tragic to see people lose their ability to do what they enjoy. It gets us excited when clients unsolicitedly tell us they’re stronger than they were 25 years ago.” -Joe Fox
At TrainSMART, we specialize in creating safe, customized programs designed to build muscle and bone, burn fat, increase strength, enhance balance, boost energy levels, and improve cognitive function. As experts in longevity, our intelligent strategies are crafted with your unique needs in mind. Through unwavering commitment and personalized care, we believe you can feel better and stronger than you did 20 years ago.
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At TrainSMART Personal Fitness, we offer a comprehensive approach to wellness by seamlessly integrating Strength Training, Physical Therapy, and Nutrition. As longevity experts, our mission is to help you move without limitations, stay strong for life, and enjoy the activities and sports you love. We believe you can feel better and stronger than you did 20 years ago. Together, we’ll make it happen!
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