OUTLIVE-Peter Attia's book

[mccoy]

1 hour ago, Ron Put said:

Statins have their benefits in diseased people, but IMO it's idiotic to suggest that healthy people take them so that they can indulge in a bad diet.

I don't know if that's the rationale, the logic in my interpretation is to adopt a good diet and on top of it to add statins. I doubt that statins are able to take ApoB levels to 30 mg/dL when TC is in the region of 300-400 mg/dL. I may have understood wrongly of course, but Attia suggests monounsaturated fats, which are those defined as healthy fats by Valter Longo and Luigi Fontana.

[mccoy]

23 hours ago, Ron Put said:

Overall, the more I learned about Attia's history before The Drive, the more my respect for him diminished. I have always disagreed with "diet doesn't matter" take, but now it makes some sense to me, from a purely business perspective.

Ron, it's good to apply skepticism and think like Pyrrho, Sextus empiricus, Arcesilaus, Carneades or some other skeptic philosopher. But I would encourage you to read the Outlive book, it's the most recent views of Peter Attia, whose thoughts have refined over the years. It's 10 US$ on kindle, a very accessible prize. In Italy, Carneades is pretty well known by everyone, if not his works, his name.

[Ron Put]

On 4/27/2023 at 6:37 AM, mccoy said:

Ron, it's good to apply skepticism and think like Pyrrho, Sextus empiricus, Arcesilaus, Carneades or some other skeptic philosopher. But I would encourage you to read the Outlive book, it's the most recent views of Peter Attia, whose thoughts have refined over the years. It's 10 US$ on kindle, a very accessible prize. In Italy, Carneades is pretty well known by everyone, if not his works, his name.

Hi mccoy. I read it a while back and he makes some great points, which is why I still listen to him. But he also ignores, fudges and at times is simply incorrect. All the while self-promoting to the hilt 🙂

Here is a review of Outlive that I just came across and with which I almost entirely agree:
 

 

[TomBAvoider]

Ha, ha, earlier to day, I also watched the video review of "Outlive", and I thought it was pretty good (in general, I like that channel). 

I read most of "Outlive", but skipped the whole "emotional health" section, as that doesn't happen to be one of my particular demons. It really is not a very good book. Some sections are commonsensical (medicine 3.0), and informative (exercise), but the diet section is kind of a disaster. Even the exercise section has significant flaws - he misinterprets evidence, doesn't look for contradictory evidence and jumps to conclusions way too fast. 

That said, I disagree with Ron insofar as I don't think Attia is a particularly mendatious grifter out to enrich himself by hook or by crook. Yes, he is somewhat commercially oriented - and certainly promotes his book - but that by itself doesn't make him a villain in my estimation. I mean, every author wants to promote their book, no? Isn't that part of the whole enterprise? He doesn't strike me as one of those guys who churns out books *just* to make cash. It took him a long time to write this one book, so no quick buck here. His various commercial ventures strike me as perhaps a bit naive, but not evil or hucksterish. We operate in a capitalist system, and I don't begrudge him his efforts at money making as I don't think he goes about it with poor ethics... hey, perhaps I'm being naive here, lol.

I must say, Attia is a bit of a puzzle to me. He's clearly smart and educated. He swears by science up and down, frequently and eloquently discourses on study methodologies, the nature of evidence in medicine and is usually really good on those topics. Yet, there's this bizarre disconnect - he appears not to put that knowledge to use when he himself formulates his thesis or approach to some health area. Diet is a perfect example - where is all that science he so swears by? And why is his methodology so poor - for example with exercise, he appears to have reached his conclusions first and only then went on a fishing expedition to cherry pick the supposed evidence for his conclusions. He does this very frequently on many subjects (f.ex. sleep). I just don't get it.

Anyhow, while the book was a big disappointment, I find it impossible to be angry with Peter Attia. Because he's so often unintentionally comical. The writing in the book is very, very poor, purely from a craft point of view. I'm not talking about the errors large and small (just one example: Mendel was German-Czech not Russian - were no proofreaders involved?) - I'm talking about stylistic and narrative clumsiness. Yes, he had a writer (Bill Gifford), but the result is still Peter Attia's voice. He's just a very poor writer (I remember one comical statement he made in one of his podcasts, can't now remember which one, where he said with zero awareness "the liver has a special place in my heart" - an instance in which his reliance on cliches and rote expressions came to bite him). I kept laughing at how bad the book was purely stylistically - as I read it, every few pages there was a howler. Nonetheles in a podcast about how he wrote the book, he dropped a gem to the effect that he expected future generations to read this book and pour over it, lol. It's so funny, that you can't be mad about it. Peter is just unintentionally comical.

But I don't want to just bag on Attia. His podcast is very valuable in the yt space. He frequently has interesting guests and there's a lot of good info being transmitted. Not that he's the best interviewer in the world - he loves to listen to himself and has to constantly show off his knowledge, so the "questions" are often more time consuming than the answers; nonetheless there's a lot of good in those shows. I think on balance Peter Attia is a fine addition to the content creating universe in the medical space. Not perfect, but who is. I enjoy his shows, and listen to them when exercising (I can get in 2-3 50 minute runs on one show!). Can't ask for much more.

[mccoy]

Re. the plant chomper's video, thanks for reminding, that's in my listening list but I forgot about it.

Re. the chapter on nutrition in the 'outlive' book, I cannot but appreciate the logic of Peter Attia. Nutrition is a hopeless science. Too many articles, most of which contradict each other. What conclusions can be drawn from such so-called science? Often little or none, at least from our side. We can only rely on the comments of competent inside people who know the studies, the metanalyses, their pros and cons, the authors, the reliability and so on. And often the competent ones have their biases.

 

[Ron Put]

22 hours ago, TomBAvoider said:

That said, I disagree with Ron insofar as I don't think Attia is a particularly mendatious grifter out to enrich himself by hook or by crook.

Great post.

I base my cynical view of Attia's motivations on details I've come across over the last few years, but of course I may be completely wrong.

For my reasons, which have accumulated over time, see for example my post here.

And here.

And here.

And here.

 

 

17 hours ago, mccoy said:

Too many articles, most of which contradict each other. What conclusions can be drawn from such so-called science? Often little or none, at least from our side.

IMO, as Gardener notes, most nutritional experts are in fact in agreement, and the data from virtually every Blue Zone and other long-lived populations rather overwhelmingly points to a broad trend in favor of mostly plant-based, generally low-calories and relatively low-fat diets as optimal for longevity.

IMO, much of the confusion stems from purposeful efforts by special interests (mostly industry) to muddy the waters, by funding institutions, using rewards to achieve regulatory capture, sponsoring favorable research, and using PR and marketing to present favorably spun alternative information. Or, to at least create enough confusion among consumers that they throw their hands up and continue to purchase their often highly palatable products. At the crossover of pharma lipid solutions and the meat/dairy/egg industries are authority figures like Dayspring and Harris, influencers such as well as Taubes, and Teicholz, as are all the purveyors of variations of the Atkins/keto diet. If there is a silver lining there, it's that they are all united in attacking the sugar-peddling industries to make their products look better by comparison. It's a dog-eat-dog world, I guess...

Edited December 24, 2023 by Ron Put

[mccoy]

9 hours ago, Ron Put said:

IMO, as Gardener notes, most nutritional experts are in fact in agreement, and the data from virtually every Blue Zone and other long-lived populations rather overwhelmingly points to a broad trend in favor of mostly plant-based, generally low-calories and relatively low-fat diets as optimal for longevity.

Absolutely yes, but that is the fruit of some sort of Bayesian elaboration of the empirical evidence accumulated thru decades (or perhaps centuries) by the practitioners of naturalistic medicine, Yoga, Buddhism and so on, and some of the scientific evidence suggested by most recent studies. The elaborations are valid when done by people who are unbiased enough like Gardener and others and there is really not very much new about it, barred a more quantitative approach and deeper understanding of nutritional biochemistry.

When I was 16, that is more than half a century ago, I read a book which suggested a diet very similar to the present Mediterranean diet, without fish and meat. I still remember, the healthiest foods where considered fresh fruit and vegetables, nuts, whole grains, legumes (with lesser emphasys than today), fresh dairy products possibly fermented. Meat and fish were rigorously excluded. An example of blue zones diet, more of a lacto-vegetarian blue zones.

9 hours ago, Ron Put said:

IMO, much of the confusion stems from purposeful efforts by special interests (mostly industry) to muddy the waters, by funding institutions, using rewards to achieve regulatory capture, sponsoring favorable research, and using PR and marketing to present favorably spun alternative information.

Probably so, and don't let's forget special groups with some sort of moral or ethical agendas like the Harvard University, insisting a little too much on vegan diets, with unduly emphasis posed on a vegan lifestyle. Everyone agrees that vegan is good or very good, but something I read or listen is beyond science, it slides more in the realm of religious fanaticism and tribalism.

My bottom line, articles on nutrition, even if published in authoritative journals, are very often totally useless to people who are not extremely specialized in that field (I mean, people like Gardner and a few others).

[mccoy]

Re. Chris MacAskill, owner of the plant chompers channel: he's becoming one of my favorite Videocasters. He has a professional scientific background (geophysicist for many years at Globe exploration, then early development of Iphones with Steve Jobs).

His attitude toward nutrition tends to be pretty much rational and one which I can share. In his presentation of the latest Dr. Greger's book, hinting at the rose-colored glasses Dr. Greger dons when speaking about a vegan diet, he explains how he has been a strict follower of the lowfat vegan diet (by Dean Ornish) but, nevertheless, he had a myocardial infarction due to genetic malformation and early scarring by a viral infection. So his stress is upon big data, which can capture almost or all the variability inherent to the population.

[Ron Put]

17 hours ago, mccoy said:

Re. Chris MacAskill, owner of the plant chompers channel: he's becoming one of my favorite Videocasters.

I agree 🙂 And I agree on the bigger picture: even vegans die, and even people who wear seatbelts and have airbags die in car crashes.

But here is an interesting twin study of the effects of a vegan diet:

Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins

In this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet.
 

[mccoy]

Very interesting study because it bypasses genetic variance and, in part, environmental influences.

Weak point: duration of 8 weeks, I don't know if the changes in LDL are significant enough in this relatively short time, lipids concentrations are usually checked after 3-4 months from inception of dietary or pharmacological changes.

The comparison is vegan versus omnivorous who eat nontrivial amounts of meat and eggs:

Edited December 27, 2023 by mccoy

[mccoy]

The twins article has been reviewed by Dr. Gil Carvalho in one of his podcasts. His channel is presently the one I'm viewing more, after an interview in the Plant chompers channel. He's a very good example of reliable expert reviewer.