Peter Attia's nutrition advice & why nutrition research is flawed

regardless of what you think the best diet is if you think it's a keto diet or a paleo diet or a low carb diet or a Mediterranean diet or a vegan diet take any version of those and consume them to excess to the point where you are no longer in energy balance and you are accumulating adapost tissue that leaks out of the subcutaneous space and gets into the liver gets into the viscera you're going to be unhealthy do you maybe want to take a minute to talk about why nutrition research is so flawed and so hard to do and then because that's true that kind of affects everything you look at within nutritional epidemiology and trying to understand kind of that question of which diet is quote unquote best I think it comes down to the complexity of the organism in question which is us and the complexity of the Intervention which is eating so it's really the worst of Both Worlds right it's it's we can study something as complicated as nutrition in a simple organism that can be put put in a cage where you can control everything and where lifespan is short enough that you can actually measure how inputs affect outputs on a reasonable time scale but to be clear even studying the effects of nutrition in a confined environment using more complicated organisms such as reesus monkeys as was the case in the Nia Wisconsin experiments from the 1980s uh which again in the late ' 80s I believe that's an experiment that could never be replicated right I mean it took you know north of 20 years to do an experiment in Reese's monkeys where you could still have perfect control over what they ate and it's not entirely clear what the answer was that was an experiment that sought to test the question does caloric restriction extend life and the answer turned out to be it depend if you it depends if your monkey lives in Wisconsin or Bethesda Maryland uh of course I'm being tongue and Chic I think that study did answer the question if you knew how to read the study I won't get into that because I I think I have a whole chapter devoted to that in the book um so that's that's basically the long and short of why it's so difficult to study so when you study it in humans you can do controlled experiments in a research setting but by definition they can't tell you anything about health in the long-term sense because it would be almost impossible to confine humans for more than a month or so and control everything they ate so one can do those types of experiments to understand very precise mechanisms of action but those rarely translate to a clear understanding of Health if you want to understand what happens over the course of a year 3 years 5 years 10 years by definition you have to do that outside of a hospital and you have to do it with patients being able to eat what they want um there are some historical exceptions to this rule so for example the Minnesota coronary study I think the actual intervention was probably closer to three or four years I could be wrong on that but it was done on patients in a nursing home and you know there you had the interesting situation where you had patients who were relatively old therefore at high risk risk for ascvd but the investigators had complete control over what those patients ate because every meal was being provided to them that experiment was rather interesting and that it did not yield what the hypothesis suggested and again I think there there's lots that could be learned from that potentially but this is why nutrition in humans tends to rely heavily on epidemiology where you are looking for patterns without doing an experiment without randomization so with your patience then are you still continuing to try manage their nutrition manage their diet not to you put everyone on the same diet but more so what is that patient doing and how do you get the best metabolic health for that patient yeah I mean we think that the most important parameter for determining metabolic health is energy balance even the quote unquote best diet if it's in excess of energy balance will produce poor metabolic Health regardless of what you think the best diet is if you think it's a keto diet or a paleo diet or a low carb diet or a Mediterranean diet or a vegan diet take any version of those and consume them to excess to the point where you are no longer in energy balance and you are accumulating adapost tissue that leaks out of the subcutaneous space and you know gets into the liver gets into the viscera you're going to be unhealthy I always think people are majoring in the minor and minoring in the major on nutrition when they start to fight in dietary tribes on this stuff there are some general principles like I do still think that CL Al in my experience patients with profound insulin resistance tend to respond better to carbohydrate restriction as the best tool to reduce total intake you have to create a caloric deficit in those patients and in my experience they respond better to carbohydrate restriction than they do Straight caloric restriction or fat restriction ultimately it matters most that you can find something that is manageable and sustainable over the Long Haul none of this matters if you can you know adhere to the perfect diet for 3 months and then you can't it's better to have a seven out of 10 diet in terms of quality and Perfection that you can sustain indefinitely than a 10 out of 10 diet that you can only sustain for 3 or 6 [Music] months

Channel: Peter Attia MD

Views: 281,197

Keywords: Peter Attia MD, Dr. Peter Attia, Early Medical, The Drive Podcast, The Drive, Longevity, Zone 2

Id: lImvn5_Bzpg

Length: 5min 23sec (323 seconds)

Published: Sat Oct 28 2023