Randomly healthy reading.

The longevity guy – Dr Peter Attia and his book ‘Outlive’.

If you have the slightest interest in health, fitness and function in later life then go watch this video and ignore my post…..

Here’s an odd and disturbing question to start this post with…..”what if you knew today that, right now, you were entering the final or ‘terminal’ decade of your entire life” ?. What would that look like and feel like, how would you act and what would you do differently, if anything, to what you are doing today ?.

It’s perhaps not something that you think about in your 30’s because you’re indestructible right – unless you have the wrong genes and get aggressive testicular cancer or say are prone to suicidal tendencies. It perhaps isn’t even something that you think about in your 40’s and 50s but maybe one day in your 60’s say you wake up one day knowing that your physical strength and health aren’t what they were and that the mortality clock is ticking.

My perspective is that i’m 65 and relatively long lived parents who both died of ‘slow’ death causes but for both of them the fact is that the last 15 years of their lives was a slow slope of ill health and increasing medical problems. Something I wonder about today is if the lack of everyday physical challenge in their lives from their 60’s onwards led to or assisted with their decline ; they lived in an average bungalow in an unusually flat city and never, for example, had to deal with anything as taxing as stairs. One of the factors of my late mother’s demise was a ‘simple’ fall after which she never really regained her full strength and mobility – there’s nothing unusual in that as a high percentage of older people that fall are dead within a year or 2 years.

Here, living on a steep Cornish lane means that the older people who have to struggle up the hill from the local shop have a bit of a fight on their hands and I wonder if that forces their bodies to maintain greater muscle strength which in turn helps with their cognitive (brain) function. If anyone wants to do a bit of comparative research it would be interesting to see if there was an actual difference in the muscle mass of older Cornish man and women compared to the flat-land fenlanders of Lincolnshire.

Anyway, enough musing for now.

It’s a sobering thought that the boat iv’e just built – WABI IV might be not only the one and only boat I build but it might also be my last boat – unless I have a mental moment next winter and build myself a sailing canoe as well. It’s more likely though that the sailing project that I am soon about to embark upon will be my last major sailing adventure and I regard that not so much as a ‘poor me’ event but just the way things are. As it happens I feel that I need to be a lot fitter for my adventure and at the same time do the main work now that would improve the state of my health for my eventual terminal decade…..there’s no escaping it but it seems that we can modify the quailty of it in either direction – depending on what we do or don’t do ahead of time.

One more thing before talking about Dr Attia and his book though.

It’s my observation of hospital based healthcare and just taking a walk around the local city that there has been a marked decline in the health and fitness of middle aged to older people ; trust me….i’m a nurse etc but this is just what I see. What I see is a much higher rate of obesity and far more people than I ever did zooming about in mobility scooters – my direct observation of many of them is that of morbid obesity often coupled with missing limbs. My knowledge and hospital experience of that is the cause is usually Type 2 Diabetes, vascular damage and eventual amputation. This is one of the features that Dr Attia describes as ‘slow death’ rather than what a lot of my healthcare career was about…..what Attia calls ‘fast’ death – I’ll explain the two terms ‘dreckly’ as we say in Cornwall.

I first became aware of Dr Attia when I did my first experiments with diet – this is going back about ten years now. As iv’e said before I have a strange history with medical/dietary education in that my student nurse education in this matter was mainly delivered by a hospital dietitian and to excuse the pun basically spoon-fed our class with a dogmatically held ‘truth’ all based around the then food pyramid but also mixed with her own convictions about vegetarianism and the benefits of a high fiber diet.

Today, I suspect that the modern version of the same person would be a zealous vegan and that the new ‘gospel truth’ of diet would be highly anti meat, anti fat and all based in some moral precept of superiority that has nothing to do with the science of nutrition.

As it happens I largely ignored diet because there wasn’t much that we really had to know compared say to the basic anatomy and physiology of the gut first and then the endocrine system and what I remember about that was no great connection being made between the standard American/English diet, the explosion of obesity that actually happened during my nursing career and it’s end points in metabolic disease and Type 2 Diabetes. It’s hard to believe today but these were all taught as separate and unrelated subjects. The end result over ten years ago is that I realized that I knew very little about diet and metabolic health and that most of what I had been taught as gospel truth was just a standardized ideology that had little to do with science.

Anyway, back then, as is when I was re-learning everything I could about diet, health and metabolic disease Dr Attia was just one of the many smart people whose ideas I engaged with. Attia seemed to be the poster boy for fasting, for keto diets, and for super accurate tracking of all his own health parameters – most of that kind-of went past me a bit because aside from his work on fasting there didn’t seem much that I could emulate. Today, Dr Attia seems to have gone through several stages of thinking and in recent interviews he doesn’t focus anything like as much as he did on the benefits of fasting and if anything seems to have dropped it as a practice himself.

I believe that it is said that un-learning is a harder thing for our brains to do than is actual first time learning and it certainly seemed to be the case with me and nutrition and/or metabolic disease – I was also trying to keep track of several new specialists in different aspects of this ; in my case I got a bit ‘lost in the woods’ and voices like that of Dr Attia faded into the background a bit. I think one reason for that was that I was more deeply invested in some of the low carbohydrate ideas because I had taken the time to read them while most of the other nutrition/health niche presenters were quickly seen and passed over Youtube video’s.

Today of course Dr Attia has come back strongly in the forefront of my thinking because he has not only done a serious long form interview with Dr Jordan Peterson but he has also written his own book about the whole story of health and longevity. If anything it was his interview with Dr Peterson that made me sit up and take notice because I’m a long term Peterson follower and have mentally invested in his work on making plans for life….it’s not that simple of course but if you have the time then dip into the Peterson/Attia interview because that seemed to me like two sides of the same playbook.

For now I would just like to highlight a few of the things that I picked up from the pair of them kicking around the whole subject of health/longevity, the standard American/English diet, the major features of ‘fast’ deaths vs ‘slow’ deaths and his most important point which is that healthy years are possibly much more important than mere years lived.

1.The food pyramid and the standard American diet.

I always used to have a very ‘conspiracy theory’ view of this – that the food pyramid was the product of a conspiracy between a small group of senators, the American agricultural industry, food industry and all aided by compliant doctors. Attia, on the other hand, takes a much less conspiratorial view and has said that he thinks that the food pyramid was an overly successful solution to a problem that genuinely existed ; that of needing cheap and plentiful food products that would feed the masses and at the same time have a good shelf life, be transportable and could be made into a delicious ‘product’. In a way an over success but one that has had catastrophic consequences for the health of the American people.

2.Fast and slow death.

According to Dr Attia what we both dealt with in the earlier stages of his medical career and my nursing one was what he refers to as ‘fast’ death – that is, deaths or serious morbidity related to major trauma and severe sepsis. Those are exactly the kind of problems that he dealt with as a trauma surgeon and the kind of cases that ended up in my intensive care unit ; that’s really the first ten years of my life as an ICU staff nurse then Charge nurse. Later on in my nursing career I mostly dealt with ‘slow death’ at the point where it’s either chronic decline gone horribly wrong or the end stages of long term deterioration and ultimately either an emergency call to deal with things far too late or the simple task of verifying an expected death.

Most of what modern medicine now deals with are the diseases of the modern age ; heart disease, stroke, diabetes, cancer and so on. Most of those have a relatively slow progression that shows up as slow decline and soaks up more and more medical time and is what largely drives the hugely successful pharmaceutical industries. It would be way too easy for me to be conspiratorial about the pharmaceutical industry because you could say that it relies on diseases that it’s co-industrialists in food and agriculture create to make their enormous profits…..pharma isn’t about curing disease, if anything it is maximizing it’s time of occurrence and therefore it’s profit.

Ok then, call me cynical.

3.Health span rather than lifespan.

This post isn’t exactly a book review, the reason for that being that I haven’t read the book yet and in fact it’s only just arrived at my local independent bookshop as I write this post. Rather than a book review it’s a reflection on what iv’e already learned about Dr Attia’s work during the time that I was listening to and studying anything that I could that was related to health, nutrition and metabolic disease. As I said earlier, one of my problems with that was that I was listening to several ‘voices’ all at once and each of them took one specific aspect of the dietary problem and ran with it. Thus I had professor Tim Noakes being by go-to guy about low-carb diets and how to deal with the brazen feminist vegetarian dietitians who were trying to take him down, then American GP Dr Berry being a full rethink of first line medical health and showing me how many things I didn’t know, Dr Cywes convincing me that I was, and still am a miserable sugar addict and so on and so forth.

Any anyway…..what I have been doing a lot of this week is watching and watching again various clips of his interviews with different presenters. At this stage I just happen to think that the best one was the long form interview between him and Jordan Peterson because what they were both talking about danced back and forth between health science, risk science and behavioral psychology science.

Oh…..the paragraph title…..OK, so his main point, which i’ll need to come back to once iv’e done the leg work is that the span of healthy life is more important than lifespan…..at this stage my understanding of that is that health span is the time in which I could still be living an active (read sailing and hiking) life, not have a major health problem, have a decent level of cardio-respiratory fitness and high strength for whatever decade I am in.

The book itself I have to pick up today and it’s going to be my major reading material during an upcoming break where I want to be offline as much as possible and sat in a comfy chair under a tarp on Norfolk camp site with coffee and biscuits to hand……oh…..wait !