Smoking is approximately a 40% increase in the risk of ACM (all-cause mortality). It means at any point in time, there's a 40% greater risk that you're going to die relative to a non-smoker and a never-smoker.It doesn't mean your lifespan is going to be 40% less. It means at any point in time, your risk of death is 40% higher. At some point that catches up.

Smoking as a cause of mortality

The 2 vectors of longevity: lifespan (whether you are alive and breathing) and healthspan (how many healthy years you live).<ul><li>What gets in the way of lifespan? The four horsemen of disease: atherosclerotic disease, cancer, neurodegenerative disease, and metabolic disease, which directly isn't the cause of many deaths, but creates the foundation for all of those other diseases. Blood testing of biomarkers provides pretty good insight into lifespan.</li><li>When you get into healthspan, you have kind of the cognitive, physical, and emotional domains. Here, the biomarkers are far less helpful, and you re<warningtag>ly more on functional testing.</warningtag></li></ul>

Vectors of longevity

An annual DEXA scan is a more comprehensive measurement than BMI – but you certainly want to monitor weight.A DEXA is a moving x-ray. So you lay down on a bed and it takes maybe 10 minutes and this little, very low power x-ray goes over your body. It measures body fat percentage, bone mineral density, visceral fat, appendicular & lean mass metrics; visually, the definition of your abs is not a bad way to assess your fat visually

Quantitative measurements of weight, BMI, for the typical person

There's a group of people who think "if I could just fix my testosterone, everything will be better." But actually, that's not true at all. The only purpose of fixing testosterone is to give you the capacity to work harder. It's really going to help you recover more from your workouts. This should just give you a greater ability to experience muscle protein synthesis.So if you get a bunch of testosterone and you sit on the couch and your nutrition doesn't change and you're not exercising anymore, you're not going to experience any benefits of this thing.

"Fixing" testosterone

<ul><li>ApoB is the concentration of LDL and VLDL particles. And they carrycholesterol and triglycerides. So anything that reduces cholesterol and reduces triglycerides, is going to reduce ApoB.</li><li>Triglycerides are generally driven by carbohydrate intake. So more insulin resistance, more carbohydrate intake, and more triglycerides. If you restrict carbohydrates, you will reduce triglycerides. But if you reduce triglycerides by raising fat intake so much, it can still raise ApoB.</li><li>Statins work by inhibiting cholesterol synthesis; the liver is really sensitive to cholesterol levels - it doesn't want too much<warningtag>, it doesn't want too little. When you inhibit cholesterol synthesis, the liver says, I want more cholesterol. So it puts more LDL receptors on its surface, and it pulls the LDL out of circulation. That's what lowers the LDL in circulation.</warningtag></li></ul>

Apolipoprotein B, diet, and statins

<ul><li>Everybody should be screened early in life.</li><li>The frequency with which you need to test really comes down to the state of interventions. It doesn't make sense to just do blood tests for the sake of doing blood tests. There has to be kind of a reason. Is something changing?</li><li>A blood test is, for the most part, a static intervention. It's a look at a window in time. And there's benefit in having a few of those over the course of a year if you're unsure about a level.</li><li>Doctors might check blood 2-4 times a year, but they can also do things there to check reactions to certain drugs or diets.</li></ul>

The frequency of blood work

<ul><li>Atherosclerotic disease: ApoB is the most important biomarker.</li><li>There’s a blind spot when it comes to cancer: blood testing & biomarker testing for cancer aren’t usually the most helpful unless/until blood biopsies are more prevalent.</li><li>Biomarkers can be helpful for dementia but not most other neurodegenerative diseases – “The same things that drive the risk of heart disease are driving the risk of dementia.”</li><li>Lipoprotein(a): you are born with this; it’s the single most prevalent genetic driver of atherosclerosis (but unfortunately most physicians don’t know what it is).</li></ul>

On biomarkers

Augmenting acetylcholine through nicotine (not by smoking) is effective for enhancing concentration and focus.On the list of things that you can do to make your brain a little more focused, this is infinitely safer than what a lot of people are doing, which is using stimulants.

Nicotine and cognitive focus

Metabolomics is just the study of metabolites. Metabolites can be defined as endogenous compounds such as amino acids, lipids, sugars, organic acids, etc., which are routinely being formed in the anabolism or catabolism process.

Metabolomics 

A marginal decade is the last decade of your life. So everyone will have a marginal decade. And outside of people who die suddenly or through an accident, most of us know when we're in that marginal decade.Until a person can tell you what it is that they want to be doing in that last decade, you can't design a program to get them there. Explicitly define what you want your marginal decade to look like, and then you sort of back script from there, figure out what you should be doing, given their current health status. This is called backcasting.

The marginal decade

What is the best way to live longer? Here are a few factors within your control

scienceandnature

Science & Nature

longevity

Longevity

food

Food

health

Health

personaldevelopment

Personal Development

How To Live A Long Life

My guest this episode is Dr. Peter Attia, M.D., who trained at Stanford University School of Medicine, Johns Hopkins Hospital and the National Institutes of Health (NIH). Dr. Attia is host of The Drive podcast and is a world expert on behavioral approaches, nutritional interventions, supplementation and pharmacological techniques to improve lifespan, healthspan and athletic performance. We discuss how best to evaluate your health status using routine blood work, body scans and regular tests of physical strength and endurance. Dr. Attia explains what he uses with his patients to “back-cast” their health goals as a way to design their exercise and nutritional programs. We also discuss hormone modulation and replacement therapy for both men and women. We explain how cholesterol and related factors contribute to cardiovascular disease risk and how to monitor and mitigate that risk. Dr. Attia details various supplementation, nutrition, exercise and prescription approaches useful to people in every decade of life to improve vitality, reduce their risk of disease and increase the number of years sustaining peak cognitive and physical health.  Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman Helix Sleep: https://helixsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Assessing Health Status & Improving Vitality  (00:02:51) Momentous Supplements  (00:03:46) Thesis, InsideTracker, Helix Sleep  (00:07:29) Lifespan: Bloodwork & Biomarkers Testing, The “4 Horseman of Disease”  (00:11:51) Healthspan: Functional Testing, Cognitive & Emotional States  (00:13:59) Blood Testing: Best Frequency  (00:16:01) DEXA Scan: Lean Mass & Fat, Bone Mineral Density & Osteoporosis  (00:22:33) Bone Mineral Density & Age-Related Decline, Strength Training, Corticosteroids  (00:29:24) Osteopenia & Osteoporosis Diagnosis, Strength Training (00:31:03) AG1 (Athletic Greens) (00:32:16) Back-casting: Defining Your “Marginal Decade”  (00:38:31) All-Cause Mortality: Smoking, Strength, VO2 max  (00:44:43) Attia’s Rule of Supplementation, “Centenarian Decathlete” Physical Goals (00:49:24) Importance of Exercise, Brain Health, MET hours  (00:55:23) Nicotine & Cognitive Focus (01:03:12) Menstruation, PMS & Menopause  (01:10:10) Hormone Replacement Therapy, Menopause & Breast Cancer Risk (01:22:06) Estrogen, Progesterone & Testosterone Therapies in Women (01:26:35) Hormone Replacement Therapy in Men, SHBG & Testosterone, Insulin (01:37:23) Clomid, Pituitary, Testosterone & Cholesterol, Anastrozole, HCG (01:47:46) Fadogia Agrestis, Supplements, Rapamycin  (01:52:06) Testosterone Replacement Therapy & Fertility  (01:59:26) Total Testosterone vs. Free Testosterone (02:02:51) Cholesterol & Dietary Cholesterol, Saturated Fat, LDL & HDL, Apolipoprotein B (02:17:42) Apolipoprotein B, Diet, Statins & Other Cholesterol Prescriptions  (02:25:15) Cardiovascular Disease, Age & Disease Risk  (02:28:53) Peptides, Stem Cells, BPC157, PRP (Platelet-Rich Plasma), Injury Rehabilitation  (02:37:40) Metabolomics & Exercise  (02:40:44) GLP-1 & Weight Loss  (02:47:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter, Huberman Lab Clips Title Card Photo Credit: Mike Blabac Disclaimer

exerciseandfitness

Exercise & Fitness

My guest this episode is Dr. Peter Attia, M.D., who trained at Stanford University School of Medicine, Johns Hopkins Hospital and the National Institutes of Health (NIH). Dr. Attia is host of The Drive podcast and is a world expert on behavioral approaches, nutritional interventions, supplementation and pharmacological techniques to improve lifespan, healthspan and athletic performance. We discuss how best to evaluate your health status using routine blood work, body scans and regular tests of physical strength and endurance. Dr. Attia explains what he uses with his patients to “back-cast” their health goals as a way to design their exercise and nutritional programs. We also discuss hormone modulation and replacement therapy for both men and women. We explain how cholesterol and related factors contribute to cardiovascular disease risk and how to monitor and mitigate that risk. Dr. Attia details various supplementation, nutrition, exercise and prescription approaches useful to people in every decade of life to improve vitality, reduce their risk of disease and increase the number of years sustaining peak cognitive and physical health.  For the full show notes, visit hubermanlab.com. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman LMNT: https://drinklmnt.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman Timestamps (00:00:00) Assessing Health Status & Improving Vitality  (00:03:07) Sponsors: AG1, LMNT (00:07:29) Lifespan: Bloodwork & Biomarkers Testing, The “4 Horseman of Disease”  (00:11:51) Healthspan: Functional Testing, Cognitive & Emotional States  (00:13:59) Blood Testing: Best Frequency  (00:16:01) DEXA Scan: Lean Mass & Fat, Bone Mineral Density & Osteoporosis  (00:22:33) Bone Mineral Density & Age-Related Decline, Strength Training, Corticosteroids  (00:29:24) Osteopenia & Osteoporosis Diagnosis, Strength Training (00:29:52) Sponsor: AG1 (00:32:16) Back-casting: Defining Your “Marginal Decade”  (00:38:31) All-Cause Mortality: Smoking, Strength, VO2 max  (00:44:43) Attia’s Rule of Supplementation, “Centenarian Decathlete” Physical Goals (00:49:24) Importance of Exercise, Brain Health, MET hours  (00:55:23) Nicotine & Cognitive Focus (01:03:12) Menstruation, PMS & Menopause  (01:10:10) Hormone Replacement Therapy, Menopause & Breast Cancer Risk (01:22:06) Estrogen, Progesterone & Testosterone Therapies in Women (01:26:35) Hormone Replacement Therapy in Men, SHBG & Testosterone, Insulin (01:37:23) Clomid, Pituitary, Testosterone & Cholesterol, Anastrozole, HCG (01:47:46) Fadogia Agrestis, Supplements, Rapamycin  (01:52:06) Testosterone Replacement Therapy & Fertility  (01:59:26) Total Testosterone vs. Free Testosterone (02:02:51) Cholesterol & Dietary Cholesterol, Saturated Fat, LDL & HDL, Apolipoprotein B (02:17:42) Apolipoprotein B, Diet, Statins & Other Cholesterol Prescriptions  (02:25:15) Cardiovascular Disease, Age & Disease Risk  (02:28:53) Peptides, Stem Cells, BPC157, PRP (Platelet-Rich Plasma), Injury Rehabilitation  (02:37:40) Metabolomics & Exercise  (02:40:44) GLP-1 & Weight Loss  (02:47:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter, Huberman Lab Clips Title Card Photo Credit: Mike Blabac Disclaimer

Huberman Lab discusses neuroscience: how our brain and its connections with the organs of our body control our perceptions, our behaviors, and our health. We also discuss existing and emerging tools for measuring and changing how our nervous system works. Dr. Andrew Huberman is a tenured professor of neurobiology and ophthalmology at Stanford School of Medicine. His laboratory studies neural regeneration, neuroplasticity, and brain states such as stress, focus, fear, and optimal performance. For more than 20 years, Dr. Huberman has consistently published original research findings and review articles in top-level peer-reviewed journals, including Nature, Science, Cell, Neuron, and Current Biology. He is a regular member of several National Institutes of Health review panels and a Fellow of the McKnight Foundation and the Pew Charitable Trusts. Dr. Huberman regularly consults for technology development companies, professional athletic organizations, and various units of U.S. and Canadian Special Operations.

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