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Jay Shetty Podcast

The LONGEVITY Doctor: Are You Actually HEALTHY? 70% Of The Population Is NOT | Dr. Peter Attia

Today, I am excited to share my conversation with Dr. Peter Attia, dubbed the longevity expert.

Dr. Peter AttiaguestJay Shettyhost

Aug 7, 20231h 31mWatch on YouTube

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CHAPTERS

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Chapter summaries

Wake-Up Calls: Feeling Healthy While Hidden Risks Build
Jay Shetty asks what it feels like to think you're healthy while something is wrong behind the scenes. Peter Attia describes being an ultra-distance swimmer who was insulin resistant and overweight, confronting a family history of early heart-disease deaths, and the birth of his daughter.
- •Attia was extremely active yet insulin resistant and overweight
- •Nearly every man in his family died prematurely of heart disease, some in their 40s
- •His 30s realizations coincided with his daughter's birth, and he had left medicine for finance at the time
- •His biggest fear was not being around for his grandkids
- •Jay shares his own health scares, including chronic fatigue and losing his voice
3:42 – 8:50
When to Start Investing in Your Health
Jay asks when people should begin investing in their health across the decades. Attia explains that some aspects of aging, like arterial damage, worsen from birth, while cognitive and physical capacity rise and then decline, and that motivation tends to arrive after a reality check.
- •Atherosclerosis begins early, so prevention is never too soon
- •Cognitive capacity and physical abilities rise and peak before declining
- •The goal is to slow the rate of decline
- •Motivation is highest near death, when there's no runway, and lowest in youth
- •The sweet spot is when decline is noticeable but time remains to bend the arc
Why Family History Beats Genetic Testing
Jay asks how aware people need to be of family history and how genetics compares with environment. Attia says a well-collected family history gives more risk information than even a whole genome sequence, and explains how he gathered his own and where his Early program fits in.
- •Attia's practice gives patients ten questions per relative, covering parents, grandparents, aunts, uncles and siblings
- •Most genes aren't deterministic, and most major conditions are polygenic
- •The environment matters and people have agency over it
- •Gathering history is hard when relatives are deceased
- •The Early program has 12 modules, with family history in the first or second
Full Body Scans, Sensitivity and False Positives
Jay asks about full body scans and how people know how healthy they are. Attia explains that MRI is the whole-body scan he finds valuable because it has no radiation, and that sensitivity versus specificity explains why false positives cause stress. Jay shares his own scare.
- •Coronary calcium scans and CT angiograms help stratify heart disease risk
- •MRI is very sensitive but has blind spots, such as small calcified breast cancers
- •Whole body scanners have low specificity and many false positives
- •Patients should be told up front about the chance of false findings
- •About ten percent of Attia's patients decline scans to avoid that stress
What We Actually Know About Nutrition and Diets
Jay asks how people can find the eating patterns that suit them amid trendy diets and fasting. Attia says little is known about nutrition because humans are hard to study, but that protein matters and over seventy percent of Americans are overnourished. He lays out three strategies to eat less.
- •Nutrition studies are either poorly controlled epidemiology or too short
- •Protein is essential, especially after 50 due to anabolic resistance
- •Overnourishment drives poor health; the fixes are calorie restriction, dietary restriction and time-restricted eating
- •Carnivore, vegan and other named diets are forms of dietary restriction
- •Portion sizes have grown, as Jay and Attia discuss
Supplements Attia Takes and Why
Jay asks about supplements, nootropics and adaptogens. Attia walks through what he takes, with disclosures about affiliations, including a greens powder, a glucose-control probiotic, vitamin D, magnesium, ashwagandha and fish oil. He also explains how glucose works and why lower average blood glucose appears better.
- •Attia discloses he invests in the greens product AG and has no affiliation with other brands he names
- •He changed his view on probiotics after a trial of a glucose-control probiotic
- •Glucose tolerance depends on sleep, muscle mass, exercise and insulin sensitivity
- •Vitamin D, B vitamins, different magnesium forms and EPA/DHA fish oil are recommended in his routine
- •He relies on third-party testing and names Jarrow and Pure Encapsulations as reputable
Soil Health and Nutrient Density in Our Food
Jay asks whether we need more supplements because of lifestyle changes. Attia suspects food is less nutrient-dense than fifty years ago, which regenerative agriculture proponents tie to degraded soil. He argues regenerative agriculture could improve health and also pull carbon into the soil.
- •Food may deliver fewer nutrients per calorie than fifty years ago
- •Soil degradation from tillage, fertilizers and less crop rotation affects plants and the animals that eat them
- •Plants fix carbon, and regenerative agriculture stores more carbon in soil
- •Attia says its potential to reduce atmospheric CO2 may exceed electrifying transportation
- •The benefit is described as two wins: climate and human health
Lab-Grown Food, Scaling Regenerative Farming and Home Gardens
Jay asks about lab-produced meat and vegetables. Attia sees no evidence they can match nature given the complexity of soil, and says scaling regenerative agriculture is an open question requiring different infrastructure and government incentives. They end with home gardens and compost.
- •Soil is likely more biodiverse than the gut microbiome, so it's hard to replicate
- •Attia recommends the book What Your Food Ate
- •Regenerative farming avoids fertilizer and pesticides and relies on crop rotation and animals
- •Scaling means moving from big to little agriculture and changing subsidies
- •Attia has a home vegetable garden that his son cares about, with composting
The Link Between Physical and Emotional Health
Jay describes how a vitamin D level of 10 and poor sleep produced emotional struggles. Attia agrees physical and emotional health are linked, explains how he distinguishes emotional health from mental health, and says the final chapter of his book is personal.
- •Jay found fatigue and irritability traced to a physical cause
- •Attia's therapist begins sessions by asking about pain, rest and stress
- •Physical problems exacerbate emotional vulnerabilities
- •Emotional health includes relationships, purpose, joy and spontaneity, while mental health is the more medicalized subset
- •Attia says that if you're miserable or your relationships are bad, the rest doesn't matter
Childhood Adaptations, Rock Bottom and Family Forgiveness
Attia describes nearly losing his family and having to get help, and traces his behavior to childhood trauma and adaptations that became maladaptive. He explains why people change only when pain forces it, credits his wife and colleagues for standing by him, and recounts Esther Perel's advice about humility.
- •Attia describes control, drive, perfection and anger as adaptations that served him as a child but harmed him as a husband and father
- •He likens the barrier to change to activation energy, needing a catalyst
- •A woman in rehab told him nobody shows up on a winning streak
- •He credits his wife and colleagues for giving him another chance
- •Esther Perel told him to keep the humility of knowing there's a monster in him that never goes away
Joy, Spontaneity and Presence
Jay raises joy and spontaneity and asks how to find them when we're overexposed to pleasure. Attia says family brings him the most joy and that he is rigid by nature, learning to drop the to-do list. They discuss how being present for small things makes bigger experiences meaningful.
- •Attia cites data that parents get roughly one year of time with kids after they leave for college, compared with 18 before
- •He makes weekend lists and has learned to abandon them, as with the Home Depot trip for his son
- •Connection with friends and family brings more joy than material things like a yacht
- •Jay argues you can't experience a forest without learning to experience a leaf
- •Jay notes some people live in urgency, not spontaneity
Structuring Time and Non-Negotiables
Jay asks how Attia balances family with the habits his book recommends. Attia describes his strict daily routine and says exercise and family time are non-negotiable. He explains how he encourages his wife to prioritize her own needs.
- •No calls or meetings before 11 AM, and 11 to 5 is scheduled for patients and team
- •Mornings include family time, work, then hobbies and exercise
- •He works some weekends and now travels two to three days a month instead of twenty
- •He urges his wife to take time for running, friends and rest
- •Jay says partners shouldn't assume a role just because someone has long filled it
Preventing, Detecting and Treating Cancer
After sharing the cancer losses in his life, Jay asks about proven ways to prevent and confront cancer. Attia frames three questions: prevention, early detection and treatment. He says prevention knowledge is limited, advocates aggressive layered screening, and sees promise in immunotherapy.
- •Smoking and poor metabolic health, meaning insulin resistance and inflammation, are known drivers
- •Some cancer biologists argue cancer is partly stochastic bad luck from mutations
- •Attia favors aggressive screening, such as colonoscopies starting at least five years before 45, plus MRI and liquid biopsy
- •Cancer survival improved about 3% over fifty years, then about 8% in ten
- •Five cancers account for over half of cancer deaths, and immunotherapy offers hope
Stress About Health, Self-Sabotage and Small Wins
Jay asks how Attia helps patients who stress about doing healthy things. Attia says people may self-sabotage, that some need trauma-based therapy, and that his own over-exercising was a form of punishment. He recommends starting with one achievable win and pivoting when something isn't working.
- •Self-destructive behavior can show up in physical health instead of emotional health
- •Some patients need trauma-based therapy to stop punishing themselves
- •Perfect is the enemy of good, so pick one thing with the best odds
- •A twenty-minute daily walk can be a big win for someone inactive
- •Each patient needs an individual approach and a willingness to pivot
Final Five with Peter Attia
Jay wraps up by promoting Outlive and then asks the Fast Five. Attia names exercise every day as the best advice and doing a cleanse as the worst, and says he is working on perfectionism. He advocates heavy strength training for post-menopausal women and an hour in nature daily without electronics.
- •Best advice: exercise every day
- •Worst advice: do a cleanse, which he has seen cause dehydration and altered liver function tests
- •Currently detuning perfectionism
- •Heavy lifting, such as farmer's carries, strengthens bones in post-menopausal women
- •His law: an hour a day in nature with no electronics

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