Preventing Chronic Disease

One of the foundational lessons we can take away from studying centenarians — those who have lived to the age of 100+ — is that if you want to live longer, you have to live longer without chronic disease, not live longer with chronic disease. Unfortunately, our current healthcare system is primarily geared toward helping you live longer once you develop chronic disease. This, of course, is the opposite of the approach I take with my patients. 

Over 80% of deaths in people over 50 who do not smoke can be grouped into 4 main categories, what I like to call the four horsemen of chronic disease. These are: (1) atherosclerotic disease (comprised of cardiovascular disease and cerebrovascular disease), (2) cancer, (3) neurodegenerative disease (Alzheimer’s disease being the most common), and (4) metabolic disease (a spectrum of everything from hyperinsulinemia to insulin resistance to fatty liver disease to type 2 diabetes).

We have five main longevity tactics at our disposal to affect our longevity: (1) exercise, (2) sleep, (3) nutrition, (4) medications & supplements, and (5) distress tolerance. Below is a collection of podcasts and articles discussing how we can use these tactics to mitigate, prevent, and reverse chronic disease.

The MIND diet on trial: can diet choices impact cognitive health?

The results were lackluster, but a closer look leaves room for other explanations

Reassessing the relationship between alcohol intake and cardiovascular disease risk

Mendelian randomization offers clearer insights than epidemiology or randomized trials to date

Continuous glucose monitoring to improve health in non-diabetics

Individualizing blood glucose control and its benefits

#279 – AMA #53: Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin, GLP-1 agonists, and the impact of statins

It is worth noting, and this is a very important question, that it does not appear that the effect of statins on insulin resistance is a function of lipids being lowered.” —Peter Attia

How does APOE status impact the relationship between obesity and dementia risk?

Obesity has been reported by some to increase risk of dementia, while other studies have reported that obesity is protective against dementia. Might the effects of APOE genotype help to explain the discrepancy?

#278 ‒ Breast cancer: how to catch, treat, and survive breast cancer | Harold Burstein, M.D., Ph.D.

We’ve completely flipped the outcomes for HER2-positive breast cancer, where it has gone from one of the most feared types of breast cancer to one of the most successfully treated types of breast cancer.” —Harold Burstein

Is the frequency of menopausal symptoms an early barometer for later-in-life brain health?

More than “bothersome”: Frequent menopausal hot flashes during sleep are associated with greater white matter hyperintensity volume

#276 ‒ Special episode: Peter answers questions on longevity, supplements, protein, fasting, apoB, statins, and more

One of the most important things to understand when you are using some sort of intervention is, do you have a biomarker to know if you’re doing it correctly?” —Peter Attia

#273 ‒ Prostate health: common problems, cancer prevention, screening, treatment, and more | Ted Schaeffer, M.D., Ph.D.

The faster that your PSA density rises, it is a canary in the coal mine. . .you need to do some additional evaluation.” —Ted Schaeffer

Statins: effectiveness, safety, and common myths on their role in ASCVD prevention

A review of the evidence for statins in combating heart disease

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