Dr. Peter Attia

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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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The Diary Of A CEO with Steven Bartlett · Anti-Aging Expert (Peter Attia): Anti-aging Cure No One Talks About! 50% Chance You’ll Die In A Year If This Happens! Boost Testosterone Naturally Without TRT! · 7 Apr 2025 podcast

And your engine efficiency, which was your zone two, your fat oxidation, exceptional. We do have this issue on the chassis that needs to be addressed or you're going to get a repetitive strain injury. So then the next thing that the team did was just a very simple test called the DEXA scan, but we do a more comprehensive one.

So we're looking at all the bone density, left hip, right hip, lumbar spine, and then total body fat, total muscle mass, and then visceral fat, which is fat around the organs. I think the most surprising aspect of the test was your bone density.

So a DEXA scan measures bone density very accurately and both sort of across the board in terms of your lumbar spine and your right hip and your left hip, you were in your lumbar spine two standard deviations below the mean. for someone your age. So that means basically you're in the bottom 10 percentile of bone density for a guy your age. And for your hips, you're not much better.

Both on the left and right hip, you're about 1.5 to 1.7 standard deviations below the mean. So what does that mean? That means that you already have something called osteoporosis. So when your T score, which in your case is almost the same as your Z score because of your age, but the Z score compares you to someone your age, the T score compares you to someone 30 years old.

So when your T score is minus one, you have osteopenia. And when it gets below minus 2.5, you have osteoporosis. Those are just technical definitions of bone density. The problem is your risk of bone fracture goes up really significantly. Now, because of how young you are, it's not like I'm worried you're going to walk out of here and something's going to go wrong.

But the risk of you sustaining an injury in sport is not trivial, right? So if you were out skiing, and Steven was out skiing, assuming he had normal bone density, and you guys both took a tumble, I would be infinitely more worried about your bone density. And we have patients in our practice who do.

They're young, healthy people, and they get these freakish fractures while skiing or playing sports and things like that. And they have really low bone density. So it's just something we want to address. The bigger concern is that what is the story of this going to be when you're 60 and 65 and 70? And that's the one where we really want to mitigate it.

So I know that the team talked to you about making sure you follow up with an endocrinologist. You want to make sure that there's nothing here that is medically obvious to be treated such as vitamin D deficiency, anything that has to do with parathyroid hormone or calcium and things that are medically obvious to treat.

The most important behavioral thing that a person can do with low bone density beyond correcting all the nutritional deficiencies that can lead to it is applying heavy load to the bone. So bones are active pieces of tissue, even though we don't think of them that way, and they respond to deformation. So you have to put strain into a bone for it to respond and strengthen. And it's counterintuitive

that running is not amazing at doing that. It's not bad. So in general, runners have better bone density than sedentary people, but not by much, believe it or not. Swimmers and cyclists, believe it or not, actually have lower bone density on average. But resistance training with heavy weights is actually kind of what is necessary. Grappling as well, by the way.

So people who do jiu-jitsu, strength training, resistance training, those are the ways that you're going to increase this. So I would say that was the first finding that is important and worth discussing.

I mean, I guess, did you have asthma as a child or anything?

Well, if there's something that was impacting your calcium levels when you were little, that would certainly be a potential risk for it. Our bones are mostly formed for males in the early 20s, for girls typically in the late teens. So anything that disrupted calcium metabolism when you were young could have played a role in this for sure.

The reason I asked if you had asthma is a lot of the times we see folks that had any medical condition that required corticosteroids. Prolonged use of corticosteroids would be another big risk factor. Of course, there's also genetics, so probably worth knowing if your parents themselves have low bone density.

But it sounds like there's something going on with calcium metabolism as a kid that might have played a role. The reason it is really important to connect with an endocrinologist now is there are actual medical studies

treatments that can increase bone density in addition to all of sort of the total optimization of the nutritional stuff, vitamin D, calcium levels, things of that nature, and of course the training.

No, I mean, I think if you think about the long bones of the body, which are the ones that we're basically measuring here, I mean, the short bones in the spine, but the femurs and hips, anything that puts those things under deformation. So anything from a farmer's carry to a step up to a box squat.

I mean, you know, it's whatever you can do safely that's loading you and placing these bones in a manner that… forces them to actually undergo deformation. And the other thing I would also make sure of is that someone's checking your blood levels to look at things like testosterone and estrogen. So estrogen, believe it or not, probably the most important hormone besides vitamin D in bone health.

So you can think of a bone as something with a strain gauge in it. And as the bone is deformed, the strain gauge sends a signal, a chemical signal to cells that build the bone. The chemical signal is estrogen.

So the reason women are so susceptible to osteopenia and osteoporosis is once they go through menopause, many of them lose their estrogen if they're not placed on, well, they all lose their estrogen, but if they're not placed on hormone replacement therapy, they don't get it back. And so they lose that chemical signal. So women see a rapid drop-off in bone density at menopause.

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