Determined to distract myself from the mayhem around me…global and family (still playing Whack an Albatross)…I decided to play catchup on my Peter Attia reading and listening materials…
Usual apologies that, as a subscriber I get the whole shebang and cannot tell if what I post is behind a paywall or where the cutoff may be
Just realised that I’ve subscribed to this podcast for a hair over 5 years. Got the heads-up that renewal was coming up in a few days a week or so back…together with the link for cancelation if wanted. Manifestly, I did not. Good value…and then some.
God bless you.
I am in the center of the chit headlines thinking. It is not like we are going to see this again?
@VeeEnn since most of us (including me) are not subscribers, we would appreciate a short summary of the conclusions of the linked articles.
Thanks,
Wendy
Will do! …was actually going to suggest that but it’s hard to judge interest.
I’m on grandma duty for the next few hours but, in the meantime, this is a bit of blurb about the podcast speaker. Something to be getting on with…
How I was attracted to the podcast series initially (early 2020…just as Covid was becoming undeniable) was the quality of speakers. I signed up for just one month…intending to cancel after I’d listened to the one I was interested in along with anything else that captured the imagination. Converted to annual subscription after just a few days. The worthwhile speakers (for me) are usually of this sort of stature.
Okay. To the first link…Metformin as a potential longevity drug…
TL:DR…no robust evidence to suggest that it has benefits beyond its well recognised effects on metabolic health, so not for folk who’re totally, 100% metabolically healthy.
It’s a really long read but actually quite interesting…the usual background of initially discovery of apparent effects in mutant mice so irrelevant, probably, to regular mice, less alone a different species. A breakdown of the cellular mechanisms and how it produces beneficial effects in T2D…or Maturity Onset Diabetes as we called it in England in the early 1970s when I did my pharmacology (and FWIW, was quite a rare phenomenon when I started in general practice in the late 1970s)
The interest in its geroprotective effects…and hype as a longevity drug…began about 2014 with a paper purporting to show a reduction in all cause mortality among diabetics taking this drug as monotherapy vs alternatives. A few more with fairly equivocal results until the more recent study that’s mentioned in the opener.
Attia’s take on why it’s hard to get unequivocal data on its efficacy outside of its beneficial effects on metabolic health (in the metabolically unhealthy) is simple. In the here and now, very few folk are truly metabolically healthy…per even readily available biomarkers, let alone the ultra “granular” measurements available at laboratory level.
As anyone who’s read his book “Outlive” is aware, he pins a lot of his longevity advice on preventing metabolic dysfunction. Actually, it’s truer to say “blames” the biggest robbers of health and vitality in the later years of life on this. All we have to do is look around (maybe in the mirror) to see there ain’t much prevention going on.
Here’s an ad for his latest sign up scheme (not interested myself but it savesca lot of writing) where he lists his Four Horsemen principle…actually not his, per se, but he uses this foundation extensively.
The breakdown of the podcast will take longer, I’m afraid. With many of the guests, the format tends to be very lecture like and, although Attia does an excellent job of guidance (obviously a lot of work in the background), their presentation is inevitably quite academic and oftentimes at a cellular level that’s above my pay grade. The “show notes” are excellent as recaps but, thinking is called for 
I read his book on your recommendation. Pretty good, reinforced a lot of what I have learned in recent years, maybe tough sledding for someone with no background knowledge.
Is he watching Lp(a)?
That is now on my radar.
True that. In fact, the podcast can be even more so on many of the topics…unfortunately, the ones of most interest/value to me, it seems.
Here’s access to his free, “non-lame” newsletters…which, granted, usually include a “teaser”, sneak preview of some podcast or other. As I mentioned upstream, though, I’m pretty sure that I stumbled on the podcast on Z2 training and mitochondrial health with Inigo San Millano (the one that lured me in) from this source…
Plenty of examples to scroll through for free for anyone interested.
Well, yeah…as I’ve mentioned many times in the past. The podcasts in question were what gave me the insight to check to see if that issue applied to me alongside the other stuff. This one in particular (double tricky for me because of the strong French Canadian accent)…
How much weight does he put on life style to manage Lp(a)?
How badly do the experts he talks with see the need for a drug treatment?
BTW odds are I will be mid 70s when a safe drug with efficacy is on the market for over 5 years. I should be okay.
In the next hour I am having my Lp(a) test self paid $45 at Quest Diagnostics.
Zero. It’s not a biomarker that’s modifiable by lifestyle or by currently available medication. It’s a risk multiplier of rather than a risk factor for the development of ASCVD.
The internet is rife with articles explaining the significance of having a high reading…tool around for a bit to find something not behind a paywall/explains the significance if you’re one of the 20% who’ve inherited this.
I’ll find out tomorrow or Friday when I get the results.
I am young enough there will be a safer drug on the market for several years before it matters to my health. Our family history is late 80s strokes.
I think you have the wrong idea on Lp(a) as a risk multiplier in ASCVD…or maybe I do. For sure, the disease process itself increases with advanced age but, if you have this risk multiplier in addition to any disease burden at all (and you’re aware that you do) then it matters to your health right now.
Most strokes are caused by plague in the arteries. I have none for now.
The calcium is confusing for the doctors. But as it is in my arteries now it is similar to coffee stains on your teeth. It amounts to nothing for now.
Maybe…but it certainly seems confusing for you. You do not know that you have no soft plaque in your artery wall…for that matter, neither do I from the Coronary Artery Calcium scan I had done. Or anyone else who’s had a CAC scan either. For the simple reason that the test is powered to detect CALCIUM, as the name suggests…which is radio-opaque. Soft, calcium free (vulnerable) plaque is not. Far from resemblimg coffee stains on your teeth…or calcium deposits lining water pipes in a hard water area…it’s actually a late stage and somewhat protective phenomenon in the disease process, rather than a passive deposition.
Of course, it might well be that your Agatson score is a sign of past disease that has now magically disappeared. As it may well be with me. The difference between the two of us is that I don’t believe that’s likely.
You can have these issues and be lower risk if the Lp(a) is low?
The two cardiologists have looked at the CAC scan and said no plaque.
My grandmother’s family mom’s side had the huge stroke history. But grandma lived to 98 with a few small strokes late in life. Her closest brother died of old age at 94. There were three siblings who had a stroke history in their late 80s. Two other siblings did not.
My granddad’s family mom’s side also lived into their 90s with better health over all.
The paternal side did not have a stroke history but died younger. Gramps at 80 had strokes. He had long outlived his brothers who died of kidney disease I believe. They worked in the East End of London in the largest pollution area in the world. Gramps left as a young man for Dublin and outlived his brothers by over 30 years.
It is a mix of symptoms and genetics that might not add up to include Lp(a). We are talking about risk not perfection.
Mom’s siblings are 88, 86.5, and her at 85. None of them are having strokes. Dad’s cousins are 80 and up and none of them are having strokes but his cousins are on his mother’s side and do not have that history.