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Risks

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.

Does pharmacological treatment for ADHD increase risk of cardiovascular disease?

A recent study suggests that use of medications commonly prescribed for ADHD treatment is associated with increased risk of certain cardiovascular conditions, but does it exceed the risks associated with untreated ADHD?

#310 – The relationship between testosterone and prostate cancer, testosterone replacement therapy, and tools for predicting cancer aggressiveness and guiding therapy | Ted Schaeffer, M.D., Ph.D.

“There’s no evidence that says exogenous T replacement causes acceleration or propagation of someone’s prostate cancer.” —Ted Schaeffer

Don’t underestimate the importance of oral health

A meta-analysis reports that toothbrushing reduced the risk of hospital-acquired pneumonia among ICU patients, hinting at the whole-body impacts of oral hygiene

Assessing metabolic health: where HbA1c falls short, and how it compares to fasting glucose, CGM, and OGTT

Exclusive reliance on HbA1c and other static metrics may miss the opportunity for early intervention

#308 – AMA #61: Sun exposure, sunscreen, and skin health: relationship between sun exposure and skin cancer, vitamin D production, and photoaging, how to choose a sunscreen, and more

“This is the beginning of a type of technology that I hope, over the coming decade, can make screening, especially for melanoma, to be a more effective tool.” —Peter Attia

Does hormone replacement therapy impact dementia risk?

A recent case-control study reports that menopausal hormone therapy is associated with increased risk of dementia, but results have little relevance for modern clinical practice

Does xylitol increase risk of cardiovascular disease?

Same study, different day: A recent study linking the sweetener xylitol to increased risk of cardiovascular events should ring a bell – but not an alarm.

#306 – AMA #60: preventing cognitive decline, nutrition myths, lowering blood glucose, apoB, and blood pressure, and more

“Metabolic health, first and foremost, is the goal of nutrition.” —Peter Attia

Is Alzheimer’s disease unavoidable for individuals with a high-risk APOE genotype?

A recent study reporting nearly 100% penetrance of the high-risk APOE-e4 variant is a lesson on the importance of unbiased sampling

Do high protein diets increase cancer risk?

Is there any merit to the idea that consuming more protein increases one’s risk of developing or dying from cancer?

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