longevity with Peter Attia

What can we do to live longer?

The Buddha said, “To keep the body in good health is a duty … otherwise we shall not be able to keep the mind strong and clear.” And Tony Robbins said, “The human body is the best picture of the human soul.”

Today, we have more medical knowledge than ever before. We’ve developed treatments for all kinds of conditions from acne to cancer, and we’ve greatly expanded our lifespans.

But here’s the problem: We’re living longer, but our quality of life is decreasing. Aging often comes with significant physical problems that are increasingly tough to deal with. As we get older, we may develop knee or hip problems, hearing or vision loss, or even memory problems. These things have a significant impact on our lives and our families — so how can we stay healthier longer?

My guest today is physician, Dr. Peter Attia. Dr. Peter focuses on the applied science of longevity, the extension of human life, and overall well-being. Dr. Peter trained for five years at the Johns Hopkins Hospital in general surgery, where he was the recipient of several prestigious awards, including “Resident of the Year.” He’s spent the last few years being mentored by the top medical scientists and now hosts The Drive, a weekly, deep-dive podcast focusing on maximizing longevity by working on physical, cognitive, and emotional health.

Dr. Peter is the perfect person to talk to about health and longevity, and I’m excited to have him on The School of Greatness today! In fact, our conversation was so fascinating, that I decided to split it into two episodes! In Part One, we talked about how mental health affects longevity, daily practices you can do to live a longer and healthier life, and all the details on Type 2 diabetes. This episode is informative, and I know you’ll get a lot of value from it. Let’s dive in!

Who Is Dr. Peter Attia?

Dr. Peter Attia is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease) while simultaneously improving healthspan (quality of life).

In addition to training at Johns Hopkins Hospital, Dr. Peter also spent two years at the National Institutes of Health as a surgical oncology fellow at the National Cancer Institute, where his research focused on immune-based therapies for melanoma. He has since been mentored by some of the most experienced and innovative lipidologists, endocrinologists, gynecologists, sleep physiologists, and longevity scientists in the United States and Canada.

Dr. Peter earned his M.D. from Stanford University and holds a B.Sc. in mechanical engineering and applied mathematics. He also receives speaking honorariums from organizations, including hospitals and health-related businesses, when he is asked to speak on longevity, metabolic-related topics, athletic performance, and his personal experience working in medicine.

In addition to being an accomplished physician, Dr. Peter is also a successful businessman. He is the Co-founder and Chief Medical Officer of the fasting app Zero. Additionally, Dr. Peter is an advisor to and/or investor in the following companies: Virta Health, Hu Kitchen, Oura Health Oy, Magic Spoon Cereal, Inevitable Ventures, Salutoceuticals, Dexcom, and Supercast.

Dr. Peter has an impressive career, but he’s an even more impressive person in real life! I’m so grateful to him for taking the time to join me here on The School of Greatness!

Lifespan vs. Healthspan

Let’s talk a little bit about the difference between lifespan and health span because there’s a really key distinction between them. Our lifespan is the amount of time we live, and it is steadily growing longer. We’re living to reach older and older ages than ever before, which is great. The problem is that we may be living longer, but we’re living with chronic health conditions that significantly lower our quality of life.

It’s great to live until you’re 90 or 100 years old, but if you spend the last 20 or 30 years in so much pain or with a neurodegenerative disease like Alzheimer’s, you’re not really enjoying those last few decades. Your lifespan may be longer, but your health span — the amount of life you live in good health — isn’t. That’s the problem that Dr. Peter and other doctors like him are trying to solve.

“Healthspan has three pieces, right? It’s the cognitive piece — so how well does your brain work as you age? … Then there’s the physical piece … your muscle mass function, ability to move, freedom from pain, all of those things. And then, of course, this third piece, … which is the emotional resilience and the ability to maintain a tolerance around distress.” – Dr. Peter Attia

When we think of extending our lifespans, we think a lot about our physical health — how well our bodies function. And that’s important, but just as important is our mental health. Throughout our lives, we experience different stressors that can cause strain on our mental health. When we start to experience those mental health issues, we “die” in a sense. Dr. Peter’s goal is to reduce those early “deaths” as much as possible.

“Most people, when they think of death, think of what we call cardiopulmonary death or what I’m calling ‘death-certificate death.’ … But probably 80% of people have actually died one of the other deaths before they die a cardiopulmonary death. So they’ve either died a cognitive death — which is to say their minds have become so dull that they’re really not able to be the people they wanted to be — [or] their body has broken down so much that the things that once gave them so much joy, … they’re deprived of … or emotionally … they’ve become depressed. … And to me, we want to minimize that gap, right? We would like it such that, when you die, it’s really your first encounter with death of any form.” – Dr. Peter Attia

That’s the ultimate goal: To practice medicine and healthy living in such a way that we avoid encountering any kind of death before we have to. That way, we can live lives that are both long and healthy! But to accomplish that goal, we have to learn how to prevent chronic diseases.

The Big Three Chronic Diseases and What We Can Do About Them

When it comes to chronic and life-threatening diseases, Dr. Peter said it comes down to three major things:

“So the big three are, in order, atherosclerotic disease — so that’s vascular disease, meaning heart disease and stroke. … But not too far behind it is cancer. And then take a little step further, and you reach neurodegenerative disease, of which Alzheimer’s disease is far and away the most common and also the most rapidly increasing. … Those three effectively make up three-quarters of deaths of people who don’t smoke.” – Dr. Peter Attia

Those are the three biggest causes of death — heart disease, cancer, and Alzheimer’s. Now, all of those diseases have different effects and treatment methods, and over the last several decades, we’ve learned a lot about preventing and reversing them. However, there’s one disease that underlies all three of these. It’s the common factor behind all three biggest causes of death — Type 2 diabetes.

“There’s one disease, which is not really thought of as a disease, but I think of it as a continuum that is the foundation upon which all of those sit. … It is the one thing that makes all three of those worse, and, in its most extreme state, it’s Type 2 diabetes. … One-half of all Americans … are on that spectrum.” – Dr. Peter Attia

Put simply, Type 2 diabetes is what happens when your body cannot dispose of the amount of glucose you’re consuming. Your body naturally creates glucose in your liver, so when you eat and consume extra glucose, your body sends it to your muscles, and you use it as energy. But when you consume too much glucose, your body can’t use it. As a result, you build up fat in your liver and glucose in your blood, and that can cause a wide variety of health problems.

So how can we combat Type 2 diabetes? Dr. Peter says there are four main ways to do it. The first two are simple: Diet and exercise. By reducing the amount of carbohydrates we consume and by exercising, we reduce the amount of glucose we’re consuming and increase our muscle so that when we do consume glucose, our bodies have somewhere to put it. The other two preventions, however, might surprise you…

Your Sleep Matters

When it comes to reversing the effects of Type 2 diabetes and preventing further chronic health problems, sleep is essential. It turns out that our bodies perform a lot of glucose disposal when we sleep, so sleep is incredibly important for preventing glucose from building up in our bloodstream.

“If I just took 20 guys like you and took them from eight hours a night to four hours a night for two weeks and then did these glucose tolerance tests, I could reduce [their] glucose disposal by 50%. I could basically, within two weeks, turn you into an almost-diabetic … by sleep depriving you.” – Dr. Peter Attia

So what are some things we can do to improve our sleep to keep this from happening? For one thing, we can avoid looking at our electronics before bed. Science has proven time and again that staring at screens right before bed can drastically reduce our sleep. So, if we can turn off the phones well before bedtime, we’ll find it a lot easier to fall asleep.

But that’s not the only thing we can do. It turns out that food has a huge effect on our body’s ability to sleep, so we need to be careful about eating before bed. In fact, Dr. Peter recommended to stop eating about three hours before bedtime.

“Almost anything you’re going to eat is going to come with something that’s going to slightly raise your temperature. So I just generally say — try not to eat too much before bed. … I actually find a fasting sleep to be some of the most amazing … because I’m watching this plummeting temperature, rising heart rate variability, falling heart rate, all of those really valuable things.” – Dr. Peter Attia

When we eat, our bodies naturally raise our temperature — it’s just part of the digestion process. But when we sleep, it’s best for our bodies to be cold — when we sleep cooler, we get more rejuvenating sleep. So, if we can stop eating a few hours before bedtime, we’ll get better sleep, our bodies will process the glucose we consume, and we can avoid Type 2 diabetes.

And when it comes to naps, Dr. Peter says they’re fine, as long as they don’t disrupt your sleep at night. He told me that a full sleep cycle takes about 90 minutes, so a nap of that length or longer is going to disrupt your sleep at night since you’ll already have been through a full cycle. But a quick 20-minute power nap is no big deal!

And finally, the fourth thing that significantly affects our chances of getting Type 2 diabetes is stress. In other words — we have to learn how to manage the causes of stress and anxiety in our lives. And for that, Dr. Peter recommended therapy.

“I think there [are] … basically three ways that we can approach dealing with this: One of these is through psychotherapy, … pharmacotherapy, … and then behavioral therapy, which I’m an overwhelming proponent of — in particular a type of behavioral therapy called Dialectical Behavioral Therapy or DBT.” – Dr. Peter Attia

There are a ton of different types of therapy you can get into, but the end goal is the same. Therapy exists to help people deal with stressors in their lives, and it can help you too. And while learning to manage stress and overcome trauma may not be the only thing it takes to prevent Type 2 diabetes, it will definitely increase your odds of staying healthy longer.

How to Be a Kick-Ass 100-Year-Old

Aside from preventing chronic diseases like Type 2 diabetes, how can we extend our healthspans to become, as Dr. Peter put it, “kick-ass 100-year-olds?” to do just that, Dr. Peter structures his exercise around four main pillars:

“My training is very specific, but now it is fundamentally organized around four pillars: … Stability, strength, mitochondrial or aerobic efficiency, and anaerobic performance.” – Dr. Peter Attia

Those four main pillars focus on the different areas Dr. Peter wants to maintain good health even into old age. He’s playing the long game and working hard to maintain the strength and overall good health he’ll need to continue living an active and fulfilled life even when he’s over 100 years old. It’s not about exercising more, especially as he gets older. It’s about exercising intentionally.

And during all of this intentional exercise, Dr. Peter has one thing in mind: his “Centenarian Olympics.” You’ll be able to read more about this in Dr. Peter’s book when it comes out, but for now, I can tell you that the Centenarian Olympics is a series of activities that Dr. Peter wants to be able to do when he turns 100.

“My Centenarian Olympics has 18 events in it. … I want to be able to pull myself out of a pool … where there’s a one-foot gap between the water and the curb. … I want to be able to hop over a three-foot fence. … And you would say, ‘Peter, those seem really easy,’ and you’d be right as a 37-year-old stud, but the point is … most 60-year-olds couldn’t do them.” – Dr. Peter Attia

Dr. Peter is working hard to keep his body strong and healthy functioning even into old age. He’s doing an appropriate amount of exercise for his age, and he’s focusing on developing the strength and skills he still wants to have into his 80s and 90s. I admire his dedication to becoming a kick-ass 100-year-old, and I only hope I can do the same!

Why You Should Listen to This Dr. Peter Attia Podcast Episode Right Now…

I learned so much from this conversation. It turns out that managing Type 2 diabetes and stress have massive effects on our overall health, and they can even help us increase our health spans. I know I’m inspired to increase my health span in addition to my lifespan, and I hope you are too!

You’ll have to wait until Wednesday for Dr. Peter’s definition of greatness, so for now, I’ll leave you with one final piece of wisdom:

“There are people out there who have so many genetic things working against them, that they’ll be lucky to make it to 80. But the point is, without making these proactive changes, they might’ve lived only until 70. And … they might’ve spent the last 20 of those years in an unbelievable state of misery. So when you contrast living to 70 [and] spending 20 years in misery versus living to 75 with maybe two years in misery, it just doesn’t even strike me as a trade-off.” – Dr. Peter Attia

DMU Timestamp: February 26, 2025 22:37

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