Dosage of exercise and trade-offs
Goal I want to understand to what extent it is cost-effective for me to exercise more. I'm confident that what I'm doing now is cost-effective, so the real question is to what extent are more investments still cost-effective? Situation I’m 34 and exercised at least 2x in the last 16 years. Here is what I’m currently doing Strength exercise: 2 x 1h / week (with a PT) Run: 1 x 30-60min / week (infrequently lately) Doesn’t really count General movement: 7 x 45min walk / week (at least 6000-7000 daily steps) Sauna: 1 x 1-2h / week (very good for well-being) Observed impact of current exercise approach Less pain in the lower back Feeling strong Not gaining much muscle, but a bit of strength (although I’m going to do a DEXA scan soon to see changes from one year ago) Rarely impact well-being post-exercise, mostly when combined with sauna Things I don’t do Tracking previous reps Tracking body explicitly weight Things I do/did DEXA scan for body composition Plan to do a VO2max test Yearly comprehensive blood panels What I understand Best predictors for low all-cause mortality are VO2max Muscle mass Other metrics Well-being: very high Energy: good, not any negative effects on work Concentration: great Pain: sometimes neck (mainly due to pillow) and lower back (when sitting a lot and poorly) Posture: could be improved Possible Stories Story 1: exercise more, sleep less I do X amount more of physical activity per day which needs to either reduce my nap need or my sleep need Reaction: not convincing right now Story 2: exercise more, make better decisions, use time more effectively I might feel more peaceful, meta-awareness, and joyful, which leads to better decisions throughout the day, so I might spend less time on stuff that isn't too relevant Reaction: not convincing right now Story 3: exercise more, get life time back larger than exercise time For 1 unit I invest in physical health, my return is 1 or more units. Reaction: unsure Story 4: exercise more now, be more productive later I'll have more energy, focus, peace, and meta-awareness 10 years from now when ageing effects set in if I don't exercise now (or at the point in the future when I feel that the returns substantially increased) It would buffer physical and cognitive decline, which would lead my later years to be more productive compared to if I wouldn’t Reaction: unsure Reservation: Maybe right now I’m at my peak capacity? That is probably not true, given that Peter Drucker wrote most of his books after 60 Any other stories I’m missing? Maths Each day has 12 disposable hours (24h-12h for basic survival = 8h sleep + 2h food + 1h hygiene + 1h go from A to B) Disposable hours refer to hours that can be used for contributions. It excludes physical, social, and mental health activities for basic functioning. Each year has 4380 disposable hours One year of life gained would be equal to 4380 additional hours Exercising one more hour per week over the next 50 years would be equal to 2600 hours, but I need to include at least 60min on average for getting dressed, transportation, and showering, which would make it 5200h I expect that it is likely that I would be able to increase my life by at least one year if I exercise one more hour every week plus everything around it (60min) as this would increase my total exercise time by 20-30%. Conclusion: Seems reasonable
Lean mass loss on GLP-1 receptor agonists: a downside of the “miracle drugs”
In Peter's article he warns against the risks of lean weight loss while taking these drugs. Is there any evidence that this lean weight loss from GLP-1 receptor agonists is any different from calorie restriction through other means? My wife is on Semaglutide and her appetite is greatly reduced and consequently her calorie intake is reduced. So far she has lost 14 lbs and wants to lose an additional 16 lbs. She has maintained her 2x per week strength workouts of Squats, Deadlifts, bench and overhead presses, and cable pulldowns. She takes a high protein shake in the morning and focuses on protein for her other meals. She should be doing this along with any calorie restriction diet. How is taking Semaglutide different, if at all?
GLP-1 receptor antagonist anecdote
I have been on semaglutide for a year now - I have gradually been increasing the dose (currently 45cc) I process drugs very quickly (I’ll wake up during surgery!) so I don’t want to hit the max too fast. I am a breast cancer survivor of ER/PR+ for 6+ years. 44yrs old. The aromatase inhibitor & lack of any hormones has made weight lose nearly impossible & discouraging. My blood pressure was too high so this was worth a shot (literally) for me. I get regular DEXA scans every 18-24mo. I have had NO change since pre-cancer. I think consistent exercise - weight bearing, Pilates, aerobics, etc has kept my lean mass loss to minimum while helping me remove that stubborn weight the drugs add. Perhaps consistent exercise/weight bearing/flexibility helps with the negative side effects of semaglutide?
Sauna before sleep makes you a sweaty mess?
Dr. Attia, you mentioned that sauna right before bed helps you sleep better and that you even brush your teeth before so that you can go right to sleep afterwards. As a woman with insanely sensitive skin & prone to rashes/histamine reactions from heat, don’t you need to rinse off after the sauna to remove the sweat? When you said that you went right to bed afterwards, it made me gag a little. Plus you said your wife joins you in the sauna for some good conversation (I loved that!) Does SHE shower off before hitting the hay?
Cholesterol blood work
You have talked many times about cholesterol on your podcasts and went very deep into the weeds. If a regular person was going to the doctor for some annual bloodwork, what do you recommend they ask for? If you’ve listed that somewhere, I apologize but it seems like that would be super helpful for the average person.