← The Peter Attia Drive

Longevity 101: a foundational guide to Peter's frameworks for longevity, and understanding CVD, cancer, neurodegenerative disease, nutrition, exercise, sleep, and more (re-broadcast)

Oct 27, 2025 1h 25m 28 insights
<p><a href="https://peterattiamd.com/longevity101/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=240729-pod-longevity101&amp;utm_content=240729-pod-longevity101-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=240729-pod-longevity101&amp;utm_content=240729-pod-longevity101-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=240729-pod-longevity101&amp;utm_content=240729-pod-longevity101-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this special episode, Peter provides a comprehensive introduction to longevity, perfect for newcomers or those looking to refresh their knowledge. He lays out the foundational concepts of lifespan, healthspan, and the marginal decade. Additionally, Peter discusses the four main causes of death and their prevention, as well as detailing the five key strategies in his longevity toolkit to improve lifespan and healthspan. Detailed show notes provide links for deeper exploration of these topics, making it an ideal starting point for anyone interested in understanding and improving their longevity.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Key points about starting exercise as an older adult [2:45];</li> <li>Overview of episode topics and structure [1:45];</li> <li>How Peter defines longevity [3:45];</li> <li>Why healthspan is a crucial component of longevity [11:15];</li> <li>The evolution of medicine from medicine 1.0 to 2.0, and the emergence of medicine 3.0 [15:30];</li> <li>Overview of atherosclerotic diseases: the 3 pathways of ASCVD, preventative measures, and the impact of metabolic health [26:00];</li> <li>Cancer: genetic and environmental factors, treatment options, and the importance of early and aggressive screening [33:15];</li> <li>Neurodegenerative diseases: causes, prevention, and the role of genetics and metabolic health [39:30];</li> <li>The spectrum of metabolic diseases [43:15];</li> <li>Why it's never too late to start thinking about longevity [44:15];</li> <li>The 5 components of the longevity toolkit [46:30];</li> <li>Peter's framework for exercise—The Centenarian Decathlon [47:45];</li> <li>Peter's nutritional framework: energy balance, protein intake, and more [58:45];</li> <li>Sleep: the vital role of sleep in longevity, and how to improve sleep habits [1:08:30];</li> <li>Drugs and supplements: Peter's framework for thinking about drugs and supplements as tools for enhancing longevity [1:13:30];</li> <li>Why emotional health is a key component of longevity [1:17:00];</li> <li>Advice for newcomers on where to start on their longevity journey [1:19:30]; 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. Prioritize Emotional Health

Actively work on improving emotional health, managing stress, fostering happiness, and building better relationships. This area is foundational, potentially more important than others, because without it, other longevity tactics may not matter.

2. Focus on Healthspan for Lifespan

Pursue improvements in your physical, cognitive, and emotional health, as these efforts simultaneously enhance both your healthspan (how well you live) and your lifespan (how long you live). Relentlessly focusing on strength, endurance, balance, cognitive function, and relationships can optimize your lifespan.

3. Define Your Centenarian Decathlon

Create a mental model of the most important activities you want to perform in the last decade of your life. Define the necessary physical traits for these activities and ‘back-cast’ your current training to increase the probability of achieving those goals at the highest level.

4. Build Foundational Stability

Focus on retraining and improving stability, which includes motor control, coordination, balance, and the ability to dissipate and receive force. This involves learning appropriate intra-abdominal pressurization, rib unlocking, maintaining a center of gravity, isometric contractions, and good foot mechanics, as these are highly plastic and retrainable.

5. Develop Strength and Power

Actively work to develop and maintain strength and power, building upon a foundation of stability. This is crucial to counteract age-related decline, as power is lost quickly with age, and strength is essential for overall physical function.

6. Enhance Cardiorespiratory Fitness

Improve your cardiorespiratory fitness by focusing on both aerobic efficiency (your ‘all-day pace’ and maximum fat oxidation) and VO2 max (your peak aerobic output or ’engine size’). These two components form a continuum essential for overall endurance and health.

7. Prioritize Energy Balance in Nutrition

Make energy balance (total caloric intake) the single most important input from nutrition to your overall health, as it is the first-order determinant. While diet quality matters, managing total calories is paramount.

8. Ensure Adequate Protein Intake

Consume approximately 1.6 grams of protein per kilogram of body weight daily, as protein is the macronutrient on which you should be least flexible. Be aware that these requirements may increase with age due to anabolic resistance.

9. Self-Assess Nutritional State

Evaluate your body composition (subcutaneous and visceral fat, muscle mass) and metabolic health (glucose disposal) to determine if you are overnourished, undernourished, or adequately muscled. This assessment guides whether you need to eat more, less, or the same total energy and protein.

10. Choose Caloric Reduction Strategy

If you need to reduce caloric intake, select one or a combination of three strategies: directly reducing total calories, dietary restriction (removing specific foods), or time-restricted eating (limiting your eating window).

11. Prioritize Quality Sleep

Recognize that short-term sleep deprivation severely impairs cognition, physical performance, metabolic health (e.g., insulin resistance), and appetite. Prioritize sleep to avoid these widespread negative impacts on your body.

12. Implement Core Sleep Hygiene

Establish a consistent sleep and wake-up time daily, aim for eight hours in bed, ensure your room is as dark and cold as possible, and detach from stimulating or upsetting activities (work, social media) for two hours before bed.

13. Avoid Late-Night Eating and Alcohol

Refrain from eating or consuming alcohol for at least three hours before bedtime to improve sleep quality.

14. Seek Professional Sleep Help

If behavioral tools are insufficient for sleep problems, consider consulting a sleep physician or exploring cognitive behavioral therapy for insomnia (CBT-I), as specialized medical and therapeutic options are available.

15. View Drugs and Supplements as Tools

Approach drugs and supplements as tools, similar to a contractor using various instruments. The goal is to have the right tools and know how and when to use them effectively, rather than avoiding them entirely or relying on them exclusively.

16. Rigorously Evaluate Drugs and Supplements

Before taking any exogenous molecule, apply a rigorous framework: determine if it targets lifespan or healthspan, if it’s disease-specific or broadly protective, assess safety and efficacy data (especially in humans), and for supplements, verify purity and what the bottle claims.

17. Prevent Cardiovascular Disease Actively

Focus on preventing cardiovascular disease by reducing APOB particles, protecting your endothelium (avoid smoking, manage blood pressure, improve metabolic health), and reducing inflammation through nutrition, sleep, and exercise.

18. Avoid Smoking and Obesity for Cancer

Significantly reduce your risk of cancer by avoiding smoking and managing your weight to prevent obesity, as both are clear environmental triggers for many cancers.

19. Manage Growth Factors to Reduce Cancer

Address obesity-related factors such as inflammation and elevated growth factors like insulin and IGF, as these are more likely to drive increased cancer risk.

20. Engage in Early Cancer Screening

Given the challenges in cancer treatment and the role of ‘bad luck’ in mutations, prioritize early and aggressive screening to detect cancers at their most treatable stages.

21. Apply Heart Health for Brain Health

Implement interventions that lower the risk of atherosclerotic cardiovascular disease, such as improving metabolic health, lowering ApoB, reducing blood pressure, and not smoking, as these also dramatically reduce the risk of dementia.

22. Exercise for Neurodegenerative Prevention

Recognize that exercise has a greater magnitude and confidence of benefits in preventing neurodegenerative diseases than other interventions, making it a critical component of brain health.

23. Build Cognitive and Movement Reserve

Actively work to increase your cognitive and movement reserve, as higher reserves in these areas enhance your resilience and ability to withstand the effects of neurodegenerative conditions.

24. Prevent Metabolic Disease

Avoid overnutrition and energy imbalance, as these are the primary drivers of insulin resistance and subsequent metabolic diseases like fatty liver and type 2 diabetes. These diseases amplify the risk of other ‘horsemen of death’ by 25-50%.

25. Start Longevity Efforts Any Age

It is never too late to begin taking committed steps towards health, even in your seventies or eighties. Start slower, prioritize injury prevention, and adapt programs to your current capabilities, as significant improvements are possible.

26. Pick One Area to Start

If feeling overwhelmed by the breadth of longevity information, choose just one area that resonates and where you feel you can achieve success (e.g., sleep). Focusing on one win builds confidence and agency, making it easier to address other areas later.

27. Share Longevity 101

Share this foundational ‘Longevity 101’ episode with friends who are new to these topics or need an introduction, to help them get up to speed on core frameworks and tactics.

28. Consider Premium Membership

If you want to deepen your knowledge of longevity, consider subscribing to the premium membership for exclusive content, detailed show notes, AMA episodes, and a premium newsletter.