AMA #68: Fasting, well-balanced diets, alcohol, exercise for busy people, wearables, emotional health, assessing cardiovascular health, and more
Peter Attia
Feb 17, 2025
Mindsip insights from this episode:
Recognize alcohol consumption as a risk factor for increased mortality
Mendelian randomization studies show that any increase in alcohol consumption leads to an increase in mortality, contradicting epidemiological studies that suggest low doses are safe.
Test for LP(a) to uncover hidden heart risk
You should specifically test for LP(a), a common heritable cause of cardiovascular disease that is disproportionately atherogenic and is missed by virtually all standard tests.
Understand calcium score limitations to assess heart health risks
A calcium score (CAC) has about a 15% false negative rate, meaning you could have a score of zero but still have soft plaque detectable by a more advanced CT angiogram.
Prioritize APOB over LDL for cholesterol management
Once you know your APOB and LP(a) levels, you don't need to concern yourself with LDL, non-HDL, or HDL cholesterol, as APOB is the aggregate marker for all atherogenic proteins.
Reassess blood pressure norms to lower health risks
A blood pressure of 130 over 85, which historically would have been considered normal, is anything but normal, and the goal for lowest risk is consistently below 120/80.
View time-restricted feeding as a tool for calorie reduction
Time-restricted feeding is no better than standard caloric restriction and should be viewed as one of several indirect tools to help you consume fewer calories.
Understand genetic factors behind women's alcohol sensitivity
Women are more susceptible to the negative effects of alcohol partly because they have genetically lower levels of alcohol dehydrogenase, a key enzyme for its metabolism.
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