Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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And what the authors of this study postulated was people who are faster nicotine metabolizers are going to have lower levels of circulating nicotine and therefore less nicotine exposure. Now, technically, you could also argue that maybe someone who's a faster nicotine metabolizer would smoke more or consume more nicotine. So put that aside for the moment.
But nevertheless, the authors used these genetic variants associated with nicotine metabolism to adjust for basically smoking heaviness. And again, we're not interested in the role of smoking. We're interested in the role of nicotine. Okay. Disease risk was increased with slower nicotine metabolism, but the added risk was abolished when adjusted for smoking heaviness.
Because of course, if you do this, you have to adjust for smoking. indicating that the main drivers of the outcomes are the non-nicotinic components of cigarette smoke. Let me state that again. This is a complicated MR, but it is the closest thing I think we have to looking at humans.
And it's looking at how much people smoked, how quickly they metabolized nicotine, trying to do an overlay of that to appreciate the nicotine exposure. And it came away basically saying that the harm of smoking is due to the tobacco and tobacco-related products, not due to the nicotine. I want to be clear, this is way, way far away from what you would want to be able to say is level one evidence.
If you wanted to do this in a level one fashion, you would actually have to randomize people to a whole bunch of different tobacco-free nicotine products and study the outcomes of interest. Now, of course, nobody's going to do that for hard outcomes like mortality, but I certainly think people could do that for softer outcomes. And my hope is that somewhere along there, people do that.
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Death is inevitable, but the rate of decline is very much up to us. The drawback that young people have is they only begin to realize the inevitability of the decline when it besets them. So your team that came in for testing that are in their 20s, when I'm looking at these results, there were issues that were uncovered that were a concern.
And ignoring it doesn't lead to a good outcome when you're 65. But a lot of people have this issue, so it's okay to speak freely about this. Yep. The biggest concern is that Dr. Peter Attia is the go-to physician for high performers, celebrities, and anyone serious about unlocking the science behind a longer, stronger, and healthier life.
I had a big epiphany at a funeral of a friend of mine who I realized had declined so much during their last decade that when they couldn't do those things that gave them pleasure because of injuries, aches, and pains, they weren't enjoying life. I call it the marginal decade. Wow, okay, so what are the most important parts of my health that I should be thinking about for longevity?
So there's muscle mass, muscle strength, but we don't have a single metric that we can measure that better predicts how long they will live than how high their VO2 max is, which is the maximum amount of oxygen you can consume. If you compare somebody who is in the top 2% to someone who is in the bottom 25%, there is a 400% difference in their all-cause mortality over the coming year.
But how do I know if it's an issue or not? We'll go into much more detail around that, but the way to avoid this is to train specifically for that marginal decade. And there's so many things that we just do wrong. So the sooner you start, the better. So rule number one.
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