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    360. Obesity, Diabetes, Cancer and You | Dr. Peter Attia

    enMay 25, 2023

    Podcast Summary

    • Healthspan for a Better Quality of LifePrioritizing healthspan over lifespan is key to a better quality of life. Regular exercise, such as cardiovascular fitness and weightlifting, and interventions like writing about past traumas and future plans can improve cognitive, physical, and emotional health. Dr. Peter Adia's book, Outlive, stresses the importance of exercise for longevity.

      Healthspan is a key component of longevity that focuses on quality of life rather than just length of life. It includes cognitive, physical, and emotional health, and is maintained through exercise and interventions that help people get their story straight. Maintaining cardiovascular fitness and weightlifting are effective methods to preserve cognitive function. Writing about past traumas and future plans can help reduce stress and improve emotional health. Dr. Peter Adia's book, Outlive, explores the Science and Art of Longevity and emphasizes the immense benefits gained from exercise in just three hours a week for a better quality of life.

    • The Importance of Exercise for Cognitive Health and Preventing DementiaExercise can improve various aspects of health, including cognitive health, and even small changes like a 10-minute daily walk can have significant benefits. Non-exercisers should consider adding exercise to their routine to enhance overall health.

      Exercise is the most important tool to improve cognitive health and prevent dementia. It acts on different levels like metabolic parameters, reduction of inflammation, vascular health improvements and production of neurotropic growth factors, making it a potent tool for neurons. Going from no exercise to three hours a week approximately reduces all cause mortality by 50%. For non-exercisers, this is a powerful piece of information they might not know. To implement an exercise routine, the simplest possible change that produces maximal benefit could be 10 minutes of daily walk in the morning. Doing 90 minutes of low intensity cardio for about six times a week could be the most effective way to improve overall health.

    • Tips to Improve Fitness and LifespanStart with small changes such as 4 minutes of walking every morning and gradually increase. Aim for 90 minutes of moderate exercise weekly. Focus on building muscle mass and peak cardio respiratory fitness to positively impact lifespan. Small changes maintained over time can make a significant difference in overall health.

      To improve your fitness level, aim for 90 minutes a week of exercise where you are out of breath enough that you can barely carry out a conversation. Start with small changes such as walking around the block for 4 minutes every morning and gradually increasing time. The behavior change will help in the long run. Also, muscle mass and peak cardio respiratory fitness are two integral functions that can positively impact your lifespan. VO2 max, a measure of peak cardio respiratory fitness, is the most highly correlated metric to one’s length of life. Small changes that are maintained can make a significant difference in one’s overall health.

    • The Importance of Strength and Muscle Mass for LongevityBuilding and maintaining strength and muscle mass is crucial for living a longer life. Adding weightlifting exercises and rucking can help delay muscle loss and stress the body more effectively than just walking.

      Strength and muscle mass are essential for a longer life as they are potent predictors of longevity. They are far more potent than negative predictors like smoking, type two diabetes, hypertension, and even cancer. As we age, sarcopenia or muscle mass loss starts to occur, resulting in a decline of overall strength. Delaying this loss is crucial for living a longer life. Cardiovascular exercise is also important, but brisk walking may not be sufficient to produce enough stress. Rucking or carrying a military-type backpack with weight plates helps stress the cardiorespiratory system without adding pressure on knees. Adding weightlifting exercises can help in building strength and muscle mass.

    • Benefits of Starting Weightlifting with Dumbbells and Step UpsStarting with body weight box step ups at a 12-inch height can improve eccentric strength, preventing falls in old age and improving mobility. Adding weights or height as strength increases and carrying dumbbells improves grip and upper body strength. Standardized diabetes testing is crucial for accurate prevalence rates.

      Starting weightlifting with just a couple of dumbbells and step ups can improve eccentric strength, preventing falls in old age and improving mobility. Box step ups with a height such that the front leg is parallel to the ground are recommended, starting with body weight at 12 inches. Adding weights or increasing the height can be done as strength increases. Carrying dumbbells improves grip strength and upper body strength. Diabetes testing should not be age-adjusted as it masks the true prevalence of the disease, which is already devastatingly high. Holding everyone to the same standard is important.

    • Insulin Resistance and Aging: Maintaining Glucose and Insulin Levels.As we age, insulin sensitivity declines making it important to regulate glucose and insulin levels to avoid age-related diseases. Physical activity and testosterone help promote insulin sensitivity to maintain metabolic health.

      Insulin resistance is a common phenomenon associated with aging. As we age, there is a decline in insulin sensitivity, making it important for us to maintain our glucose and insulin levels to avoid age-related degenerative diseases. Women are given a little more latitude during an oral glucose tolerance test as they have less muscle mass than men. Testosterone, a pro-metabolic hormone, promotes insulin sensitivity and lipolysis, and its decline with aging also plays a role in insulin resistance. Being physically active plays a crucial role in preserving insulin sensitivity. Excess glucose needs to be regulated carefully, and a healthy person has only a teaspoon of glucose circulating in their body at any given time.

    • The Cascade of Metabolic Disease and the Dangers of Excess Fat and Insulin ResistanceExcess fat leads to insulin resistance and high blood sugar, causing damage to blood vessels and increasing the risk of serious conditions like kidney disease and heart disease. Chronically elevated insulin levels also increase the risk of obesity and cancer, while exceeding the body's capacity for subcutaneous fat storage can lead to metabolic issues.

      Insulin resistance and type two diabetes come from a cascade of metabolic disease that starts with excess fat spilling into areas it shouldn't, like the muscle, liver, and pancreas. High blood sugar due to this excess fat and insulin resistance is bad for small blood vessels and can lead to end stage kidney disease, coronary artery issues, and erectile dysfunction. Chronically elevated insulin levels can damage large and medium blood vessels and is a pro-growth factor that can lead to obesity and cancer. To store energy, our bodies have a depot of subcutaneous fat, but exceeding its capacity leads to the propagation of fat tissue and other metabolic issues.

    • The Impact of Excess Fat and Carbohydrates on Our Health and Organs.Excessive fat storage in the wrong places and consuming excess carbohydrates can lead to obesity, insulin resistance, and other health issues. It's essential to focus on the quality and quantity of food to maintain a healthy energy balance.

      Excess fat storage in the wrong places can have detrimental effects on our organs and health. The liver plays a crucial role in turning glucose into fat and protein into glucose, which can lead to obesity and insulin resistance. The food pyramid, which encouraged a carbohydrate-heavy diet, may have contributed to the obesity epidemic. However, consuming excess carbohydrates is not necessary for everyone and can lead to health issues. It's important to pay attention to the quality and quantity of the food we eat to maintain a healthy balance of energy.

    • The Consequences of the Standard American DietThe standard American diet was created to be cheap and tasty, but with no attention to the health implications. This has resulted in the obesity and diabetes epidemic. The food industry also hides the effects of junk food on our appetite.

      The standard American diet, created to solve a business problem, is responsible for the obesity and diabetes epidemic. The diet was designed to be non-perishable, portable, cheap, and palatable, with no attention paid to its health implications. The food pyramid was a product of this design, and while it solved the problem of under-nutrition, it also led to overeating and ill health. The food industry is not honest about the impact of junk food on appetite, and while some people can manage it in small amounts, most struggle with overeating and addiction to hyper palatable foods.

    • The Disconnect between Modern Diets and True Nutritional NeedsOur bodies are hardwired to seek out certain nutrients and when we don't get enough, we tend to overeat. The modern diet high in calorie-dense foods leads to health problems, but elimination diets and testing for food triggers can help improve symptoms.

      Our modern diet, which is high in calorie-dense foods, disconnects us from our true driver of appetite and nutritional needs. Researchers hypothesize that we are hardwired to get a certain amount of nutrient value, protein, and other nutrients, and when we do not get them, we tend to overeat. However, being opportunistic omnivores worked for our ancestors who were wildly active, but it does not work for us anymore, leading to overeating and health problems. For some people, carnivore diets, which consist of beef, have shown remarkable effects on weight loss and reducing disease symptoms. Elimination diets and testing for immunological reactions to food can help identify specific triggers and improve symptoms.

    • Jordan Peterson's High-Fat Meat Diet for Maintaining Youthful BodyPeterson's beef-based diet helped him maintain his physique and improve muscle tone. However, it's important to consult with a nutritionist before experimenting with such diets.

      Jordan Peterson experimented with a diet which helped him maintain the same essential body morphology he had when he was 23 even at 60. He eats a lot of high-fat meat and doesn't crave carbohydrates as long as he's not hungry. He hypothesizes that beef works because it's a very purified form of nutritional food processed through multiple stomachs. People who've lost significant weight on this diet have been rejuvenated and have experienced a significant change in muscle tone. However, it's suggested to not experiment with this diet without proper consultation and knowledge.

    • Comparison of Ketogenic and Carnivore DietsA ketogenic diet can improve type two diabetes and promote weight loss, while a carnivore diet allows for unlimited eating and has cognitive benefits. However, individual results may vary, and both diets can cause weight gain if energy intake exceeds needs.

      A ketogenic diet helps in ameliorating type two diabetes and produces significant weight loss, but its efficacy may vary from person to person. The carnivore diet allows eating as much as one wants and does not require deprivation or cause a yo-yo effect. It also distinguishes itself from diets that rely on mere calorie restriction. However, some people on a ketogenic or carnivore diet may gain weight by eating past their energy point. Both diets have shown positive results in biomarkers and intense exercise, and ketogenic diet has an easy compliance. Additionally, the carnivore diet has cognitive benefits, reversing the deterioration of concentration in older age and increasing reading efficiency.

    • Jordan Peterson's Experience on the Carnivore Diet and CancerJordan Peterson experienced various health improvements on the carnivore diet, but the potential health benefits and risks of the diet are not yet fully understood. Cancer is caused by a genetic mutation that leads to oncogenic cells that are recognized by the immune system as not self.

      On a carnivore diet, Jordan Peterson noticed improved mood stability, stress tolerance, concentration, stamina and strength; however, there is a lack of research on the diet's potential health benefits and associated risks. Cancer, a leading disease of aging, has seen little improvement in overall survival rates despite incremental advancements. The critical step for cancer to occur is a genetic mutation, leading to oncogenic cells that look different from normal cells and are recognized by the immune system as not self.

    • The Importance of Early Detection and Aggressive Screening in the Fight Against CancerEarly detection can significantly impact survival rates, making regular screening important. Maintaining a healthy weight and avoiding smoking can help reduce the risk of cancer, but aggressive screening is also necessary as non-smokers and metabolically healthy people can still get cancer.

      Early detection is crucial in the fight against cancer; a fundamental difference can be seen in treating somebody when they have a billion cancer cells versus a hundred billion or a trillion cells. Screening is very important as it allows for the detection of cancer in its early stages, which can ultimately influence survival rates. Obesity and smoking are two main environmental triggers for cancer, making it important to maintain a healthy weight and avoid smoking. However, despite these preventative measures, another important tool is aggressive screening, as many who are non-smokers and metabolically healthy still get cancer

    • Importance of Prevention and Early Screening for Colon CancerStarting colon cancer screening at 40 instead of 45 can prevent advanced cancer treatment. Investing in prevention is crucial in combating metabolic disease, obesity, Alzheimer's, and environmental toxins but is challenging due to difficulty in monetizing it.

      Colon cancer screening should begin at 40 years of age instead of 45, to prevent advanced cancer treatment. Prevention is difficult to fund and market as it isn't dramatic. Investment in prevention could have been a better choice on the government side to combat diseases like metabolic disease, obesity, and Alzheimer's disease. Environmental toxins are also responsible for a significant fraction of cancer cases. Prevention of diseases like Alzheimer's disease is essential as treatments have almost no efficacy. Monetizing prevention is difficult which makes it challenging to invest in it.

    • Investing in Exercise Programs for Long-Term Health Benefits.By promoting physical activity through enjoyable habits starting from youth, we can improve our emotional health, reduce healthcare costs and thus enhance our longevity.

      Monetizing prevention is challenging but investing in physical activity through interwoven exercise programs can improve the quality of life and lower healthcare costs. Incentivizing and making exercise habits enjoyable is key. Starting from youth to habitually promote physical activity, such as walking, biking or even replacing chairs with standing desks in schools. Emotional health ties into longevity through lifestyle modifications that promote exercise and diet.

    • The Impact of Emotional Health on Longevity and Deaths of DespairTaking care of our emotional health is crucial for a longer and fulfilling life. Seeking professional help and addressing unresolved childhood trauma can be vital steps towards emotional growth and healthier living. A focus on living a fulfilling life is key to longevity.

      Emotional health has a significant impact on longevity, and deaths of despair (suicide, overdose, and alcohol-related death) have been increasing at an alarming rate in the United States in recent years. However, the impact on lifespan and quality of life can also come from failing to take care of oneself, negative self-talk preventing self-care, and living without purpose or happiness. While there is no clear-cut solution, exploring unresolved childhood trauma and seeking professional help can be a vital step towards emotional growth and healthier living. A focus on how to live a fulfilling life, rather than just how to avoid death, may be the key to longevity.

    • The Importance of Self-Development and Relationships for Mental HealthTaking time to reflect on your life, clearing baggage, evaluating virtues and faults, and developing a vision for the future can provide a reason to live, leading to better mental health. Maintaining functional relationships is also essential.

      Developing a comprehensive account and vision for your life is necessary for psychological and physiological health. The self authoring suite can help you with this by clearing up excess baggage, analyzing your faults and virtues, and developing a vision for the next five years. This leads to a reason to live, which is necessary for mental health. Having a network of functional relationships is also crucial to psychological well-being. The marginal decade exercise is another helpful tool where you write down your age and tick off at 10-year increments to ensure you are on track with your goals.

    • The Importance of Long-Term Planning for Your Health and Relationships.Creating a multi-decade plan for your health and relationships can motivate positive behavior changes, increase resilience and improve the quality of life for you and future generations.

      Having a long-term vision for yourself and your loved ones can help motivate positive behavior changes, such as exercise and nutrition. It's important to consider the actuarial expectation of your life and imagine how you want to function during each decade. Having a reason to make sacrifices, like quitting alcohol or eating healthier, is essential to successfully following through with prevention strategies. Taking responsibility for others and improving relationships can also increase resilience and positive emotion. Developing a multi-decade plan can be instrumental in achieving long-term goals and being present for future generations.

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    Michelle is an all-around athlete, having played sports from a young age. After a layoff from sports in college, she discovered endurance training while in PT school and began running 5k and 10k races. She quickly became hooked and ran her first half marathon, then full-marathons, punctuated by occasional trail runs as well. Michelle describes her first marathons as brutally hard, as she learned how to develop a strong mindset and properly fuel her body for the hours-long race. Nevertheless, she stuck with them and slowly began getting better.

     

    Recently, she began working with Coach D to improve her times. Together they came up with a plan to incorporate strength training 2x per week, with an emphasis on developing the hips and trunk or "core" strength. This meant plenty of squats, deadlifts, and overhead presses. Coach D also encouraged her to run speed days 2-3x per week, where she focused on power; sometimes this included hill runs, since the Boston Marathon includes several notorious hills (one such know as "Heartbreak Hill"). On long-distance days she progressively increased her mileage, however she never ran more than ~18 miles prior to the race. She followed a model known as "cumulative fatigue" in which she tracked her weekly mileage -- a proxy for fatigue -- aiming to progressively increase that number while limiting the total mileage in a single day. As she puts it, "it's like running the last 18 miles of a marathon."

     

    Her times at the Boston speak for themselves, but most importantly, Michelle is healthy, uninjured, and feels great. Her time qualifies her for the 2020 Boston Marathon, which she is already looking forward to. You can follow Michelle's training on Instagram @akmtnmotherrunner.

     

    Got a question about running or endurance training in general? Send us a message on Instagram or send us an email at info@40fit.com!

     

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