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Peter Attia, MD is a highly respected expert in preventive medicine, focused on the crucial subject of longevity and cardiovascular health. He's also the author of the NY Times best selling book Outlive - which I highly recommend if you have not read it already. Peter's philosophy transcends the conventional goal of merely extending lifespan; it's about enriching the quality of every year, ensuring that each stage of life is lived with optimal health and vitality.

In this episode, we discuss:

• (00:07:36) Defining cardiovascular disease
• (00:09:43) Coronary plaque and fatality risk
• (00:11:09) What is cholesterol?
• (00:13:34) How ApoB predicts heart disease
• (00:21:34) Factors elevating ApoB
• (00:25:24) ApoB reference range explained
• (00:27:23) Does high ApoB cause cardiovascular disease
• (00:37:01) ApoB thresholds for ASCVD prevention
• (00:40:27) Dietary factors raising ApoB
• (00:39:33) Genetics of ApoB and LDL
• (00:53:24) Does low LDL increase cancer?
• (00:56:19) Cholesterol-lowering drugs
• (00:59:59) Statins, uses, and side effects
• (01:03:12) Are statins toxic to mitochondria?
• (01:09:56) Ubiquinol for statin-induced muscle soreness
• (01:11:09) How to train in zone 2
• (01:17:09) Statins and neurodegenerative disease risk
• (01:21:54) Cholesterol synthesis in the brain (desmosterol role)
• (01:25:58) Statin alternatives – pros and cons
• (01:27:30) Ezetimibe
• (01:31:01) Bempedoic acid
• (01:36:49) Berberine for CVD Risk Reduction?
• (01:39:36) Muscle as a glucose sink
• (01:45:58) Chronic glucose toxicity and vascular impact
• (01:51:38) Hemoglobin A1C Levels and Mortality Data
• (01:55:35) 80/20 Zone 2/VO2 Max Training Protocol
• (02:02:12) Insights from VO2 max testing data
• (02:12:17) How obesity increases cancer risk
• (02:15:03) Cancer screening benefits and risks
• (02:20:47) Dr. Attia's recommended cancer screening age
• (02:28:54) Liquid biopsies for detecting cancer
• (02:34:48) CT scans, mammograms and radiation concerns
• (02:40:32) Menopause – hormonal shifts and health effects
• (02:45:13) Hormone replacement therapy (HRT)
• (02:58:57) Perimenopause diagnosis with hormone levels
• (03:02:04) HRT's impact on dementia, cancer, and heart disease risk
• (03:04:49) Estrogen's role in bone density
• (03:07:42) Vitamin D
• (03:16:24) Testosterone replacement for women's sexual function
• (03:18:47) HRT safety 10 years post-menopause
• (03:23:05) Treating low testosterone in men
• (03:29:53) TRT side effects and risks
• (03:32:33) Ways to reduce blood pressure
• (03:39:33) How to measure blood pressure
• (03:45:30) Peter's longevity optimization routines

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Download the 9-Page "Cognitive Enhancement Blueprint" companion guide at bdnfprotocols.com.

This episode challenges common perceptions about exercise, delving deep into the benefits of vigorous exercise for not just physical health but also brain function, aging, and even cancer prevention. It tackles fundamental questions, like what genetic and metabolic adaptations occur with vigorous exercise and how it can contribute to combating heart's age-related changes. We also unpack how these rigorous exercises affect glucose transport, mitochondrial health, and brain health at an intricate level. Lastly, it introduces practical applications like the Norwegian 4x4 interval training protocol, the benefits of "exercise snacks," and how to incorporate vigorous-intensity exercise into everyday life.

In this episode, I discuss:

• (00:00) Introduction
• (04:34) What differentiates "vigorous" from "zone 2" training
• (08:34) Ties between VO2 max & life expectancy
• (11:55) Why zone 2 training doesn't guarantee VO2 max improvements
• (14:17) How to balance zone 2 training & vigorous-intensity workouts
• (16:17) Why the Norwegian 4x4 protocol may improve your VO2 max
• (19:35) Evidence-based methods to estimate VO2 max outside a lab.
• (22:33) What it takes to reverse 20 years of heart aging: a two-year protocol
• (28:24) HIIT and type 2 diabetes – how vigorous exercise can reduce risk.
• (29:38) The mitochondria argument: HIIT vs. Zone 2 – which intensity is better?
• (32:09) Rethinking the 80-20 rule for everyday exercisers (less zone 2, more effort)
• (35:18) The role of high-intensity workouts in enhancing mitophagy
• (38:03) Why lactate accumulation from higher training intensity benefits the brain
• (40:28) Why the "glucose sparing" effect of lactate benefits brain injury and aging
• (43:26) The unique BDNF benefits of high-intensity exercise: the lactate advantage
• (44:42) The angiogenic effects of VEGF on the blood-brain barrier (in response to lactate)
• (46:58) The greater the exercise intensity, the greater the myokine release
• (49:48) How physical activity affects death risk in breast & colorectal cancer survivors
• (50:56) How vigorous aerobic exercise kills circulating tumor cells
• (52:36) Why exercise reduces depression and neurotoxicity (kynurenine mechanism)
• (54:13) The surprising power of "exercise snacks" against mortality
• (1:01:36) Download "The Cognitive Enhancement Blueprint" at bdnfprotocols.com 

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