Peter Attia ON: Scientific Ways to Slow Down Aging & How Your Emotional Health is Impacting your Physical Health

Have you ever found yourself thinking you're fine, only to discover that something is not right within your own body? When is the right time to consciously invest in your health, and just how crucial is it to understand your family's health history? There are so many questions and so many answers are needed for us to get a better understanding of our own health. Today, I am excited to share the conversation I had with Peter Attia. Peter is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. He is the host of The Drive, one of the most popular podcasts covering the topics of health and medicine. We explore the the detrimental effects of over-nourishment and three transformative approaches to address this imbalance and unlock the path to optimal well-being, the concept of glucose control and its profound impact on our overall health, and the consequences of consuming nutrient-deficient plants and unravel the complex interplay between regenerative agriculture and the quality of our soil. In our pursuit of healing, we delve into the profound connection between childhood wounds and maladaptive behaviors in adulthood and identify the self-destructive behaviors that may be hindering your progress. In this interview, you'll learn: How to reverse aging When is the best time to invest in your health How to predict and prevent possible health risks The benefits of changing your diet to address deficiencies in your body The link between physical and mental health How unaddressed big T traumas negatively affect our adult life How to undo your self-destructive behaviors Join us on this transformative journey as we uncover the wisdom and insights needed to cultivate a life of vitality, resilience, and healing. With Love and Gratitude, Jay Shetty What We Discuss: 00:00 Intro 00:14 When you think you’re doing okay but you found out that something is wrong with your body 03:42 When is the right time to consciously start investing in your health? 08:50 How important is it to know your family’s health history? 11:26 What is the best methodology to get a complete family history? 14:16 How do people know how healthy they are? How can you predict health risks early? 19:02 Did you know that over-nourishment is bad for our body? There are three ways to address this 25:31 Do you need to take supplements? If so, what types of supplements are good for your body? 28:39 Are you familiar with glucose control? What is it and how can it help you? 35:50 What happens when you’re eating plants that are less nutrient-dense? 39:11 What is regenerative agriculture and complexity of agricultural soil? 45:09 Should people grow their own vegetable garden, and how can they maintain a good quality soil? 49:04 What is the link between your physical and mental health? 53:10 How do wounded children become adoptive children and become mal-adoptive in their adult life? 55:23 Why is it difficult for us to turn around and acknowledge the root of our pain and suffering? 01:04:54 What are your regrets in life? At the moment, what’s your greatest source of joy? 01:10:39 There are certain things in our life that are non-negotiable 01:17:36 Are there any proven ways to prevent and confront cancer? 01:23:53 Have you identified your self destructive behaviors? 01:28:09 Peter on Final Five Episode Resources: Peter Attia | Website Peter Attia | YouTube Peter Attia | Instagram Peter Attia | Facebook Outlive: The Science and Art of Longevity The Drive Podcast Early See omnystudio.com/listener for privacy information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Jay Shetty?

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• 0:45Jay Shetty?

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• 1:28Jay Shetty?

  and it's clinically shown to enrich the gut microbiome. For a limited time, save 20% on your first subscription order of AG1 Next Gen or AG1 Pro at drinkag1.com/onpurpose. That's drinkag1.com/onpurpose. This episode is brought to you by Orange Theory Fitness. One of the best investments you can make is in your own strength. The choices you make today can help shape how you feel for years to come. Orange Theory Fitness provides a one-hour workout to build strength, burn fat, and build muscle with an expert coach guiding you every step of the way. Head to orangetheory.com/onpurpose to learn more and get your first class free.

• 2:12Jay Shetty?

  Orange Theory Fitness: helping people live longer, more vibrant lives. Terms and conditions apply. See webpage in studio for details.

• 2:20Peter Attia?

  You talk to a person the day before they're going to die, they would give anything and everything for more chance at life.

• 2:28Speaker 02

  The bestselling author and host.

• 2:29Speaker 03

  The number one health and wellness podcast.

• 2:31Speaker 02

  On Purpose with Jay Shetty.

• 2:35Jay Shetty?

  Hey, everyone. Welcome back to On Purpose, where you're choosing to listen to become happier, healthier, and more healed. That's our mission here, to leave you feeling happier, healthier, and more healed after listening to these conversations, these workshops, every single day. And I'm so grateful to you for your commitment and dedication to yourself, your investment in yourself, and lending your ears and your eyes to me. I know some of you are listening every single day, so thank you. And keep those reviews coming, keep all of that positive energy coming. It means the world to me. And today's guest is honestly the person that I've been waiting to talk to all year. Because of scheduling, we kept missing each other. I was on a world tour. He's busy traveling. He's launched an incredible

• 3:16Jay Shetty?

  new book this year, helping people. And I'm just so happy that we finally have him here at our LA studio. I'm talking about Peter Attia, the founder of Early Medical, a medical practice that applies the principles of medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their health span. Peter is the host of The Drive. If you don't already subscribe, make sure you do, a podcast covering the topics of health and medicine. Peter is also the author of the number one New York Times bestseller, Outlive: The Science and Art of Longevity. This is the book that I recommend. If you're going to read about your health right now, this is the book I want you to

• 3:57Jay Shetty?

  go and get. Peter Attia, welcome to On Purpose, and thank you for being here.

• 4:02Peter Attia?

  Thank you so much, Jay.

• 4:03Jay Shetty?

  I meant everything I said. I was, you know, really, really looking forward to this conversation. And I want to dive into many aspects of the book, many topics. I've also sourced questions from my team, community, people, real, real life questions that I think people are really struggling with. But I actually want to start with your journey and your story, because I've Gone through similar moments in my life where at a young age I've had different health challenges. When I started to get the right help and support, I started to realize how detrimental those health challenges could be long term if I wasn't to shift things. And the problem is I've always been a fairly healthy guy and had healthy habits.

• 4:43Jay Shetty?

  And so when you get that kind of news, it's kind of alarming and scary and can set fear into you. Now, I know that in your journey, you were a generally healthy person doing pretty healthy things, only to find out that actually you were prone or open to a terrible disease down the road. So could you walk us through what it feels like to think you're healthy, to maybe even feel you're doing okay, but in reality, there's something going on behind the scenes?

• 5:12Peter Attia?

  Yeah, I mean, I think there were two sort of things that were a wake up call for me, and neither of these things happen immediately. I think it's just sometimes the realization that happens immediately. So the first one is I'd always been an athlete my whole life, insanely active, potentially even, you know, active to an unhealthy level. And, you know, the focus of that obsession had always shifted, but at the point in the story that we're talking about, at this point, I was sort of a ultra distance swimmer. So I was, you know, probably in the water, swimming 24 to 28 hours a week, plus, you know, other types of training. Yet, you know, I found out, this is probably around 15 years ago, that, well, actually, on top of that, I was sort of insulin resistant, I was overweight. And again, not that I didn't know

• 5:55Peter Attia?

  I was overweight, you sort of can realize that, but that I was sort of insulin resistant, and, you know, that's sort of the first step on the way towards type 2 diabetes. It was really at that time that I also, I think, confronted my own family history. So just within my genes, the acknowledgement that, you know, basically every man in my family died prematurely of heart disease, and in some cases, very prematurely, in their 40s. Those two realizations in my mid 30s, which also happened to coincide with the birth of my daughter, which was my first child, was a real wake up call. And the realization that, you know, I needed to figure something out so that I didn't just, you know, march down the footsteps of what seemed to be my destiny.

• 6:35Jay Shetty?

  And even then, you were in the medical profession. Right or no?

• 6:38Peter Attia?

  Yeah, although I had actually left medicine at this point. So after ten years of medical training, including medical school, I became sort of disillusioned with medicine and left. So at the time that I'm having this realization, I'm actually in the world of finance and quite far from medicine.

• 6:53Jay Shetty?

  What was your biggest fear at the time? Like, if you could take yourself back to that moment, like, what was the fear that you had?

• 7:00Peter Attia?

  Yeah, that I wouldn't be around to, you know, be with my grandkids and things of that nature. Because I think, you know, prior to my daughter being born, I didn't really think I would be the kind of person that would find any joy in having kids. And that changed in an instant the second she was born. I'm sure there are lots of people who can relate to that, probably more so men than women, I think, because the switch is a little more binary when we have kids. And then the thought of, you know, I'm not going to relive this in thirty years with grandkids. I think that was probably the thing that was the most motivating factor.

• 7:32Jay Shetty?

  Wow, yeah, it it needs that kind of incentive to get activated. And the reason I ask that question is everyone who's listening or watching, I want you to think about what that fear, what that challenge is for you, because often fear isn't a great motivator to keep going, but it's a great place to start. And and our health almost starts there sometimes. Like, I remember that. I remember feeling like Superman when I was in my early twenties. And then all of a sudden, having certain health challenges, I got into chronic fatigue, I had polyps in my throat that had to be lasered out, I lost my voice for a few months. And that wasn't life threatening, but it was life altering in the sense that I couldn't communicate in the same way. It was different getting my voice back and not

• 8:12Jay Shetty?

  feeling like it was as strong or powerful. And then having gut issues and inflammation issues and acid issues and all of these things, again, like, they weren't, it's not that my life was going to end that year, but it's like you start thinking long term and you start thinking about living a unhealthier, harder life. When is the right time for people to consciously start actually investing in their health? And I'm going to caveat that with, what is generally happening in the different decades of our life? So what's happening between zero to ten, ten to twenty, twenty to thirty, thirty to forty, forty to fifty? And when is the time when you have a bit more control and ability to shift the trajectory of your health, bar any, of course, major complications or surprises?

• 8:58Peter Attia?

  I've never actually been asked it that way, but the way you asked it kind of makes me think about different things. The aging process, in some ways, uh, there are some aspects of it that are moving in the wrong direction the moment you were born. In other words, the, the moment a fetus comes into this world, there are certain aspects of aging that are only getting worse. There are others that are not. So you have to imagine now they're talking about different things. So I'll give you an example of each. Something that's getting worse the second you're born is the damage to your arteries. So we call this process atherosclerosis. This is what leads to heart attacks and strokes. Heart attack and stroke is the leading cause of death in the United States for both men and women and globally for both men and women.

• 9:43Peter Attia?

  But it takes an awfully long time. That's why you've never heard of a baby having a heart attack. That's why teenagers don't have heart attacks and people in their twenties, it's almost unheard of, they would have a heart attack. But the disease is starting right away. And we know this because when we've looked at people who have died prematurely from other causes, car accidents, homicide, suicide, and you look at their coronary arteries, you already see evidence of disease. So we know that this is happening right away, and it's simply a matter of time until it reaches a critical level that results in disease. And of course, everybody's accelerating at a different rate based on many factors, genetics, smoking, high blood pressure, metabolic health, all these other things. But point being, that's something for which

• 10:28Peter Attia?

  you could technically argue it's never too soon to start prevention. Then there are other things in which we're actually getting better and better and better until we reach a certain point and then we start to demise. And an example there might be sort of cognitive capacity. So we might have our greatest neuroplasticity in the first few years of life, but we're also building on that. And if we're in the right environment, we're exposed to the right things, we're actually getting, you know, better and better and better at our fluid intelligence. And that probably reaches our peak sometime in our third decade. So that's something where you're actually getting better and better and better. And then it slowly starts to decline. And then there are all sorts of things that are mixtures of these things.

• 11:08Peter Attia?

  So for example, your physical capacity, your muscle mass, strength, power, type two muscle fibers, cardiorespiratory fitness, all of those things are also increasing in capacity. Again, depending on which of those things we're talking about, if it's power and explosiveness, that probably peaks early in the third decade. If it's strength, that peaks a little bit later. Peak cardiorespiratory fitness again in your twenties. And then those things will start to decline. What's undoubtedly clear is for you and I, we're pretty much in decline. So most people listening to this are in a state of decline. And part of the objective, I think, ought to be to slow the rate of decline as much as possible. But there's another aspect to your question, I think is very important, right?

• 11:50Peter Attia?

  Which is like, at what point should you start putting effort into this? And that's a very difficult question because it encompasses a couple of things. When you talk to a person, let's do this as a thought experiment. You talk to a person the day before they're going to die. I mean, they would give anything and everything they have for more chance at life. Despite how high their motivation is, there's no runway left. Conversely, if you went into a high school and talked to a bunch of freshmen and said, I've got the program for you that is going to add 15 years to your life. I mean, they couldn't be less interested, right? So there's a sweet spot somewhere where I almost think people need to go through a little bit of decline.

• 12:35Peter Attia?

  Kind of like what you described, it wasn't life threatening, but you just need to realize that you're fallible. To sort of say, hmm, I can project this movie forward a couple of decades. I've now mature enough to maybe see my parents, see my grandparents, aunts, uncles, friends. People's health deteriorate and realize that's a bit of a reality check that it's coming for me, but yet I still have long enough to bend the arc of my life. And so I think those are the two curves that we're trying to intersect.

• 13:05Jay Shetty?

  Yeah, that's a great answer and I appreciate that. I feel the same way. Unfortunately, it always comes through some sort of pain or some sort of reality check or wake up call that gets us going. And it's interesting what you were saying about cognitive function and ability as well. There were studies that I read that said that the average age of most successful entrepreneurs is thirty seven. And it's fascinating because we live in a world right now where everyone wants to be a successful entrepreneur by the time they're twenty one or twenty five. And we put these artificial pressures on ourself when actually there's so much more to it. In the genetics versus environment debate, what have you, what's the latest in that space of like, because I think we're not,

• 13:47Jay Shetty?

  you said you dove into your family's history. I think most of us are not fully aware of our family's history, even though every time I saw a doctor growing up, they'd always ask, is there this in your family's history? Is there that? First of all, how aware do we need to be of our family's history? How important is that for people to figure out? And second of all, what is that breakdown between genetics and personal environment and career and work?

• 14:10Peter Attia?

  You know, I think actually family history is such an important thing. It's one of these things that we stress to the nth degree with our patients. So much so that, you know, it takes them weeks sometimes to gather the information that we want to know because we want to know. And we give them ten questions for each member of the family. So your parents, your grandparents, your aunts and uncles, your siblings, like, we want to know everything. Do they have high blood pressure? Do they have high cholesterol? Do they take this medication? Do they take that medication? What was their cognitive function like in the last decade of their life? You know, what type of cancers did they have? Did they have low bone density? You know, do they have osteoporosis? I mean, we really want to understand every detail about it. And I think a big part of the reason why is contrary to what

• 14:54Peter Attia?

  Maybe people believe a genetic test does not give you that information. So if you and I went out and got a genetic test, and I don't just mean an over the counter genetic test like 23andMe, but I'm saying if we went out and got the best whole genome sequence money could buy, we spent thousands and thousands of dollars and literally looked at every one of our 20 to 30,000 genes, we still wouldn't be able to impute from a risk standpoint what you can gather from a very well-collected family history. And the reason for that is most genes by themselves are not deterministic, which really gets to your second question. So if most genes are not deterministic, they need something in the environment to sort

• 15:34Peter Attia?

  of trigger them. Furthermore, most conditions that we care about are polygenic. It's easy to think of the sort of Mendelian mono gene type conditions. They get a lot of attention, and they're important to be sure. But the vast majority of things that people care about, cancer, heart disease, dementia, they are not really just related to a single gene. And in many cases, we don't even know what the collection of genes look like. So genes matter, but I think we're going to get the majority of our information by understanding our family history in terms of susceptibility, and the environment matters greatly. And the extension of that is, of course, you have great agency over that.

• 16:14Jay Shetty?

  Yeah. And what is the best methodology for getting the family history in a complete, comprehensive way that's actually going to be?

• 16:20Peter Attia?

  It can be hard if members of the family are deceased. So for people your age and my age, our grandparents, I mean, at least for me, my grandparents are long gone.

• 16:28Jay Shetty?

  Yes, same.

• 16:28Peter Attia?

  So it's, do your parents really remember? And part of it, it just comes down to are they being prompted by the right questions? Now, again, to be honest, in my family history, I have very limited understanding of grandparents because they just died long enough ago. And frankly, I don't think my parents were necessarily great historians of this. In my case, where the bulk of my understanding came from was that my dad came from a very large family. There were 10 kids, two that died young, so eight that survived to adulthood. And there, I was able to elucidate really good information and really understand that there's something very bad going on with respect to heart disease. On my mom's side, I could also see some issues with her two siblings as well that also gave me a sense of what some predispositions might be.

• 17:14Jay Shetty?

  Where can people find those questions or how can they connect with that approach?

• 17:18Peter Attia?

  You know, it's a good question. I don't, we, we have a, a program that we've developed called Early, which is like a digital product that is our practice. I know that it is within there.

• 17:29Jay Shetty?

  Got it.

• 17:30Peter Attia?

  Yeah. So if people like look for early, I don't know if you, I shouldn't know how to do this. If you go to like earlymedical.com, there's a way to find it.

• 17:38Jay Shetty?

  Got it. Got it. Okay. Perfect. Yeah, no, I think that, that kind of practical step is so needed because one of the biggest things when I was talking to my team and talking to the community about health, one of the biggest things that came out is Jay, we're just stuck on where to start. Like, I don't know where to start. I don't, there's just too much information out there. It's oversaturated. Everyone's telling me to do this and that. And it's almost like, well, let's figure out your genetic history. Like, that's a great place to start because that's where we came from.

• 18:04Peter Attia?

  Yeah, this program early is divided into 12 modules. We think each module would take you about a month to get through. And that's the first or second module. I think the first module is setting your goals and going through kind of this type of exercise. And then the second module is, okay, how do you get your family history? How do you take that information and extract what the implications are for you and then go from there?

• 18:25Jay Shetty?

  What's your take on like full body scans and that kind of testing and how often should it be done? Because I think again, what's happening, I was talking to some younger people in our audiences, Gen Z, and it was just like going to see a doctor has become like not even a thought. And I could see that in my generation, but I remember my parents' generation, like my mom will still call me up and be like, have you seen the dentist every six months? Like, have you been to the doctor every 12 months? Like, you know, my mom will still do that with me. But I find that that kind of culture is diminishing day by day because of a lack of trust, because of a lack of transparency, so many different things. Could just be laziness and complacency. What is your take on getting checks? Which checks? How often?

• 19:08Jay Shetty?

  And I guess the question is, how do people know how healthy they are? And early is a great plan, but from the other point of view?

• 19:15Peter Attia?

  It depends on the type of scan. So for example, there are certain scans that are going to be very helpful at predicting risk from heart disease. So for example, a coronary calcium scan for the heart or a CT angiogram for the heart. Those are tests that I don't think are absolutely essential, but they can be very helpful if you're trying to further stratify risk. You referred to a whole body scan. So for the best example of a whole body scan that I think provides value is an MRI. The reason being is an MRI doesn't have radiation, whereas a whole body CT scan or a PET scan would have staggering amounts of radiation. We would never want to do that just from a screening perspective. But of course, not all MRIs are created equal. And anytime you're doing a screening test, you have to be aware of something called sensitivity and specificity.

• 19:59Peter Attia?

  And these are really important parameters. We've put out a lot of content on this because I think it's very confusing for people. So sensitivity is the capacity of a test to detect something if the something is present. So if you're looking at a sensitivity of an MRI scanner for cancer, the sensitivity is how likely is this to detect cancer if cancer is present? So on the topic of whole body scanners, MRIs are very sensitive. Again, not all MRIs are created equal, but I'm assuming we're talking about the best of the best.

• 20:31Jay Shetty?

  Yeah.

• 20:31Peter Attia?

  That's good news. Means if you go into an MRI scanner and you have a cancer, the MRI is quite likely to pick it up. Now, it does have some blind spots and every screening test has a blind spot. So a blind spot that's worth acknowledging for an MRI is a small calcified breast cancer. That's easily going to get missed by an MRI, and that's why it's not a substitute for mammography. A woman would need to do both. The next parameter of a screening test is the specificity. This says, how likely is this test to give you a negative result if indeed the condition is not present? So it's the mirror opposite of sensitivity. Here is where those whole body scanners are abysmal. They have very low specificity.

• 21:15Peter Attia?

  What that translates to in English is they have a lot of false positives. I always tell patients, look, if you're going to go and get these scans, and we advocate that our patients do, but we do it in a much more kind of robust way where it's part of a multiple system of screening tests so that we're covering the bases of everything and trying to attach to the strength and weakness of each study. But when it comes to that MRI, we say, look, there's a really good chance you're going to come out of this test and there's going to be some false positives we're going to need to chase down. So I always feel bad when people sign up to do these scans and they aren't aware of that because it generates sometimes more stress on the back end.

• 21:53Jay Shetty?

  Yeah, I went through that. We had an MRI done and they found like, almost like a group or a cluster of things in an area. And they were like, oh, that could be cancer. Then I had to go and do a endoscopy as well. And luckily they found it was nothing. But I remember for that week before, I was like, that's it. It's all over. Here it is. Like, you know, I need to.

• 22:16Peter Attia?

  Whereas I think sometimes if you're told upfront, hey, Jay, there's like a 15% chance.

• 22:20Jay Shetty?

  Yeah, I didn't, I was not told upfront.

• 22:22Peter Attia?

  Yeah, and we want to make sure our patients understand. And by the way, a subset of our patients, probably 10%, decide, I don't want to have the scan because I don't want to cope with that.

• 22:31Jay Shetty?

  The stress, yeah. Yeah, and it was real. I was like, all right, I'm going to have to get focused on figuring this out because it sounds bad and I didn't have that layup, as you said. And it's really interesting and that's what I find so fascinating today, right? Like, there's managing your health and then there's the stress and the pain that comes with figuring your health out, whether it's the overexposure to too much information, whether it's bad information in the past. And then we're like, oh, well, just forget it. I don't want to do any of it. I mean, that's what I feel your book does, and that's what your work does is trying to help people figure out, well, let me give you all the information. Here's how you can know what's good for you and tested for you and right for you. One of the things that I love that you talk about is you talk about the need to get rid of,

• 23:14Jay Shetty?

  you know, just focusing on a random diet or following a random diet and actually looking at like eating habits and patterns that work for you. And so just putting a little footnote for everyone who's listening. The book will walk you through how to make sense of how to know what is right for you, what is wrong for you, whether you should do something, which I think is like the biggest anxiety driver for so many people when it comes to their health. When it comes to food, I think fasting has become trendy. It's become a big thing that everyone's talking about. You know, we hear so much about every single diet in the world. There's always a new one that's coming on the surface. How have you helped people one on one actually discover what's right for them?

• 23:54Jay Shetty?

  Because I found that my eating patterns are very different to the trending habits of how to eat food and even fasting.

• 24:01Peter Attia?

  Yeah, I mean, I think the first thing is, as you said, it's just letting people understand that the less you can pay attention to social media fads and your news feed on Google or whatever, the better. Acknowledge that there is surprisingly little known about the relationship between nutrition and health, and people are going to be shocked to hear that. Because I think most people think the exact opposite. Most people think that nutrition is the most important pillar of health. And the reality of it is outside of very extreme states, that's, that's really not true. And the very little bit we know about nutrition just frankly speaks to the challenge of scientific inquiry into something as difficult as nutrition to study. And the reason for that is

• 24:44Peter Attia?

  you can't study us as humans very well. We're very messy subjects. So we're not like mice where, you know, you can put us in a cage and control what we're eating and follow us through the duration of our lives. It doesn't work that way. So when you're trying to make inferences about nutrition in humans, you have to rely on poorly controlled studies called epidemiologic studies, which are fraught with all sorts of limitations that I talk about in the book. Or if you're going to control the study, you can only do it for a very short period of time. There's only a short period of time in which I can control exactly what you're eating. So as a result of that, we don't know a lot. So I always want to start with what do we know? Well, we know that protein is a very important macronutrient. There are four macronutrients,

• 25:27Peter Attia?

  carbohydrates, fats, proteins, and alcohol. People kind of forget alcohol, but it's important to understand it's very caloric, and so it constitutes a source of energy. It's the worst macronutrient, but nevertheless, it's, you know, you'd be amazed. Sometimes people are getting like 15 to 20% of their calories from alcohol if they drink enough. So protein is really important, and it's not a source of energy the way carbohydrates and fat is, but it's a structural macronutrient. And so I always start with that and say, look, rule number one is you have to make sure you're getting enough protein. And this is especially true if you're over 50, because if you're over 50, you start to become resistant to the effects of protein. That's called anabolic resistance. And loss of muscle

• 26:06Peter Attia?

  mass in people over 50 is a significant driver of mortality and a significant driver of a poor quality of life. You know, if you really start to think about it, even if a person is of sound mind and they're not, you know, suffering from some intractable disease later in life, a great source of misery is simply being physically unable to do things. After that, it really comes down to what do we understand about energy balance? Well, we understand that too much nutrition, I call this overnutrition, is bad, and that the body historically developed lots of tools to store energy because that's what allowed us to evolve the way we did. And up until, I don't know, 100 years ago

• 26:51Peter Attia?

  or so, that was a great skill to have. It's now thwarting us in an environment of too much food. So now this ability that we had, this superpower basically to store excess energy, has become a liability. In the United States, certainly, the vast majority of people, probably over 70% of people, are overnourished. And that's the thing that's driving a lot of their poor health. If you're overnourished, you have to correct that problem. The way to correct that problem is to eat less. And there are three strategies to do that. One of them is to deliberately go about cutting calories. That's called calorie restriction or CR. The other one is called dietary restriction. That means limit certain things within the diet.

• 27:32Peter Attia?

  And if you are restrictive enough, that will indirectly also reduce total intake. And then the third is fasting or time restricted eating, where you create a narrower and narrower window each day in which to eat. All of these things can work and all of those things have significant limitations that you, as an individual practicing this, need to know.

• 27:54Jay Shetty?

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• 28:38Jay Shetty?

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• 29:20Jay Shetty?

  Yeah, it was incredible. I was looking at the just history of the design of plates and cups randomly. I don't even know how I got there.

• 29:29Peter Attia?

  How much bigger they're getting.

• 29:30Jay Shetty?

  Just how much bigger they're getting. And it was insane for me to think that the way plates are designed, the way cups are designed, the way anything's designed transforms how we consume. And it's fascinating to think that just because of a larger plate size, we're now eating larger amounts. And we think it's normal in our time. Whereas someone else would have think we were feasting.

• 29:52Peter Attia?

  I'm sure you still get back to Europe all the time, but like, look at the difference in portion sizes when you're in, you know, Italy versus the United States. It's comical what a difference it is.

• 30:01Jay Shetty?

  Yeah, I remember as a kid coming to the States and obviously when you're a kid, everything that's big is better.

• 30:07Peter Attia?

  Yeah, yeah.

• 30:07Jay Shetty?

  And I remember like pulling over at the gas station and I'd see like this massive like, you know, jumbo thing to fill your drink cup in and like, you know, forever refilled or whatever it is. And just that, as a kid, I was like, this is the coolest thing in the world. And now you look at it, you're like, wow, that's, you know, there's no need for that. So it's fascinating also how these cultural shifts and cultural changes have made some of these things harder for us today. So you said CR, DR and TR. Those are the three that people need to experiment with each of those.

• 30:37Peter Attia?

  Yeah, basically, if you are in that overnourished camp, you need to employ some combination of CR, DR and/or TR. And if you're adequately muscled, that's you can just focus on that. If you're inadequately muscled, you have the added challenge of needing to boost protein intake to match strength training while engaging in CR, DR, TR.

• 31:03Jay Shetty?

  Yeah.

• 31:03Peter Attia?

  But the raw of it is, that's it.

• 31:05Jay Shetty?

  Yeah.

• 31:05Peter Attia?

  You know, the rest of it, the alphabet soup of diets is just, it's all noise. I just encourage people to not fixate on the trend and just think about those different things because, you know, look, each of the alphabet soup diets fits into some form of DR. I mean, and that's true, whether you're talking carnivore or vegan or everything in between. Those are just forms of DR and they can all be effective. But you have to be aware of the limitations of each and make sure you're circumventing them.

• 31:31Jay Shetty?

  Yeah, absolutely, absolutely. I think that.

• 31:35Jay Shetty?

  One of the things that there's a lot of question marks around as well from the community that they were asking was nutrition, which you've beautifully clarified there, but nutrition versus supplements.

• 31:44Peter Attia?

  Yeah.

• 31:44Jay Shetty?

  And the need for supplements. And I think I would love to hear your takes on supplements that are working, types of supplements, types of ingredients, types of chemicals that are making a difference, natural supplements too. I'd love to hear your thoughts on nootropics, because I'm just hearing about nootropics everywhere right now. Adaptogens, as you just tried as well, we've been, we've been focusing on adaptogens. I'd love to, let's talk about your take on great supplements that everyone needs to take, not, not a brand, but I mean, like, and then your take on nootropics and adaptogens. That would be fantastic.

• 32:15Peter Attia?

  I mean, I definitely do take some supplements. I'm always careful to kind of make disclosures. So one thing I do supplement, I take something called AG. And I'm an investor in AG, but I'd been taking it long before I invested in it. And I know the founder very well. I'm very under the hood of exactly how their products are made and sourced. And for folks who aren't aware, AG is like a green that you, you know, just mix in with water. I drink it every morning.

• 32:38Jay Shetty?

  They sponsor the podcast.

• 32:40Peter Attia?

  Are they?

• 32:40Jay Shetty?

  Yeah.

• 32:41Peter Attia?

  Okay, cool.

• 32:41Jay Shetty?

  Yeah.

• 32:42Peter Attia?

  And my approach to that is if you buy the thesis that we need to be having X amount of vegetables a day, and let's be clear and be transparent, I can't guarantee that that is true, because we don't know. That's another example of something that the epidemiology tells us is true, but there are many confounders there. But my view is that it's better to err on the side of that's probably true than the, than the counter. So if you buy the thesis that you need X amount of vegetable a day, I actually find it very difficult to do that without exception. There are lots of days I can, but there are enough days that I can't. So my view of a supplement like AG is it's my belt and suspenders

• 33:27Peter Attia?

  approach. It's, it's basically my way of guaranteeing that by seven o'clock in the morning, I've met my needs. And then if I have a salad for lunch and dinner as well, perfect, I went a little overboard. But that's better than the reverse to me. So that's one.

• 33:41Jay Shetty?

  And, and AG specifically, talking about that kind of a supplement, that's a vegetable focused supplement.

• 33:45Peter Attia?

  That's right.

• 33:46Jay Shetty?

  Not all supplements are.

• 33:47Peter Attia?

  That's right.

• 33:48Jay Shetty?

  Specifically focused on that.

• 33:49Peter Attia?

  No, no, that's, that's specific to AG.

• 33:50Jay Shetty?

  Yeah, yeah.

• 33:50Peter Attia?

  There's another supplement I take, which is a probiotic. Now, no one has been a more. Vocal critic of the probiotic space than me. I have generally viewed it as a space that has demonstrated no efficacy despite all the intentions in the world. In the past year, I have sort of changed my take. So there was this study that came out that looked at a certain type of probiotic and noted that a certain type of bacteria in it would help with the production of something called butyrate, and this was actually helping with glucose disposal. The results of the study actually were pretty impressive. It was a relatively short study, a three-month study, but it demonstrated in the group that

• 34:31Peter Attia?

  was actually taking this probiotic, and this was in a blinded randomized trial, that these patients with type 2 diabetes had a significant reduction in blood glucose. Even though I don't have type 2 diabetes, I sort of subscribe to the idea that everybody benefits from lower blood glucose, including those without diabetes. So that's a probiotic that I take. I don't have any involvement with the company. The company's called Pendulum, but I take their glucose control probiotic.

• 34:54Jay Shetty?

  Can you walk us through a bit on glucose control? Because I think that's still an area that, for people who are not as well-informed, that's an area that I learned about probably in the last year and a half that has changed what I eat first thing in the morning. It's changed what I'm eating at different times. Like, to me, I was just like, oh, if I need a boost of something, as long as it's a healthy sugar, it's fine, not only to realize that, you know, causing spikes in my blood glucose level. So could you walk us through that a little bit?

• 35:21Peter Attia?

  You know, glucose is this essential, very simple carbohydrate. It's kind of the final common pathway of most carbohydrates. There are other simple carbohydrates as well, fructose being one of them. So sugar, for example, table sugar, is a molecule of fructose and a molecule of glucose. But glucose is the most abundant carbohydrate, final breakdown product, and it's very highly regulated. At any point in time, you're walking around with, you know, if you haven't eaten that day, somewhere between four and five grams of glucose in your blood, maybe, say, four to six grams of glucose in your blood, which is just over a tablespoon, or a teaspoon, rather. So tiny, tiny amount.

• 36:03Peter Attia?

  But you're using it constantly and therefore your liver is constantly putting more out into your circulation ever so delicately. And the balance of that is so fine that if that level were to be just twice as much, if you were to go from one teaspoon, two teaspoon to two teaspoons, that would be consistent with having type 2 diabetes. So type 2 diabetes is a condition where an individual can't control the amount of glucose in their blood. This is very problematic because glucose, when it becomes too high, starts sticking to proteins and it starts causing damage all over the place, but primarily to small blood vessels. So blood vessels in the heart, blood vessels in the kidney, in the brain, if you're, if

• 36:45Peter Attia?

  you're, you know, in the extremities of the toes, that's why people with type 2 diabetes are more susceptible to amputations, kidney disease, heart disease, strokes, Alzheimer's disease, all of these things, anything that compromises blood flow and oxygen. So it turns out that even if you don't have type 2 diabetes, and that today is just defined by a threshold of average blood glucose above 140 mg per deciliter, even if you are not in that category, it still appears that your mortality goes down the lower your average blood glucose. So, meaning within the normal range of glucose, lower is still better. People sometimes say, "Well, does that just mean, you know, you should never eat a food that raises blood glucose?"

• 37:29Peter Attia?

  No, that doesn't necessarily mean that at all. What it means is you need to be mindful of matching your glucose consumption to your capacity to dispose of glucose. And those are factors that are of course highly impacted by how much you sleep. So sleep, interruptions in sleep dramatically reduce your capacity to put glucose into your muscles, which means glucose levels get higher. It also has to do significantly with how much you exercise and how much muscle mass you have. So people can have completely different tolerances for glucose, and I think I write quite a bit about this, which is, you know, basically trying to understand your, your glucose tolerance level comes down to matching it with... Your insulin sensitivity, muscle mass, activity levels, sleep, stress, et cetera.

• 38:12Jay Shetty?

  Absolutely. Thank you so much. Sorry, and I cut you off from moving forward.

• 38:15Peter Attia?

  No, that's okay. So just to go back to this other point quickly. So there are lots of other supplements that I think can be really valuable. I think B vitamins are very important, especially methylated B vitamins. Vitamin D is very important. Many people, I think, don't have sufficient levels of vitamin D. I think the data on vitamin D, we could do an entire podcast on that. The clinical trials looking at vitamin D levels are really poorly done, clinical trials. And so I think if a person looks at the literature and the literature says there's no evidence that vitamin D really helps, I would argue pretty strongly that those trials haven't asked the right question and weren't designed correctly. So my view is it's better to probably err on the side of caution and make sure your vitamin D is probably somewhere between about 40 and 60. And if you're not achieving that through natural exposure to sunlight, which many people are not, then you're probably better off supplementing. There are a couple

• 39:00Peter Attia?

  of other supplements I really believe in, and I think magnesium is a very important one. And I think you have to be thoughtful about the form in which you take magnesium. So you can take magnesium in a slow absorbing form or a fast absorbing form that's poorly absorbed technically. And I think we need both, right? So I think that like a poorly absorbed magnesium would be like a citrate, glycinate, or oxide. And those actually really help with bowel regularity. So for anybody who's a little bit constipated, or just, you know, kind of needs to be a little bit more regular, we always want to have in anywhere from 200 to 500 milligrams of one of those forms. Conversely, I think virtually everybody also benefits from a slow absorbing form of magnesium. The brand that I like is called

• 39:44Peter Attia?

  Slow Mag. Again, I don't have any affiliation with any of these companies unless I'm disclosing it as I did with AG. That actually, you know, so most people, if they notice, oh, I have a little bit of cramping sometimes, or, you know, I'm getting little palpitations called PVC sometimes, those get a lot better with magnesium supplementation. So, so I think most people benefit from that. There's another type of magnesium that I'm a fan of called magnesium L-3-nit, which is magnesium paired to a transporter that gets the magnesium into the brain. I think there's reasonable evidence. I wouldn't say it's incredible, but I think it's quite good that magnesium L-3-nit is beneficial to the brain and might

• 40:23Peter Attia?

  even have some capacity to reduce the risk of dementia. Before bed, I tend to rely on ashwagandha, which I believe you said is in there. So I take a big dose of ashwagandha and glycine. And again, I take that magnesium L3 and 8, and those are kind of things that I think help with reducing cortisol and making it a little easier to sleep. Then the final supplement that I do think most people benefit from, and there are probably many others, but I'm just sort of going through a few that I can think of, would be fish oil. So, most people probably don't consume enough marine fat to get what I think are

• 41:02Peter Attia?

  ideal amounts of EPA and DHA, which are two very special types of fats called omega-3 fatty acids. And EPA and DHA, I think the balance of evidence is quite strong, that they're both beneficial to the heart and the brain. EPA probably a little bit more for the heart, DHA probably a little bit more for the brain. I take a brand that I've had tested, because you always want to be careful about contaminants here, and it's made by a company called Carlson's. Again, I have no affiliation with them, but I take their EPA and DHA daily as well.

• 41:40Jay Shetty?

  That's a fantastic summary for anyone who's looking. I take all those things. You know, I think that's a brilliant summary, and I really hope everyone who's listening and watching, you know, get those checks and tests done and grab those supplements. Because again, I like what you're saying, that it's all about erring on the side of caution, right? It's almost like protecting yourself, being safe, rather than assuming that A, you get this, or B, it doesn't really matter. You know, is it that we used to find these supplements in other forms before? Or as humans, have we always ignored this, and now we've suddenly figured it out? Or has our lifestyle just got so stressful and intense that we're needing more of all of this to support the pace at which we're moving?

• 42:22Peter Attia?

  Yeah, it's a great question. I do think that the supplement world is such a slippery, dirty world, that I always want to throw out a disclaimer, which is when I talk about these things, I'm also very diligent about the brands that I buy. So, again, I have no affiliation with any of these entities, but having looked at third-party testing, I find the brand Jarrow, J-A-R-R-O-W, the brand Pure Encapsulations, to be two of the most reputable companies out there. So, I'm basically always going to try to buy from them if I can, even if I'm paying a little bit of a premium. Your question is a very good one, and I don't know how much you've paid attention to kind of the field of regenerative agriculture, but it's a topic that interests me quite

• 43:05Peter Attia?

  a bit. And the more I've read about it, the more I've come to realize that I actually think part of the problem is our food today is far less nutrient dense than it once was. And so I do think that many of us don't get the same quantity and density of nutrients today that we did for the same caloric intake, say, 50 years ago. And the proponents of regenerative agriculture would argue that a big part of that has to do with soil health. So as the health of the soil has deteriorated with more tillage, more fertilizers, less crop rotation, all of these things, the net result of that is the plants themselves

• 43:47Peter Attia?

  are less healthy. So when you're eating a plant, you're getting less nutrient density. And of course, when you're eating meat, if you're an omnivore, the meat is also less healthy and less nutrient dense because it's eating a less nutrient dense plant, which is growing in a less nutrient dense soil. And so the old adage that, you know, it's hard to be healthier than the animal you eat, which can't be much healthier than the plant it eats, which can't be much healthier than the soil it grows in, brings this whole thing full circle. And so I suspect that that plays a pretty significant role in it, coupled with the changes in our lifestyle, right? So many of us would have got sufficient vitamin D, for example, in the past, because we would have been outside more and we would

• 44:30Peter Attia?

  have been active more. And, you know, today we aren't, as one example.

• 44:33Jay Shetty?

  Are you seeing the rise of more regenerative farming and places to buy regenerative vegetables?

• 44:41Peter Attia?

  Yeah, I mean, you have

• 44:42Jay Shetty?

  Is that even a thing?

• 44:43Peter Attia?

  No, it absolutely is. And there are, there are some great places. You know, certainly one of my sincere hopes is that You know, we see, we see a greater and greater movement to scale this because I, I do think regenerative agriculture is not only what I think of as one of the most important ways in which we can improve human health through nutrition, but, but for folks who are also concerned with, with climate change and the effects of anthropogenic CO2, regenerative agriculture probably has more potential to attenuate that than anything else, inclusive of electrifying the entire transportation grid. And that's a pretty bold statement.

• 45:23Jay Shetty?

  It is, it's very bold and that's why I want to dive into it too. Like what gives you confidence to make that bold statement? Like what have you seen that has given you that conviction?

• 45:31Peter Attia?

  It really comes down to understanding the capacity for plants to fixate carbon. I'm sure everybody understands, you know, the basics of how, how CO2 works, right? So why, why is there a concern with the combustion of fossil fuels? Because when you're combusting a fossil fuel, whether it be coal or natural gas, you're taking carbon that was sequestered billions of years ago in the form of fossilized, you know, organic matter, and you're now liberating that carbon dioxide out. So how do we get carbon dioxide back in the system? Well, plants do that. So plants have a capacity to do something that no animal does, which is they fixate carbon. So they fix, fixing carbon literally is just the chemical process of taking a carbon out of the, out of CO2 and attaching it to another hydrocarbon.

• 46:16Peter Attia?

  The way that regenerative agriculture works is by storing more and more CO2 and carbon specifically in the soil. So right now, the way conventional agriculture works, when you're constantly tilling the soil, you're leaching carbon out of the soil. And so, you know, when you look at the mathematical models that look at how much carbon could be brought back into the ground and sequestered, i.e. brought out of the atmosphere, it's more significant than the carbon that's being put out through the combustion of fossil fuels. The reason I'm particularly excited about that is you're basically getting two wins for the price of one, right?

• 46:58Peter Attia?

  So you're reducing atmospheric CO2, but doing so in a manner that's also very positive for our health because in doing that, you're increasing the soil health and by extension, then the nutrient density of plants and ultimately animals and our

• 47:16Jay Shetty?

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• 48:00Jay Shetty?

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• 49:12Jay Shetty?

  What's your take on regenerative agriculture versus lab-produced?

• 49:17Jay Shetty?

  Vegetables.

• 49:18Peter Attia?

  I have yet to see any evidence that laboratory produced meats and vegetables can be done really well at scale or that they are particularly certainly any more viable in terms of of the nutrient density. I think in part it comes down to the complexity of soil. There's a great book I would recommend for people who want to go really deep on this. I believe the book is called What Your Food Ate and it's it's a wonderful book. It's a it's a bit of a deep dive. It's a nerdy book. It's not light reading and they go into incredible detail about

• 49:52Jay Shetty?

  David R. Montgomery is that?

• 49:54Peter Attia?

  Yes, and there's another author as well, a female.

• 49:56Jay Shetty?

  Anne?

• 49:57Peter Attia?

  Yep.

• 49:57Jay Shetty?

  Anne Beekley?

• 49:58Peter Attia?

  Yep. Once you get under the hood of how complex soil is. So for example, many people talk about the human gut biome. And, you know, we talked a minute ago about probiotics, right? Well, the human gut biome is really complicated and we haven't figured out a way to perfectly model it. I mean, maybe we're just getting to the point where we can figure out if we add a little bit more of one bacteria, can it make a difference in the direction that this thing goes? Well, it turns out that soil is probably even more biodiverse and complicated than the bacteria in our gut. And so again, I just think it's very difficult for us to sort of play super farmer and think that we can kind of replicate what nature has figured out for, you know, literally a billion years.

• 50:43Jay Shetty?

  Wow. So yeah, so your understanding is actually that we don't know enough about the complexity of the soil, which is actually what is impacting the quality of the vegetable or hence the meat.

• 50:56Peter Attia?

  And all the way up the chain.

• 50:57Jay Shetty?

  And all the way up the chain.

• 50:58Peter Attia?

  Yeah.

• 50:58Jay Shetty?

  Hence, even if we can produce a vegetable or meat in a lab, it won't have that same.

• 51:05Peter Attia?

  That's my take on it, which says nothing about, which says nothing, by the way, about the scale factor. I think at the end of the day, scale matters. Like, I mean, food.

• 51:16Peter Attia?

  I think it's safe to say agriculture is the second largest industry in the world. Just in terms of like the magnitude of what it takes, you have to have solutions that work broadly. And by the way, I think that's still, there are certainly proponents of regenerative ag who say it can be scaled, but I think that's an open question still.

• 51:35Jay Shetty?

  Regenerative agriculture being scaled.

• 51:37Peter Attia?

  Can it be scaled to meet the needs of the entire world?

• 51:40Jay Shetty?

  Yeah. What are the challenges with scaling that?

• 51:43Peter Attia?

  It's a totally different infrastructure, truthfully, right? It's not going to rely on as much automation. So for example, like you're not going to be able to rely, you know, so one of the hallmarks of regenerative ag is you're not using fertilizer, you're not, so you're not using the nitrogen of a fertilizer. You're actually using the nitrogen of the animals. Another one is you're not using pesticides. So you're crop rotating instead of using pesticides and allowing, you know, the crops themselves to generate resistance by cycling them and not letting the pests get used to the same crop, not to, you know, belabor the point. But all of a sudden, the industry that is now dominated by the pioneers, the Cargills, the Monsanto's of the world, it's going to have to look very different.

• 52:25Peter Attia?

  So I think that's a big challenge is going from big to little and then scaling little, if that makes sense.

• 52:31Jay Shetty?

  Where are the places, like if people are fascinated to, have you been out to any regenerative agriculture farms?

• 52:37Peter Attia?

  Yeah, yeah, there's, there's one outside of Austin. There's actually one here in California.

• 52:43Jay Shetty?

  So there's not that many, there's like.

• 52:45Peter Attia?

  I mean, there's, so the one out in California is called, there was a documentary made about it called, I think the documentary was called Biggest Little Farm. It's not too far from here, by the way. And my kids were obsessed with this, so we like watched this documentary like, I don't know, 15 times. But you'll get a sense of what it looks like, but yes, no, I mean, you, I think everybody can find regenerative farms near them. So really, it's just a question of helping farmers understand why ultimately it is in their best interest to do this. So economically, it makes more sense. But look, it's going to require the government completely changing incentive structures and changing the way they subsidize certain crops today. It's a big shift.

• 53:23Jay Shetty?

  Yeah. What's your take on people trying to create little farms in their home? Like they're like mini growing.

• 53:29Peter Attia?

  Yeah, I mean, look, I think it's wonderful. I think if you can grow your own vegetables. I mean, we have a vegetable garden and there's no question that the vegetables we grow taste infinitely better than anything we're going to buy at the grocery store.

• 53:42Jay Shetty?

  And how do you take care of the soil in your area? You're saying because it's untouched, it naturally has.

• 53:47Peter Attia?

  Yeah, I mean, we use, we compost our own stuff. So, but it's, you know, look, it's not even big enough to completely feed us. So, you know, it's, it's, there's work that goes into this. And I, and I have friends that, that do have the time and effort to at least, you know, support themselves fully.

• 54:04Jay Shetty?

  That's beautiful. Yeah, I love that. You know, my wife's really, my wife's really big on that. She wants to build a little vegetable garden on the back right now in, in the same way, because that's one of her core beliefs as well. So.

• 54:14Peter Attia?

  Just this past weekend, I was, I had to put all this chicken wire around the fence where our garden is because these squirrels are figuring out a way to get under the fence. And they're like eating all the tomatoes and the peppers and stuff. And it's like my son, who's eight, this is his project. And it just drives him nuts when the squirrels are getting them. So.

• 54:34Jay Shetty?

  What a great age to like get connected to.

• 54:37Peter Attia?

  So, so great.

• 54:38Jay Shetty?

  Yeah, to the land and to the soil and to growing. That's so beautiful. I love that. Yeah, we've had a gopher problem for, for years here. And it's like, it's always ruining the lawn. And I'm like, well, if I plant vegetables here, those vegetables are going to be gone.

• 54:50Peter Attia?

  Yeah, you have to be, you have to be smart about it.

• 54:52Jay Shetty?

  Yeah, yeah. Incredible. I, I want to make sure that everyone knows that the book dives into cancer, Alzheimer's. We talked, we were going to dive into exercise in a second. We talked about diet, you know, eating less, eating patterns. I want to make sure, because I don't want to either repeat things that are already in the book or repeat things you've talked about in other interviews. And so I just want everyone who's listening to know that, that, you know, it dives into multiple key diseases that we're all struggling with today and the biggest challenges. One thing I wanted to talk to you about, which I think you really wonderfully highlighted was this challenge between physical health and emotional health. And you talk about the need for prioritizing emotional health

• 55:35Jay Shetty?

  as well. And I've found that so much of my.

• 55:41Jay Shetty?

  Subtle emotional health was so based on physical health. So what I mean by that is I found at one point in doing all of my checks and tests that, and by the way, I was doing, I was functioning at like a really optimal level. I was just feeling tired. And when we did my test, we found that my vitamin D was at a 10. This was around two, three years ago. And I realized the majority of the challenges I was having was because I was sleeping. We rented a home during COVID. We moved from our apartment and when we rented this space, I never slept well in that space because it was just the most like noisy, loud area because they were, it was, it was in

• 56:24Jay Shetty?

  the middle of too many animals, too many things at night, like going through the floorboards. Like it was an old, old space. And so there was like, I was waking up multiple times, which I don't usually go through. And so I started to find that a lot of my emotional challenges, whether it was fatigue, irritability, um, you know, stress because of that environment was causing emotional challenges, but it was actually all coming from a physical space, if that makes sense?

• 56:51Peter Attia?

  For sure.

• 56:52Jay Shetty?

  And, and I think so often these days I find a lot of us are just trying to solve everything in our mind rather than recognizing that often it's a chemical, it's biological, it's, it's physical. Uh, so I want to just point that out to people because I think a lot of us are like, I could have done anything to change. I was working out, I was trying to sleep right, I was doing everything I possibly could. But because my vitamin D was at a level 10, there's not much you can do instead of taking, apart from taking vitamin D supplements. How, where are you saying this relationship? Where are you seeing this relationship between emotional health and physical health?

• 57:25Peter Attia?

  Well, they're absolutely linked and you know, I think that one of the things that I've observed. You know, my therapists will always ask me at the beginning of a session is, how are you doing physically? So are you in pain? Right? Is, you know, is your shoulder bugging you? Is your back bugging you? Do you have like an ulcer in your mouth or something like, like literally something like that? How are you rested? And how much stress are you under? And the reason I think is those things exacerbate vulnerabilities that we have on the emotional side, on the mental side. So if you take an individual in two parallel, the same individual in two parallel universes, but in one situation, they have lots of issues going on physically. Right?

• 58:09Peter Attia?

  So they're not well rested. Their vitamin D is low. They're in pain. And you have another individual for which everything is physically firing on all cylinders. And you present them with the same emotional distress. You're going to see a completely different response. That's a big part of why I think it does matter to keep your physical health in order to optimize your emotional health. But I would also argue that you could still have your physical health in perfect order. And, you know, not becoming close to addressing your emotional health.

• 58:42Jay Shetty?

  When you use the term emotional health, what does that constitute for you?

• 58:47Peter Attia?

  I try to distinguish it from mental health. Right? I think mental health is a subset of emotional health, but it's the, perhaps the more medicalized piece of it. So in, in medicine, we use something called the DSM, the Diagnostic and Statistical Manual. I think we're in version five. And that's the one that codifies psychiatric illnesses, right? Everything from depression, anxiety, different personality disorders and all sorts of things like that. And those things clearly matter. But I'm talking about something that is applicable to everyone, whereas those things might only be applicable to people who would meet diagnostic criteria. So emotional health in the sense, the way I think about it, kind of encompasses your relationships with other people, your sense of purpose, fulfillment, happiness, joy.

• 59:32Peter Attia?

  Spontaneity, all of these things that every human should be thinking about because every human is a part of those things. In my case, you know, so the, so the book is written, basically it's 17 chapters. 16 of the chapters are me, you know, writing about it as the doctor, the scientist. And then the last chapter, which is about emotional health, is me actually just writing about my personal experience and my own, well, transformation, I think would be an understatement. You know, I think that the most important lesson for me in the past decade has been that all the health stuff that's, that makes up most of that book, how do you reduce your odds of getting cancer? How do you reduce your odds of getting heart disease, Alzheimer's disease?

• 1:00:17Peter Attia?

  How do you make sure your muscles work better in the last decade of, you know, all those things? They're very important. But if you're miserable, none of it matters. Right? If your relationships suck, none of it matters. And I can't state that enough, but I, I couldn't have understood that a decade ago. You know, I had to personally experience things going really wrong. I had to nearly lose everything to realize I've really missed the plot here. And if I don't get this stuff addressed, then the rest of this outliving doesn't mean anything.

• 1:00:55Jay Shetty?

  What was the wake up call for you or what was the?

• 1:00:58Peter Attia?

  Uh, I mean, I think it was essentially almost losing my family. Right? It was just being so, so selfish and so, such an awful person that, you know, I, I finally woke up and realized how much I was hurting everybody around me. And I was confronted with that and confronted with the reality that I had no choice but to go away and get help to, to sort of address my own reasons for why my coping mechanisms were so negative.

• 1:01:24Jay Shetty?

  What, what made you so selfish and awful? Like, where did that come from?

• 1:01:28Peter Attia?

  Well, I mean, again, at the time I had no clue, but, but also at the time, I don't think I was even privy to understanding what, um, what I was doing. But, but obviously as I, as I talk about in the chapter and I. What I basically learned is, I think a lot of my adaptations had to do with, you know, certain things in my childhood, some of which were, you know, I describe as kind of big T-trauma, and some of which are frankly just little T-trauma. But collectively, they just produced a response, an adaptation. I talk about this sort of model of trauma where wounded children become adaptive children. And adaptive children are there to protect the wounded children. And I think that's a remarkable trait of us as humans, right? We are very resilient.

• 1:02:13Peter Attia?

  The problem is that a lot of those adaptations become maladaptive in adult life. And I think that's really what I was dealing with, was so many of my adaptations, you know, for example, control, drive, perfection, anger, all of those things served me quite well as a child. But as a husband and as a father, they were not serving me well anymore. And all of the good that came from those adaptations, for example, a strong work ethic, a desire to do good, was more being done for the wrong reasons. It was, I'll show them, I will, you know, I will matter. My self-esteem will be based on performance, et cetera.

• 1:02:59Peter Attia?

  And I think all of that had to be turned on its head. For me, that was sort of my journey, was learning how to undo all of the maladaptive behaviors to try to keep the good parts of the adaptation, and then shed the harmful ones.

• 1:03:14Jay Shetty?

  Why do you think it takes us? Thank you for sharing, by the way, and I know you go into more depth in the book. And I find this fascinating, and I think people, I'm so happy that you address it, because I think people find it especially fascinating from coming from you. Because often they're just seen as such separate things and separate pursuits. But for you to unify in them is really, really interesting. Why do you think it takes so many of us so long to address the very root cause of so much of our problems? And you partly covered it there, that some of these things become superpowers in the material world, like they're phenomenal. You know, manipulating the outside world through control and perfectionism, et cetera.

• 1:03:58Jay Shetty?

  But then in the inner world and the the family tends to suffer from that. Why does it take us so long to look backwards, almost to look forwards in both our genetic

• 1:04:09Peter Attia?

  Yeah.

• 1:04:10Jay Shetty?

  background and our also genetic trauma in that sense?

• 1:04:14Peter Attia?

  I don't think we want to uncover painful things unless the pain that we're confronting is greater than the pain we're going to encounter by doing so. That's probably my simplest thought as to why. I just think that, like, how many people without ever having experienced dental pain would go to the dentist, right? Like, you do as a kid because you're sort of told. But but when I think about now, like, why do I put so much effort into taking care of my teeth? It's because I've learned how miserable it is when when I don't.

• 1:04:50Peter Attia?

  I think until you experience enough discomfort in the present, and in my case, that came through the circumstances I write about, the pain of turning around and going back and exploring what happened and why, and and then embarking on the corrective steps and learning a whole new language and a whole new set of skills. I mean, there's we in chemistry, we call that the activation energy of a chemical reaction, right? So, you know, every chemical reaction has to overcome some sort of activation energy. And the higher that activation energy, the less likely that reaction is to take place. So enzymes, which people have heard, what's an enzyme do?

• 1:05:35Peter Attia?

  An enzyme or a catalyst will make that reaction more likely. It lowers that barrier to activation. So I think what we need in our life are catalysts. We need something, and unfortunately, I think sometimes it often has to be painful, a loss, to to force us to do that. I make a point when I showed up in the first rehab place I went to, there was this, there's a woman that I met there who could sort of see from the look on my face that I wasn't happy to be there. She just said to me in a manner that was just so perfect. She said, hey, nobody shows up here on a winning streak.

• 1:06:09Jay Shetty?

  Yeah.

• 1:06:10Peter Attia?

  This is just 100% true.

• 1:06:11Jay Shetty?

  Hmm. How how did you help the people around you that you cared about? Be patient as you went through your own journey because I feel like it's really interesting. When we're trying to solve our own wounds and pain, it's already so hard. But because we've taken on responsibilities or commitments, whether that be in a marriage or as a parent or even as a CEO or a boss or whatever it may be, it's like all of a sudden you have so many other commitments that you had taken on even before you realized you had to work on yourself. Did you find yourself helping them while you helped yourself to be around and be supportive as opposed to like tap out and say, you know what, we don't want to be around?

• 1:06:55Jay Shetty?

  Because I think we often look at like, how are people helping us in our time of struggle? But sometimes it's like, we already committed to them and then we realized that. Does that make any sense?

• 1:07:05Peter Attia?

  It makes a ton of sense and I, I, I will tell you, I think it just speaks to how fortunate I am and perhaps why I feel I have an obligation to talk about it, which is I just think I was really lucky and that the people around me stood by me and let me go through this and, and gave me the chance to do it and stood by me because I don't, I don't think many people would have. I really, you know, I've said this to my wife many times. I describe her as like, you know, sort of Hall of Fame wife who didn't really need to stick by me. I think she had enough reasons to leave and take my kids away and just say, to hell with that guy. And that she didn't, I will forever pay that forward. And I think the same is true of people that I worked with who knew I was struggling.

• 1:07:47Peter Attia?

  I think deep down believed that I was not a bad person. I was a good person who did very bad things and that I deserved another chance. I wish I could say I was supporting them on that journey, but I don't think I was. I think I was just reeling in pain and lucky that they stood by me.

• 1:08:04Jay Shetty?

  Well, thank you for sharing that. That's, that really hit me. There's, you know, don't expect people to catch you when you're falling, but if they stand by you, never let them leave your side because I think most of us could probably.

• 1:08:20Jay Shetty?

  The fortunate ones attest to that. I would say that about my wife too. I'd say that about my parents. I'd say that about the people that I'm surrounded by, that sometimes I haven't had the capacity to help them as I help myself, even though I intend to. But the problem sometimes is we do the other extreme where we demand them to help us. That's the balance. It's like the gratitude that you're displaying right now is actually like the right, I think, a wonderful balance because we do either or. We either go, I'm gonna solve this myself and I don't need anyone, or I want my family to solve my problems for me.

• 1:08:53Peter Attia?

  Interesting, yeah.

• 1:08:54Jay Shetty?

  And like, we live in one of those extremes. And you're actually saying, well, I had to help myself. I had to admit, I didn't have the capacity to help them at the time. But now I'm just grateful and I'm humbled by the fact that they stayed here. Like, there's some, there's some beauty to that. And that, that really resonates.

• 1:09:11Peter Attia?

  It's probably four years after one of the events that I write about in this book, which was when my son almost died. I was talking to Esther Perel, and I was just saying, I don't think I could ever forgive myself for what I did. And she said, that's okay. I think it's okay that you remember this for the rest of your life. I think there's a degree of humility you need to carry with you forever. And I think that was a really wise thing to say, right? Like, I think it would have been easy to have said, no, no, no, no, no. You should just forget about this and move on. But she's like, no, you should remember this forever. This is the humility you need to remember. And, and she described it in a very eloquent way, which was,

• 1:09:52Peter Attia?

  you need to understand that there's a monster in you, and he's never gonna go away. I'm confident you will keep him in the corner for the rest of his life, but don't ever take an eye off him.

• 1:10:04Jay Shetty?

  Yeah.

• 1:10:05Peter Attia?

  And don't ever think that just because you're better now, you're better for life. This is a constant process.

• 1:10:10Jay Shetty?

  Yeah. And, and remembering that there's a monster in you, but you are not that monster.

• 1:10:16Peter Attia?

  That's right. Yeah. He's over in the corner, and you have the, you are the one in charge of whether he stays in that corner.

• 1:10:21Jay Shetty?

  Yeah, it reminds me, I remember in my early experience of living as a monk, I said to one of my monk teachers, I was, I said, I just feel like I'll never overcome my ego. Like it just is too big, like there's, there's too much to deal with. And it's not that it's coming out in an externally gross way that it's manifesting, but I, I can, I know it's there. You know, we've trained in self-awareness and, and I can see it. And he said to me, yeah, it's always gonna be there. He goes, it's not going anywhere. And he said, it will always act as your anchor and ground you and humble you. Even when you soar to new heights or whatever else your life brings to you, that you knowing that it's there is actually what will help you.

• 1:11:04Peter Attia?

  Right.

• 1:11:05Jay Shetty?

  You know, stay grounded, which is such a beautiful reminder as opposed to like ego death and we're gonna crush it in. It's interesting with health too, right? With emotional health and physical health that from what you said, the first thing you said today was, you know, there are certain things from the moment you're born that that's it. It's already going in the wrong direction. And we often think of like, how do I end this? So how do I start this? How do I finish this? And it's like, well, most things are just in motion. They're not beginning or ending, they're just

• 1:11:33Peter Attia?

  Yeah.

• 1:11:34Jay Shetty?

  already happening. And as you said earlier, we're trying to slow it down or we're trying to be aware of it. We're, we're trying to monitor it. When you were speaking about your family there and you were talking about that emotional wellbeing, there was something that came to mind. There were these two beautiful words you used, which one of them is used a lot, but one of them not so much. But you talked about joy and spontaneity, and I love that word spontaneity. I think it's not used enough when we talk about emotional health. Joy is used, but the challenge I find today, when I'm talking to people is that we're so overexposed to, whether it's, whether chemically we're talking about dopamine or whether we're just talking about like joy, like fun, pleasure, instant gratification,

• 1:12:16Jay Shetty?

  which we've talked about for such a long time, that everything feels boring almost. It's, it's hard for people to get to a state of joy or spontaneity. I find that a lot of people have a sense of like, well, what's there to look forward to or like, oh, well, nothing's that great. It's okay. Like, you know, whereas before, and now it's like, it feels like you've got to up the. Results so hard and the problem is even when you up it like you're thinking that happiness is in Europe on that yacht, right? And it's like, even if you got there, it won't actually even live up to that experience that you put in your mind.

• 1:12:56Peter Attia?

  Right.

• 1:12:57Jay Shetty?

  Because it was never about the physical manifestation of it. It was, it was the idea that you've overexposed yourself to so much pleasure that now even the highest pleasures don't satisfy or suffice. How do we work on that? Like, what is the health and emotional version of approaching that problem?

• 1:13:15Peter Attia?

  I wish I knew. And I think you're addressing one of the most important questions. And this is something I, I really struggle with because, you know, for me, I, and I was just talking about this with someone earlier today, I think about the next decade of my life, this amazing time where I get to be with my kids the most. Because, you know, as you're probably aware, the, the data are pretty clear that once your kids leave for college, the amount of time you will get to spend with them is, is quite small. I think it works out to basically, you have a total of 19 years with your kids, 18 of which occur until they leave for college. And then one year is the sum total of time you will spend with your kids the rest of your life on average.

• 1:14:00Peter Attia?

  So I look at that and I think, I regret the time I've wasted so far, right? But so, so that's the stuff I talk about. And now I'm here in the future. I think, wow, the greatest source of joy I really experience is with my family. That to me is what spontaneity is, right? Spontaneity for me is an important, the reason I brought it up is I'm a very rigid person by nature. Like, part of control for me is rigidity. Deviating from my plan is a very hard thing to do, but I also realize it's a very important thing to do. So, like, I'm the kind of guy who makes lists on weekends.

• 1:14:37Jay Shetty?

  Me too.

• 1:14:38Peter Attia?

  Right? Like, there's just, like, there's a list of 12 things that have to be done on Saturday and eight things that have to be done on Sunday. And you can imagine that that, that rigidity takes any spontaneity out of life. And one of the great things I've learned is how to screw the list sometimes. The other day, when I went to get, you know, had to go to Home Depot to get all the chicken wire to do the thing like that wasn't on the list that day. But I could see that my son was upset that the squirrels were eating his tomatoes. And I was like, you know what? I'm supposed to be doing X, Y, and Z. Let's go to Home Depot.

• 1:15:13Jay Shetty?

  Yeah.

• 1:15:13Peter Attia?

  I think interestingly, anyone who does that, which I'm sure is everybody listening to this at some point can experience that. Those are probably the things that bring more joy than the yacht in Ibiza. It doesn't mean that you should never go on the yacht in Ibiza.

• 1:15:27Jay Shetty?

  Yeah, definitely.

• 1:15:27Peter Attia?

  I think it just means, yeah, I think it just means that don't dismiss the stuff that's right in front of you. And again, for most people, I really do believe connection is that thing. Like just having intimate connection with friends and family probably provides more of that than any of these other kind of material things.

• 1:15:48Jay Shetty?

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• 1:16:33Jay Shetty?

  That's indeed.com/podcast. Terms and conditions apply. Need to hire? This is a job for Indeed sponsored jobs. This episode is brought to you by Amtrak. You know that feeling when you're already tired and you haven't even gotten there yet? That's where Amtrak comes in. Leave the driving behind and settle into a comfortable seat with plenty of room to stretch out. Catch up on work with wifi, grab a snack at the cafe car, or just sit back and enjoy your favourite podcast. Choose a cellar or North East Regional and get there without the stress of getting there. Visit amtrak.com to plan your next trip. This episode is brought to you by Whole Foods Market.

• 1:17:15Jay Shetty?

  If you're talking about quality food, you can't forget Whole Foods Market, who've been holding themselves to the highest standards since they opened in 1980. That means you'll see thousands of organic products across their stores, from the produce department to the aisles. It also means you'll never see certain ingredients. They've banned artificial sweeteners and colours, high fructose corn syrup and more, so you can shop with peace of mind. Shop Whole Foods Market in-store or online.

• 1:17:46Jay Shetty?

  And I think what you're saying is actually true, and I want to clarify that point too, that I actually think that when you are not missing the simple things that are right in front of you, then when the big material thing is right in front of you, you won't miss that either. That's, that's the point, I believe. Like, I think that if someone is grateful for where they're at and what they see and what they experience and are able to immerse themselves in it, then the same happens on vacation, the same happens on the yacht as our thought experiment. Like, the idea is that the ability to experience a flower as a thought experiment in the most immersive way allows you to experience a garden,

• 1:18:26Jay Shetty?

  which allows you to experience a forest, which allows, you know, it's, it's that you can't really fully experience the forest if you didn't know how to experience a leaf. That idea of that much immerse. And I've, and I've personally experienced both the presence and absence of those experiences, where sometimes I'm walking up and down here or doing my morning hike. And you completely missed the view because you're on your phone or even if your phone's not there, you're thinking about something and then and then the second you look up and you go, oh, wait a minute, like this was right there. And so I think we all experience presence and absence. And I've found that beautiful, we think beautiful things will make us more presence.

• 1:19:09Jay Shetty?

  But actually, we'll be absent even in beautiful things if we're not present for the small things. And I've seen that again and again and again. Uh, and in your example, and I'm just, I'm only picking at this because I think there's so much lived experience in what you're saying. And and the scientific backbone helps too. It's like, how have you also not ended up? Because it sounds like your kids and your family is just so important to you, which is beautiful. And I think that's true for so many people. But again, I find that a lot of the people that I'm talking to are living at the other extreme where they're like, Jay, I am so giving in to everything my kids want to do or my family wants to do that I don't even have any of my own habits and disciplines.

• 1:19:48Jay Shetty?

  Right? Like for you going to get chicken wire was a spontaneous moment of love for your son who's worried about this project that he loves. Whereas for some people, all they're living in is not spontaneity, but in urgency. And and then they're not getting, I was speaking to a friend the other day and they were telling me, Jay, I wake up at six AM, but what happened? And then I was kind of walking through their schedule with them for the day and helping them map habits. And they were like, I don't know what. And I was like, well, when do you start cooking lunch? For example, that they as part of their day they have to do. And they were like 12. And I was like, so what happens between six AM and 12 noon? They're like, I don't know. And I was like, what do you mean? Like, you don't know? Like, that's six hours of time. Like, where does it go?

• 1:20:29Jay Shetty?

  And then they were like emails, phone calls, random people call, random things happen. It's all like, I'm like, wow, you're waking up pretty early, which is amazing. But now all of that six hours is just lost in kind of moving. How have you found that balance between like, I love my children, I want to be there, but I also need to do everything I say in this book, which takes time and energy.

• 1:20:49Peter Attia?

  I don't want to necessarily use myself as an example because I also realize like I have some really good things going for me, which is I have like an amazing spouse and I have an amazing team and all of these things. But what everyone around me has figured out is if you want to get the best out of me as a husband, as a father, as a friend, as a boss, as a colleague, whatever it is, if you want the best version of Peter. He also has to be well rested. He has to be eating well. He has to be exercising. He has to be doing the things that he has to do every day for his mental health. I am actually quite structured when it comes to that stuff. So I'm very routine with how I do things.

• 1:21:29Peter Attia?

  So I do not take a single call or meeting with very rare exceptions. Once a month, there's an exception to this rule before 11 a.m. I am scheduled without a break from 11 to 5 every single day. So I have six hours of pure scheduled that I consider that not my time. That's my patient's time. That's my team's time. That's me giving 30 hours a week to everybody. I get up at about 6. From 6 to 11 is really sacred time. So 6 to 7 is just coffee with my wife and playing with the kids. So my daughter, of course, no, she's still sleeping.

• 1:22:10Peter Attia?

  But the boys were playing board games, doing puzzles, having coffee, doing whatever. From 7 to 8 is work. Just get the emails done, read whatever I need to read, et cetera, et cetera. From 8 to 11 is hobby plus exercise. So every day I'm either in the simulator, driving or shooting my bow and arrow, and then I'm exercising. From 5 till about 7 is family time. So I'm usually cooking dinner, playing with the kids, going to jiu jitsu, whatever it is. And then 7 till 10 is some combination of family time plus work. And that's where there has to be some flexibility. Like, how much more work do I need to do?

• 1:22:54Peter Attia?

  And the price I pay for that is I have to work on weekends too, right? Why? Because like I'm forcing the time to be spread out. And so that means like, yeah, there's just, you know, there's other things I'm gonna have to make sacrifices around. But I guess my point of that is you have to kind of try to take hold of the schedule a little bit and sort of say, like, there are certain things that are non-negotiables. So not exercising is a non-negotiable. Not having some time with my family is a non-negotiable. I rarely travel anymore. I used to travel 20 days a month. I travel two to three days a month now. Just very deliberate and conscious decisions about. How I want to spend my time and the importance of, you know,

• 1:23:38Peter Attia?

  taking care of my body in an effort to take care of everything else.

• 1:23:41Jay Shetty?

  Absolutely. No, and I definitely, I agree. I don't think we want to use ourselves as examples or, you know, as the way to do it because everyone's so personal. I think it's just useful understanding that that structure is needed for that spontaneity.

• 1:23:56Peter Attia?

  What might be more helpful for people to understand how I communicate this with my wife. So my wife is that person who will put everybody ahead of herself. So what I have to help my wife do is realize, hey, like you need to go for a run too, because that matters a lot to you. And you need to go out with your friends and have drinks once every two weeks because that matters. Or you need to go and get a mani-pedi with your daughter and actually relax. I'll pitch in and do this other thing because I really feel strongly about you doing that. And that's not something I would have done before. Before I would have just sort of said, hey, it's awesome. You're doing everything great.

• 1:24:32Jay Shetty?

  Yeah.

• 1:24:33Peter Attia?

  So I think as a spouse, you want to sort of really understand that as true as that is for me, it's just as true for her.

• 1:24:40Jay Shetty?

  I think that's the key thing in a, and I, we don't have kids, but I can definitely say on a relationship level, it's like just because your partner can do something and is doing something, doesn't mean that you should just accept that as reality for the rest of time. And I see that that's one of the biggest challenges in relationships is people feel like their role is assumed because of what they've done in the past, but no one checked with them as to whether they were okay continuing to do it or whether they felt good doing it. And we think, well, they should tell us if they don't like it, they would, they would tell us like I would tell them. But often you find that someone so ingrained in playing a role that they've even forgotten that they have needs or, or who they could be or can be.

• 1:25:25Jay Shetty?

  Or they feel this overbearing burden or urgency in their role that they just can't disconnect from it. So yeah, I think that's a great point to highlight. Peter, I mean, there's so many, I really do want to talk to you, if you're still at the time. I really do want to talk to you about cancer and maybe Alzheimer's as well, because we went on a different direction, which I wanted to go into and which I loved. But I want to talk to you about cancer just because I lost, I've lost three people in my life to cancer. I lost my uncle, who was my mother's brother when I was around, gosh, maybe I was around.

• 1:26:03Jay Shetty?

  Maybe just about to be eighteen or something like that. He had throat cancer and it was tough to see him go through that. It was the first time someone in my direct circle had kind of witnessed the journey of someone like struggling, going through pain and then, you know, dying at a young age. He was like fifty seven years old. And then I saw my, one of my, probably my closest friend, who I lived as a monk with, and he was still a monk when he passed away. And he had colon cancer.

• 1:26:34Peter Attia?

  How old?

• 1:26:35Jay Shetty?

  He was like my age, so like he died two years ago now. So like he was a bit, a couple of years older, so like thirty five, around thereabouts. I believe some of that was genetic, which we found out afterwards or like during the process. And he went through tons of cycles of chemo and like, he tried everything. Like that guy had spirit and resilience and everything in it. You know, it was tough. And then I lost my spiritual mentor to brain cancer in the same timeframe during the year of COVID. So I also missed both of these people's funerals because I couldn't go back to London because you couldn't fly at the time. So anyway, all of that to say, I've just lost so many people to cancer.

• 1:27:17Jay Shetty?

  And I think that's just not uncommon, which is even worse in one sense. Like I think everyone who's listening is like, yeah, Jamie too. And so I think it's so important to talk about because I don't know, was it one in three? One in two? Is it, I don't know what the stats are, but because it's so common, because it's so normal now and just someone having cancer. But at the same time, it's the most painful news in the world because you kind of feel like you know where it's going to go. What have we seen as proven ways of preventing and confronting cancer? Both holistic and, you know, traditional medicine.

• 1:27:55Peter Attia?

  You know, the way I sort of think about it is there are three things to be thinking about, three categories. So the first, as you said, is What steps can you take to prevent cancer? The second question is, if you get cancer, how can you catch it as early as possible? One thing we really do know is that if you treat a cancer earlier, your chances of beating it go up. And the longer you wait to treat it, meaning the later you catch it, the worse your odds. And then the third question is, if you do find cancer, what are the ideal treatment strategies? Let's start with the first question, and this is the least satisfying because we don't know a whole lot about what's causing cancer. So we know two things for sure.

• 1:28:38Peter Attia?

  We know that smoking is a big driver of cancer, and we know that obesity is a big driver of cancer. Now, obesity is a bit of a misleading term because it's just kind of a overly simplistic way to think about what's actually happening. The data say obesity, but really what it means is insulin resistance and inflammation. Those are two hallmarks of obesity that are present in 70, 80% of cases of obesity. And if you look at the data more closely, that's what's actually driving cancer. So it's not actually how much fat you have on your body. It's more how much fat is in certain parts of your body that are metabolically problematic. But after those two things,

• 1:29:22Peter Attia?

  smoking and instead of obesity, I just prefer to say poor metabolic health, we have some one-off examples. We know that there are certain types of exposures, pesticide, you know, certain types of pesticides, for example, certain type of toxins. But those don't account for the significant majority of them. So for many people, cancer is still a mystery. In other words, whatever it caused, whatever caused the initiation of the genetic mutations that ultimately led to a cancer that the body was not able to, on its own, remedy. It's still a bit of a black box. And some very prominent cancer biologist actually just argued that it's bad luck. In other words, it's a stochastic process. So our genes are constantly replicating, but when mistakes are made, mutations occur.

• 1:30:06Peter Attia?

  And some of these mutations drive cancer. And there's broadly speaking, two types of mutations. There are mutations in tumor suppressor genes. So these are mutations in genes that are there to stop cancers when cancers appear. And then there are mutations in what are called oncogenes. These are genes that propagate cancer. So mutations in any of these things can actually lead to cancer. So once you sort of accept that you're going to do everything in your power to not get cancer, which is to say you're not going to smoke, you're going to be as metabolically healthy as possible, you're going to exercise, sleep, do all those things right. The next most important thing is thinking about your strategy for cancer screening. You know, this is where I probably differ significantly from the mainstream establishment

• 1:30:48Peter Attia?

  view, which is actually kind of, you know, not that aggressive on cancer screening. I would argue that we have to be very aggressive on cancer screening, provided we can get our minds around the problem we discussed a little while ago, which is we understand that there's going to be, the harder you look for something, the more likely you are to find something that isn't relevant. But if you understand that going in and you're willing to accept that risk and evaluate each finding in a thoughtful way, I think that for most people psychologically and physically, the benefit is a net positive one.

• 1:31:24Speaker 03

  Got it.

• 1:31:24Peter Attia?

  And so that means looking at things that are, for example, with a colonoscopy, doing it earlier and more frequently than is the standard recommendation. The standard recommendation is not to begin until you're 45. We would recommend that everybody, even without a family history, begin at least five years before that. It also means repeating colonoscopies more frequently, especially in the finding of certain types of polyps, whole body screening you talked about with certain types of MRIs. We also use something called the liquid biopsy. So it's a blood test that looks for really, really small fragments of DNA in the blood and can identify the presence of cancer and the tissue of origin. Now, again, none of these tests are perfect. So each of these tests have things that they're going to miss, but the idea is that the more you're layering these tests, the better your odds are of finding something earlier.

• 1:32:07Peter Attia?

  And then the final point is, okay, well, what are the strategies? You know, should you have cancer? And this is where I think we just have a little bit more promise now than we did a decade ago. So a decade ago, Because this is the first time I did this analysis. In the previous 50 years, so from, you know, 60 years ago until 10 years ago, the overall survival improvement in cancer was about 3%.

• 1:32:30Jay Shetty?

  Wow.

• 1:32:31Peter Attia?

  It was abysmal, but in the past 10 years, it's been about another 8%. And while that doesn't sound remarkable, and the implication of that is, half the people who are diagnosed with cancer today will still die from cancer. It's the biologic insights and the trajectory that we're on right now that gives me much more hope. And that is primarily based on a couple of things. The first is the field of immunology has really taken off. The tools that we have to harness the immune system to attack cancer have become so dramatic.

• 1:33:07Jay Shetty?

  Immunotherapy, right?

• 1:33:08Peter Attia?

  That's right.

• 1:33:08Jay Shetty?

  Yeah.

• 1:33:08Peter Attia?

  That it really is, I think, within the next decade, which I know seems like an infinite amount of time for someone who's got cancer right now. We're really seeing changes that I think are going to allow immunotherapies to go from the niche place that they occupy in only working for certain types of cancers, like melanoma and kidney cancer, to being able to go after the holy grail of cancers, which are what we call the solid organ epithelial tumors. Breast, pancreatic, colon, lung. These are the big cancers that do the majority of the killing. 50% of cancer deaths are just five cancers.

• 1:33:50Peter Attia?

  Lung, colon, breast, prostate, pancreatic. That's more than 50% of all cancer deaths. Until you have a solution for those, we're not, we don't have a solution for cancer.

• 1:34:02Jay Shetty?

  Got it.

• 1:34:02Peter Attia?

  And I do believe that we are really moving in that direction.

• 1:34:05Jay Shetty?

  We've touched on this point a few times of almost the stress about stress for health. And that's a really interesting way of thinking about it. It's like the stress of, oh, I need to work out today. The stress of, I need to have my supplements. The stress of, I can't sleep. Why am I not sleeping? Right? Like, we stress about the things that are good for us. How have you helped your patients? How have you coached them through that? How do you guide people through that? Because I think a lot of people go, well, then I'm just not going to do anything because at least then I'm not stressed. I don't think that's the wisdom in what you're saying. I don't think you're saying, "Well, yeah, it's better not to have any stress at all." How do you help people to engage and, you know, use that stress in a healthy way?

• 1:34:49Jay Shetty?

  Or how do you guide patients through that stress?

• 1:34:51Peter Attia?

  I mean, I think every patient's different and I think you have to sort of get to know the person a little bit and figure out what's the underlying issue. So I do think that there are a lot of people who frankly self sabotage. Going back to kind of like where I was, I mean, my self destructive behaviors weren't coming directly at the expense of my physical health. They were coming at the expense of my emotional health. But I actually think there were a lot of people who have very similar stories to mine, but their manifestation is it's coming at the expense of their physical health. They are sabotaging their ability. They they are coming up with a million excuses why they can't eat well. They can't exercise. They can't do this. They can't do that. And so you have to be able to get to the root of the problem.

• 1:35:33Peter Attia?

  And so there are many patients where we just think, "Look, you're not going to get better without trauma based therapy." Like until you come up with a way to care enough about yourself to stop punishing yourself in this way, because I do, I think people punish themselves in different ways. You could almost argue, "I used to punish myself by overdoing all of those healthy things." Like some of the exercise I was doing was actually a form of punishment. So on the surface, you'd say, "Boy, that guy's really healthy," but no, he wasn't. Another thing I always think about is when we're in the spirit of trying to build new habits, sometimes perfect is the enemy of good. Typically, what I want is a win. And I think that what people just need is a win. And it doesn't have to be the biggest win. It just has to be a win.

• 1:36:17Peter Attia?

  So if you're looking at a person for whom nothing is optimal, don't try to fix all things at once. Pick the one thing that you think they have the greatest odds of being able to make a difference on and just work on that. And accept the fact that the other things will continue to be suboptimal. But you develop their confidence in that one thing. How about for 20 minutes a day, you do something active? You go and walk for 20 minutes a day. If you're talking about a person who's never lifted a finger. That would be a huge win and you might do that before you get into the details of this type of training or that type of training, or we're going to tweak your nutrition and optimize your protein intake. I mean, that's just overwhelming and you're probably just more likely to fail at everything and create kind of a compensatory negative reaction.

• 1:37:00Peter Attia?

  But again, I don't think there's a paint by numbers approach. I think you, in the way we do it with patients, I think you just have to treat everybody individually. And by the way, when something's not working, you have to accept it and pivot and try something that is.

• 1:37:12Jay Shetty?

  I think that's the key word pivot.

• 1:37:13Peter Attia?

  Yeah.

• 1:37:14Jay Shetty?

  That's the key word. Everyone, Peter Attia, the book is called Outlive: The Science and Art of Longevity. If you don't already have it, please go and grab a copy. I highly recommend it, of course. Today's conversation's been fantastic. I've tried to touch on topics that Peter may not have been asked about in a million different interviews. He's got fantastic interviews out there on so many awesome podcasts as well. So if you're more interested in the parts we didn't cover, please do go and watch those and get informed. Peter, it's been such a joy sitting down with you today. Honestly, there's been moments where I've been mind blown and moments where I've been taken aback and felt really, you know, in my body and really present where my feet are. And I'm just really grateful that we got to have this conversation. We got to share so much incredible insights with

• 1:37:57Jay Shetty?

  our community today. And I want you to make sure that you tag me and Peter on Instagram, on TikTok, on threads with what you're learning, what you've taken away. What are the things you're going to apply and practice with? What's something you're going to experiment with this week? That would make me really happy is that you just take one thing away from this and you're like, I'm going to try that out. I'm going to figure this out for myself. That would be an awesome place to start. Peter, we end every episode with a final five, a fast five. So these questions have to be answered in one word to one sentence max. So Peter Attia, these are your final five or your fast five. The first question is what is the best health advice you've ever heard or received?

• 1:38:37Peter Attia?

  Exercise every day.

• 1:38:38Jay Shetty?

  Second question, what is the worst health advice you've ever heard or received?

• 1:38:42Peter Attia?

  Do a cleanse.

• 1:38:43Jay Shetty?

  Ah, interesting. Why? That's, yeah, okay.

• 1:38:46Peter Attia?

  Oh, I just think that, you know, I've seen, I've seen some of those things go really bad where people, you know, get. Really mucked up and dehydrated. And I've seen people actually take in some chemicals and compounds that dramatically alter liver function tests and things like that.

• 1:39:01Jay Shetty?

  Wow. Okay. All right. Question number three. What's something you're currently trying to unlearn?

• 1:39:06Peter Attia?

  Continuing to work on perfectionism, unlearning or detuning it.

• 1:39:12Jay Shetty?

  Uh, question number four. What's something that you're a very big proponent of, but a lot of people may disagree with you and you're like, I'm not sure about it.

• 1:39:20Peter Attia?

  Maybe the importance of very heavy strength training in post-menopausal women.

• 1:39:29Jay Shetty?

  Interesting. Let's dive into that because that's, that's fascinating. I'm really glad how specific you are. That's great.

• 1:39:34Peter Attia?

  Women post-menopause are so unbelievably susceptible to osteoporosis and osteopenia with the loss of estrogen. Unfortunately, many women in that situation are not getting hormone replacement therapy. And so they're doubly susceptible to it. I think there's just a cultural belief that, you know, women don't need to lift weights. And if they do, it's very light. But the truth of it is you really need to lift heavy things to make your bones stronger. And that doesn't mean it has to be complicated stuff like squats or deadlifts or things like that. But, you know, one of the most important things is carrying, doing a farmer's carry. So, holding very heavy dumbbells in your hands and walking. So important. And it doesn't matter how old you are.

• 1:40:14Jay Shetty?

  Got it. Great. Fifth and final question. If you could create one law that everyone in the world had to follow, what would it be?

• 1:40:21Peter Attia?

  You must go into nature for at least an hour a day with no electronics.

• 1:40:29Jay Shetty?

  And just be?

• 1:40:30Peter Attia?

  Just be outside, be in nature, but be untethered to electronics or obvious distractions.

• 1:40:39Jay Shetty?

  Beautiful. Peter, that's fantastic. Thank you so much again for your time, your energy, your presence today. I hope this is the first of many times that you'll come back on, on purpose. And again, if you don't already follow Peter, Peter, where's the best place you'd like people to find you? I know you're on Instagram and YouTube and everywhere.

• 1:40:55Peter Attia?

  Yeah, I think everything is Peter Attia M.D. is all the handles everywhere. And so thank you very much. I really appreciate this.

• 1:41:01Jay Shetty?

  Thank you. If you loved this episode, you'll enjoy my interview with Dr. Daniel Amen on how to change your life by changing your brain.

• 1:41:09Speaker 05

  If we want a healthy mind, it actually starts with a healthy brain. You know, I've had. The blessing or the curse to scan over a thousand convicted felons and over a hundred murderers. And their brains are very damaged.

• 1:41:26Speaker 03

  Mr. President, my company for me of the explosion on our rig on October 2nd. Causing massive water displacement and triggering a tsunami.

• 1:41:33Jay Shetty?

  They all heap the blame on me.

• 1:41:35Peter Attia?

  Tom Cruise is.

• 1:41:37Speaker 03

  Digger got us into this mess and Digger's gonna dig us up.

• 1:41:40Peter Attia?

  From the director of Birdman and The Revenant.

• 1:41:43Speaker 05

  What would happen if I stopped drilling? You stop, you freeze in there, that's what.

• 1:41:47Peter Attia?

  With great power comes great deniability.

• 1:41:50Speaker 03

  I'm not the first then.

• 1:41:51Peter Attia?

  Digger. See the trailer online. Only appears October 2nd. Rated R. Under 17. Under 17.0 without parent.