[mhb]

Looks like the basic ideas are right, but Attia seems a lot more thorough:

https://peterattiamd.com/about/

Summary:

Eat 1g of protein per pound of body weight

Creatine seems good on the margin and there's no downside to it.

Resistance training and cardio are both very important and you should probably be doing significantly more than is comfortable.

Sugar in moderation isn't as big a problem as it is made out to be.

Alcohol has no benefit and is harmful, to some extent, but Attia still drinks it.

[tejohnso]

I could never personally validate the 1g protein per lean muscle pound requirement. I've worked out six months without worrying about protein as well as six months on a heavy protein overload with multiple shakes per day. And I don't eat meat, so when I'm not deliberately increasing my protein intake, it's probably extremely low by these standards. Regardless, I couldn't make out a significant difference.

[cykros]

That's fantastic to hear, because no amount of fiber seems to combat the gastrointestinal distress caused by ingesting over 100g of whey protein a day.

I really don't get how anyone actually keeps up with such a regimen for any serious length of time. Perhaps they just play T-Rex at a chicken farm every morning.

[oarfish]

1g/lb is also higher than really needed. IIRC the current evidence supports 1.4-1.7g/kg is enough for most people, and eating more will just displace other useful things from your diet. Since the number should be based on lean body mass, the heuristics are less applicable to individuals with obesity or competitive physique athletes. I think the average american already consumes >1g/kg of protein, so most people won't need much more to max out muscle protein synthesis from diet.

[Fire-Dragon-DoL]

I think there was an informed (with links to sources) comment in HN some days ago that stated that anything above 0.8g/kg drastically reduces lifespan. I wish I could find it

Edit: found https://news.ycombinator.com/item?id=38727635

[sn9]

These studies are never in populations engaging in resistance training, the benefits of resistance training far outweigh any risks from protein consumption, which probably disappear once you increase strength and endurance training along with the proportion of whole foods that are plant based in the diet.

[mhb]

It would sure be nice if that paper explained what it meant by "high protein/high meat" without needing to delve into its 10 references. Ideally in the abstract.

[H1Supreme]

> Eat 1g of protein per pound of body weight

I believe it's 1g per pound of "lean" body mass.

[gradys]

There are many different rules of thumb on this floating around. 1g per lb of body weight is indeed something a number of well informed people recommend, but those people generally acknowledge that it’s something like an upper bound on the amount that is useful.

[cykros]

Sugar's big issue is that it's empty calories that doesn't go toward building muscle, and consumed prior to a work out, is going to make the workout itself harder without any real benefit.

Arguably sugar is more of an issue for those trying to lose weight than for those trying to gain muscle, as it will induce a glycemic roller coaster effect that will ramp up food cravings, which, when fed with processed carbs, becomes self-perpetuating. And that's not even touching on how it interacts with Candida.

Throw all that on top of the calories you NEED from other nutrients and you're running a serious surplus.

[a12k]

Can you share a source for your summary? It's not in the link you provided and I don't see anything searching Peter's site directly on point (though may be contained in podcast episodes or something).

[mhb]

I listened to him on this podcast and then attempted to follow up by reading the book, but the book (Outlive) was way too much for me.

https://www.samharris.org/podcasts/making-sense-episodes/328...

[bbasketball]

It's from his book Outlive. Here's a summary of it. https://littlerbooks.com/summary/outlive

[kayg04]

- You don't need 1g per pound of body weight. Most of the muscle gain can be had at 0.8g per pound of body weight.

- You can replace sugar with stevia and immediately introduce a calorie deficit.

- Cardio isn't super important if you are already doing Resistance Training. Simply getting around 10k steps per day is more than enough.

[AlexErrant]

Cardio is important to the health of your mitochondria. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793839/

> Mitochondrial dynamics, including continuous biogenesis, fusion, fission, and autophagy, are crucial to maintain mitochondrial integrity, distribution, size, and function, and play an important role in cardiovascular homeostasis. Cardiovascular health improves with aerobic exercise, a well-recognized non-pharmaceutical intervention for both healthy and ill individuals that reduces overall cardiovascular disease (CVD) mortality. Increasing evidence shows that aerobic exercise can effectively regulate the coordinated circulation of mitochondrial dynamics, thus inhibiting CVD development. This review aims to illustrate the benefits of aerobic exercise in prevention and treatment of cardiovascular disease by modulating mitochondrial function.

Attia is a fan of "zone 2" training in particular because it trains mitochondria to burn fat, which leads to "metabolic flexibility". https://pubmed.ncbi.nlm.nih.gov/28467922

> Metabolic flexibility is the ability to respond or adapt to conditional changes in metabolic demand. This broad concept has been propagated to explain insulin resistance and mechanisms governing fuel selection between glucose and fatty acids, highlighting the metabolic inflexibility of obesity and type 2 diabetes. In parallel, contemporary exercise physiology research has helped to identify potential mechanisms underlying altered fuel metabolism in obesity and diabetes.

Weightlifting, if anything, depletes muscle glycogen, a sugar, so you aren't really training your fat-burning.

[gradys]

Cardio isn’t super important for what? It certainly has longevity benefits over and above those from resistance training.

[kayg04]

Sorry, I meant cardio isn't super important for losing weight if you are already resistance training.

[sn9]

If losing weight is the only goal, then even resistance training isn't important.

You can just reduce portion sizes and caloric intake until you reach your goal weight.

You train strength and endurance for health and body composition, and performance if you care about that.

[claytongulick]

> Cardio isn't super important if you are already doing Resistance Training.

I'm a bit of a gym rat, mostly lifting though also some bodyweight/calisthenics.

I don't really do cardio.

I was concerned about it, so talked to my doc.

He said "you're lifting for an hour a few times a week. Your heart rate spikes when you're doing heavy lifts, right?"

"Yes".

He replied, "you're fine".

To test the theory, I got into the pool without having done any cardio at all in years. I had no trouble swimming 500 yards straight.

I wouldn't characterize my cardio capability as great, but it's moderate and good enough.

[AlexErrant]

The thing is, you want great cardio capability. https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

> Extreme cardiorespiratory fitness (≥2 SDs above the mean for age and sex) was associated with the lowest risk-adjusted all-cause mortality compared with all other performance groups.

Sure your cardio might be "good" now, but see Table 2 for what happens to you over time (with and without training).

Put more plainly https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153509/

> Individuals with higher cardiorespiratory fitness (CRF) showed lower risks of all-cause, CVD and cancer mortality; those with higher grip strength (GS) had lower all-cause mortality. All-cause and CVD mortality risk was lowest in adults with both higher CRF and higher. Improving both CRF and muscle strength, as opposed to either of the two alone, may be the most effective behavioral strategy to reduce all-cause and cardiovascular mortality risk.

[sn9]

Your doc, like most docs, is probably woefully undereducated on the subject. Or at the very least he's so used to the average patient that anything above average is just a relief.

But by not doing cardio, you're actually leaving a lot of low-hanging fruit on the table. The second slide in this video might be persuasive: https://youtu.be/ovM3mD5Roow?si=IRSRjsq8MRas9Yq6

Episodes 236-238 of the Barbell Medicine podcast goes more in depth about the health benefits of endurance training and what a good target is for health benefits.

[throw1234651234]

Is your resting heart rate under 70bpm? Can you run 2 miles in 18 minutes? If not, you could use some cardio. If only so you can breathe when you get COVID.

[Fire-Dragon-DoL]

Resting heart rate of 70bpm is the average, so not a good measure.

[throw1234651234]

The average is a huge range of 60-100. 70 is usually on the lower end and implies some cardiovascular fitness. It usually won't be that low from sitting on a couch. Running 2 miles at 9 minutes / mile isn't some accomplishment either, but it does imply some sort of training for an adult. I wanted to list a real standard for health, not athletic performance.

If you want athletic performance, there are the Iron Man / RASP standards and a heart rate between 40-60. Do note that while under 60 is highly trained, 40 is more on the elite athlete side of things.

[Fire-Dragon-DoL]

you seem way more informed than me, but if that's the case, I'm confused by your suggestion: if 70 already implies cardiovascular fitness, why do you recommend cardio, given the person already should have some cardiovascular fitness?

[plexman]

Sugar is poison.

Check out the latest talk from Dr Robert Lustig https://www.youtube.com/watch?v=n28W4AmvMDE&pp=ygUGbHVzdGln

Its a 3.5h video, but roughly sugar is as toxic as alcohol and the food industry is adding it to most products. In short if it has a label (like most processed foods with many ingredients) you should avoid, switch to the ones that don't have (like an apple).

This book is also great "The hacking of the American mind"

`While researching the toxic and addictive properties of sugar for his New York Times bestseller Fat Chance, Robert Lustig made an alarming discovery—our pursuit of happiness is being subverted by a culture of addiction and depression from which we may never recover.

Dopamine is the “reward” neurotransmitter that tells our brains we want more; yet every substance or behavior that releases dopamine in the extreme leads to addiction. Serotonin is the “contentment” neurotransmitter that tells our brains we don’t need any more; yet its deficiency leads to depression. Ideally, both are in optimal supply. Yet dopamine evolved to overwhelm serotonin—because our ancestors were more likely to survive if they were constantly motivated—with the result that constant desire can chemically destroy our ability to feel happiness, while sending us down the slippery slope to addiction. In the last forty years, government legislation and subsidies have promoted ever-available temptation (sugar, drugs, social media, porn) combined with constant stress (work, home, money, Internet), with the end result of an unprecedented epidemic of addiction, anxiety, depression, and chronic disease. And with the advent of neuromarketing, corporate America has successfully imprisoned us in an endless loop of desire and consumption from which there is no obvious escape.

With his customary wit and incisiveness, Lustig not only reveals the science that drives these states of mind, he points his finger directly at the corporations that helped create this mess, and the government actors who facilitated it, and he offers solutions we can all use in the pursuit of happiness, even in the face of overwhelming opposition. Always fearless and provocative, Lustig marshals a call to action, with seminal implications for our health, our well-being, and our culture.`

https://robertlustig.com/hacking/

[oarfish]

I haven't watched the talk here, but anything about medicine from Huberman should be considered with extreme skepticism, given his often reductionist/mechanistic or outright unsupported claims.

> Sugar is poison.

So no fruits and vegetables then?

[plexman]

I mean bad sugar, one glucose molecule (not so sweet) plus one fructose molecule (very sweet), like HFCS https://en.wikipedia.org/wiki/High-fructose_corn_syrup

Fruits and vegetables have fiber, its a different story.

By the way he goes on talking about diet soft drinks, and explain that they are also bad, you produce insulin anyway.

[phil21]

> By the way he goes on talking about diet soft drinks, and explain that they are also bad, you produce insulin anyway.

This is where I'd start to tune out on other stuff this person is saying. I looked into this a while back when my son sent me those studies/links (we've been in a constant bar-argument debate over if real Coca-Cola is better or worse for you than Diet Coke) and I recall that it was highly specific to individuals. Some displayed a slight insulin response, while others did not.

I hit my weight loss extremely aggressively in the past year, and as part of that wore a CGM. I drink far too more diet coke than I reasonably should, and I've never been able to correlate any blood sugar events (high or low) to my diet coke or coke zero consumption. You'd think there would at least be a small amount of data in the graphs to tease out given it's a daily thing for me.

Of course abstaining from both is the right answer - but there has been no clear repeatable data I've seen yet that shows detrimental health from the artificial sweeteners commonly used. A lot of the first studies that got traction were either extremely flawed, non-repeatable, or using dosing that never made sense to test with.