Dr. Peter Attia’s 7 Golden Longevity Rules for Living Longer

Dr. Peter Gattia, I want to talk non-negotiables here, especially in the world of longevity, so to speak. What would you say your five non-negotiables are for the average person, things that they can just implement starting today or strive to implement today to really improve their quality of life and strive for longevity? I would think of them kind of by buckets, right? So in the bucket of nutrition, I would say the two things that really matter most are probably not the things that people are fixated on, which is like, you know, what's my ratio of, you know, how many omega-6s am I getting and how many omega-3s and how much monounsaturated, saturated fat? Those things matter, but I don't think they're the first order term. I think the two most important things there are going to be total energy intake and total protein intake. And so, you know, maintaining energy balance, which is easiest to document by total body fat and visceral fat, which you can both pull off a DEXA, and maintaining adequate protein intake would probably be the two most important things there. Again, there's a list of three through 10 that would be really important, but, you know, those are going to be really important. Adequate protein intake, by the way, is probably higher than most people think, especially as we get older. So the older you get, the more anabolically resistant you get, and therefore, the more protein you need for muscle protein synthesis. So I tell people that a really good rule of thumb is somewhere between about 0.8 and 1 gram of protein per pound of body weight, which sounds like a lot, and it is a lot if you're comparing it to the recommended dietary allowance, which is, you know, woefully low. It's something to the tune of 0.8 grams per kilogram of body weight. So it's about half what I would suggest is ideal. Everything else, I think, you know, there's a lot more detail to that. If we want to get into it, for example, the timing with which you consume that protein matters greatly. You can't just eat it all in one meal. So for people who are into intermittent fasting and want to eat one meal a day, that strategy is not going to work. You're going to have to, you know, eat protein outside of that fasting window to make sure you get it, because we have a really hard time using all the protein for muscle protein synthesis. So it kind of has to be in smaller doses, typically 30 to 50 gram doses. I want to mention, I popped a 30% off discount link down below for Thrive Market. Now Thrive Market is an online grocery store, but it's not like a regular grocery store. It's set up by different diet categories. Okay. So you've got keto, you've got vegan, you've got paleo, you've got different diet categories. So it allows you to get the best quality foods and no preservatives, no garbage. 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And it is definitely where you want to be going as pretty much your one-stop shop, almost entirely your one-stop shop for what you can get delivered to your doorstep for your intermittent fasting routine. So yeah, that would be kind of the nutrition bucket. I think the next thing I would say is exercise. And here I think, you know, shy of being injured, there are very few people who, maybe outside of people like you, who are going to overdo it, right? So for most people, the answer is do more. And when people say the next question is, well, strength or cardio? Yes. So you need both. These things are complementary to each other. They both have enormous benefits, and this is demonstrated really clearly through the data. So high cardio respiratory fitness is the single most potent correlate with longevity, but a pretty close second is high strength and muscle mass. So, and that doesn't mean you have to be a bodybuilder, right? It means that you have to have sufficient mass for glucose disposal, and you have to have a high amount of strength, especially later in life, when things that we take for granted now, like getting up off the floor, become very difficult. So, you know, also stepping off a curb, like, again, having adequate strength, not just in one plane, and not just in one direction of muscle movement. So not just concentric strength, but eccentric strength. So I often get asked, how much exercise do you need to be doing a week? It really depends, but I've never been able to come up with a number less than about eight hours a week, if you're really trying to hit all of these metrics well. So that's two. When we come back to protein for just a second, in the space of longevity, there's all this noise about methionine, and this and that, that, you know, obviously you have one camp that says protein restriction is key. You have another camp that says not, and is there a middle ground there, or is that research, I mean, the only methionine research is really rodent model, and it's not the strongest, in my humble opinion, but I'm not an expert. What's your take on that? Do we need to be concerned there? Yeah, I think, again, I think, and I've done two podcasts on this topic, one with Rhonda Patrick, one with Matt Kaeberlin. We go into this in great detail, and maybe, you know, you guys can link to those for all the detail. But yes, I think that the animal research here is, I think, conflating what we see in the human data. And in the human data, I think it's much more abundantly clear, especially over 50, right? So you could maybe argue that below 50, it's not as clear if excess protein or low protein is harmful, but it's clearly harmful for people over 50. And I would argue that's where it matters most, right? Because, let's be honest, most people who are 40 years old, their absolute risk of mortality is so low that offsetting that by a few percent means nothing. Whereas when you're talking about people who are 50, 60, 70, I mean, it becomes exponentially greater. This is not a linear increase in mortality. It's an exponential increase in mortality by decade. Therefore, we should ultimately be focused on what do we need to do to reduce mortality for people in that setting? And I think the answer from the human data is crystal clear, and that is more protein is better. And I suppose it ultimately doesn't matter, plant-based or animal-based, as long as you're getting the complete profile. That's almost true. The people who are plant-based have to at least be cognizant of the fact that they're going to have to work harder. So plant-based proteins are not as bioavailable, and they don't have as favorable an amino acid distribution. So for example, they're not going to get as much methionine. They're not going to get as much leucine. They're not going to get as much lysine. And if it's not cooked, the plant protein is not cooked, they're only really getting about 70% of it just due to the binding of fiber. So I don't think you have to eat animal protein, but I do think it's a lot easier. And again, I always sort of want to understand a person's opposition to animal protein. If it's on the health, I'll usually try to explain to them that they probably don't need to be worried about that. If it's on the basis of some other opposition, such as animal treatment, I don't try to talk them out of that position at all. I just say, let's come up with other ways that you can work around that. Absolutely. Okay. So we've got protein, we've got exercise. What else do we have on this? It's pretty low-hanging fruit. And I think more people are so aware of it today, in large part, thanks to the work of someone like Matt Walker, who I think has probably single-handedly done more to educate people about the importance of sleep. But for anybody who's listening who maybe isn't quite aware of that, it's really clear that virtually all people need somewhere between about seven and nine hours of sleep at night. And the easiest way I would think about that is, you know, being in bed for about eight hours for most people gets you there. Because remember, you're not sleeping the whole time you're in bed. So you're only sleeping for about 85 to 90% of the time you're in bed, if you're lucky. And so if you're in eight hours, you should gravitate towards that. Now, from an operational standpoint, most people can achieve this without, you know, complex interactions and without pharmacotherapy and things like that. But you do have to be diligent, right? So the sort of sleep hygiene is a really important part of sleeping. And I think the most important things to be thinking about there are consistency in bedtime and wake-up time, including weekends. Now, I'm really lucky because I have small kids, and my boys get up at six o'clock every single day, like clockwork. It doesn't matter. If it's Christmas, it's a little earlier. But for most, you know, it's never 6.30, it's never seven o'clock. So my wife and I kind of know we are up at six regardless. And that makes it actually kind of easy for us. We go to bed at 10, and we're up at six. We have no what's called social jet lag, which is when you sleep different times on the weekends. So if you don't have kids, you have to be a little more diligent about doing that yourself. And I think it's not unreasonable if you're in that situation to have a little bit of drift, maybe an hour more or less from week to weekend. Darkness is important. So you'd be amazed at how much light people have in their rooms, and it's totally unnecessary. You really don't need any light in your room. And if you have an alarm clock, you can set it to the dimmest setting. I do have an alarm clock. I never use it. I don't even know why it's there, but I probably take it away. But I turn it away from me anyway, so I can't see it, right? I also don't keep a phone in my room. And I think it's a pretty important, I mean, I'm amazed at how many people still keep their phone in their bedroom, as though somehow our species made it this far, you know, without phones in our bedroom, and now we just can't go on without it. So phone in bedroom is a horrible source of light. And more importantly, it almost assuredly suggests you're looking at it before you go to bed, which is not something you want to do. And it's less about the light in that situation, and frankly, more about the stimulation. You know, you could say, well, maybe I'm looking at like a calming meditation sleep app, and maybe in that case, it's actually fine. But for most people, you're looking at something that is somewhat stimulating. So we want to kind of avoid stimulation. And then the other things are just avoiding alcohol and food before bed. And I like to kind of have a three-hour gap. So again, alcohol in general, not going to be pro-sleep under any circumstance, but certainly not if it's within about three hours of bedtime. And the same with food. My rule of thumb is go to bed hungry, not starving, not so hungry that I can't sleep. But if I go to bed full, I'm not going to sleep very well. If I go to bed hungry, I haven't eaten in three or four hours, I'm going to sleep really well. Yeah, I definitely agree there. And there's some interesting twists that I've found with that, you know, as far as carb allocation three hours before bed and things like that tend to help me. But anything closer to bedtime tends to disrupt it. I definitely noticed that. I'll touch on alcohol for just a second. I mean, one of the things that I do know is that alcohol kind of creates this illusion like you're sleeping well, but your actual, you know, non-REM and REM sleep are like kind of consolidated to the earlier stages and it kind of messes up everything on the back half. Yeah. I mean, I think people confuse consciousness with sleep. You know, so there's no doubt that alcohol can reduce consciousness. Obviously at the extreme stage, you could black out, but even absent that, alcohol can certainly make you feel drowsy, but that shouldn't be confused with functional sleep. So, so you're absolutely right. I mean, you know, glib example would be right. Like, you know, getting hit in the head with a baseball bat will make it look like you're sleeping. Like you, if you laid somebody in a coma next to somebody sleeping to the outside, they look the same on the inside. They look nothing alike. Absolutely. All right. So what's next on the line? Next on the line would be for most people, most of us drive cars and I don't think we want to underestimate the risk of automotive accident. I have three people in my life. So three friends of my wife, so people I know very well who have all been in very bad car accidents in the last two months. Now, luckily all of them are totally fine. All three of their vehicles are totaled. And in each situation, the other person was 100% at fault. So the thing I say here is we want to drive around with a mindset that says somebody on the road today is trying to kill you. So what can you do to be aware of the fact that somebody is trying to kill you? And the two most common ways somebody is going to kill you in a car is, if they're at fault, is crossing over into your lane and hitting you in two-way traffic that's not separated by a median and at a junction that is either an intersection or a T-junction. So that can either be a formal intersection like a light or a T-junction, which is like someone coming out of a parking lot erroneously when you're going straight or vice versa. So what do you do and how do you operationalize that? Well, it's silly things, but I'm constantly doing them. So when I'm on two lanes in each direction, I'm never in the left lane unless I am passing, but I'm always going to be in the right-hand lane. In other words, I want to give myself one more little buffer of oncoming traffic for somebody who's looking at their phone, gets distracted, and ends up in my lane. Secondly, I'm just always thinking of that scenario. I'm always sort of scrutinizing traffic and I pay very close attention to where the sun is. So, you know, it's interesting when the sun is at your back, you feel great, but you have to remember the lower the sun behind you, the worse it is for the person in front of you. So that person, when they have a low sun in their face, they don't see you. And if you live where I live in Texas, we have fast, windy roads that are often without medians. I think they're very dangerous. At the intersection, what I'm basically doing is never driving through an intersection without scanning it first, when I have a green, of course, and assuming someone's going to run it. That's amazing that you put that in there. It's because, again, when you look at all-cause mortality, right, you have to look at car accidents, and I feel like that is such an undervalued piece of it. I absolutely love that you put that in there. Yeah, it's funny. I wanted to have a chapter on accidental death in my book, but I got outvoted by the publisher. They just thought it was too much, too long, save it for another time, which, of course, I'm not going to write a book about accidental death. So anyway, that's something we have to talk about. The fifth and final thing, I think, would be just not ignoring your emotional health and the state of your relationships. I think that all those things that we just talked about factor probably disproportionately into length of life, although I think exercise functions at least as much in quality of life. But I also think this emotional health piece of managing your relationships, both with yourself and others, it just can't be overstated. If you're unhappy, if your relationships suck, if your wife hates you, if you're detached, if you're not a good parent, if you're not a good coworker, not a good friend, who cares how long you live, who cares how much money you have, who cares about any of these other variables? So I think some sort of exploration of your own emotional health is something that I think everybody should be doing. And if you come up short, if you come up through a survey or an internal survey of this and you realize maybe things aren't what I want them to be, there are just so many resources for how to go about addressing that. And I think that's very important. Yeah. And it goes hand in hand with everything else we're talking about, too. I mean, if your emotional health is not in the right place, it's a heck of a lot harder to make good nutritional choices. It's a heck of a lot harder to exercise. And it kind of ends up being this massive roadblock. Yeah, incredibly true. So, well, cool, man. Well, as always, thanks for keeping it locked in here. And then where can everyone find you? Plus, talk a little bit about your book here. Yeah. So Outlive is my book that came out a little while ago. And it's available, obviously, anywhere you buy books. I can be found basically everywhere is through peterottmd. So that's the URL of the website. That's where I spend time on social, mostly on Instagram. And then the podcast that I host is called The Drive. We're coming up to the five-year anniversary of that. And that comes out every Monday. And that's kind of more of a deep dive podcast on all topics related to health and longevity, the word I love. Beautiful. Well, we'll link out to all of these below. And thanks, man. Yeah, thank you.