AMA #68: Fasting, well-balanced diets, alcohol, exercise for busy people, wearables, emotional health, assessing cardiovascular health, and more

**Peter Attia** (0:10)
Hey, everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com/subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything, episode number 68 I'm once again joined by my cohost, Nick Stenson. In today's AMA, we're gonna go through many of the questions you submitted to us through the website and summarized as a way to answer some of the most common questions that have come through. Through this, we'll cover a wide range of topics and frameworks. We cover topics such as how to assess cardiovascular health, including what markers to pay attention to, talk about intermittent fasting, including prolonged and time-restricted fasting methods, as well as alcohol consumption and its impact on health, as well as the association with certain diseases. Talk about nutrition, outlining the principles of a well-balanced diet, and answering some of your questions about protein intake. We also speak about the benefits and downsides of ketogenic diets and low-carb diets. Talk about exercise, including how to create effective fitness routines, the importance of recovery, and we explore the topic of wearables. Lastly, we touch on emotional health. Needless to say, this is an episode that has something for everyone. If you're a subscriber, you can watch the video on the show notes page. And if you're not a subscriber, you can watch a sneak peek of the video on our YouTube page. Without further delay, I hope you enjoy AMA number 68

**Nick Stenson** (1:53)
Peter, welcome to another AMA. How are you doing?

**Peter Attia** (1:55)
Good. Thanks for having me.

**Nick Stenson** (1:57)
Always welcome on your own show. So today, what we're going to do is we actually have gathered all the questions over the past three or so years that people have submitted on the AMA portal. For people who don't know, we have an AMA portal on our website where you can submit a question. So if anyone hasn't done it, we'll link to it in the show notes. And that way, there's questions you have that you want follow up on, whether it's something related to something happened to you, questions on podcasts, newsletters, whatever it may be.
And so that's kind of what today's AMA is going to be. And we'll hit different diseases, we'll hit nutrition, we'll hit exercise. We'll kind of hit a little bit of everything, because as people can imagine, questions came through, included a little bit of everything. So I think we'll just jump into it. But with that being said, anything you want to add before we start with the first question?

**Peter Attia** (2:49)
The only thing I would add is we talked about maybe if this format, which is more questions, less depth, more of how I would sort of answer questions if I were at a party and people were asking me, if people want more of this, but on a personal level, we've talked about accommodating that. So maybe we just do a quarterly episode where I take very specific questions from individuals. If they want to be acknowledged, do so and do that. So anyway, I think there's just a lot we can play with in this format. So let's just see if folks find this helpful.

**Nick Stenson** (3:25)
Yeah, perfect. First question, how does someone assess their cardiovascular health? It's obviously a topic that we've covered in such a variety of podcasts, very important. You've often talked about number one cause of death, not only in the US, but in the world. And so kind of in general terms, if someone's sitting there thinking, okay, I'm curious about where I'm at cardiovascular, and as it relates to cardiovascular disease, how would you talk to them about how they can assess where they're at?

**Peter Attia** (3:52)
So fortunately, if somebody wants to assess their risk of cardiovascular disease, we have a lot of tools to do it. We always start with the obvious, which is often neglected, but we should really know our family history. It's not enough to just know, my grandparents lived till such and such an age, or my aunt and uncles lived to such and such an age. Whenever possible, you really want to understand how grandparents, parents, aunts and uncles lived and died. And sometimes it's easier to ask questions like, hey, did they take medication or do they take medication for cholesterol, for blood pressure and understanding those things. Again, some of the patterns that tend to show up here, when you see people perishing really young from cardiovascular disease, or when you see them requiring procedures, such as revascularization, stents, cabbage, things of that nature, especially at a young age, you have to be thinking about heritable causes of ASCVD. And again, the two most common are going to be Lp-a and some form of familial hypercholesterolemia. Now, the latter is a lot easier to spot because these people have sky-high cholesterol levels. The former is much more difficult because virtually nobody is getting their Lp-a tested. And so that's sometimes the individual who themselves is kind of interested in assessing their own risk is the first to figure it out. And then it explains what has happened over generations.