Category

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.

#63 – AMA #7: Exercise framework, deadlifting, lower back pain, blood pressure, nootropics, CGM, and more

“The single greatest risk to my longevity is my lower back.” —Peter Attia

#62 – Keith Flaherty, M.D.: Deep dive into cancer— History of oncology, novel approaches to treatment, and the exciting and hopeful future

“We can’t keep hitting the same pillar and expect that we’re going to cure cancer. . .we need the activators of the immune system, we need the inhibitors of the activated oncogenes, we need the drugs that target epigenetic regulators, and we need the metabolic switch regulators.” — Keith Flaherty

#61 – Rajpaul Attariwala, M.D., Ph.D.: Cancer screening with full-body MRI scans and a seminar on the field of radiology

“This is where an MRI becomes a beautiful machine in the fact that it actually allows you to take the ‘yes or no’ binary answer of functional nuclear medicine and combine it with the anatomic localization and understanding of tissue types of radiology. . .I merged those two together on the one machine.” — Raj Attariwala

#59 – Jason Fung, M.D.: Fasting as a potent antidote to obesity, insulin resistance, type 2 diabetes, and the many symptoms of metabolic illness

“We think of all these responses, obesity, insulin resistance, and the beta cell failure, as pathologic. They’re actually protective.  . .Your body is actually trying to protect itself against the root cause of the problem which is too much insulin, too much glucose.” — Jason Fung

#58 – AMA with sleep expert, Matthew Walker, Ph.D.: Strategies for sleeping more, sleeping better, and avoiding things that are disrupting sleep

“[Sleep] is like that master volume button on a mixing deck that you see in the studio. You can manipulate each one of those dials, or you can go to the far left and just move that one dial…and all of the other levers seem to move with it.” — Matthew Walker

A hidden blockbuster drug for Alzheimer’s disease?

How, you might ask, can a company withhold information about a drug that could potentially prevent such a devastating disease?

#54 – Kevin Sayer, CEO of Dexcom: Continuous glucose monitors – impact of food, sleep, and stress on glucose, the unmatched power of CGM to drive behavioral change, and the exciting future of CGM

“One of the most humbling things about this job is when I meet the children or the adult patients who has had this device change their life . . . it’s really why we come to work every day, what keeps us going.” —Kevin Sayer

#52 – Ethan Weiss, M.D.: A masterclass in cardiovascular disease and growth hormone – two topics that are surprising interrelated

“Primary prevention is still very much art and not science and probably will be for our lifetime so we’ll have to get used to that.” —Ethan Weiss

#51 – Robert Sapolsky, Ph.D.: The pervasive effect of stress – is it killing you?

“The [stress response] system has been serving vertebrates, doing a lot of help for them for an awful long time, and it’s only been a very recent modification to instead secrete [cortisol] in response to thinking about taxes.” —Robert Sapolsky

#50 – AMA #5: calcium scores, Centenarian Decathlon™, exercise, muscle glycogen, keto, and more

“We’re really talking a completely new model, which is actually forcing your way to become a centenarian rather than just sort of gliding your way into it and therefore, I think it’s going to require much more deliberate attention around what your mind and body are doing at that point and time.” — Peter Attia

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