<p class="p1"><span class="s1"><a href="https://peterattiamd.com/strong-convictions-loosely-held-2/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220411-pod-epi200&utm_content=220411-pod-epi200-podfeed"> View the Show Notes Page for This Episode</a></span></p> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220411-pod-epi200&utm_content=220411-pod-epi200-podfeed"> Become a Member to Receive Exclusive Content</a></span></p> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220411-pod-epi200&utm_content=220411-pod-epi200-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></span></p> <p class="p2">In this second edition of the "Strong Convictions, Loosely Held" episode, Peter discusses topics on which his thoughts have evolved as a result of his interviews with podcast guests and other information he's gained since episode 100. Peter covers topics including cancer therapy and screening, as well as prevention strategies for cardiovascular disease and Alzheimer's disease. He also describes changes in his perspectives on time-restricted feeding and protein consumption and on the therapeutic use of psychedelics, and he discusses some sleep supplements with remarkable efficacy. He ends with a special discussion on all things Formula 1 racing.</p> <p class="p2"><strong>We discuss:</strong></p> <ul class="ul1"> <li class="li2">The concept of "strong convictions, loosely held" [3:10];</li> <li class="li2">Update on Peter's upcoming book [8:30];</li> <li class="li2">Cancer: the promise of immunotherapy [14:15];</li> <li class="li2">Cancer: how aggressive screening for gastrointestinal cancers could save lives [24:30];</li> <li class="li2">Cardiovascular disease: how early and aggressive lowering of apoB could change the course of ASCVD [31:30];</li> <li class="li2">Alzheimer's disease: genes that modify risk associated with the APOE4 variant [40:15];</li> <li class="li2">Time-restricted feeding: where the benefit comes from, and when this practice can be problematic [44:00];</li> <li class="li2">The common problem of protein underconsumption [51:45];</li> <li class="li2">The tremendous impact of exercise on lifespan and healthspan [54:45];</li> <li class="li2">Peter's shoulder surgery [1:00:15];</li> <li class="li2">An uninspiring viewpoint on NAD precursors as a longevity tool [1:06:15];</li> <li class="li2">Psychedelics: a powerful therapeutic tool in the right setting [1:09:30];</li> <li class="li2">Sleep: updated thoughts on blue light and a remarkable drug for aiding sleep quality [1:13:15];</li> <li class="li2">Book recommendation from Peter [1:20:45];</li> <li class="li2">Formula 1: the 5 variables that determine the winner [1:22:00];</li> <li class="li2">F1: the drivers [1:26:00];</li> <li class="li2">F1: the tires [1:27:30];</li> <li class="li2">F1: the engine and chassis [1:32:00];</li> <li class="li2">F1: rule changes around cars [1:34:15];</li> <li class="li2">F1: importance of qualifying races [1:41:15];</li> <li class="li2">F1: racing strategy [1:47:30];</li> <li class="li2">F1: season outlook and predictions [1:51:00]; and</li> <li class="li2">More.</li> </ul> <p class="p2">Connect With Peter on <a href="https://twitter.com/PeterAttiaMD"><span class="s3">Twitter</span></a>, <a href="https://www.instagram.com/peterattiamd/"><span class="s3">Instagram</span></a>, <a href="https://www.facebook.com/peterattiamd/"><span class="s3">Facebook</span></a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg"><span class="s3">YouTube</span></a></p>
Actionable Insights
1. Embrace Multimodal Exercise
Engage in a broad range of exercise types, as it has an “unbelievable impact” on lifespan and healthspan, likely more than any other intervention, and is accessible to everyone.
2. Aggressive GI Cancer Screening
Be aggressive with screening for gastrointestinal cancers, including colonoscopies and upper endoscopies, as early detection of polyps can prevent colon cancer deaths. Consider colonoscopies every 1-3 years starting around age 40, and advocate for this with your doctor.
3. Aggressively Lower ApoB Early
Aim to lower ApoB levels aggressively and early, ideally to a ceiling of 60 mg/dL (or below the 5th percentile) by your late 30s or early 40s, to significantly reduce the risk of atherosclerotic cardiovascular disease.
4. Increase Daily Protein Intake
Consume more protein than the recommended daily allowance, aiming for closer to two grams per kilogram or about a gram per pound of body weight, as current RDAs are insufficient for thriving and muscle maintenance.
5. Use DEXA for Body Composition
Utilize DEXA scans to accurately track body composition, including fat-free mass index (FFMI), appendicular lean mass index (ALMI), and visceral adipose tissue (VAT), to make informed decisions about diet and exercise.
6. Boost Cardio Fitness & Strength
Prioritize improving cardiorespiratory fitness (VO2 max) and overall strength, as these metrics are strong drivers of mortality reduction and contribute significantly to lifespan and healthspan.
Constantly update your assumptions and beliefs with new information, rather than digging your heels in, as this approach is crucial for evolving understanding in science and medicine.
View psychedelics like psilocybin and MDMA as powerful tools to create vulnerability for deep therapeutic work, rather than standalone cure-alls, and pair them with hard work before and after to achieve lasting benefits.
9. Consider Trazodone for Sleep
Discuss Trazodone (typically 25 to 100 milligrams nightly) with your doctor as a potential sleep aid, as it can produce remarkable sleep quality and duration while preserving sleep architecture, unlike some other medications.
10. Skepticism on NAD Precursors
Remain uninspired by NAD precursors (NR, NMN) for general longevity, as current data does not clearly demonstrate phenotypic benefits in normal aging outside of very pathological states.
11. “Kill Your Babies” in Work
Apply the principle of “killing your babies” in creative or scientific work by relentlessly cutting content that, while interesting, is not essential to the broader point, to improve clarity and impact.
12. Prioritize Mental Calm for Sleep
Focus on reducing mental stimulation from electronics before bed, rather than solely blocking blue light, as the content consumed (e.g., social media vs. relaxing videos) may be a greater disruptor of sleep.
13. Incorporate Intentional Discomfort
Seek appropriate doses of discomfort in your comfortable modern life to recoup benefits for mental and physical health, as constant comfort can have negative outcomes.
14. Train Grip Strength Regularly
Improve grip strength by regularly picking up heavy things and performing dead hangs, as it is a great proxy for overall body strength, muscle mass, and longevity.
15. Request ApoB Blood Test
Ask your doctor to include an ApoB test in your lab work, as it provides a single number for total ApoB concentration and is a better indicator of cardiovascular risk than standard LDL cholesterol.
16. Avoid Ambien for Sleep
Do not use Ambien for sleep, as it renders you unconscious but reduces slow-wave/deep sleep, trading quality sleep for low-quality sleep and potentially causing memory alterations.
17. Use BFR & Isometrics for Recovery
In the context of recovery from injury or surgery, consider using blood flow restriction (BFR) training and isometric exercises to get muscles to work without putting stress on the joint.
18. Provide Podcast Feedback
Send a message to the podcast team if you have strong opinions on topics like Peter reading the audiobook, as feedback helps shape future content.
19. Watch “Drive to Survive” (F1)
Start watching the Netflix series “Drive to Survive” (seasons 1 or 3 recommended) to gain an understanding of Formula One, its teams, drivers, and dynamics.
20. Read “The Comfort Crisis”
Read Michael Easter’s book “The Comfort Crisis” to explore how modern comfort negatively impacts mental and physical health and how to strategically reintroduce discomfort.