BEATING THE DISEASES OF CIVILIZATION I
When I started this series of articles on healthspan I shared the following excerpt from Dr. Attia’s book, Outlive:
“in the first half of the 20th century most people were likely to die from “fast” causes: accidents, injuries, and infectious diseases of various kinds.? Since then, he advises, SLOW DEATH HAS SUPPLANTED FAST DEATH.
That slow death was attributed to what Dr. Attia refers to as the Four Horsemen.? These four harbingers of slow death, cancer, heart disease, type 2 diabetes, and dementia are also known as “diseases of civilization,” because they seem to have spread in lockstep with the industrialization and urbanization.
This week as promised, I will summarise the first two of the five tactical domains that Dr. Attia recommends we can address to combat the horsemen: exercise, and nutrition.? Next week I will discuss sleep and emotional health.? Note that the five tactical domains are:
I strongly suggest that you refer to Dr. Attia’s book, Outlive , to learn more about the fifth and final domain, which consists of the various drugs, supplements, and hormones that doctors learn about in medical school and beyond and discuss these with your doctor.?
Before we get into the discussion, I want to refer you to a recent study by the University of Exeter and Maastricht University published in JAMA Neurology which confirms some of the causes of early dementia suggested by Dr. Attia, including carrying two copies of the APOE gene, Vitamin D deficiency, depression, low blood pressure, stroke, heart disease, type 2 diabetes, and lower handgrip strength.? You can find the full article in Huffpost .
Now let’s get into the first two tactical domains.
EXERCISE
Exercise is the most effective ‘drug’ against the Horsemen.
Aerobic Fitness
As Dr. Attia notes:
“high aerobic fitness and strength are associated with longer lifespan and healthspan. … The data on exercise tell us, with great clarity, that the more we do, the better off we will be. … “Exercise in all its forms is our most powerful tool for … reducing our risk of death across the board. ?It slows the decline, not just physically but across all three vectors of healthspan, including cognitive and emotional health.”
He advises that the best indicator of aerobic cardiorespiratory fitness is your VO2 max which represents the maximum rate at which a person can utilize oxygen.? He believes that this is perhaps the single most powerful metric for longevity.? And today your wearable devices can measure and help you to monitor your VO2 max.
“VO2 max is typically expressed in terms of the volume of oxygen a person can use, per kilogram of body weight, per minute.? An average 45-year-old man will have a VO2 max around 40 ml/kg/min, while an elite endurance athlete will likely score in the high 60s and above. ?An unfit person in their thirties or forties, on the other hand, might score only in the high 20s on a VO2 max test.”
The bottom line is that we must exercise regularly at a speed slow enough to still maintain a conversation but fast enough that the conversation might be a little strained, i.e., you’re able to talk in full sentences, but just barely.
Study after study has found that regular exercisers live as much as a decade longer than sedentary people?
As Dr. Attia notes:
?“Going from zero weekly exercise to just 90 minutes can reduce your risk of dying from all causes by 14%.? It’s very hard to find a drug that can do that.? … Study after study has found that regular exercisers live as much as a decade longer than sedentary people.”?
Strength
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Muscle helps us survive old age.
It is also very important to maintain muscle mass at all costs.? As Dr. Attia advises:?
“Just as we want to retire with enough money saved up to sustain us for the rest of our lives, we want to reach older age with enough of a “reserve” of muscle (and bone density) to protect us from injury and allow us to continue to pursue the activities that we enjoy.”
He also notes:
“… I suspect that having more muscle mass delays death precisely because it also preserves healthspan. This is why I place so much emphasis on maintaining our musculoskeletal structure—which I call the “exoskeleton” ….?Your exoskeleton (muscle) is what keeps your actual skeleton (bones) upright and intact. Having more muscle mass on your exoskeleton appears to protect you from all kinds of trouble, … —but most important, it is highly correlated with a lower risk of falling, a leading but oft-ignored cause of death and disability in the elderly. …?
“This is why I place such an emphasis on weight training—and doing it now, no matter your age. ?There are dozens of studies showing that strength training programs can significantly improve the mobility and physical function of subjects who are obese, or recovering from cancer treatment, even those who are already elderly and frail. ?Therefore, I will find a way to lift heavy weights in some way, shape, or form four times per week, no matter what else I am doing or where I might be traveling.”?
Grip strength predicts how long you are likely to live
And he believes that grip strength—literally, how hard you can squeeze something with one hand—predicts how long you are likely to live, while low grip strength in the elderly is a symptom of sarcopenia (age-related muscle atrophy).? This is based on an enormous body of literature linking better grip strength in midlife and beyond to decreased risk of overall mortality.
Dr. Attia recommends the following exercises:
NUTRITION 3.0
Dr. Attia is very reticent about the topic of diet and nutrition.
He advises:
“Diet and nutrition are so poorly understood by science, so emotionally loaded, and so muddled by lousy information and lazy thinking that it is impossible to speak about them in nuanced terms at a party or, say, on social media. … Thanks to the poor quality of the science, we actually don’t know that much about how what we eat affects our health.”
And he concludes:
“I am no longer a dogmatic advocate of any particular way of eating, such as a ketogenic diet or any form of fasting. ?It took me a long time to figure this out, but the fundamental assumption underlying the diet wars, and most nutrition research—that there is one perfect diet that works best for every single person—is absolutely incorrect. …
“Instead of diet, we should be talking about nutritional biochemistry.? That takes it out of the realm of ideology and religion—and above all, emotion—and places it firmly back into the realm of science.? We can think of this new approach as Nutrition 3.0: scientifically rigorous, highly personalized, and (as we’ll see) driven by feedback and data rather than ideology and labels.? It’s not about telling you what to eat; it’s about figuring out what works for your body and your goals—and, just as important, what you can stick to.”
Based on my reading, I believe that the goal with Nutrition 3.0 is to help reduce energy intake while adding lean mass. ?To find ways to get people to consume fewer calories while also increasing their protein intake, and to pair this with proper exercise.
Dr. Attia believes that:?
“Nutrition is relatively simple, actually.? It boils down to a few basic rules:
Beyond that, we know relatively little with complete certainty. Read that sentence again, please.”
?The bottom line is that nutrition is important, but one size or one diet does not fit all.? I urge you again to read Outlive , it will change the way you think about diet and nutrition.? It will give you the tools to help you find the right eating pattern for yourself, one that will make your life better by protecting and preserving your health.
Next week we will look at the importance of sleep and emotional health in the battle against the four horsemen.? If you find this advice helpful, please share with your friends and colleagues.? As usual, I look forward to your questions and comments.? Be safe.? Take good care, and if you can, help someone in need.
Cheers, Nigel
Nigel Romano, Senior Director, Moore Trinidad & Tobago, Chartered Accountants