<p><a href="https://peterattiamd.com/ama68/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250217-pod-ama67&utm_content=250217-pod-ama68-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250217-pod-ama68&utm_content=250217-pod-ama68-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250217-pod-ama68&utm_content=250217-pod-ama68-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this "Ask Me Anything" (AMA) episode, Peter tackles a diverse set of listener-submitted questions, covering a wide range of health and performance topics. He dives into assessing cardiovascular health, discussing key biomarkers and risk factors, and breaks down various fasting approaches, including time-restricted eating and prolonged fasting. The conversation also explores the impact of alcohol on health and disease risk, fundamental principles of nutrition, and optimal protein intake. Additionally, he examines the pros and cons of ketogenic and low-carb diets, strategies for building effective exercise routines, and the role of wearables in tracking health metrics. The episode concludes with insights on emotional health, making this a well-rounded discussion packed with practical takeaways for anyone looking to optimize their well-being.</p> <p>If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250217-pod-ama68&utm_content=250217-pod-ama68-podfeed">private RSS feed </a>or our website at the <a href="http://peterattiamd.com/ama68/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250217-pod-ama68&utm_content=250217-pod-ama68-podfeed">AMA #68 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250217-pod-ama68&utm_content=250217-pod-ama67-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Episode format: overview of common health topics based on listener questions [1:30];</li> <li>How to accurately assess your cardiovascular health [3:00];</li> <li>The impact of fasting, time-restricted eating, and dietary restriction on metabolic health [9:00];</li> <li>Alcohol: health risks of consumption, limitations of research, and how to weigh the risks against social and personal enjoyment [13:45];</li> <li>Principles of a well-balanced diet: macronutrients, micronutrients, protein, energy balance, and more [23:45];</li> <li>The benefits and drawbacks of ketogenic diets: impact on satiety, metabolic health, athletic performance, lipid levels, and more [29:15];</li> <li>Protein: best sources for muscle growth, total intake, PDCAAS scoring system, and getting adequate amounts on plant-based diets [36:15];</li> <li>Creating an effective fitness routine that fits into a busy schedule [41:45];</li> <li>The role of rest and recovery in a workout routine [46:00];</li> <li>How to track fitness progress beyond just weight on a scale [48:30];</li> <li>The best low-impact exercises for individuals with joint issues [52:00];</li> <li>Wearables: insight vs. compliance, and how to use them effectively [54:45];</li> <li>How to evaluate the risks and benefits of medical interventions: procedural risks, complication rates, and asking informed questions [59:00];</li> <li>Sleep: impact on metabolic and cognitive health, and tips for improving sleep quality [1:03:45];</li> <li>How to identify and address emotional health challenges [1:08:30]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Stop Smoking
Eliminate smoking entirely, as it causes an enormous increase in your risk of cardiovascular disease.
Actively manage and improve your metabolic health, including conditions like hyperinsulinemia, insulin resistance, and type 2 diabetes, to significantly reduce your risk of cardiovascular disease.
3. Prioritize Calorie Restriction
To improve metabolic health, focus on restricting total caloric intake, as this is the primary factor that provides the greatest benefit, regardless of the method used.
4. Consider Alcohol Abstinence
Seriously consider abstaining from alcohol entirely, as it is not an essential nutrient, provides no inherent health benefits, and is associated with increased mortality and disease risk.
5. Understand Family History
Thoroughly investigate your family history for cardiovascular disease, asking specific questions about how relatives lived and died, including medication use for cholesterol or blood pressure, to identify potential heritable risks like LP little a or familial hypercholesterolemia.
6. Measure Blood Pressure Correctly
Accurately assess your blood pressure by resting for five minutes before checking, using a correctly fitting cuff at mid-chest level, not crossing your legs, and taking duplicate or triplicate readings twice a day for a couple of weeks, once a year. Aim for readings below 120/80 mmHg.
7. Focus on APOB and LP(a)
Assess your cardiovascular risk by prioritizing your lipid profile, specifically APOB and LP little a levels, as these are the most critical markers for atherogenic proteins, making other cholesterol metrics less important.
8. Manage Triglycerides (If High)
Monitor triglyceride levels, but only manage them if they are dramatically elevated (north of 400 mg/dL), as levels below this threshold are less concerning once APOB and LP(a) are known.
9. Consider a Calcium Scan (CAC)
Evaluate for existing arterial damage by considering a calcium scan (CAC), which can indicate advanced disease and the presence of plaque, though a zero score has a 15% false negative rate.
10. Experiment with Calorie Methods
Try different calorie reduction techniques—direct counting, time-restricted feeding, or dietary restriction—to discover which method best suits your lifestyle and preferences, understanding each has distinct pros and cons.
11. Be Judicious with Alcohol
If you choose to consume alcohol, do so judiciously and critically evaluate if it negatively impacts other aspects of your life, such as sleep quality or eating habits.
12. Limit Daily Alcohol Intake
If consuming alcohol, limit intake to conservatively one drink per day to minimize potential health risks, acknowledging that women generally fare worse with alcohol than men.
13. Avoid Alcohol Before Bed
Refrain from drinking alcohol too close to bedtime, as it is known to disrupt sleep quality, which can be observed using sleep trackers.
14. Mind Alcohol’s Caloric Load
Be aware that alcohol is a calorie-dense nutrient (7 kcal/gram) and can contribute significantly to your total caloric intake, especially if you are a moderate to heavy drinker.
15. Moderate Social Drinking
If consuming alcohol for social enjoyment, a pattern of three or four beers a couple of times a month is considered by the speaker to be ‘probably not that bad’.
16. Do Not Use CIMTs
Avoid using Carotid Intima-Media Thickness (CIMT) tests for cardiovascular risk assessment, as they are not considered sufficiently helpful or supported by data.