top of page

Peter Attia: Medicine 3.0

Updated: Jan 15

Podcast Duration: 1:11:30

Release Date: 11/14/22

5 Key Takeaways

  1. The future of medicine will treat diseases and health conditions before they arise

  2. A blood marker known as ApoB is the most crucial value to quantify heart health

  3. The use of a new drug known as pcsk9 inhibitor can take atherosclerosis (plaque in arteries) from the number 1 killer in the world to the 10th leading cause of death

  4. It is important to balance short term pleasure (example: drinking alcohol) with long term pain (example: working out on a regular basis)

  5. The Five Buckets of Health

  6. Nutrition

  7. Sleep

  8. Exercise: “the most important/potent drug we have for longevity”

  9. Stress/Emotional health

  10. Drugs and supplements (sometimes taking drugs is the only way to achieve optimal health)

The conversation begins with Peter discussing the evolution of medicine. He states that there have been 3 pivotal shifts in its growth.

Medicine 1.0

  1. This practice predates the 1700s

  2. It is non-science based

  3. Treatments provided had no backed evidence or hypotheses

  4. Doctors believed that illness is the work of spirits/god

Medicine 2.0

  1. Started changing in late 1700s

  2. Germ theory (the idea that microscopic organisms are responsible for infection) marks full transition to 2.0 in the late 19th century

  3. Scientific thinking

  4. The ability to hypothesize (making an educated guess) and test theory

  5. Randomized control trials (a way to test hypothesis)

Peter believes that our current healthcare system is good at dealing with acute conditions, but not effective for longevity.

He gives the example that we are “great at putting bandaids on bullet holes but terrible at fixing underlying issues.”

This approach is reacting to symptoms rather than addressing them before they arise.

He believes that we have reached capacity for medicine 2.0 and that it is time to push for the acceleration of a new approach.

Medicine 3.0

Peter argues that we are currently in the transition from 2.0 to 3.0 but it is unknown when the shift will be complete. This will be dependent on how quickly the mindset of the public begins to change.

  1. Evidence informed (a more inclusive designed treatment) instead of evidence based (objective evidence only)

  2. Extremely early and preventative in nature

  3. Treating a chronic condition early so that it doesn’t become acute and cause death

  4. It must be highly personalized and specific to each individual

Peters Background

Dr. Attia went to school for Engineering and had a change of heart after graduation. He then took prerequisites for Med school and attended Stanford and Johns Hopkins University.

Later Peter left medicine because he felt that 2.0 was a failed approach to health care.

He then became very interested in nutrition which reignited his passion within medicine but with an entirely different approach.

He began reading immensely about nutrition, lipids and metabolic health.

Peter believes that his superpower is finding specialists who are the best in the world in a given subject and extracting as much information from them as possible.

He began to learn from the leaders in the subjects he was interested in.

Peters Approach to Care

After learning a great deal about metabolic health he began to develop a new approach that involves assessing risk when making medical decisions.

  1. Risk that is symmetrical to reward is better than a high risk decision

  2. If a mistake is made the consequences should be very low, not enormous

When asked about anti-aging he explains that longevity is complex because it is a biological science. This makes it very hard to make a “causal inference.”

Peter uses the example that we don't know what drinking a gallon of coke everyday will do to the human body over time, we can speculate, but nothing is guaranteed.

Peter talks about metabolic health and explains that Atherosclerosis(calcium build-up in arteries) is the #1 cause of death worldwide.

He argues that if we used a relatively new drug called pcsk9 inhibitor and started injecting it in patients at the age of 30, then atherosclerosis could potentially be the 10th leading cause of death.

These drugs also have potential to drastically reduce obesity.

Peter believes that a blood marker called ApoB (apolipoprotein B) is one of the most crucial indicators for atherosclerosis/ stroke risk.

He explains that young people with high ApoB are often not treated. He believes that not treating high ApoB in young people is a failure in medicine and follows a 2.0 approach. (waiting for issues to develop before they are addressed)

Best ways to lower ApoB

  1. Nutrition- lower triglycerides

  2. Lower saturated fat consumption

  3. Reduce carbohydrate (sugar) intake

  4. Exercise

Peters 5 buckets of Health

When asked about how he maintains his own health, Peter states that it is about

“Balancing short term pleasure with long term pain, either extreme makes little sense.” He is essentially saying that short term pleasure is usually a detriment to health, drinking alcohol for example. He continues to say that choosing a harder or more uncomfortable path often yields better results in the long run, for example exercising daily.

  1. Nutrition

  2. Sleep

  3. Exercise: “the most important/potent drug we have for longevity”

  4. Stress/Emotional health

  5. Drugs and supplements (sometimes taking drugs is the only way to achieve optimal health)

Peter explains that with the Ebbs and flow of life, oftentimes one bucket has to suffer. When this happens it is important to try and optimize others if you can.

For example, If you are stressed, make more of an effort to control your diet, exercise and sleep.

bottom of page