The Diary Of A CEO with Steven Bartlett
Anti-Aging Expert (Peter Attia): Anti-aging Cure No One Talks About! 50% Chance You’ll Die In A Year If This Happens! Boost Testosterone Naturally Without TRT!
Mon, 07 Apr 2025
Dr. Peter Attia is a physician, researcher, and best-selling author of Outlive: The Science and Art of Longevity. He founded Early Medical, a longevity-focused practice, and co-founded 10 Squared, a hybrid testing lab and training center. In this episode, Peter and Steven dive into the real science of aging, the #1 predictor of mortality most people ignore, the silent epidemic of male loneliness and addiction, and how to boost testosterone and extend your healthspan naturally. Chapters: 00:00 Intro 00:02:16 What Is Peter Focused On at the Moment? 00:06:50 What Steven Wants To Be Able To Do in His Last Decade 00:10:20 Ageing Is Inevitable 00:15:15 What Peter Wishes Someone Had Told Him in His 30s 00:17:13 Men's Health 00:17:59 What Is It To Be a Man? 00:18:46 Is Testosterone on the Decline? 00:23:31 Sleep and Bad Choices 00:26:50 What Are the Things Peter Wants To Do in His Marginal Decade? 00:28:48 How To Prepare Now for the Marginal Decade 00:32:11 Peter's Workout Routine 00:35:39 What Causes Injury in the Gym? 00:37:45 Why Is Building Muscle Mass Important? 00:38:27 Training on Fatigue 00:40:43 Grip Strength Test as a Longevity Indicator 00:42:44 Danger of Falling After Age 65 00:45:32 How To Train Power To Prevent Falling in Older Age 00:46:46 Is Training Balance Important? 00:47:46 Peter's Approach to Flexibility Training 00:52:04 Peter's Strength Training Routine 00:53:06 Why Endurance Exercises Are Gaining Popularity 00:53:58 What Is VO2 Max and Why It Matters for Longevity 01:03:59 Jack's VO2 Max Results 01:05:40 Jack's Heart Rate Recovery Results 01:06:31 Jack's Zone 2 Test Results 01:08:34 How Can Jack Improve His Results? 01:09:00 Ads 01:11:18 Jack's Cardio Routine 01:13:21 Measuring Bone Density and Muscle Mass – DEXA Scan 01:19:52 Preventing Bone Density Loss 01:21:32 Nutrition for Bone Density 01:23:44 Building Muscle Mass 01:25:30 Gaining Muscle Mass Through Nutrition 01:27:26 How Different Are Women's Results Generally? 01:28:34 Determining if Subcutaneous Fat Is an Issue 01:29:52 What Causes Visceral Fat? 01:30:59 Intermittent Fasting To Reduce Visceral Fat 01:31:28 Sleep, Stress, and Visceral Fat Connection 01:32:34 Is Alcohol Acceptable from a Health Perspective? 01:36:24 Are People Electrolyte Deficient? 01:37:56 Importance of Nuance in Navigating Information 01:42:21 Peter's Book 01:44:13 Question From the Previous Guest Follow Dr. Peter: Instagram: https://g2ul0.app.link/CABLVLhrgSb Podcast: https://g2ul0.app.link/aKZjQEmrgSb Early Medical: https://g2ul0.app.link/42mSperrgSb 10 Squared: https://g2ul0.app.link/YOtJ2furgSb Article on alcohol: https://g2ul0.app.link/fK6HL1StiSb Buy Outlive: https://g2ul0.app.link/MXsH4WCrgSb More from DOAC: Watch on YouTube: https://g2ul0.app.link/DOACEpisodes Buy 'The 33 Laws Of Business & Life': https://g2ul0.app.link/DOACBook Get the Conversation Cards: https://g2ul0.app.link/f31dsUttKKb Newsletter Signup: https://bit.ly/diary-of-a-ceo-yt 100 CEOs Newsletter: https://bit.ly/100-ceos-newsletter Follow Steven: https://g2ul0.app.link/gnGqL4IsKKb Independent research: https://peterattia.tiiny.co Sponsors: Fiverr: https://fiverr.com/diary (Code: DOAC) ZOE: http://joinzoe.com (Code: BARTLETT10) Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: What is Dr. Peter Attia's current focus in anti-aging science?
I wish I could say one thing. There's probably a few things, and maybe that's not good. Maybe the most successful people in life only think about one thing. I would say one of the things I'm thinking a lot about is how to translate Outlive into a delivery system, obviously digitally, that...
basically operationalizes what is in that book in a manner that allows people to, with as little friction as possible, implement the solutions for themselves. So basically, how do you live a longer life? How do you age as gracefully as possible and maximize your health span?
Chapter 2: What are the benefits of planning for the marginal decade?
Chapter 3: How does maintaining muscle mass and strength affect longevity?
So there's muscle mass, muscle strength, but we don't have a single metric that we can measure that better predicts how long they will live than how high their VO2 max is, which is the maximum amount of oxygen you can consume. If you compare somebody who is in the top 2% to someone who is in the bottom 25%, there is a 400% difference in their all-cause mortality over the coming year.
But how do I know if it's an issue or not? We'll go into much more detail around that, but the way to avoid this is to train specifically for that marginal decade. And there's so many things that we just do wrong. So the sooner you start, the better. So rule number one.
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If you could do me that small favor and hit the follow button, wherever you're listening to this, that would mean the world to me. That is the only favor I will ever ask you. Thank you so much for your time. Back to this episode.
Dr. Peter Attia, what is keeping you busy at the moment in terms of the subjects that you wrote about in Outlive, but the work that you do online and the work you do in the variety of businesses that you have? What is keeping you fascinated at the moment? What is one's mind focus on?
I wish I could say one thing. There's probably a few things, and maybe that's not good. Maybe the most successful people in life only think about one thing. I would say one of the things I'm thinking a lot about is how to translate Outlive into a delivery system, obviously digitally, that...
basically operationalizes what is in that book in a manner that allows people to, with as little friction as possible, implement the solutions for themselves. So basically, how do you live a longer life? How do you age as gracefully as possible and maximize your health span?
I think the other thing I'm focused on that is related to that, of course, but distinct, which I know your team got to participate in a little bit this week, was kind of how to train people for their marginal decade, right? So this idea of we're all going to have a last decade of life.
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Chapter 4: Why is testosterone declining and how can it be boosted naturally?
On that point of advice that you gave me there about emotional health, one of the things that's been very front of mind for me at the moment is men's health, specifically men's emotional health.
Because I read a report that came out in March called Lost Boys, and it just details this pretty horrific picture of men's emotional health in the UK at the moment in particular, but the trend holds around the world. And It came out in the start of March. It's been in all the newspapers in the UK. And it details a couple of sort of headline stats. The reverse gender pay gap amongst young men.
So women are now earning more. You know the stats probably around suicide. Yeah, suicide. And one in seven young men are unemployed or out of work. All these sort of horrific stats. And then it compounds with things like suicidal ideation, et cetera, et cetera. I was thinking about this this morning when I was listening to some of your work.
I was thinking, I wonder what Peter's perspective is on what it is to be a man. Actually, it does kind of dovetail into some of your work around testosterone and the decline in testosterone. And because one of the things I was thinking about is how testosterone plays a role in what it is to be a man. But if you look at the stats around testosterone, it appears to be declining. Yes.
And I say this in part as well because testosterone causes a certain set of behaviours.
um in men that define and shape what a man is and what they want and how they show up and even when i said earlier on protection as one of the three things i cared about that's probably in part because of the testosterone in me this debate around testosterone this conversation around testosterone um and its decline Is it declining? It is. It is. Why is it declining?
And does it matter? Well, I think the second question is easier to answer than the first. I do think it matters. The why is probably multifactorial, and the why is just as important as the fact that it is. In other words, the fact that it's declining is both relevant for the fact that a very, very important hormone that has –
incredible benefit to men and women by the way is going down and we have to come up with an answer to that right like so how do we address that do we address it medically where we replace that hormone exogenously meaning we give you that hormone directly or do we try to fix the underlying problem so if you want to do the latter you have to know what the underlying problem is now at the population level the best answer as to why testosterone levels are declining
And unmistakably, they are. So the data here are unambiguous. There's no debate on this fact. The debate is around the why. I believe that the best answer probably has to do with two things. One is increase in body weight and body fat specifically in men. and some combination of reduced quality of sleep and sort of disruption to sleep. So why are those two things relevant?
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Chapter 5: What role does sleep play in health and testosterone levels?
So if you come and you see a man who's got very low testosterone, and you can't understand why, you give him luteinizing hormone. If he still has low testosterone, you know that he has what's called primary hypogonadism, which means his testosterone is low because his testes can't make testosterone.
Conversely, if you give the man luteinizing hormone and all of a sudden his testosterone goes up, he has secondary hypogonadism. I mean, you could mix the primary secondary there, but really the terminology doesn't mean anything. What matters is he can make testosterone, but... for some reason, his brain isn't giving his body the signal to do it.
And that's a classic finding in a person who's under high stress and or not sleeping well. So that's a long-winded answer to your question, but I think that those are probably the greatest contributors to this.
Now, people have talked a lot about what about microplastics, what about other environmental factors, what about other factors in nutrition beyond just the ones that would contribute to excess body fat. The evidence there is less compelling, but I don't think we should discount it. But I think that if those things are playing a role, it is probably much smaller than what we just talked about.
I was thinking as you were speaking about sleep and testosterone, about how, and also the link there with bad diets, how if I've not slept well, I wake up and make...
worse food choices for sure and i was like is that like dopamine dysfunction no it's probably more due to insulin signaling so um we know from really good experimental studies that when you sleep deprive people they become insulin resistant And the more insulin resistant a person is, the less they're able to access their stored energy.
So higher insulin resistance means greater difficulty accessing stored energy. So if you wake up and you have successive days of poor sleep and you're becoming somewhat insulin resistant, you're going to want to eat more because you're not able to access your own natural stores of fat, which is where we want to go for energy.
So if you look at one experiment that was done out of the University of Chicago, they took healthy subjects, young subjects, and sleep deprived them for hours. somewhere between 10 and 14 days. So not a huge period of time. And they only let them sleep four hours a night, which by the way, I know a lot of people who are doing that for years at a time.
In that 10 to 14 day period of time, their insulin resistance was worsened by 50%. In other words, they do an experiment called a euglycemic clamp where they inject them with glucose to see how effectively they can put glucose into their cells. That's the hallmark of insulin sensitivity is how well you can put glucose into your muscles when it's infused in you.
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Chapter 6: What is Dr. Peter Attia's workout routine?
Just to get some tips from you around your strength training regime. How many exercises do you do? What does, I'm really curious. So you train three days a week doing strength and resistance stuff. Do you do like shoulders and back and as like a pet? Yeah, yeah, exactly.
So on Monday, Monday is pure lower body. Okay. And Wednesday is arms and shoulders. And Friday is chest and back. Okay. Super simple. Like nothing, no rocket science. An hour? I mean, it's like an hour and a half of lifting plus maybe 20 minutes of the warm-up stuff. So on the chest and back day, how many chest exercises are you doing?
Four. Four, okay. And then four on back?
Yeah. Okay. And I'm just super setting them. And I'm going to do maybe five sets of each, so five working sets. So there's a lot of warm-up in there too. And I'll also do some other stuff like some med ball slams or things like that as well. Okay.
There's been this huge rise in people doing these high rocks and sort of elite endurance events and such. It's really interesting that it's become so popular. Even things like running clubs, I know, but the fact that more people are doing marathons now than ever before. Why do you think this is happening?
I don't know. I mean, I think it's a very net positive thing, though. I mean, I do think that there's more and more people that are taking up things like rucking and running and, you know, finding camaraderie in these things. The only thing I hope is that people are doing it in a manner that's sustainable and safe and allows them to do it indefinitely.
So, you know, I'm always hopeful that whatever thing that people are doing, they're not injuring themselves because, again, rule number one is don't get injured. The name of the game is to play the game as long as possible.
In front of me, I have a bunch of different graphs and images. And some of them relate to a word you said earlier on, which is VO2 max. And this is something I've heard you talk about previously. But for anyone that doesn't understand what VO2 max is or why it's important, can you explain what it is and why it's so critical to longevity and healthspan?
I think most people will be familiar with the idea that we are obligate anaerobes, which in English means we cannot survive without oxygen. Okay. So why is that? So oxygen is absolutely essential to catalyze the chemical reaction that turns food into a currency for energy called ATP. So everybody's probably heard of ATP. ATP is the money, the currency of energy in our body.
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Chapter 7: Why is building a balance and flexibility routine important?
Just for a second, I want to talk about a company I've invested in and who sponsored this podcast called Zoe. Like me, many of you are big on tracking your fitness and your sleep. But how many of you understand how your body handles food? Metabolic fitness is all about understanding your metabolism's response to food. And we all react differently.
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As a Zoe member, you'll get an at-home test kit and personalized nutrition program to help you make smarter food choices that support your health. That's zoe.com with code Bartlett10. I've got a story that I think you'll be interested in hearing, and it's brought to you by my show sponsor, Fiverr.
About six months ago, my team and I sat down to try and work out how we were going to build the most valuable newsletter for ambitious entrepreneurs ever. And after hours of discussion, we finally agreed that to tip the odds in our favor, we needed to be constantly experimenting. But to do this, we needed manpower or womanpower.
So we hired a group of freelancers through Fiverr and tasked them with testing different elements, which are like the visuals in the newsletter, the subject lines, the copy links. And even after launching 100 CEOs, the new newsletter and getting 93,000 signups on the first day, our experimenting hasn't stopped.
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So I've invited Jack in because I feel like he might have some questions and you might have some questions. So you guys go ahead.
All right. Well, first off, Jack, thanks for being an awesome guinea pig yesterday. You hit it out of the park as far as your cardio training. So tell me a little bit, like, what are you doing for cardio? How often are you running?
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Chapter 8: Why are endurance exercises gaining popularity?
But it sounds like there's something going on with calcium metabolism as a kid that might have played a role. The reason it is really important to connect with an endocrinologist now is there are actual medical studies
treatments that can increase bone density in addition to all of sort of the total optimization of the nutritional stuff, vitamin D, calcium levels, things of that nature, and of course the training.
Are there specific exercises I would do to increase that? Or is it just an all-round thing?
No, I mean, I think if you think about the long bones of the body, which are the ones that we're basically measuring here, I mean, the short bones in the spine, but the femurs and hips, anything that puts those things under deformation. So anything from a farmer's carry to a step up to a box squat.
I mean, you know, it's whatever you can do safely that's loading you and placing these bones in a manner that… forces them to actually undergo deformation. And the other thing I would also make sure of is that someone's checking your blood levels to look at things like testosterone and estrogen. So estrogen, believe it or not, probably the most important hormone besides vitamin D in bone health.
So you can think of a bone as something with a strain gauge in it. And as the bone is deformed, the strain gauge sends a signal, a chemical signal to cells that build the bone. The chemical signal is estrogen.
So the reason women are so susceptible to osteopenia and osteoporosis is once they go through menopause, many of them lose their estrogen if they're not placed on, well, they all lose their estrogen, but if they're not placed on hormone replacement therapy, they don't get it back. And so they lose that chemical signal. So women see a rapid drop-off in bone density at menopause.
Peter, is this graph accurate, roughly? Yes, this would be accurate.
So if this is broadly accurate, what is the game then for someone like Jack? Is it building bone or is it preventing loss?
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