I can always "spot" a patient who is an engineer. They are extremely logical, systems-based thinkers (which is great!) but very focused on the body and health as a "system" or machine that can be "figured out and managed". And it generally doesn't work like that. I would imagine Dr Attia considers good health to be much more "controllabl…
I can always "spot" a patient who is an engineer. They are extremely logical, systems-based thinkers (which is great!) but very focused on the body and health as a "system" or machine that can be "figured out and managed". And it generally doesn't work like that. I would imagine Dr Attia considers good health to be much more "controllable" than I have observed it to be over 30 years of watching the aging process up close. Primary care (for adults only, otherwise known as Internists) gives a great overview of life and aging that cardiologists do not see. The specialists are always going to see things from their vantage point.
The statins make most sense in preventing early death due to CAD, but I don't see them as the key to healthy aging and longevity. Of all my 90+ year old "outliers" - which a functional, independent 90-something will be, they are almost never taking a statin - or much medication at all!
and nobody's intentions are that pure. I would believe Dr Attia does have a strong personal interest in all of this as well as a physician's motives to help people - but, you can believe he is making money on book sales, supplements (if he sells or is sponsoring), podcast ads, etc. "Health" is big business these days.
I don't mean to say Attia is perfect, but here are a few thoughts in response to your comment. I don't know if you've listened to all his podcasts as I have, but he is more holistic than you'd think, as he focuses on many aspects of health, including mental health. I think he is very much aware that good health is not under anybody's complete control, but he thinks we can control it more than we generally do, and he's interested in exploring that topic with a variety of experts in their field and exploring varying perspectives. Based on a few things he has said, it seems like his shift to extending healthspan occurred when he first had kids at an age when he wasn't all that young, and it just hit him that he wanted to not only be around to see his grandkids, but to actually be able to lift and play with them, even in his geriatric years. He doesn't sell supplements, doesn't have ads (you can pay for AMA episodes, which I never have) and he always discloses potential conflicts of interests (e.g., if he mentions a company in which he has invested). Now he is going to sell a course called "Early." It's pricey, and maybe he's just in it for the money, but I think if that were his primary motive, he would have stuck with surgery, or his job at McKinsey and Company. I like hearing what he and his interesting guests have to say, and then doing my own research on what they said if it might apply to me. As for your 90+ patients who don't take statins, maybe they're super-agers, and genetics can certainly play a role in that. You didn't mention whether any of them have high LDL-C, and if not, they don't need a statin. Maybe naturally low LDL-C is why they lived so long! But I have high LDL-C and a CAC score showing atherosclerosis, despite a healthy lifestyle, so I will take my advice on statins from the Skeptical Cardiologist and highly respected Lipidologist Thomas Dayspring. The latter is 78 years old, sharp as a tack, and takes statins. My biggest fear is actually not a CVE, but dementia, which my mother had. Know what else she had? Uncontrolled high cholesterol. Same story with my mother-in-law. I know the data on that is mixed, but I'm not taking chances, so long as I have no side effects from Pravastatin. (My blood sugar is still good.)
Thank you for the helpful summary on Dr Attia! My general (medical) personality seems a bit different than his, which is probably why he strikes me as over the top from my broad (and very limited) sense of him. I appreciate your insight! It makes me more interested in checking out some of his podcasts.
And I am totally behind statins. Metformin seems like it should have some potential here (though studies have been ongoing for decades and I have not seen definitive recommendations). With family history and already indicators of LDL-C and CAC score risks - I'm all for statins!
Agree that Attia addresses all aspects of health. And I really like his concept of centennial decathlons. Think about what you want to be able to do when you are 90 and target your diet, lifestyle, exercise to achieve those goals.
Yes, I do know he also espouses lots of exercise, strength-training, etc - which I agree makes sense in our goals for healthspan. All I can give are my direct observations over a 30-year career (thus far!) in internal medicine that the "outlier" 90-somethings are not typically the engineer-types with laser focus on daily goals of long and active life. They are more typically people with general healthy habits, who typically were just good, consistent walkers, didn't smoke etc. For those extremes (> 90), good luck seems to be as big a factor as anything else. I think the "Blue Zones" approach seems more balanced.
I love to ask 90+ year olds what are their secrets to healthy, active long life - the most memorable reply was a 97 y/o who told me "smoking! It kept me calm and relaxed!" (and I certainly don't suggest smoking is a + factor in any way - but her answer, and her as an active, bridge-playing, 'spicy' 97 y/o just showed how random extreme longevity and healthspan can be.
Yes, gene mutations are often random, and inheritance is also a luck of the draw that we don't control. I think the goal is to make the most with the hand you were dealt, and since none of us has perfect execution, aim high! I love hearing stories about "spicy" 90+ year olds! If I live that long, I hope to be very spicy! 🤣
I can always "spot" a patient who is an engineer. They are extremely logical, systems-based thinkers (which is great!) but very focused on the body and health as a "system" or machine that can be "figured out and managed". And it generally doesn't work like that. I would imagine Dr Attia considers good health to be much more "controllable" than I have observed it to be over 30 years of watching the aging process up close. Primary care (for adults only, otherwise known as Internists) gives a great overview of life and aging that cardiologists do not see. The specialists are always going to see things from their vantage point.
The statins make most sense in preventing early death due to CAD, but I don't see them as the key to healthy aging and longevity. Of all my 90+ year old "outliers" - which a functional, independent 90-something will be, they are almost never taking a statin - or much medication at all!
and nobody's intentions are that pure. I would believe Dr Attia does have a strong personal interest in all of this as well as a physician's motives to help people - but, you can believe he is making money on book sales, supplements (if he sells or is sponsoring), podcast ads, etc. "Health" is big business these days.
I don't mean to say Attia is perfect, but here are a few thoughts in response to your comment. I don't know if you've listened to all his podcasts as I have, but he is more holistic than you'd think, as he focuses on many aspects of health, including mental health. I think he is very much aware that good health is not under anybody's complete control, but he thinks we can control it more than we generally do, and he's interested in exploring that topic with a variety of experts in their field and exploring varying perspectives. Based on a few things he has said, it seems like his shift to extending healthspan occurred when he first had kids at an age when he wasn't all that young, and it just hit him that he wanted to not only be around to see his grandkids, but to actually be able to lift and play with them, even in his geriatric years. He doesn't sell supplements, doesn't have ads (you can pay for AMA episodes, which I never have) and he always discloses potential conflicts of interests (e.g., if he mentions a company in which he has invested). Now he is going to sell a course called "Early." It's pricey, and maybe he's just in it for the money, but I think if that were his primary motive, he would have stuck with surgery, or his job at McKinsey and Company. I like hearing what he and his interesting guests have to say, and then doing my own research on what they said if it might apply to me. As for your 90+ patients who don't take statins, maybe they're super-agers, and genetics can certainly play a role in that. You didn't mention whether any of them have high LDL-C, and if not, they don't need a statin. Maybe naturally low LDL-C is why they lived so long! But I have high LDL-C and a CAC score showing atherosclerosis, despite a healthy lifestyle, so I will take my advice on statins from the Skeptical Cardiologist and highly respected Lipidologist Thomas Dayspring. The latter is 78 years old, sharp as a tack, and takes statins. My biggest fear is actually not a CVE, but dementia, which my mother had. Know what else she had? Uncontrolled high cholesterol. Same story with my mother-in-law. I know the data on that is mixed, but I'm not taking chances, so long as I have no side effects from Pravastatin. (My blood sugar is still good.)
Thank you for the helpful summary on Dr Attia! My general (medical) personality seems a bit different than his, which is probably why he strikes me as over the top from my broad (and very limited) sense of him. I appreciate your insight! It makes me more interested in checking out some of his podcasts.
And I am totally behind statins. Metformin seems like it should have some potential here (though studies have been ongoing for decades and I have not seen definitive recommendations). With family history and already indicators of LDL-C and CAC score risks - I'm all for statins!
Agree that Attia addresses all aspects of health. And I really like his concept of centennial decathlons. Think about what you want to be able to do when you are 90 and target your diet, lifestyle, exercise to achieve those goals.
Yes, he doesn't just say, "take a pill;" his approach is comprehensive. And who doesn't want to "kick ass" at 90?! 🤣
Yes, I do know he also espouses lots of exercise, strength-training, etc - which I agree makes sense in our goals for healthspan. All I can give are my direct observations over a 30-year career (thus far!) in internal medicine that the "outlier" 90-somethings are not typically the engineer-types with laser focus on daily goals of long and active life. They are more typically people with general healthy habits, who typically were just good, consistent walkers, didn't smoke etc. For those extremes (> 90), good luck seems to be as big a factor as anything else. I think the "Blue Zones" approach seems more balanced.
I love to ask 90+ year olds what are their secrets to healthy, active long life - the most memorable reply was a 97 y/o who told me "smoking! It kept me calm and relaxed!" (and I certainly don't suggest smoking is a + factor in any way - but her answer, and her as an active, bridge-playing, 'spicy' 97 y/o just showed how random extreme longevity and healthspan can be.
Yes, gene mutations are often random, and inheritance is also a luck of the draw that we don't control. I think the goal is to make the most with the hand you were dealt, and since none of us has perfect execution, aim high! I love hearing stories about "spicy" 90+ year olds! If I live that long, I hope to be very spicy! 🤣