The LIFE-EXTENSION Doctor: "The ONE thing that's increasing your chance of early-death by 170.8%!" Peter Attia (E267)

If you're saying I want to be the absolute best fittest version of me that is humanly possible when I'm in my 80s, how much do I need to be training for that? The answer is probably one and a half to two hours a day.

I think the biggest challenge of fasting comes down to protein intake. And protein is, in my view... the most important, macronutrient ... When you are intermittently fasting, it is very difficult to get the right amount of protein in and in the right doses. And therefore, it's the most difficult to maintain muscle mass.

When I meet somebody who's in the last decade of their life, do you know how much they are thinking about this? It's all they're thinking about. It's all they're thinking about. Every minute of every day is a confrontation with their own mortality. The problem is they don't have much time to change the direction of the ship.

A 30-year-old, like you, has unbelievable potential to change the arc of your life. You have so much runway through manipulating nutrition and exercise and sleep and stress and all of these things to completely alter the disease trajectory of your life. The problem is... it's harder to find the motivation, because there are no reminders of your own mortality; you're superman.

Muscles are where you dispose of glucose. So, glucose regulation is one of the most important metabolic functions of the body. Our ability to metabolize glucose and regulate glucose levels is central to our existence on this planet—and when we get it just a little bit wrong, we go to hell in a hand basket. That's what type 2 diabetes is.

Once you hit the age of 65, if you fall—which is pretty likely—and you break your hip or your femur, the long bone in your leg, there's a 15-30% chance you will be dead within the next 12 months.

I don't drink sugar-sweetened beverages. That's definitely a place where I draw a line. So, I think there's something about liquid sugar that is more problematic than solid sugar. So, I'd rather eat my sugar and at least have the benefit of it being more slowly absorbed than drink it.

Nothing compares to exercise. Nothing compares to having a high VO2 max, high muscle mass, and high muscle strength. They are more beneficial for you than any bad thing you can think of is bad for you.

When I see people who are struggling, for example, with weight loss, and they're drinking 4 Diet Cokes a day, one of the first things I'll do is have them stop completely and replace that with just water or sparkling water.

Ethanol, which is the alcohol we drink, is toxic. Its toxicity is nonlinear ... At low levels, it's just a little bit of an increase, but the more you drink, the more it becomes toxic. So, for most people, there's not an appreciable amount of toxicity at 1 drink a day; but 2-3 drinks a day starts to become quite toxic.

We have a lot of data on the use of testosterone replacement therapy in men. And while I think it is generally overprescribed—and I think, generally, at least in the US, men are receiving TRT far too early in their lives—I think the data for responsible use of TRT are very positive.

As you enter your 30s, you will now start to experience a shrinkage of the those type 2 muscle fibers. You will be less powerful in your 30s, in your late 30s especially, than you were in your mid-to-late 20s. So, that's a form of aging; you are declining.

Going from zero activity to just 90 minutes a week is about a 15% reduction in all-cause mortality.

I think that eating less is the more important step towards weight loss and that the role of exercise is important but less because of just the straight number of calories you burn. In other words, the increase in energy that you expend through exercise is usually offset by increased appetite.

I think that there is no greater desire for people than to be healthy, especially when you consider how we can define health more broadly than just physical health. Once you can include kind of emotional health, it's kind of the great equalizer, and nothing else really matters.

Most people do not die from fast death, but it's been supplanted by slow death. Today, most people listening to us are going to die from cardiovascular disease, from cancer, dementia or other neurodegenerative diseases, complications of diabetes.

I think doctors are very good at thinking about the risk of doing something ... But I don't think we spend enough time thinking about the risk of not acting or the risk of not acting when we do.

I think many people have maladaptive behaviors in their life that are indirectly or directly their response to something that we would define as trauma.

I think that insoles, foot inserts, arches, arch support probably should be reserved only for some people; and most people actually need to learn to strengthen the intrinsic muscles of the foot.

If you are drinking sugar, there's a real problem. And the problem is this: When you make ATP out of fructose, you temporarily deplete the cell of energy to the point where more energy is needed.

The real issue with sugar is calorie for calorie, is it more damaging than just glucose? I actually think the answer that question is probably not.

High stress, poor sleep, inactivity—all of those things will make it very difficult to lose weight, even in the presence of whatever perfect diet you're on.

I had a bit of a wake-up call, which was I realized that all the men in my family died prematurely of heart disease ... If you don't figure something out and do something about this, you're probably going to die of heart disease in your 60s.