#517: Dr. Peter Attia on Longevity Drugs, Alzheimer's Disease, and The 3 Most Important Levers to Pull

I just encourage people to be much more attuned to all of the tools: caloric restriction, dietary restriction, time restriction. You've probably heard me go on and on about my framework, the 3 levers—always pull one, sometimes pull two, occasionally pull three, never pull none.

Exercise is so important. It can't be overstated. It's potentially one of the most potent drugs we have.

There's a bit of a, I think, just a misunderstanding around ketosis. I think a lot of people assume it is automatically a weight loss diet or a fat loss diet, but of course, that's not necessarily true; it's only a fat loss diet if you use your endogenous fat stores.

So, I think the answer in how you live longer with respect to cancer.... So, what can we do to prevent cancer? Not smoking and being metabolically healthy are hands-down the two biggest things that you can do.

ApoB is a far superior measurement to LDL-C when trying to predict cardiovascular risk. So, it is hands-down the best biomarker we have for cardiovascular risk because it is the total concentration of all particles capable of inducing atherosclerosis.

Statins are a really safe drugs. 10% of people have unwanted side effects and shouldn't take them, but they're very well-tolerated drugs. And, in my mind, that's kind of a miracle when you consider what they do, which is they inhibit cholesterol synthesis. And when you think about how important cholesterol synthesis is, it's kind of amazing to me that that works without killing people.

That gets to the problem: We don't have a meaningful biomarker of aging. I mean, that's full-stop the biggest problem in aging research today, hands-down. Nothing else matters.

The longer a cancer gets to fester in your body, the more chance it has to develop mutations. And the more mutations it generates, the more difficult it is to target later on.

I'm just less bullish on the idea that we're going to 'cure cancer.' If you put cancer in perspective, the overall survival for people with metastatic cancer has improved about 5% in 50 years—and virtually all of that improvement has come with a handful of very specific types of cancers.

About three years ago, I was becoming more and more interested in this idea of zone 2 training ... The definition of zone 2 is the highest level of output you can produce while keeping lactate below 2 mmol.

People know that HDL: good, LDL:bad. But that's a little overly simplistic. What we really mean to say is that HDLs do not cause atherosclerosis; LDLs do. But it turns out, LDLs aren't the only thing that cause atherosclerosis; anything with an apoB on it causes atherosclerosis.

Lower ApoB is synonymous with improved all-cause mortality, cardiovascular mortality, and even mortality associated with diabetes and things like that.