Télécharger

Pratique du shadowing : Best Exercises for Overall Health and Longevity - Dr Peter Attia and Dr Andrew Huberman

Écoute la phrase, puis dis-la à voix haute
Phrase 1

Transcription complète

  1. I've heard you talk before about some of the prime movers for longevity and all risk mortality.0:03
  2. And I'd love for you to review a little bit of that for us.0:11
  3. I think we all know that we shouldn't smoke because it's very likely that we'll die earlier if we smoke nicotine.0:15
  4. I'm neither a marijuana nor a nicotine smoker, so I feel on stable ground there.0:21
  5. But anytime we see smoking nowadays, people really want to distinguish between cannabis and nicotine.0:26
  6. So I am curious about any differences there in terms of impact on longevity.0:31
  7. But in that context, what are the things that anyone and everyone can do, should do to live longer basically?0:37
  8. How long you got?0:46
  9. Well, you tell me.0:48
  10. You tell me.0:51
  11. I'd like my final decade to be between 90 and 100.0:52
  12. No, I meant how long do you...0:56
Afficher les 169 phrases Afficher moins de phrases
  1. I'm just kidding.0:58
  2. And will we spend from now until you're 90 talking about this?0:58
  3. Well, there's a risk of that.1:01
  4. So let's start with a couple of the things that you've already highlighted.1:02
  5. So smoking, how much does smoking increase your risk of all -cause mortality?1:05
  6. And the reason we like to talk about what's called ACM or all -cause mortality is it's really agnostic to how you die.1:09
  7. And that doesn't always make sense.1:16
  8. I mean, if you're talking about a very specific intervention like an anti -cancer therapeutic, you really care about cancer -specific mortality or heart -specific mortality.1:18
  9. But when we talk about these sort of broad things, we like to talk about ACM.1:27
  10. So using smoking, smoking is approximately a 40 % increase in the risk of ACM.1:30
  11. What does that translate to?1:36
  12. That means I'm shortening my life by 40 %?1:39
  13. No, it means at any point in time there's a 40 % greater risk that you're going to die relative to a non -smoker and an eversmoker.1:43
  14. So it's important to distinguish.1:50
  15. It doesn't mean your lifespan is going to be 40 % less.1:51
  16. It means at any point in time standing there, your risk of death is 40 % higher.1:53
  17. And by the way, that'll catch up with you, right?1:58
  18. At some point that catches up.2:00
  19. High blood pressure, it's about a 20 to 25 % increase in all -cause mortality.2:02
  20. You take something really extreme like end -stage kidney disease.2:08
  21. So these are patients that are on dialysis, waiting for an organ.2:12
  22. And again, there's a confounder there because there's what's the underlying condition that leads you to that.2:15
  23. It's profound hypertension, significant type 2 diabetes that's been uncontrolled.2:20
  24. That's enormous.2:25
  25. That's about 175 % increase in ACM.2:26
  26. So the hazard ratio is like 2 .75.2:30
  27. Type 2 diabetes is probably about a 1 .25 as well.2:34
  28. So 25 % increase.2:38
  29. So now the question is like, how do you improve?2:40
  30. So what are the things that improve those?2:41
  31. So now here we do this by comparing low to high achievers and other metrics.2:43
  32. So if you look at low muscle mass versus high muscle mass, what is the improvement?2:48
  33. And it's pretty significant.2:55
  34. It's about 3x.2:56
  35. So if you compare low muscle mass people to high muscle mass people as they age, the low muscle mass people have about a 3x hazard ratio, where 200 %2:58
  36. increase in all -cause mortality.3:06
  37. Now, if you look at the data more carefully, you realize that it's probably less the muscle mass fully doing that.3:08
  38. And it's more the high association with strength.3:17
  39. And when you start to tease out strength, you can realize that strength could be probably 3 .5x as a hazard ratio, meaning about 250 % greater risk if you3:19
  40. have low strength to high strength.3:32
  41. And high strength is the ability to move loads at 80 to 90%.3:34
  42. It's all defined by given studies.3:38
  43. So the most common things that are used are actually, they're used for the purposes of experiments that make it easy to do.3:40
  44. I don't even think they're the best metrics.3:48
  45. So they're usually using grip strength, leg extensions, and wall sits, squats, things like that.3:49
  46. So how long can you sit in a squatted position at 90 degrees without support?3:58
  47. It would be a great demonstration of quad strength, a leg extension.4:02
  48. You know, how much weight can you hold for how long relative to body weight, things like that?4:06
  49. You know, we have a whole strength program that we do with our patients.4:10
  50. We have something called the SMA.4:13
  51. So it's the Strength Metrics Assessment.4:15
  52. And we put them through 11 tests that are really difficult.4:16
  53. You know, like a dead hang is one of them.4:21
  54. Like how long can you dead hang your body weight, stuff like that?4:22
  55. So we're trying to be more granular in that insight, but tie it back to these principles.4:25
  56. If you look at cardio respiratory fitness, it's even more profound.4:30
  57. So if you look at people who are in the bottom 25 % for their age and sex in terms of VO2 max, and you compare them to the people4:34
  58. that are just at the 50th to 75th percentile, you're talking about a 2X difference roughly in the risk of ACM.4:43
  59. If you compare the bottom 25 % to the top 2 .5%.4:53
  60. So you're talking about, you know, bottom quarter to the elite for a given age.4:57
  61. You're talking about 5X, 400 % difference in all cause mortality.5:02
  62. That's probably the single strongest association I've seen for any modifiable behavior.5:09
  63. Incredible.5:13
  64. So when you say elite, these are people that are running marathons at a pretty rapid clip.5:14
  65. Not necessarily.5:19
  66. It's just like what the VO2 max is for that.5:19
  67. Like my VO2 max would be in the elite for my age group.5:21
  68. My VO2 max, you know, but again, I'm training very deliberately to make sure that it's in that.5:25
  69. So I wouldn't consider myself elite at anything anymore, but I still maintain a VO2 max that is elite for my age.5:29
  70. I consider you an elite physician and guy all around.5:35
  71. But true.5:41
  72. But in terms of.5:44
  73. OK, so the point is like you don't have to be a world class athlete to be a leader.5:45
  74. Yeah, got it.5:49
  75. So maybe we could talk a little bit about the specifics around the training to get into that, you know, top two tiers there, because it seems that those are5:51
  76. enormous positive effects of cardiovascular exercise far greater than the sorts of numbers that I see around, let's just say supplement A or supplement B.5:58
  77. And that's, you know, like this is my whole pet peeve in life, right?6:08
  78. It's like I just can't get enough of the machinating and arguing about this supplement versus that supplement.6:11
  79. And I feel like you shouldn't be having those arguments until you have your exercise house in order.6:19
  80. You know, you shouldn't be arguing about your this nuance of your carnivore diet versus this nuance of your paleo diet versus this nuance of your vegan diet.6:26
  81. Like until you can deadlift your body weight for 10 reps, like then then you can come and talk about those things or something like that.6:35
  82. Let's just go up with some metrics like until your VO2 max is at least to the 75th percentile and you're able to dead hang for at least a minute6:41
  83. and you're able to wall sit for at least two.6:49
  84. Like we could rattle off a bunch of relatively low hanging fruit.6:51
  85. I wish there was a rule that said like you couldn't talk about anything else health related.6:56
  86. Like we just we can make that rule.6:59
  87. No one will listen to it.7:01
  88. I don't know about that.7:02
  89. We can make whatever rules we want.7:03
  90. We can call it a Tia's rule.7:04
  91. And one thing I've done before in this podcast on social media is just borrowing from the tradition in science, which is it's inappropriate to name something after yourself unless7:06
  92. you were a scientist before 1950.7:13
  93. But it's totally appropriate to name things after other people's.7:16
  94. I'm going to call it a Tia's rule until you can do the following things.7:18
  95. Don't talk about.7:22
  96. Please refrain from talking about supplements and nutrition.7:23
  97. There it is.7:26
  98. Hereafter, thought of referred to and referenced as a Tia's rule.7:26
  99. I coined the phrase not him.7:31
  100. So there's no ego involved, but it is now a Tia's rule.7:32
  101. Watch out.7:35
  102. Hashtag a Tia's rule.7:36
  103. Oh, God.7:37
  104. Wikipedia entry, a Tia's rule in all seriousness.7:39
  105. And I am serious about that.7:42
  106. Dead hang for about a minute.7:43
  107. Seems like a really good goal for a lot of people, at least.7:45
  108. That's our goal.7:48
  109. I think we have a minute and a half is the goal for a 40 year old woman.7:49
  110. Two minutes is the goal for a 40 year old man.7:52
  111. So we adjust them up and down based on age and gender.7:54
  112. Great.7:59
  113. And then the wall sit.7:59
  114. What are some numbers?8:00
  115. We don't use a wall sit.8:01
  116. We do as just a straight squat, air squat at 90 degrees.8:02
  117. And I believe two minutes is the standard for both men and women at 40.8:06
  118. Great.8:10
  119. And then because for some people thinking in terms of EO2 max is a little more complicated, they might not have access to the equipment or to measure it, etc.8:11
  120. What can we talk about, think about in terms of cardiovascular?8:19
  121. So run a mile at seven minutes or less, eight minutes or less?8:22
  122. That's a good question.8:25
  123. So there are a really good EO2 max estimators online and you can plug in your activity du jour.8:26
  124. So be it a bike, run or rowing machine.8:34
  125. And it can give you a sense of that.8:37
  126. And I used to know all of those.8:39
  127. But now that I just actually do the testing, I don't recall them.8:42
  128. But it's exactly that line of thinking.8:45
  129. Can you run a mile in this time if your EO2 max is approximately this?8:47
  130. Great.8:51
  131. And I think somewhere in my podcast realm, I've got all those charts posted of this is by age, by sex, this is what the EO2 max is in each8:52
  132. of those buckets.9:05
  133. Trivate.9:06
  134. We'll provide links to those.9:07
  135. We'll have our people find those links.9:08
  136. And then you mentioned deadlifting body weight 10 times.9:10
  137. I just made that one up.9:13
  138. That's not one that we include.9:14
  139. But something like that.9:15
  140. We use farmer carries.9:18
  141. So we'll say for a male, you should be able to farmer carry your body weight for, I think we have two minutes.9:20
  142. So that's half your body weight in each hand.9:26
  143. You should be able to walk with that for two minutes.9:29
  144. For women, I think we're doing 75 % of body weight or something like that.9:32
  145. Yeah.9:35
  146. Great.9:36
  147. I love it as indirect measures of how healthy we are and how long we're going to live.9:36
  148. It's basically grip strength, it's mobility.9:42
  149. Again, walking with that much weight for some people initially is really hard.9:44
  150. We use different things like vertical jump, ground contact time, if you're jumping off a box, things like that.9:49
  151. So it's really trying to capture, and it's an evolution.9:54
  152. I think the test is going to get only more and more involved as we get involved.9:57
  153. Because it took us about a year.10:02
  154. Beth Lewis did the majority of the work to develop this.10:04
  155. Beth runs our strength and stability program in the practice.10:07
  156. And basically I just tasked her with, hey, go out to the literature and come up with all of the best movements that we think are proxies for what you10:10
  157. need to be the most kick -ass, what we call sentinary into Catholic, which is the person living in their marginal decade at the best.10:17

Mesuré dans ce clip

Débit
208 mots par minute — plus rapide que 67% du catalogue
Niveau CECRL
B2
Mots à connaître
tiers, percentile, marathons, referenced, agnostic, shortening
Télécharger dans l’App Store