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How To Live A Long & Healthy Life with Dr Peter Attia #389

Oct 3, 2023 2h 15m 29 insights
Imagine yourself in the last decade of your life. What would you like to be able to do? I’m talking about the simple stuff, such as walking up a flight of stairs without losing your breath or picking up your grandchild. How about being able to stand up unaided, after sitting comfortably on the floor? Or simply being able to get yourself on and off the toilet with ease? It’s so easy to assume these everyday movements will still be easy when we’re old. But my guest this week wants us to get real to the fact they probably won’t – unless we take action now. Dr Peter Attia is a medical doctor and founder of the Early Medical Practice, a private clinic in America, which helps patients lengthen their lifespan and improve their ‘healthspan’. He is the author of the New York Times bestseller: Outlive: The Science and Art of Longevity. In our first conversation (Ep 356) Peter explained how years of research have shown him that physical activity is the number one predictor of longevity. In this new episode, we unpack what that means and what strategies you can use to live a long and healthy life. Peter explains a concept that he calls the Centenarian Decathlon – a novel, but specific way of thinking about the various forms of movement we might require IF we want to be strong, fit, and active in our later years. He explains you need to be a good generalist with a high peak cardiorespiratory fitness, a wide aerobic base, functional strength, and good levels of stability, and why each of those metrics is important and how we can start improving them. If you’re in your 30s, 40s, 50s, or 60s – then training today for your twilight years might seem too distant a goal to feel motivating. If you’re active now, it’s easy to think you’ll be fine by then. But, Peter says, you’re kidding yourself if you think that your day-to-day function will not decline, as you get older. And, so he wants to empower us and demonstrate what we need to do today, to ensure we will have the life we want later. We also cover resistance training, Zone 2 training, grip strength, and foot strength, training for teenagers, training for women around menopause and so much more. This is an insightful episode, full of practical advice and wisdom. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore or via https://fblm.supercast.com. Thanks to our
Actionable Insights

1. Define Your Centenarian Decathlon

Identify 10 specific physical activities you want to be able to perform in the last decade of your life, as this provides a concrete framework for current training and future goals.

2. Embrace Exercise Responsibility

Understand that living in the modern world, which has removed the need for natural movement, comes with a huge responsibility to deliberately exercise and go ‘above and beyond’ to compensate.

3. Adopt a Generalist Exercise Approach

Train as a ‘generalist’ by developing high peak cardiorespiratory fitness, a wide aerobic base, high levels of strength, and great stability to prepare for the diverse physical demands of later life.

4. Prioritize Strength and VO2 Max

Focus on improving both strength and VO2 max, as these two metrics have the most undeniable data and strongest signals for predicting longevity and reducing all-cause mortality.

5. Train for Future Function Now

Recognize that physical decline is inevitable with age; therefore, you must train today to build a buffer and ensure you can perform desired activities in your later years.

6. Lift Heavy Weights Regularly

Engage in heavy weightlifting at every age, for both men and women, to maintain type 2 (fast-twitch) muscle fibers, which are crucial for power, fall prevention, and bone mineral density.

7. Master Zone 2 Cardio Training

Incorporate Zone 2 cardio, the highest exertion level you can sustain while keeping lactate below 2 millimole, to enhance mitochondrial efficiency and build a wide aerobic base.

8. Build Grip Strength with Farmer’s Carry

Perform farmer’s carries (walking with heavy weights in your hands) as a functional exercise to improve overall strength and grip strength, which is a strong proxy for overall strength and longevity.

9. Encourage Teen Strength Training

Encourage teenagers and young adults to lift heavy weights to achieve their genetic potential for bone mineral density by their early 20s, as bone density naturally declines thereafter.

10. Women: Prioritize Strength Training

Women, especially around menopause, must prioritize strength training to combat the natural decline in muscle mass and bone mineral density, which is exacerbated by estrogen loss.

11. Practice Self-Compassion & Consistency

Avoid negative self-judgment after a missed workout or unhealthy meal; instead, give yourself a ’total pass’ and focus on getting back on track with the very next meal or workout to prevent a negative spiral.

12. Address Underlying Behavior Drivers

Before attempting to change a behavior, understand its underlying purpose or emotional driver (e.g., emotional hunger, stress) to implement more effective and sustainable strategies.

13. Cultivate Emotional Health

Recognize that unresolved emotional issues, including ’little t’ trauma, can lead to maladaptive behaviors that undermine physical health and compromise interpersonal relationships, happiness, and joy.

14. Practice Forgiveness for Health

Consider practicing forgiveness, not for others, but for your own well-being, as letting go of anger and resentment can positively impact physical health metrics like blood pressure and reduce sympathetic tone.

15. Start with Any Movement

Remember that any movement is better than none, and generally, the more you move, the better, providing an accessible starting point for improving health.

16. Broaden Your Exercise Approach

Evaluate your current exercise routine and consider diversifying it to include a wider range of activities that address all four pillars of fitness (VO2 max, strength, zone 2 cardio, and stability).

17. Gauge Zone 2 Cardio Intensity

To ensure you’re in Zone 2, aim for an exertion level where you can speak in full sentences, but it feels uncomfortable and you don’t want to, indicating optimal aerobic efficiency training.

18. Apply 80/20 Rule to Cardio

Allocate approximately 80% of your cardio training time to Zone 2 and 20% to much higher intensity workouts to optimize results, prevent overtraining, burnout, and injury.

19. Optimize VO2 Max Intervals

For high-intensity VO2 max training, aim for work intervals of 3 to 8 minutes, followed by an equal duration of recovery, as this is the ‘sweet spot’ for maximizing VO2 max.

20. Improve Foot Strength

Consider wearing minimalist shoes for daily activities, as this can significantly increase foot strength by allowing your feet to do more work compared to cushioned, restrictive footwear.

21. Incorporate Rucking for Conditioning

Add rucking (walking with a heavy-weighted backpack, especially on hills) to your routine as an effective way to combine conditioning and strength training.

22. Set Health Goals, Not Just Problems

Shift your perspective from merely addressing health problems to proactively setting clear, specific goals for your ‘marginal decade’ and the next 12 months to guide your health journey.

23. Prioritize Time Over Money for Health

Recognize that dedicating consistent time to health-promoting behaviors (e.g., an hour a day for exercise) is ultimately more impactful for longevity than financial resources or access to advanced clinics.

24. De-emphasize Over-reliance on Blood Tests

Understand that blood tests are only one of many inputs for assessing health risk and have significant blind spots, so avoid over-indexing on them and consider a broader range of metrics.

25. Individualize HRT Decisions for Women

For women considering Hormone Replacement Therapy (HRT), make an individualized decision based on the severity of vasomotor symptoms, personal concerns, and a balanced assessment of risks and benefits, such as bone protection versus breast cancer screening.

26. Insight 26

Aim to be in the top 5% of VO2 max for someone 10 to 20 years younger than yourself to ensure thriving in your final decade of life, understanding that most people can reach at least the top 25%.

27. Insight 27

If you are a woman in your 40s, aim to carry 75% of your body weight (split between hands) for one minute in a farmer’s carry to ensure sufficient strength for daily tasks in later life.

28. Insight 28

If you are a man in your 40s, aim to carry 100% of your body weight (split between hands) for one minute in a farmer’s carry to ensure sufficient strength for daily tasks in later life.

29. Insight 29

When lifting weights, aim for sets where you are 1-2 repetitions short of failure (1-2 reps in reserve) to effectively recruit type 2 muscle fibers and build strength.