→ Join us on Patreon ← Dr. Peter Attia, MD is the founder of Attia Medical, PC, a medical practice that focuses on increasing healthspan by minimizing the risk of chronic disease and preserving quality of life. Peter trained for five years at Johns Hopkins in general surgery and then spent two years at NIH as a surgical oncology fellow.  He has since been mentored by some of the most experienced and innovative physicians and scientists in the US and Canada. On this podcast Dr. Tommy Wood, MD talks with Peter about the critical components of lifespan and healthspan, including the factors he has identified as most important. They also discuss the controversial role of statin medication and take a close look at the necessity and sufficiency of risk factors for atherosclerosis. If you want to learn more about Peter’s work, he has a blog, a podcast and an active social media presence. Here’s the outline of this interview with Peter Attia: [00:00:35] Mellow Johnny’s Bike Shop. [00:04:01] Eddy Merckx. [00:04:16] Healthspan. Video: Peter Attia - Reverse engineered approach to human longevity. [00:05:23] Components of healthspan: cognitive, physical, emotional. [00:07:21] Lewis Hamilton; Ayrton Senna. [00:08:35] Reverse engineering healthspan. [00:11:34] Strength, power, aerobic and anaerobic fitness, flexibility. [00:14:57] Injuries affecting healthspan. [00:16:27] Exercise dosing studies: Marshall, Simon J., et al. "Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes." American journal of preventive medicine 36.5 (2009): 410-415; Merghani, Ahmed, Aneil Malhotra, and Sanjay Sharma. "The U-shaped relationship between exercise and cardiac morbidity." Trends in cardiovascular medicine 26.3 (2016): 232-240. [00:17:26] Atrial fibrillation; mitochondrial injury. [00:18:39] Study: Nakayama, Hiroyuki, and Kinya Otsu. "Mitochondrial DNA as an inflammatory mediator in cardiovascular diseases." Biochemical Journal 475.5 (2018): 839-852. [00:19:28] Functional threshold power (FTP). [00:23:58] Podcast: The High-Performance Athlete with Drs Tommy Wood and Andy Galpin. [00:23:59] Twin study: Bathgate, Katherine E., et al. "Muscle health and performance in monozygotic twins with 30 years of discordant exercise habits." European journal of applied physiology 118.10 (2018): 2097-2110. [00:24:50] The emotional component of healthspan. [00:24:56] The Drive Podcast: Paul Conti, M.D.: trauma, suicide, community, and self-compassion. [00:25:59] Dave Feldman; Podcast: How to Drop Your Cholesterol. [00:26:40] Sam Harris: Meditation. [00:29:30] Video: Commencement speech by David Foster Wallace from 2005 at Kenyon College, This is Water. [00:30:45] Vulnerability as a practitioner. [00:33:46] Time-restricted feeding. [00:34:23] Continuous glucose monitoring (CGM); Oura ring. [00:35:38] Factors contributing to longevity: deprivation of calories and rapamycin. [00:37:54] Benefits of fasting. [00:41:04] Free T3:Reverse T3 ratios during fasting. [00:42:50] Study: Finkelstein, Joel S., et al. "Gonadal steroids and body composition, strength, and sexual function in men." New England Journal of Medicine 369.11 (2013): 1011-1022. [00:43:30] Robert Lustig. [00:45:07] Multi-Ethnic Study of Atherosclerosis (MESA). [00:46:09] Statins; side effects. [00:48:36] Lipoprotein(a) - Lp(a). [00:49:19] Coronary Artery Calcium (CAC) scan. [00:54:03] The Drive podcasts: Dave Feldman, Ron Krauss, Tom Dayspring: (parts 1, 2, 3, 4, 5). [00:54:32] Risk factors for atherosclerosis: necessity and sufficiency. [00:56:16] Lead study: Lanphear, Bruce P., et al. "Low-level lead exposure and mortality in US adults: a population-based cohort study." The Lancet Public Health 3.4 (2018): e177-e184. [00:59:03] LDL cholesterol; ApoB. [01:01:15] Familial Hypercholesterolemia (FH). [01:04:41] Hyper-responders. [01:06:25] Saturated fat/cholesterol study: Jones, P. J., A. H. Lichtenstein, and E. J. Schaefer. "Interaction of dietary fat saturatio