What Peter Attia prioritizes to live longer and better

In a wide-ranging Q&A episode, Peter Attia explains how he thinks about long-term health when the discussion jumps from topic to topic: lipids, blood pressure, fasting, early diagnostics, and what to do when time is tight. A core idea shows up early: if every longevity intervention disappeared tomorrow except one, he would choose exercise. From that foundation, you can build a realistic plan that combines training, key markers, and nutrition without making life complicated.

The one non-negotiable habit: exercise

Attia frames this in two ways. First, the data: when you compare interventions that reduce mortality (quitting smoking, controlling hypertension, treating lipids, preventing type 2 diabetes), cardiorespiratory fitness and muscular strength tend to show very large benefits. Second, real life: in the final decade of life, what often reduces quality of life most is a movement problem—pain, frailty, and loss of capacity to do basic tasks.

Practically, this means you don’t train only to feel good today; you train to keep independence tomorrow.

What to train (and why)

• Aerobic capacity (steady work and short peaks): improves cardiovascular efficiency and effort tolerance
• Strength and muscle mass: protects against frailty, falls, and loss of independence
• Mobility and stability: reduces pain and helps you train consistently

Practical tip: if you’re starting, prioritize consistency over perfection. An average plan done for 40 weeks beats an ideal plan done for 4.

The numbers that guide decisions: ApoB, blood pressure, glucose

The episode touches on treating ApoB, blood pressure, and metabolic dysfunction. These markers turn an abstract conversation into concrete actions.

ApoB and cardiovascular risk

ApoB reflects the number of atherogenic particles (the ones that can enter the arterial wall). In practice, many people have “normal” LDL but elevated ApoB, especially when insulin resistance or high triglycerides are present.

Useful actions:

• Get ApoB at least once if you want a clearer risk picture
• If it’s high, review weight, diet, activity, sleep, and family history
• Discuss strategy with your clinician: lifestyle changes and, when appropriate, medication

Blood pressure

High blood pressure damages vessels and accelerates kidney and cardiovascular issues. The most useful approach isn’t a single reading, but a pattern.

• Measure at home for 7 days (morning and evening) and calculate an average
• Adjust what moves the needle: weight, alcohol, sleep, ultra-processed foods, daily movement

Metabolism: prediabetes and “silent dysfunction”

If you’re in the prediabetes range, the goal isn’t panic; it’s early intervention. Insulin resistance often improves with a combination of modest fat loss, strength training, walks after meals, and a diet that’s less dominated by ultra-processed foods.

Nutrition, fasting, and the “all or nothing” trap

Time-restricted eating and fasting can be tools, but they don’t replace the basics: food quality, adequate protein, and an environment that supports adherence.

A simple approach

1. Start with what you remove: sugary drinks, ultra-processed snacks, frequent alcohol
2. Secure protein and fiber: they keep you full, protect muscle, and stabilize glucose
3. Use schedule as support: if it helps, eat within 10–12 hours. If it stresses you out, it’s not mandatory

Practical tip: if you fast, watch that it doesn’t turn into late-night “compensation.” Weekly consistency matters more than one perfect day.

How to train when time is minimal

Attia often hears the same line: “I’ll exercise later.” The problem is that physical capacity works like a bank account—if you don’t deposit for years, the future cost rises fast.

A minimum plan (30–40 minutes)

• 3 Days/week strength (30 min): a squat pattern, a hinge (Romanian deadlift), a push (push-ups or press), a pull (row), plus core
• 2 Days/week cardio (30 min): conversational pace (zone 2) or cycling/brisk walking
• Daily: a 10-minute walk after one meal

If you can only do one thing

Do strength training. Keeping muscle and power buys you years of autonomy.

Turn the future into a measurable target

The episode mentions a simple tool to move beyond abstraction: define what you want to be able to do physically in 10–20 years. For example, carry groceries up stairs, get up from the floor without support, complete a demanding hike, or play with your kids without pain.

Try this exercise:

• Write your 10 most important physical abilities
• Rate each from 1 to 10 based on where you are today
• Pick two bottlenecks (leg strength, aerobic capacity, balance, hip mobility, and so on)
• Build your week around those bottlenecks for 8–12 weeks, then re-rate

This turns training from a generic idea into a project with metrics.

Conclusion

The message is simple: exercise is the pillar because it supports health and independence. From there, use markers like ApoB, blood pressure, and glucose to decide what to adjust and when to ask for help. You don’t need a perfect plan; you need one you can repeat.