The Peter Attia Drive
#329 ‒ Special AMA: Peter on exercise, important labs, building good habits, promising longevity research, and more
Mon, 16 Dec 2024
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter In this special episode of The Drive, Peter tackles a wide range of listener questions submitted over the past year. The discussion spans essential topics such as exercise—covering grip strength, traveling workouts, and why Peter doesn’t consider exercise an ideal weight-loss strategy—and the top biomarkers everyone should track. He also explores promising new longevity research, his evolving views on longevity, and frameworks like “objective, strategy, tactics” for personalized decision-making. The episode wraps up with insights on building good habits and a glimpse into Peter’s recent reading list. If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the Special AMA show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Overview of episode topics (and Peter’s car stereo saga) [1:45]; The importance of grip strength and the best methods for training it effectively [3:45]; Exercise while traveling: strategies for staying active and maintaining an exercise routine [14:45]; Why women should prioritize strength training [18:00]; The limited role of exercise in weight loss and its greater importance in improving health, body composition, and insulin sensitivity [19:45]; The “top five most important biomarkers” for assessing health [22:45]; Promising developments in longevity research [28:15]; The development of Klotho as a neuroprotective drug: challenges, timelines of trials, and more [34:00]; Peter’s updated view on the potential of epigenome manipulation to restore aged cells to their youthful state [39:45]; How reversing age-related epigenetic changes in immune cells could revolutionize our approach to aging and disease [43:30]; The “objective, strategy, tactics” framework, and the importance prioritizing impactful lifestyle habits over less significant health trends [49:30]; Strategies for building and maintaining good habits [56:45]; How to think about drugs and supplements as part of a longevity toolkit [1:02:00]; Peter’s recent reading list [1:05:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Chapter 1: What are the key topics discussed in this AMA?
Hey everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of The Drive Podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe.
So without further delay, here's today's sneak peek of the Ask Me Anything episode. Hey everyone. Welcome to a special rapid-fire Ask Me Anything episode. I'm once again joined by my co-host, Nick Stenson.
In today's AMA episode, we thought it would be fun to do an end-of-year bonus AMA in a more rapid-style manner to answer many questions that are commonly asked that have come through over the past year across a wide range of topics and frameworks.
We discuss questions on exercise such as grip strength, exercise while traveling, the importance of strength training, and why I don't believe exercise is an ideal strategy for weight loss. We talk about labs, including the quote, top five most important biomarkers, unquote, that everyone should know for themselves. Spoiler alert, I hate that question.
We talk about new research on longevity that has come out and that has been particularly exciting. And I answer the question if I have changed my mind on anything recently as it relates to longevity. We speak about some of the frameworks that I use and the importance of using the objective strategy tactics model as an approach versus a one size fits all approach.
We close the conversation by talking about building good habits and my recent reading list. If you're a subscriber and want to watch the full video of this podcast, you can find it on the show notes page. If you're not a subscriber, you can watch the sneak peek of the video on our YouTube page. So without further delay, I hope you enjoy this bonus AMA rapid fire.
Peter, welcome to a special bonus AMA. How are you doing? I'm doing well. Thank you for having me back. Anything new going on in your life?
Just a few things.
I say that with not knowing anything, but just anything that jumps out to you.
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Chapter 2: Why is grip strength important?
Chapter 3: How can I maintain exercise while traveling?
That was residency.
Oh, residency.
Yeah.
Med school is not that exhausting. I love it. So for today's AMA, it's going to be kind of a little different style, just more conversational, a little bit covering questions that come through that we haven't covered before. Some of it will be conversations that we've had internally that we were like, ah, it'd be great to record this and kind of put it out there.
So it's going to be a mix of specific questions, more framework, organizing principle questions. We'll cover things like labs. prioritization as it relates to actions, what you're excited about in the field of longevity, books you've maybe read recently, and a bunch of other random stuff. So with all that said, we'll get going. First topic, your favorite exercise.
And within it, we're going to cover grip strength. So It's something you've talked about before, the importance of, but I don't think we've ever really covered a little bit in depth on like how you train for it and how you think about it in the weight room. So before we get to that, do you just kind of want to remind people why you think grip strength is important?
Yeah, so grip strength is important probably for a little bit of the reasons that we understand the drunk under the streetlight problem, which means the old adage of the drunk guy standing under the streetlight and someone asks him what he's doing and he says he's looking for his keys and they ask him if
this is where he dropped him and he says no but this is where the light is right so sometimes where it's brightest is where you end up looking so i don't want to of course minimize grip strength but i also want to just point out that in the literature when you are interested in studying the relationship between strength and outcomes everything from onset of dementia all-cause mortality cardiovascular disease all of these things which has been studied are
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Chapter 4: What are the top five biomarkers for health?
You need objective measurements of strength to test. If your hypothesis is strength is positively associated with, correlates with, or even causal towards these things, you have to be able to test it. And so the question then becomes, well, how do you test strength? Should we have people deadlift things?
And I think if you go through that exercise, you pretty quickly realize that's probably not a good idea. because most people don't deadlift and technique is pretty important in deadlifting and it's pretty easy for somebody to hurt themselves.
So what scientists have done instead over the years is they've tended to study things that anybody can do, even if they don't do the particular exercise that's being tested. You shouldn't be testing squat strength or deadlift strength if a person doesn't deadlift or squat. So the things that have typically emerged as strength tests are grip strength, wall sits.
So that's a test of, you know, at least isometric quad strength. Bench press. If you don't bench press, that's a bit of a stretch. Leg extension. Those tend to be the big ones. Sometimes leg press as well. So I just want to caveat it by saying I don't think there's something super, super magical about grip strength.
We just have such an abundance of data on it because it's such an easy thing to test. So the next question then would be, is there something magical about having a strong grip? And here I think the answer is partly yes. A strong grip in isolation doesn't really exist.
So there's really no example I can think of where a person has a very strong grip in their hand, but their forearm, deltoids, scapula, triceps, all of these other things are weak. So a strong grip is sort of a way to test that. Very strong, very stable control through the upper extremity all the way down to the outside world. And again, it's a very practical thing.
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Chapter 5: What promising developments exist in longevity research?
Just talk to any person who's reached an age where they can't open a new jar of pickles or they struggle to unlock a door or they struggle to carry a heavy plate. So when your grip strength goes, your quality of life absolutely goes. But again, I think it's just a proxy for people who are strong. And that kind of leads into your question, which is how should you train it?
So what's undeniable is the strength of the association. So I'm not even going to go into that because the data are overwhelming. The strength of the association between grip strength and any and everything positive warrants no further discussion. The more important question is, is it causal? If grip strength is just a proxy for health.
and increasing grip strength does nothing to increase health, then we really shouldn't be talking about this. I don't believe that that's the case. I make an argument for that in Outlive, which is going through sort of the Bradford Hill criteria and explaining why I think there is causality in the association.
In other words, why is it that increasing metrics of strength and endurance also improves lifespan and healthspan, not that they are just markers of healthy people who go on to have a better lifespan and healthspan? So how would you train it?
Well, I can't tell you the number of times I give a talk or I just run into somebody in the airport and they tell me that they went out and bought a little grip squeezer on Amazon. And they said, Peter, you've got me convinced I got to strengthen my grip. So now I sit around and I squeeze these little things all day. And I said, well, that's great.
I don't think there's anything wrong with that, but I don't think that's the optimal way to train grip strength. I think what you really want to do is do all of the other things that rely on strong grip. And the most obvious example of these things are exercises that involve carrying and pulling and hanging. That's really where we put our grip to the test.
So I'm giving you a very long-winded answer, Nick, but the point is you want to train your grip strength by doing the things that rely on grip. So when you pick things up, when you carry things, when you pull things, if you're doing a seated cable pull, if you're doing a pull down, if you're doing a pull up, if you're doing a farmer's carry, if you're doing a deadlift,
Those are the way we train grip. So I don't do very many things that are quote unquote deliberate grip strength exercises. I suppose that when I do farmer's carries, I'm almost exclusively doing that to push the limits of my grip.
And maybe let's isolate two of the things you mentioned that I think are easiest for people to potentially test on themselves at a gym, you know, with the least amount of equipment. Like you said, if you haven't deadlifted before, you probably shouldn't just start deadlifting without understanding the form. So I think looking at farmer's carry and dead hang, let's say farmer's carry.
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Chapter 6: How can I build good habits effectively?
Yeah, there are standards and I apologize. They're not tip of tongue for me. I want to say two minutes is considered a pretty good wall sit for anybody. I don't tend to do wall sits like that. There's another exercise I prefer to do, which is I'll do an air bike. I'll ride on the air bike for a minute hard, and then I'll hold a kettlebell and wall sit for 30 seconds to a minute.
So it's a shorter sit, but I come in pre-fatigued. Plus I'm adding some stress to it by holding a weight. But if you just do a straight up wall sit, I apologize. We'll put it in the show notes for what a good standard is. I want to say it's two minutes, but it might be five minutes. I honestly don't remember.
Anything else on grip strength before we move on? No, I think that's good. Perfect. Another question that comes through a lot is on exercises, people who are traveling. So whether it's for work, whether it's family, you're not at your traditional location, gym, whatever it may be.
So if you're traveling, any advice you would give patients on easy exercises they can do, ways they can continue to stay active even when they're not in an ideal setting?
Yeah, I do get asked this question a lot. And honestly, like my answer is you have to be deliberate. And that sounds like maybe not what people want to hear. I think people are looking for a quick fix. But when I travel, you can ask my assistant, what's the first thing I'm asking? What's question number one? It's show me the gym. I want to know exactly what the gym looks like.
And if the website doesn't have good pictures, please have somebody who works at the front desk go down with their phone, film the gym, send us the video so we can evaluate. Yeah, I know. That sounds ridiculous. I get it. But unless you're going to the middle of nowhere where you have no choice in hotel, you have a choice in where you stay. Now, you'll have to make a concession.
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Chapter 7: What should I consider for my longevity toolkit?
Maybe you have to be a little bit further from the place you want to be at. Maybe you're going to add 10 minutes or 15 minutes of driving time. Maybe the hotel is going to be a little bit more expensive. There will be a trade-off, and everyone has to make that trade-off. But I start with that question, which is, how can I make sure that whatever hotel I'm at has a good enough gym?
It's not going to be the gym I have at home. It's not going to allow me to do everything I would do at home. but that's okay. Basically, I've never been to a hotel where I can't do something. Even if they just have a bench and dumbbells and I can do presses and I can do rows and I could do pushups and hopefully the bench incline. So maybe I can do an incline bench as well as a flat bench.
I could do rear foot elevated split squats, regular split squats. There's a lot you can do with a modest amount of dumbbells and a bench. And then of course, most gyms have much more than that. That to me is sort of step one. Step two is when traveling, you have to sort of be mindful of what jet lag is going to do to you.
Chapter 8: What is Peter's recent reading list?
So because I'm in central time zone and when I travel west, it's really easy for me to work out early in the morning. A 5 a.m. workout is easy when I go to California for three days. So I can start my meetings actually quite early on those days because I know I'm going to get the workout done early. Conversely, if I go to New York, I have to keep in mind like I'm going to be a little bit tired.
I am not going to want to work out at six because six feels like five and I don't like working. I mean, even though I'm comfortable getting up at five, I don't want to work out first thing at five o'clock. So then I have to adjust the timing of the meetings.
So I think those are basically the two big things is make sure that your schedule has the time for you to do the workout and budget according to what jet lag is going to do to you and pick a place to go so that you can get the workout in time. the hotel. That's always going to be easier than if you have to leave the hotel to go to the gym. You can do that.
And of course, there's been many times in my life when my training was so elaborate that I had to go into a commercial gym, but it was the same playbook. I would just book a hotel near the commercial gym.
100%.
The goal of exercising when you're traveling is not to maybe make the most incredible gains. It's just to prevent the losses.
Another question that comes through often is sex specific. So if you have female patients who prefer cardio compared to weightlifting, why do you think women should pay special attention to strength training?
Yeah, there are two big reasons for this. The first is that women naturally have less muscle mass and are not as strong as men. And yet they still live in the same environment as men do, which is to say they're going to be subject to all the same forces. And this is one of the reasons why we see women fall more than men.
It's not just that women are more injured by falls, which they are, and we'll discuss that in a moment. It's that women actually fall more than men. And one of the reasons for that is a disparate exchange in strength. So that's reason number one.
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