The problem with freedom is freedom. It means, in most aspects of life, you're responsible for yourself. Obesity is self-inflicted as is addiction. I'm not sure life expectancy means anything when these poor behaviors are included.
I was looking forward to this podcast as a follow up to the one on Levels last Fall. By comparison I found this pretty dull. Attia provides no clear list of foods to eat and what to avoid, which blood tests matter and why, not any other real “hard” examples of what we can do. Lots of long sentences but limited usefulness.
I enjoyed this piece as far as it went but like most medically based perspectives (I am a retired physician!), it completely avoids spiritual perspectives. For me, my grounding in a Christian worldview allows me to see myself and my sins clearly and to be involved in the lifelong process of sanctification, becoming more like Christ. Silicon Valley is largely bereft of real spiritual insights.
Dr. Attia's description of his inability to open up and talk to his friends or his wife about his emotional pain and suffering sounds a lot like what Kat Timpf discusses candidly and eloquently in her new book "You Can't Joke About That".
I’m a little surprised by the comments here. I found the thesis of “Medicine right now addresses problems once they’re full blown diseases. We should be addressing problems before they become diseases if we can. In many instances we can.” to be exactly where medicine needs to be pivoting.
I incurred a pelvic floor injury during the birth of my third child (like had been injured in the first two as well). 13% of women will have pelvic reconstruction surgery or surgery to correct incontinence by the time they reach 80. Most of it is due to vaginal delivery and damage from years before. And these instances are often the worst cases. 50-90% of women who’ve had a baby have some degree of damage to their pelvic support structures. For context, knee surgeries are done in about 4% of the entire population. The medical community’s response is to either do nothing as it’s normal after babies (medical gaslighting of symptoms; they won’t diagnose you), or to insist you never run, lift weights, squat, or do any higher impact activities for the rest of your life, and then do surgery after menopause when it’s much worse. Diagnosis is almost always patient prompted. Early surgical intervention to address damage is almost unheard of. Even getting PT can be a battle.
This experience was so shocking to me, and yet clearly so so common, that it forced me to assume that most healthcare must be functioning this way. Blood test says your healthy? Don’t trust it! As Dr. Attia points out, “normal” results are often not optimal results, and no one is going to tell you until it’s an emergency. Even if your quality of life could be improved, both in the present and the future. And the reason doesn’t seem to be entirely malicious. The paternalism in the medical community is incredible. They genuinely believe people are not willing or capable of making lifestyle changes, or doing hard work in PT. They don’t want to scare them. So they don’t tell them about issues that may be on the horizon. Preventative care also takes way more patient/provider time working on education and a customized plan that they then have to trust the patient will follow. It doesn’t reimburse like surgery or prescriptions. Our model does not reward prevention.
I thought there was a lot of good info in this interview, mainly the mindset shift needed in medicine. It prompted me to buy the book, and while dense, I’ve come to appreciate understanding the nitty gritty of why certain advice is being given. I really appreciate the prompt to take personal responsibility for our health instead of just considering it a crap shoot. I think people don’t like to hear that drinking was less, exercising and eating with intentionality, and managing stress and sleep actually does make a difference because it’s hard. But we really should be thinking of it like smoking. Especially considering the astronomical expense it will cost every person on insurance in the US.
Sounds like Bruce Banner when black widow asks him how he summons the rage, he says the rage is always there, is about controlling it not summoning it.
My assumption is most of us commenters resemble that description, pissed off with all the idiots, and all the assholes trying to control our lives.
Hate to think of myself as a rage machine but i probably am.
Grrr as someone w chronic fatigue and who can’t get past level one training, this Q&A drove me nuts. What do I do about exercise if i literally can’t do more than a not even brisk walk 1/2hr per day? I’m worried about bone density. I’m worried about disintegrating. I used to run marathons and do CrossFit. Played soccer as a kid. Hiked my brains out. Now I’m limited beyond what I ever dreamed possible. What am I supposed to do???
Since I am a doctor, these comments may sound defensive or self-serving, but I believe statistics will refute his contention that medicine does not handle chronic conditions well. Anti-hypertensives drugs and statins have lowered the incidence of cardiovascular disease and are no longer controversial. Along with cessation of smoking, these interventions have cut the rate of heart attacks and stroke to record lows.
Your argument is not defensive or self-serving, you are just giving your expert point of view.
He does discuss this in his book.
His argument is that by the time you get to the point of needing those interventions, your metabolic health is already on the decline, and you will need more interventions as life progresses. The result is the lengthening of life, but the quality of that extended life is poor.
"white, working-class men are committing suicide at alarmingly higher rates than other demographics. Why is this happening? " The current administration (the D's) are waging economic war against the productive man who works with his hands, against fishers, farmers, ranchers, miners, engine mechanics, oilfield workers, builders. Shop is no longer taught in many school districts. Men need to do, to build, to make, to use their strength and skill. It is part of the male identity. Restore the entrepreneurial economy (which was booming under Trump) and watch suicides go down.
One other thought: it's not just longevity but quality of life. If you are fat and lazy, then you cannot do much with your time but consume. The lowest animals do that. We have to do it too, but not like that.
I grew up a very typical suburban American. I ate the Standard American Diet, watched Gilligan's Island reruns and Rockford Files when I got home from a school where nobody was really thinking or being asked to think.
I think I began changing when I read "On Walden Pond", and Thoreau's justly famous line "the majority of men lead lives of quiet desperation". I decided I didn't want that. But finding the alternative is taking a LONG time!!! We all want something, now, that we can buy on Amazon. We want something simple that all our friends are doing.
But nobody else can answer the question of what makes YOUR life worthwhile. That is up to you. You have the entirety of most of the extant cultural treasures that have been generated in perhaps 4,000 years of recorded history as resources. But how many of us avail ourselves of those resources?
Actually, an image that occurs to me is that most of us are on treadmills, going nowhere. Some of them, however, are higher up relative to others. Jeff Bezos has a much, much higher treadmill than me. But if the goal is to go somewhere, most of us are failing.
With all due respect, Dr. Attia in all his credentialed wisdom appears to be one more “specialist”, the Anointed One. Yet, nothing that he says is new. As for his personal journey, he is still running, writing books, saving us from certain death. He offers no solutions that have not been repeated a million times. He is preaching to his choir. And getting wealthier while our health sustem gets worse. Maybe he should turn his boundless energy towards helping resolve it. Now, that would be impressive!
That was quite a punt on food. We can do better than “don’t eat too much and avoid food poisoning.” Bari was on the right track with the criminal fail of dietary recommendations in the 80’s. Inexplicably, the resulting frankenfoods are STILL on the shelves and being consumed by people who think they are “dieting”. (fat-free sour cream anyone?). Please invite Mark Hyman on to present the cause of “diabesity” as he calls it. It’s about blood sugar, insulin and how the body responds to a constant overload of both. Another voice crying in the desert was Gary Taubes in 2002. It has indeed been a big fat lie, and continues to be. https://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html
When asked how I want to die, my answer is always 'looking forward to tomorrow".
Betty White is a prime example. I'm 68 and I just bought a puppy. Optimism is just so much better than the alternative..
The problem with freedom is freedom. It means, in most aspects of life, you're responsible for yourself. Obesity is self-inflicted as is addiction. I'm not sure life expectancy means anything when these poor behaviors are included.
Who wants to live to be 120? not me.
I was looking forward to this podcast as a follow up to the one on Levels last Fall. By comparison I found this pretty dull. Attia provides no clear list of foods to eat and what to avoid, which blood tests matter and why, not any other real “hard” examples of what we can do. Lots of long sentences but limited usefulness.
"Risk ownership is broken."
Yes, yes, yes. I've tried to say this many times, but never managed to do so as succinctly and clearly as Dr. Attia.
I enjoyed this piece as far as it went but like most medically based perspectives (I am a retired physician!), it completely avoids spiritual perspectives. For me, my grounding in a Christian worldview allows me to see myself and my sins clearly and to be involved in the lifelong process of sanctification, becoming more like Christ. Silicon Valley is largely bereft of real spiritual insights.
In his book he does discuss mental health. Not everyone is a believer.
Dr. Attia's description of his inability to open up and talk to his friends or his wife about his emotional pain and suffering sounds a lot like what Kat Timpf discusses candidly and eloquently in her new book "You Can't Joke About That".
I’m a little surprised by the comments here. I found the thesis of “Medicine right now addresses problems once they’re full blown diseases. We should be addressing problems before they become diseases if we can. In many instances we can.” to be exactly where medicine needs to be pivoting.
I incurred a pelvic floor injury during the birth of my third child (like had been injured in the first two as well). 13% of women will have pelvic reconstruction surgery or surgery to correct incontinence by the time they reach 80. Most of it is due to vaginal delivery and damage from years before. And these instances are often the worst cases. 50-90% of women who’ve had a baby have some degree of damage to their pelvic support structures. For context, knee surgeries are done in about 4% of the entire population. The medical community’s response is to either do nothing as it’s normal after babies (medical gaslighting of symptoms; they won’t diagnose you), or to insist you never run, lift weights, squat, or do any higher impact activities for the rest of your life, and then do surgery after menopause when it’s much worse. Diagnosis is almost always patient prompted. Early surgical intervention to address damage is almost unheard of. Even getting PT can be a battle.
This experience was so shocking to me, and yet clearly so so common, that it forced me to assume that most healthcare must be functioning this way. Blood test says your healthy? Don’t trust it! As Dr. Attia points out, “normal” results are often not optimal results, and no one is going to tell you until it’s an emergency. Even if your quality of life could be improved, both in the present and the future. And the reason doesn’t seem to be entirely malicious. The paternalism in the medical community is incredible. They genuinely believe people are not willing or capable of making lifestyle changes, or doing hard work in PT. They don’t want to scare them. So they don’t tell them about issues that may be on the horizon. Preventative care also takes way more patient/provider time working on education and a customized plan that they then have to trust the patient will follow. It doesn’t reimburse like surgery or prescriptions. Our model does not reward prevention.
I thought there was a lot of good info in this interview, mainly the mindset shift needed in medicine. It prompted me to buy the book, and while dense, I’ve come to appreciate understanding the nitty gritty of why certain advice is being given. I really appreciate the prompt to take personal responsibility for our health instead of just considering it a crap shoot. I think people don’t like to hear that drinking was less, exercising and eating with intentionality, and managing stress and sleep actually does make a difference because it’s hard. But we really should be thinking of it like smoking. Especially considering the astronomical expense it will cost every person on insurance in the US.
Hmmm
Sounds like Bruce Banner when black widow asks him how he summons the rage, he says the rage is always there, is about controlling it not summoning it.
My assumption is most of us commenters resemble that description, pissed off with all the idiots, and all the assholes trying to control our lives.
Hate to think of myself as a rage machine but i probably am.
Grrr as someone w chronic fatigue and who can’t get past level one training, this Q&A drove me nuts. What do I do about exercise if i literally can’t do more than a not even brisk walk 1/2hr per day? I’m worried about bone density. I’m worried about disintegrating. I used to run marathons and do CrossFit. Played soccer as a kid. Hiked my brains out. Now I’m limited beyond what I ever dreamed possible. What am I supposed to do???
Since I am a doctor, these comments may sound defensive or self-serving, but I believe statistics will refute his contention that medicine does not handle chronic conditions well. Anti-hypertensives drugs and statins have lowered the incidence of cardiovascular disease and are no longer controversial. Along with cessation of smoking, these interventions have cut the rate of heart attacks and stroke to record lows.
Your argument is not defensive or self-serving, you are just giving your expert point of view.
He does discuss this in his book.
His argument is that by the time you get to the point of needing those interventions, your metabolic health is already on the decline, and you will need more interventions as life progresses. The result is the lengthening of life, but the quality of that extended life is poor.
"white, working-class men are committing suicide at alarmingly higher rates than other demographics. Why is this happening? " The current administration (the D's) are waging economic war against the productive man who works with his hands, against fishers, farmers, ranchers, miners, engine mechanics, oilfield workers, builders. Shop is no longer taught in many school districts. Men need to do, to build, to make, to use their strength and skill. It is part of the male identity. Restore the entrepreneurial economy (which was booming under Trump) and watch suicides go down.
One other thought: it's not just longevity but quality of life. If you are fat and lazy, then you cannot do much with your time but consume. The lowest animals do that. We have to do it too, but not like that.
I grew up a very typical suburban American. I ate the Standard American Diet, watched Gilligan's Island reruns and Rockford Files when I got home from a school where nobody was really thinking or being asked to think.
I think I began changing when I read "On Walden Pond", and Thoreau's justly famous line "the majority of men lead lives of quiet desperation". I decided I didn't want that. But finding the alternative is taking a LONG time!!! We all want something, now, that we can buy on Amazon. We want something simple that all our friends are doing.
But nobody else can answer the question of what makes YOUR life worthwhile. That is up to you. You have the entirety of most of the extant cultural treasures that have been generated in perhaps 4,000 years of recorded history as resources. But how many of us avail ourselves of those resources?
Actually, an image that occurs to me is that most of us are on treadmills, going nowhere. Some of them, however, are higher up relative to others. Jeff Bezos has a much, much higher treadmill than me. But if the goal is to go somewhere, most of us are failing.
That's my two cents today.
With all due respect, Dr. Attia in all his credentialed wisdom appears to be one more “specialist”, the Anointed One. Yet, nothing that he says is new. As for his personal journey, he is still running, writing books, saving us from certain death. He offers no solutions that have not been repeated a million times. He is preaching to his choir. And getting wealthier while our health sustem gets worse. Maybe he should turn his boundless energy towards helping resolve it. Now, that would be impressive!
That was quite a punt on food. We can do better than “don’t eat too much and avoid food poisoning.” Bari was on the right track with the criminal fail of dietary recommendations in the 80’s. Inexplicably, the resulting frankenfoods are STILL on the shelves and being consumed by people who think they are “dieting”. (fat-free sour cream anyone?). Please invite Mark Hyman on to present the cause of “diabesity” as he calls it. It’s about blood sugar, insulin and how the body responds to a constant overload of both. Another voice crying in the desert was Gary Taubes in 2002. It has indeed been a big fat lie, and continues to be. https://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html
Too bad about pay walls!