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Hello and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. Today we're discussing heart health. The heart is at the center of everything within our bodies, constantly pumping oxygen and nutrients throughout our tissues and organs. We all know if our heart fails, we're in trouble. However, we only tend to start thinking about the health of our heart when we encounter a problem. So how do we prevent a problem from occurring? Dr. Peter Attire is here to explain how by making changes to our lifestyle today, we can take control of our heart health tomorrow.
B
Let's just talk about cardiovascular disease because it is.
C
It's like heart attacks and strokes.
B
Heart attacks and strokes, because that's the number one cause of death globally, and it's the number one cause of death for men and women. So if you're listening to us talk today, chances are this is your number one risk factor. We know from autopsy studies that are conducted on people in their 20s who have died for unrelated causes that they already have signs of atherosclerosis, which is the technical name for what happens when cholesterol gets inside the artery wall and an inflammatory process takes place that ultimately leads to, for example, a heart attack.
C
And this is sort of the furring up of your artery slowly over.
B
Yeah. And what's really happening is the body is attacking the inside of the artery where this cholesterol gets, thinking it's a foreign adversary, when in reality it's not. But in the process of doing so, it creates more of a problem than is warranted.
C
And you're saying that when they've done autopsies of somebody in their twenties for nothing to do with someone who dies.
B
In a car accident.
C
Car accident, you can already start to see the signs.
B
You can see evidence that this. That this process has been a decade in the making. In other words, this process basically begins at birth. Now, for the average person, that process probably won't reach clinical significance if you're a male until you're in your mid-60s. So 50% of men who go on to have a heart attack, stroke, or die suddenly from one of those two will have that event take place before the time they are 65. So for women, it's a third of women who will have a heart attack, stroke, or die of heart attack or stroke will have that occur before they are 65. So when you ask the question, okay, I'm in my late 40s, is it too late for me? Well, I would say, no, it's not. Right. The fact that you're sitting here. Right. Tells me it's not too late to do anything about it. But where a lot of people get lulled into a false sense of security is, hey, I'm in my late 40s and everything looks pretty good.
C
Yeah. So how do we change the focus from treating diseases to preventing people becoming sick in the first place? And I guess particularly, I think if you're listening to this, it's not just an abstract question, but maybe, you know, for the individual themselves, because I think generally they will find that if they go and see their doctor, if they're not clearly sick with something, then they'll be like, oh, you're fine, you know, go away. Come back when you're sick.
B
Yeah. I mean, there's two ways to think about your question. And I think there's one way that I feel qualified to speak and there's one way that I don't. So I'll start with the way that I don't. If you're asking the question from a structural standpoint, how would we fix the healthcare system? I would say to do that, you have to go back to the way physicians are trained. When I was in medical school, I only really learned about two tools, which were procedural tools and pharmacologic tools.
C
Procedural tool means like, surgery. Surgery.
B
Yeah. I mean, I trained as a surgeon. So basically those were the two things that you learned.
C
You basically chop something out or you give someone a drug.
B
That's right. Those were your tools. And again, I do not want to suggest that those are not valuable tools. I do not want to disparage the remarkable things that those tools have done. Again, they have doubled our lifespan in four generations. Right. I'm simply pointing out that all the stuff we are now talking about will require that you understand nutrition and you understand exercise and you understand sleep and you understand emotional health. And I was not trained in any of those things, and I know that my peers were not trained in any of those things. So some of us have learned those things, but we had to learn them outside.
C
Tim always says that, you know, if you're lucky, you get a half day of training on nutrition in your entire training as a doctor. And probably most of the students aren't even there for that, like, half day on nutrition.
B
I mean, even if you said, okay, going forward, you know, physicians are going to have to spend an entire semester learning about exercise, nutrition, and sleep. They would have to really understand how to apply those tools. I don't think there's any doctor listening to this or for that matter. Any patient listening to this who hasn't been told by their doctor that they should sleep, that they should eat less, that they should exercise more, but that's relatively unhelpful advice. It's sort of like a patient with cancer being told by their oncologist that they should get chemotherapy. I mean, if the advice ended there, it would be of no value, right?
C
Yes.
B
The reason that you see the oncologist when you have cancer is the profound precision that goes into which chemotherapy. How should it be dosed? Based on my body weight, based on my kidney function, based on my liver function, how would you monitor for recurrence? How would you modify the treatment if I'm not responding? Think of all the nuance that a physician can provide today within his or her area of expertise, and think about the complete and utter lack of that nuance and sophistication that goes into the primary tools of prevention. And I haven't really answered your question because all I did was tell you the part that I don't know how to fix, which is, how do you change the medical infrastructure?
C
Tell me about the bit you can fix.
B
Well, I think the part that we can fix is where you started with, which is, as the individual, we just have that agency to ourselves. That's kind of why I wrote the book. Right. I wanted to write a book that could be an operating manual for the person who acknowledges that maybe the system isn't perfect. But what can I do to say, okay, like, now I know a lot of this stuff and I don't need a physician for it. I mean, you don't need a physician to help you fix your nutrition or your exercise or your sleep or your emotional health.
C
And I think, you know, one of the things that is frustrating, I think, is clearly we're spending almost all of our money on healthcare in this prevention regime, which, you know, I think often some extraordinary fraction of this is spent in the last 12 months of somebody's life. It's sort of got too late to be able to really improve.
B
It's really infuriating.
C
I'm very frustrating about this.
B
Yeah. And in fact, even if you didn't care one iota about a person's life, even if you were simply counting the beans, it would make so much more sense to take half of that money that is being spent in the last year or two of a person's life and spend it in the earlier part of their life. And again, I'm just going to use the NHS as an example, because we're here, but Imagine if the NHS said, you know what, we're going to slap CGMS on everybody and we're going to pay for it. And you know what, we're going to make sure that there are a lot of really high quality trainers out there who can work with people and get them independently working and exercising. And you know what, we're going to fix the system such that, you know, it becomes less expensive to buy high quality foods so that, you know, we're kind of subsidizing the right foods instead of the wrong foods. Like, I could go on and on. You would save money as a society and improve the quality of an individual's life. There just has to be kind of, you know, an inertia that has to be overcome to do that. There's an enormous activation energy to make that happen.
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That's all for this week's recap episode. You can find a link to the full conversation in the episode description. If you want to make smarter food choices for your body and transform your health for life, why not try Zoe Membership? The first step is easy. Take our free quiz. To find out what Zoe Membership could do for you, Simply go to Zoe.com podcast.
Episode: Recap: How to Stop the Rise of Heart Disease | Peter Attia
Host: Jonathan Wolf
Guest: Dr. Peter Attia
Release Date: November 19, 2024
The episode opens with an emphasis on the critical role of the heart in maintaining overall bodily functions. Jonathan Wolf highlights the often reactive approach to heart health, where individuals typically focus on their heart only after encountering a problem.
Key Quote:
“The heart is at the center of everything within our bodies, constantly pumping oxygen and nutrients throughout our tissues and organs.”
— Host, [00:01]
Dr. Peter Attia delves into the prevalence of cardiovascular diseases, particularly heart attacks and strokes, identifying them as the leading causes of death globally for both men and women.
Key Statistics:
Key Quote:
“Heart attacks and strokes are the number one cause of death globally, and it's the number one cause of death for men and women.”
— Dr. Peter Attia, [00:42]
Dr. Attia explains atherosclerosis, the buildup of cholesterol in artery walls leading to inflammation and potential heart attacks. He references autopsy studies revealing that signs of atherosclerosis can be present in individuals as young as their twenties, often unnoticed until life-threatening events occur.
Key Insights:
Key Quote:
“This process basically begins at birth. Now, for the average person, that process probably won't reach clinical significance if you're a male until you're in your mid-60s.”
— Dr. Peter Attia, [01:55]
The conversation shifts to the necessity of transitioning healthcare from a treatment-oriented model to one focused on prevention. Dr. Attia emphasizes the individual's role in proactively managing their heart health through lifestyle changes.
Key Quote:
“How do we change the focus from treating diseases to preventing people becoming sick in the first place?”
— Host, [02:51]
Dr. Attia critiques the current medical education system, which predominantly equips physicians with procedural and pharmacological tools, lacking comprehensive training in nutrition, exercise, sleep, and emotional health. He argues that this gap hinders effective prevention of cardiovascular diseases.
Key Points:
Key Quote:
“Physicians are going to have to spend an entire semester learning about exercise, nutrition, and sleep. They would have to really understand how to apply those tools.”
— Dr. Peter Attia, [05:02]
Recognizing the systemic challenges, Dr. Attia advocates for individual empowerment. He authored a book aimed at serving as an "operating manual" for those willing to take charge of their health independently, focusing on nutrition, exercise, sleep, and emotional well-being without relying solely on medical professionals.
Key Quote:
“I wanted to write a book that could be an operating manual for the person who acknowledges that maybe the system isn't perfect.”
— Dr. Peter Attia, [06:27]
The discussion turns to potential systemic reforms that could enhance preventive healthcare. Dr. Attia suggests strategies such as:
He argues that reallocating healthcare funds towards these preventive measures could save money and improve quality of life.
Key Quote:
“If the NHS said... we're going to make sure that there are a lot of really high quality trainers out there who can work with people and get them independently working and exercising... you would save money as a society and improve the quality of an individual's life.”
— Dr. Peter Attia, [07:18]
The episode wraps up with a reminder for listeners to engage with the full conversation through the episode description. Additionally, it encourages individuals to take proactive steps towards better health by exploring ZOE Membership, starting with a free quiz to tailor health advice based on personal data.
Closing Remark:
“If you want to make smarter food choices for your body and transform your health for life, why not try Zoe Membership? The first step is easy. Take our free quiz.”
— Host, [08:32]
This episode serves as a compelling call to action for both individuals and healthcare systems to prioritize heart health through proactive and informed strategies.