James O'Keefe, M.D.: Preventing cardiovascular disease and the risk of too much exercise.

**Peter Attia** (0:11)
Hey everyone, welcome to The Drive Podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in-depth content if you want to take your knowledge of the space to the next level. At the end of this episode, I'll explain what those benefits are, or if you want to learn more now, head over to peterattiamd.com forward slash subscribe.
Now, without further delay, here's today's episode.
My guest this week is Dr. James O'Keefe. James is a cardiologist and medical director of the Charles and Barbara Duboc Cardio Health and Wellness Center at St. Luke's Mid-American Heart Institute, an enormous practice of more than 60 cardiologists in the middle of this lovely country. He is also a professor of medicine at the University of Missouri, Kansas City. James has authored best-selling cardiovascular books for health professionals, including The Complete Guide to EKGs, Dyslipidemia Essentials, and Diabetes Essentials.
James has also co-authored, with his wife Joan, the best-selling consumer health book, The Forever Young Diet and Lifestyle. He is actively involved in patient care and research and has published numerous peer-reviewed articles, which honestly, I feel like I'm reading at least one every couple of weeks.
I came across James for the first time about nine or 10 years ago when I heard him speak at a conference, and frankly, what he had to talk about just threw me back on my heels. And since that time, of course, we've become friends, and James is in many ways a mentor to me with all things that pertain to preventative cardiology. In this episode, we talk about a lot of things, starting with his background and how he made the pivot from going into interventional cardiology to now this much broader area of preventative cardiology. We get into some really detailed but very accessible physiology of what the heart does, how it works, and therefore how it's susceptible to disease. And then we kind of launch into some of the things I wanted to get to. I wanted to talk about the impact of exercise on the heart, both positive and negative. We go into that in exceptional detail. We get into the role of nutrition and specific nutrients such as sodium, magnesium, etc. And then we round the discussion out with a sort of tour de force discussion of many of the pharmacologic agents that some of you have probably heard of.
And frankly, even this discussion taught me quite a bit and actually invigorated my knowledge for this space. So I always enjoy talking with James, and I suspect you will all enjoy this episode very much. So without further delay, please enjoy my conversation with Dr. James O'Keefe. James, thanks so much for sitting down with me today, albeit not in the same physical location, which is always a shame. The last time we were in the same location, you swung by my office in New York. I remember it was probably about three years ago and you were kind enough to bring a recent manuscript you'd just published about the impact of exercise on heart disease and we had a lovely discussion. I don't think we had the time for a meal that day because it was an impromptu visit, but I never imagined it would be almost three years before we'd be doing our podcast, which is something that from the moment I started a podcast, I knew I wanted to sit down and talk with you. You're also just an incredibly gracious guy who's always sending me stuff. And so I consider you one of those people as my sort of constant educators. So this is going to be an exciting episode because I'm going to be learning a lot. And I know that anybody who cares about heart disease is going to be learning a lot. And I don't know how you can not care about heart disease if you care about longevity.

**James O'Keefe** (4:15)
Yeah, it's the heart of the matter for sure. And yeah, I think we all instinctively understand how important the heart is to our health.
And I might say in the spirit of educating each other, I love your podcast. I think it is easily my favorite podcast. I love the way you dig down into the science and really get to the heart of the matter without over-hyping things. And I just think you're doing a wonderful public service for improving the health of the population. And the other thing I'm really impressed at because a lot of my fellows and residents and kids will talk to me about what they heard on Peter Attia. So your audience is particularly, if I might say, tuned in, intelligentsia, you know, interested in health and well-being. And I think you have a really, you have really curated a remarkable audience.