Dr. Peter Attia is a world-renowned physician and the author of Outlive: The Science and Art of Longevity. In this episode, Dr. Attia and Dr. Russell discuss why we are obsessed with living longer, why we care so much about it, and why we should care so little about the quality of our lives. This episode was produced and edited by Russell Boll. Our theme music was made by Micah Vellian and our ad music was written and performed by Mark Phillips. Additional music was produced by Joseph McDade. The show was mixed and produced by Matthew Boll and Matthew Boll. Additional production and editing was done by Ben Koppel. Music in this episode was written, produced, and performed in part by Ben Boll and Mark Phillips, with additional assistance from Matthew Boll, who served as editor-in-chief of The Daily Mail, and was the editor of The New York Times best-selling memoir, Outlive. Outlive, The Science And The Art Of Longevity: A Guide To Living Longer Than Usual, by Peter Atta, is out now and will be available on Amazon Prime on November 15th, 2019. Subscribe to Outlive on all major podcast directories, including Audible and Podchaser, wherever you get your book recommendations. books are available. If you like what you read and listen to, please consider subscribing to our podcast on Audible, iTunes, or wherever else you re listening to your favourite podcast is available. Thanks for listening to podcasts, and share it with your friends and posting us on your podcast. We re looking for the best listening experience. You can also become a friend of the podcast by clicking here. We re listening and sharing it on social media! Thank you for listening and reviewing our podcast and sharing your thoughts on the podcast on the pod? we re listening out loud and posting it on your feed in the pod is also listening to us and we re spreading the word out there to your friends on all of our social media platforms , and we hope you re getting the message out to the rest of the world everywhere you re spreading it everywhere you get a chance to spread the word about this podcast is spreading it out there, everywhere you can reach us everywhere you do it and everywhere you listen it s listening to it, it s everywhere thank you, and we appreciate it.
00:00:55.000The quantitative model when it comes to life expectancy, that so many of us are living lives that are mired in misery, distraction, depression, doubt, feeling trapped, imprisoned, depressed, distracted, addicted, that prolonging the experience sometimes seems like an odd marker.
00:01:15.000I'm certainly not suggesting alternative and certainly not suggesting interventionist measures, but Why is there an assumption that we should want to live you know forever endlessly and what does it tell us sometimes about what does it indicate around our fears around death?
00:01:34.000So I think Russell you've hit on two very interesting points and given that we could literally spend an hour just talking about these two things because on the one hand you're asking the question what is it about our finitude that obsesses us?
00:01:50.000And the other part of your question, you're basically asking, at least the way I would hear it, why the hell would you want to live longer if the quality of your life, and you're referring, I think, to perhaps the most important aspect of that, which is emotional health, is unwell?
00:02:05.000So we could talk about both of those, and I'll just briefly offer my take.
00:02:10.000So first, this is a book that took me seven years to write and three versions.
00:02:16.000The first version of that book had no emphasis whatsoever on your first question, right?
00:02:21.000It was really a Silicon Valley-esque, you know, how to hack your way into a longer life, inch by inch, but with no attention paid to the quality of that life.
00:02:32.000And I think through my own sort of struggles, the final version of this book came to reflect a very different viewpoint, which is if your relationships to other people, to yourself, are suboptimal.
00:02:44.000If you're living in pain, you know, living longer would actually be the greatest form of torture.
00:02:50.000I think to your second question, why are we obsessed with it?
00:02:53.000I think truthfully, I think mortality is a very difficult concept for us to accept.
00:02:59.000So we can intellectually sort of say, well, you know, none of us actually matter that much.
00:03:04.000Our time on this earth is incredibly small.
00:03:07.000It's, it's a sliver of a sliver of a sliver, a degree of time relative to even just Homo sapiens, let alone life on this planet.
00:03:15.000But yet emotionally, that fact is so difficult that you and I won't be here in 50 years.
00:03:21.000I mean, we're, we're simply not going to exist anymore.
00:03:24.000And I think we tend to want to claw at that as well.
00:03:27.000So I guess those would be my high-level inputs on those two important questions.
00:03:34.000What I feel sometimes, Peter, is that it's a war to remain healthy in a society that requires you to be sick.
00:03:41.000I feel sometimes from some of the great guests we spoke to on our show that we're kind of, systemically at least, regarded as blobs.
00:03:49.000Blobs to pump bad food into and sometimes questionable pharmacological remedies into.
00:03:56.000And so sometimes to remain healthy can be a campaign that has to be almost militaristic.
00:04:06.000How did we arrive at the point where wanting to be fit and healthy was regarded as a, well, most recently it's been called a right-wing issue?
00:04:13.000How has health become regarded in this way and how is it that our life has become a kind of commodity in itself where we're latched onto vampirically by parasitical big food and big farmer interests?
00:04:27.000So again, I think you you ask these interesting questions, Russell, and there are several layers to it.
00:04:31.000So so in the order, I think that you're asking it, I think there's a very important transition that has occurred in our species.
00:04:38.000And even though our entire lives, meaning those of us that are talking here now and listening, all took place in one era in the arc of humanity, most of the time we died very fast deaths.
00:04:59.000And, you know, obviously infant mortality was enormous.
00:05:03.000So mothers were dying all the time, giving birth to kids, many of whom would just die right away.
00:05:08.000And if you somehow managed to survive childbirth and childhood, you were going to be mauled by an animal or die of an infection.
00:05:14.000And that was the way it was for 99.9% of our existence as a species.
00:05:21.000We, as a species, had this enormous victory in the late 19th and early 20th century, which was we basically figured out the remedy for how to stop fast death.
00:05:32.000And that basically became sanitation, antibiotics, and all of the things that came with germ theory and around that.
00:05:43.000Also, we developed things in medicine around critical care, trauma, acute care, things like that.
00:05:49.000The good side of that was we stopped dying from those conditions.
00:05:53.000The bad news was that toolkit for how to prevent people from dying quickly really had no efficacy against preventing people from dying slowly, which is how we all die today.
00:06:05.000Most people today are going to die from cardiovascular disease, cancer, dementia, diabetes, things of that nature.
00:06:12.000And the approach of wait till you're sick to treat those things doesn't work very well.
00:06:18.000So that's why we have become these entities that, you know, we're kind of using the wrong playbook.
00:06:26.000And you've alluded to a number of other things as well, right?
00:06:34.000I mean, all of these things are kind of working against us.
00:06:37.000But I think of those as basically the flip side of a technology that also gave us a great advantage.
00:06:43.000And we're just kind of out of balance with it, I think would be the simplest way to describe that.
00:06:47.000Do you have anything to say on the politicisation of health and wellness?
00:06:52.000It seems that during the pandemic era, like, get outside, get some vitamin D, natural immunity, all became sort of contested ideas, and there's no doubt that there can be a machismo attached to staying fit and healthy, participating in martial arts, and indeed pull-up challenges against RFK, which I'm personally Engaged in right now, I'm having a competition with Robert F. Kennedy to see who can do the most pull-ups.
00:07:51.000Now, I'm somewhat surprised by the phenomenon you've described.
00:07:58.000I saw an article yesterday, not yesterday, maybe last week that said something to the effect of, and this was a serious article, like it was in Time magazine or something.
00:08:06.000And it talked about how the origins of fitness are racist.
00:08:11.000And it went on this long rant about how it's really because of the KKK that we have the fitness industry or something like that.
00:08:19.000And I don't know, truthfully, I'm just, I'm kind of apoplectic when I see stuff like that.
00:08:27.000I think that during COVID somehow that became the entire entity of COVID became political and the people who said, you know, I would probably rather have My own immune system bolstered by being outdoors, exercising, being in the sauna, being fit, eating well.
00:08:47.000That became a right-wing view, which it shouldn't be.
00:08:51.000That should be, I think, the view of everybody.
00:08:54.000And I think what we're seeing now is simply the snowballing extension of that.
00:08:59.000Yet, Peter, life expectancy in the United States is the shortest it's been for a couple of decades.
00:09:06.000Is that because our modern diet is killing us?
00:09:11.000What is it that is decreasing life expectancy?
00:09:13.000You've already given us a sort of a bit of an understanding that the causes of fatality were more environmental traumatic disease or an ID historically.
00:09:23.000Why is there this incremental and sudden decline in life expectancy?
00:09:30.000So, if you go back to, I don't know, 1880-ish, and you look at the change in life expectancy for the next hundred years, it doubled.
00:09:40.000And it doubled only because the top eight causes of death, which were all infectious, came out.
00:09:49.000So, you doubled human lifespan from roughly 40 to 80 by removing the eight most prevalent sources of infectious diseases and communicable diseases.
00:09:59.000But, to your point, no real bearing on chronic diseases.
00:10:02.000Now, to your question, why has UF's life expectancy been in decline, The answer is actually in the numbers, which is, it is the increase in the deaths of despair.
00:10:13.000So it is not an increase in cardiovascular disease, cancer, diabetes, or dementia.
00:10:20.000It is the increase in suicide, overdoses, and alcohol-related deaths.
00:10:26.000So those three, which I lumped together as deaths of despair, are growing at such a clip that it is outpacing any incremental improvements we have in the others.
00:10:37.000And as you probably know, Russell, in the past year, we've seen now over 100,000 people die in the U.S.
00:10:50.000The gains that have been made as we advance beyond the era of dying like dumb apes as a result of infections is warping and metastasizing into the era where we're being killed by an ailing civilization that induces and perhaps you could even argue requires despair.
00:11:10.000Now on that spectrum of addiction I would definitely include Eating disorders.
00:11:15.000I've had an eating disorder when I was a young person, specifically bulimia.
00:11:21.000And I've seen you talk about obesity and weight loss.
00:11:24.000And while we're still on YouTube, I'll pose this question.
00:11:27.000What is the real reason, Peter, that some people can never lose weight, no matter what they do?
00:11:34.000But before you answer, we're going to leave YouTube now and we're going to do our show Exclusively over on Rumble, where we can speak freely and openly in the spirit of love, not so that we can convey misinformation, disinformation, malinformation, nor so that we can engage in senseless and pointless rhetoric of hate, so that we can freely and openly discuss ways that we might live better, individually and collectively, and there's no question that Peter's fine work is contributing on a grand scale to that endeavour.
00:12:02.000Join us over on Rumble to hear the answer to the question, what is the real reason some people I'll preface this by saying I don't think I know the answer and I don't think anybody knows the answer.
00:12:26.000And the reality of it is this, we are very, very hardwired, Russell, to store energy.
00:12:34.000OK, so this is like the superpower of Homo sapiens.
00:12:40.000So you go back 200 to 250,000 years ago, as our particular species began to diverge from others, chimps, Neanderthals, there are lots of reasons that we out-competed them.
00:12:54.000We can talk about our capacity to work in concert with other members of our species in large numbers.
00:13:02.000But from a biologic perspective, I think our superpower was our ability to store energy.
00:13:10.000And that's what enabled the organ between our ears to be so prolific, right?
00:13:16.000So your brain weighs like 2% of your body weight and consumes between 20 and 25% of your energy.
00:13:22.000Just kind of reflect on that for a moment.
00:13:24.000This tiny little organ is so energetically demanding that the only way our species could kind of leapfrog all the others was to make sure we never went without energy.
00:13:36.000And to do that, we had to be able to store energy when food was plentiful.
00:13:42.000And so we spend hundreds of thousands of years honing this genetic tool to basically be able to put fat into fat stores so that we can access it later on.
00:13:54.000And until food became entirely plentiful a hundred years ago, that problem basically didn't, you know, come back to bite us in the ass.
00:14:03.000I think it's important to understand that when we think about how we are mired in an epidemic of obesity, we need to understand that we are putting these very, very, very old genes in an environment in which they never had a chance to adapt.
00:14:17.000We would never, in the current food environment, optimize around energy storage the way we have today.
00:14:25.000The question then becomes, why are some people more genetically susceptible to this?
00:14:30.000Why are some people more behaviorally sensitive to this?
00:14:35.000Why are some people in an environment where, for example, they don't have the education, they don't have the means, they're in food deserts?
00:14:48.000It's easier for me to answer the question at the species level, why are we getting fatter?
00:14:53.000It's harder for me to answer at the individual level, but I don't dispute for a moment that there are social and genetic factors that account for those differences.
00:15:02.000interesting to ponder, Peter, where the distinction between genetics and behavior might lie, where that
00:15:09.000particular line might be drawn, and also to reflect on the earlier part of our conversation
00:15:16.000where we discussed the crisis of despair, and whether or not that is similarly the result
00:15:22.000of finding ourselves suddenly in an environment more similar to a farm or a zoo than a forest
00:15:29.000or a plane, where suddenly hundreds of thousands of years of evolution, obviously much longer if
00:15:34.000you consider the entire lineage, are suddenly warped into an unnatural and perhaps, what do
00:15:43.000I want to say, antithetical, punishing condition, that we have diets that are not reflective of our
00:15:50.000We have systems of government that are not reflective of our needs.
00:15:53.000We have relationships that are not reflective of our needs.
00:15:56.000We have power systems that do not reflect our needs.
00:15:59.000Our emotional and spiritual requirements are neglected, warped and misunderstood in the same way that, more observably, our dietary requirements have been inverted and reversed.
00:16:10.000People that are storing energy in the form of obesity would have been hugely advantaged in previous incarnations of our civilization, and they would never have found themselves in that condition.
00:16:23.000Furthermore, I was talking about the sort of the culture of reverence for elders, that revering elders makes sense in a culture where being an elder was an indication that you've survived, you've survived disease, you've survived the traumas and causes of death that you would have described.
00:16:41.000So you can see an evolutionary, biological and psychological undergirding for the concept of elder worship and You know, perhaps even ancestor respect.
00:16:52.000So those are interesting things to tie together.
00:16:55.000I wonder about the carnivore diet, Pete.
00:16:58.000A lot of folk like, you know, like Jordan Peterson comes on here a lot.
00:17:02.000He's a friend of ours, a friend of mine.
00:17:04.000And I know that he's not happy unless he's biting a lump out the side of a cow.
00:17:08.000Is the carnivore diet just another fad?
00:17:13.000I'm vegan, so like, you know, I've got my own little struggles.
00:17:17.000What do you think about the carnivore diet?
00:17:19.000Yeah, vegan and carnivore would be about as far apart as possible.
00:17:22.000You know, it's funny, I did talk a little bit about this with Jordan when I was on his show a few months ago, and he posed the question, you know, genuinely from a place of curiosity, right?
00:17:32.000And as you know, because you're close to Jordan, You know, his arrival at a carnivore diet was not some sort of ideologic choice, right?
00:17:40.000This was a trial-and-error process brought on by his own physical ailments and a search for elimination, right?
00:17:49.000How could he eliminate things from his diet that were causing him inflammatory symptoms?
00:17:59.000I would really like to see this diet studied more.
00:18:02.000I think what we can say with relative clarity is that the carnivore diet, like any highly restrictive diet, will almost assuredly result in weight loss.
00:18:12.000And when a person loses weight, a number of parameters in their health will improve.
00:18:18.000But it's not clear that everything will improve, and it's not clear to me that any form of highly restrictive diet is in the long term going to be as healthy as a less restrictive, somewhat more balanced diet.
00:18:32.000And in particular, with the carnivore diet, I think the one thing I would want to have better insight
00:18:37.000into before embarking on it for the rest of my life would be what is the effect on, for example,
00:19:15.000It's not like you package and sell a diet.
00:19:18.000So who's the one that's going to pay $12 million to do, you know, even the three-year study on the carnivore diet, which is a pittance, right?
00:19:27.000If you think about it, like, $12 million is a trivial sum of money in the pharma landscape, and we'll happily spend You know, frankly, close to a billion dollars to gain approval for any single drug as you go from IND to Phase III approval.
00:19:44.000In fact, that's a little bit below typical.
00:19:46.000But we would never spend that much money to understand the questions about diet, and I think that's just an unfortunate consequence of our existence.
00:19:54.000One of the concerns I've had around the rhetoric around science recently is that it presents itself as neutral empiricism when the funding of clinical trials, the experimentation that is done, the experimentation that is not undertaken, can plainly be tracked By the interest that you've described.
00:20:19.000Who is undertaking the experiments that do not lead to a profitable product?
00:20:26.000Who is looking into the efficacy of natural immunity?
00:20:29.000Who is looking into the efficacy of any behavior or habit that doesn't lead to some benefit for a financial interest?
00:20:41.000Also, Peter, I wonder if the assumption, and it's certainly one that I lean into quite a lot, that if you are able to emulate our native conditions, that will be healthy.
00:20:58.000Because presumably the biomechanical machine that we live within is organized around periods of fasting, and if you emulate that, you are rewarded.
00:21:11.000Pretty much the same rationale that leads to obesity, I suppose.
00:21:16.000Is there veracity in that type of, if not assumption, then, I don't know, what do I want to say, that framing?
00:21:26.000Yeah, I think that's a fantastic question and one that I think people who are serious about this line of inquiry will always find themselves abutting.
00:21:36.000So there is no question that as our species evolve, we were faced with periods of nutrient deprivation.
00:21:45.000Now, I've already made an example or provided an explanation of how we managed to thrive in that environment, which was, unlike other species, we became very adept at storing energy and we could go longer periods of time without nutrients.
00:21:59.000It's also important to point out what our bodies did biochemically in that time of nutrient deprivation, which was we would undergo a process called autophagy.
00:22:08.000I think I write about this quite a bit in the book.
00:22:09.000So, autophagy, as its name suggests, autophagy, self-eating.
00:22:14.000It's when the body basically begins to take cells that it deems suboptimal, right?
00:22:20.000So, you might have some cardiac muscle cells and You know, some cells in your gut and some cells in your liver that are good, some immune cells that are good, and some that are not so good.
00:22:30.000And you basically, in the period of nutrient deprivation, will eat.
00:22:34.000The cells that are not so good will self-eat and recycle the important components.
00:22:39.000So it became a very efficient way for the body to thrive and prune cells that may potentially go on to be cancer, for example, or become diseased cells.
00:22:49.000So now, fast forward to 2023, and the question is, Should we be replicating this behavior?
00:22:58.000And it's frustratingly, to me, a question for which we don't have the answer.
00:23:02.000So going back to, like, where should we be spending research dollars?
00:23:07.000We should absolutely be spending research dollars on answering that question.
00:23:11.000You know, I used to fast a lot, Russell.
00:23:13.000So I used to do 7-10 days of water only fasting once a quarter and 3 days once a month.
00:23:21.000month. So I was very aggressive in my use of fasting. And I have
00:23:28.000no way of knowing if all the years of doing that added, you know, years to my life, subtracted years from my life.
00:23:35.000We have no way of knowing this because we don't even have a biomarker for all those processes I spoke about.
00:23:41.000Now, what I can tell you is after many years of doing that fasting, I lost a staggering amount of muscle mass, probably to the tune of 20 pounds over a decade.
00:23:52.000And for me, now we're fast forward to the year 2020, I kind of took one more look at a DEXA scan, which is a body scan that shows you how much muscle you have and I realized that actually for something like over six years I'd lost 20 pounds of muscle.
00:24:08.000I was like, you know, I think I've got to cut back on this fasting thing because one of the drawbacks of so much fasting is you just can't maintain lean mass.
00:24:17.000But I had no idea what the dose should be.
00:24:19.000And to this day, I don't know what the dose should be.
00:24:22.000Which, again, ties into this frustration that says, boy, I wish we could study that problem.
00:24:27.000Because if you took the amount of money that it takes to approve one drug, I believe we could answer all of these questions with respect to how much to exercise, what kind of exercise, how much to fast, for how long.
00:24:40.000It truly is a distorted set of priorities.
00:24:45.000It shows you what a proper health industry should look like.
00:24:47.000Not even health industry, health policy, a culture around health, a society that values and cherishes health and indeed proper vigorous scientific endeavour to provide us with real answers that aren't always generated in order to guide us towards profitable pursuits.
00:25:03.000for establishment interest. I'd love to know the answers to some of those questions.
00:25:08.000What I find myself talking about because of my age, because of the kind of circles I move in,
00:25:11.000are how is it not that we prolong life? That's not what I'm thinking about yet,
00:25:14.000because I'm not old enough to be concerned about that, I suppose, quite yet. I'm more
00:25:18.000concerned about like, should I be taking testosterone supplements?
00:25:23.000What do you think about the more natural testosterone enhancing products?
00:25:27.000We know one of our sponsors, Black Forest, gives me things like Tercotestosterone and NMNs and things like that.
00:25:34.000How effective are they if you want to put on muscle, if you want to be stronger, if you've got young children like me?
00:25:41.000That for 15-20 years I'm going to have to be able to physically control them and sometimes strike them on the basis of how they're behaving at the moment.
00:25:49.000What kind of supplements can I take that are effective and will allow me, when I'm in my 60s, to be an RFK-style pull-up machine?
00:25:59.000Well, as you know, because RFK has talked about this publicly, I mean, he takes testosterone replacement therapy, which is a pretty common therapy for men as they age, because like women, we see a reduction in our sex hormones with age.
00:26:30.000And your estrogen, your progesterone, they go away.
00:26:33.000Now, for women, it happens immediately, right?
00:26:35.000I mean, women within a period typically of 18 months will go from totally normal sex hormones to virtually none.
00:26:42.000For men, it is a much more gradual decline.
00:26:44.000So, you peak at your testosterone level in your late teens and early 20s.
00:26:51.000And you have been on a slow decline since, but there's a threshold at which it starts to become apparent.
00:26:57.000And the places where it starts to become apparent are going to be, you're going to start to see a reduction in muscle mass, a reduction in strength, a reduction in libido, and maybe even just a reduction in your overall mood.
00:27:08.000Now, there are other things that can factor into all of these things.
00:27:11.000Nutrition, exercise, training, I mean, the gamut is there.
00:27:14.000And that's what I think makes testosterone replacement therapy not a very straightforward question.
00:27:20.000We do this all the time in our patients.
00:27:22.000I mean, this is kind of our bread and butter work in treating people, is understanding how does your testosterone, It's low, potentially contribute to this.
00:27:36.000And how do we know if we're doing the right thing?
00:27:38.000And again, all of this can be done safely.
00:27:42.000And there are a lot of unfortunate myths about testosterone replacement therapy.
00:27:46.000To be clear, there is zero evidence that testosterone replacement therapy increases the risk of prostate cancer, though it might increase the risk of cardiovascular disease in susceptible men, specifically those with high blood pressure or sleep apnea.
00:27:58.000So you always have to be careful that those things are treated before you assume testosterone replacement therapy.
00:28:04.000But it is undoubtedly something that many men who start out with low testosterone feeling like they're horrible, you know, when you normalize their levels to that of a 30-year-old, a lot of men will say, this is the most remarkable thing I've experienced.
00:28:18.000Just as many women will say the same thing when you replace their estrogen and progesterone after they go through menopause.
00:28:25.000What about if it's someone like me who's, let's say, psychologically volatile?
00:29:41.000uh within a very short period of time your body will stop making its own testosterone you are absolutely correct and the reason for that is When the brain, when the hypothalamus and the pituitary gland sense the presence of testosterone being high, which it will from the injected testosterone, it's going to say, well, great, we don't need to make any more.
00:30:01.000So the hypothalamus will stop sending the message to the pituitary, which will stop sending the message to your testes to make testosterone.
00:30:07.000So you will stop making it and your testes will shrink.
00:30:19.000Now you won't feel that because you're going to have more testosterone than you had in the first place, but you'll notice that you're, you got smaller, you got a smaller sack.
00:30:27.000The next thing that's going to happen, you brought up hair loss.
00:30:32.000If I, like, when I'm doing my regular nut checks and not for testicular cancer, simply as a hobby, if I noticed that I've gone from Conker to Malteser, and could I use any more British examples than that?
00:30:45.000Um, from, uh, I don't know, I don't know, ping pong ball to chocolate raisin.
00:30:52.000Like, then I'm gonna be, uh, that's gonna, I'm not gonna like that, Peter.
00:30:56.000So, firstly, that's gonna be a shock when I do my regular checks.
00:32:36.000And frankly, I feel some of your reservation, which is look, after a year or two of doing this, I'm going to be dependent on this for life.
00:32:47.000Now, truthfully, I will very likely at least give it a three-month stint to see how much better I feel.
00:32:54.000Because at three months, nothing irreversible happens.
00:32:57.000At three months, if I say, you know what, I've taken this testosterone, my numbers have gotten a lot better, I don't feel any better, you can stop it and you've lost nothing.
00:33:07.000Your testes will come back, you will resume making testosterone.
00:33:10.000So I think that's a worthwhile empirical approach to the problem.
00:33:14.000And frankly, that's the approach we take with all of our patients that we put on testosterone replacement therapy is if you don't feel better, it doesn't matter if your numbers got better.
00:33:27.000The data becomes abstract when it's just numbers on a page compared to the subjective experience of being you.
00:33:33.000And this is, of course, the sort of the hard problem in the endeavor of science.
00:33:39.000How do we ever describe that subjective experience?
00:33:42.000I'm astonished to hear you say that you can't be bothered to do it.
00:33:44.000You might as well have written a book called, I Outlive the Science and Art of Longevity, If You Can Be Bothered, by Dr. Peter Atiyah.
00:33:53.000Also, there were a few other questions.
00:33:55.000Compared to the, let's call them the pharma hardcore testosterone, how do the more natural ones perform?
00:34:04.000Are they worth considering or are they not effective?
00:34:07.000Yeah, nothing is remotely as effective as either testosterone itself or other hormones that tell your body to make testosterone, provided you still have the capacity within the cells of your testes.
00:34:20.000So the two most common versions of that are a drug called HCG, which is a,
00:34:25.000this is actually taken from, it's going to sound crazy.
00:34:29.000It's taken from the urine of pregnant women. So this is, you know, you hear when,
00:34:33.000when a woman gets a pregnancy test, they're testing her HCG level.
00:34:36.000So this hormone goes way up during pregnancy and it is an exact replica of a
00:34:41.000hormone we make called luteinizing hormone that tells our body to make
00:34:46.000So you can inject luteinizing hormone effectively and you will make more
00:34:51.000You can also take another fertility drug that women use during IVF called clomiphene or Clomid, and that will tell your pituitary gland to make LH and FSH, which will tell you to make testosterone.
00:35:06.000I personally am not a fan of the latter.
00:35:12.000I would say that the former, HCG or testosterone, would be the preferred way to do this.
00:35:17.000The reason I don't like using Clomid is, among other things, it is blocking the signal of estrogen at the brain.
00:35:29.000Believe it or not, estrogen is a very important hormone to men as well as women.
00:35:34.000Men actually need to be in perfect estrogen balance.
00:35:37.000If they are not, they can have depressive symptoms, lower libido, even in the presence of normal testosterone.
00:35:44.000So, my bias is actually against clomid or clomiphene and in favor of testosterone or HCG.
00:35:50.000A lot of the supplements out there, Russell, A, they just don't have the efficacy, and B, you have absolutely no capacity to quality control them.
00:36:01.000They are completely unregulated, over-the-counter molecules.
00:36:04.000And truthfully, we have a hard enough time regulating Drugs in the United States through the FDA.
00:36:10.000I mean the FDA's track record of regulating drugs is decent, but not stellar.
00:36:16.000There is nobody paying attention to the regulation of the supplement industry.
00:36:19.000So when in doubt, I always would prefer a pharmacologic regulated product to an unregulated one.
00:36:27.000And I think in the case of hormones, you will also find greater efficacy.
00:36:32.000elsewhere in our content we have such skepticism and cynicism in particular about the conduct
00:36:36.000of the FDA, the manner of their funding, that it's difficult for us to endorse being reliant
00:36:42.000on them elsewhere, even though I know there's so much complexity in subjects like this and
00:36:46.000so much expanse that's being covered. But my general tendency is in favour of remaining
00:36:54.000kind of natural wherever possible. I was once told that you're a complex individual. If
00:37:00.000you start introducing endocrinal agents into your operating system, you might have unexpected
00:37:09.000results. I've got a history with addiction issues, mental health issues, all that kind
00:37:13.000of stuff. I feel like it requires for me, I have to expose myself to cold temperatures,
00:37:19.000hot temperatures, meditate, go to group therapy, drink green juice, exercise, do Brazilian
00:37:24.000Jiu-Jitsu, Yoga, and then I might feel alright for that day.
00:37:28.000You know, like, that's the level of endeavor required for me to retain balance.
00:37:33.000So, the idea that there's, you know, when there's people like, take this drug to stop you eating, take this drug to make your nuts bigger, take this one to make the nuts go back to a normal size, you know, and I feel like, bloody hell, I can't take that Level of intervention, you know, so how do you embark on such a bold and I know much-loved and extremely successful project knowing that many of the people you're talking to will be cynical about pharmacological remedies, doubtful about authority more broadly and in a cultural climate where exercise itself can be regarded as a
00:38:10.000An entrepreneurial notion that emerged at the KKK.
00:38:15.000How do we keep this stuff plain and accessible to all?
00:38:43.000Everything about the tools you can manipulate around emotional health.
00:38:46.000You've already addressed a number of them.
00:38:48.000And then pharmacology and hormones and supplements being the fifth and final one.
00:38:52.000This book really focuses on the first four.
00:38:55.000I think if a person comes into this with a very skeptical view of pharmacology, I don't really think that precludes you from taking 80% of the steps that are, in my view, helpful at turning the odds in your favor.
00:39:06.000Now, when you want to think about these things, I believe that the data are unequivocal that exercise is the most potent of these tools, both in terms of its impact on the length of your life, But also in terms of the quality of your life, because what I don't think people are paying enough attention to is this idea of the marginal decade.
00:39:31.000The marginal decade is the last decade of your life, and everyone has a marginal decade.
00:39:37.000You don't know the day that you enter it, but you will figure it out pretty quickly when you're in it, when you are down to that last roll of toilet paper.
00:39:47.000And what I don't think people are thinking enough about is what steps am I taking to make sure that I'm physically robust enough during that decade?
00:40:41.000Between the three of them, I'd say it's a real trifecta of arse pain.
00:40:48.000Well, as much as the ass pain is there, I would also bet it's a great source of joy.
00:40:52.000And as they continue to grow, you'll probably continue to find things you absolutely love doing with them.
00:40:58.000And the reality of it is, at some point, those three kids are going to have their kids.
00:41:02.000And if, you know, what I see in people is true, it sometimes is better to be a grandparent than a parent.
00:41:10.000My point being is at some point you're going to be in your 80s and you have a choice, right?
00:41:15.000You can be a decrepit 80 year old who, you know, can't sit on the floor with a grandkid, can't pick a grandkid up off the floor, can't even get up off the floor under your own strength, can barely walk up the stairs.
00:41:27.000I mean, that's the kind of thing that is in line for many people if they're not deliberate about the choices they make with respect to training and exercise.
00:41:37.000And what I think is It doesn't matter what your view is on drugs.
00:41:41.000It doesn't matter what your view is on nutrition.
00:41:43.000It doesn't matter what your view is on most of these things.
00:41:46.000If you simply focus on what type of exercise do I need to do to make sure that when I'm in my 80s, I function like a person who would ordinarily be in their 60s, which A, is completely attainable with the right amount of exercise.
00:42:00.000I think that brings the greatest quality of life in that final decade.
00:42:06.000Peter, I don't want to be floundering about on the floor, hopeless and facile, like a mollusk, clutching for the last roll of toilet paper that you... It sounds like I'm going to spend the last 10 years of my life shitting on a grandchild, grinning from ear to ear.
00:43:26.000You can become a member of our Locals community.
00:43:29.000They get to join these conversations live when they're happening in the event that we have high profile guests that are challenging to book because of their busy schedules like Dr. Peter Attia.
00:43:37.000And you can join us live and ask questions like Jane71 who asks, what does your weekly exercise program entail if you're so fantastic and better than us all?
00:43:46.000Dr. Peter, I added the last bit to add some hostility.
00:43:51.000Um, well, I always say, look, I'm happy to tell you what I do and I will, but I also want to say that you don't have to do what I'm doing, right?
00:43:57.000You can do half of what I'm doing and still get a lot of benefit.
00:44:54.000Especially the bit where he was carrying a doppelganger you around on your back like our lord and saviour on his way to Calgary.
00:45:03.000What also, HeyNavigator asks, big agriculture, big business, big pharma, all developed cheaply made food drugs, seed oil, sugar saturated, highly processed foods that give us dementia, diabetes and chronic illness.
00:45:15.000What are the strategies for giving them up completely doc?
00:45:21.000In Pharma's effort and Big Ag's effort to solve one set of problems, it created another.
00:45:28.000One strategy that I always tell people, and it's certainly not my own, I don't take credit for it, is, if you're grocery shopping, one, don't do it when you're hungry.
00:45:38.000Two, stick on the perimeter of the store.
00:45:40.000So, there's really nothing that can be gained from walking down the aisles of the grocery store.
00:45:44.000That's where the most concentrated, most processed, most garbage food resides.
00:45:49.000And I believe in setting a default food environment that is healthier, so that in your moments of weakness when you're hungry, you're surrounded by better food choices.
00:45:58.000I don't have the willpower to surround myself with a pantry of garbage.
00:46:03.000If there's garbage in the pantry, I will eat it.
00:46:05.000But I do have a little bit of willpower to show up at the grocery store not hungry, make good food choices, put those in the home, and then when I'm hungry, I kind of have no choice but to eat reasonable food.
00:46:18.000And don't say that you can't be bothered because you just said you carry a knapsack on your back with another you in it for 30-second struts.
00:46:45.000You know, I think for the listeners, I would say, look, this is a 17 chapter book that of which 16 chapters focus on all dimensions of physical health.
00:46:55.000But I did include a 17th and final chapter that deals with emotional health.
00:46:58.000And we started this discussion by talking about deaths of despair, purpose and things like that.
00:47:04.000And I just want to make sure that people who are coming to this discussion because they are interested in living longer do not neglect the other side of it.
00:47:14.000There's no reason to live longer if your relationships suck.
00:47:18.000There's no reason to live longer if you are unhappy.
00:47:20.000So, you know, please be sure that you are putting as much effort into that as you are figuring out, you know, which drug to take, which food to eat or which exercise to do.
00:47:30.000Yeah, otherwise we're kind of life misers just clinging on to a perennial winter, which you described earlier as scrambling about on the floor like a spineless slug, clutching a Kleenex to dab a forever drooling butthole.
00:47:48.000And I believe that's chapter 18 in your book.
00:47:53.000Hey, Dr. Peter Atiyah, thank you so much for making time for us.
00:47:57.000All the success in the world, not that you need my good wishes, for Outlived, the Science and Art of Longevity.
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