r/PeterAttia

Honestly, digging into this was a bit of a downer. I'd sort of assumed my own drinking was fine, nothing crazy, a few times a week, the normal stuff. And a few years ago you could find a longevity podcast to back that up: red wine was heart-healthy, resveratrol was a miracle, a glass a day was basically medicine. I actually started writing this with a glass of red wine by my side.

Turns out the story I'd been telling myself doesn't really hold up. The people who actually read the studies have quietly converged, and the answer isn't the one I was hoping for.

Rhonda Patrick

She did a full episode on this in 2024, and her summary line is blunt: "it's abundantly clear that the number of alcoholic drinks per week that will be associated with optimal health is zero."

She's careful, though. She's not telling non-drinkers to panic, and she acknowledges the old cardiovascular data. But she explains why the "moderate drinking is protective" finding fell apart: the sick-quitter effect. A lot of people counted as non-drinkers had actually quit because they were already sick, which made drinkers look healthier by comparison. Correct for that, and the protective effect mostly disappears.

Her practical floor for people who do drink: one to two drinks per week, driven mainly by cancer risk.

Full episode: https://leita.io/search?domain=health&video=ZsFNeQVuUPM&t=11280 (The Truth About Alcohol, 2024)

Andrew Huberman

Same conclusion, and he's visibly tired of the media flip-flopping: "my read of the data was that zero is better than any. And two drinks per week is sort of the upper limit for adult non-alcoholics that don't want to incur any additional health risk."

His guest in that episode, addiction researcher Keith Humphreys, put it more personally: "statement against interest, because I like red wine. I would love to believe it is healthy. It's not."

Clip: https://leita.io/search?domain=health&video=t6RCTP4fc9Q&t=1440

Richard Miller (the researcher who actually tested resveratrol)

The reason red wine ever sounded healthy was resveratrol. Richard Miller, a pathology professor at Michigan who runs the Interventions Testing Program, put resveratrol through the actual mouse lifespan study. It failed. On the human angle, to get a meaningful dose "you need to drink 30 bottles a day."

The whole "red wine is good for you" story rested on this one molecule, and the lab that tested it most rigorously found nothing.

Clip: https://leita.io/search?domain=health&video=sZ-krUa6VH0&t=7200 (Peter Attia's podcast, guest Richard Miller)

Peter Attia

Attia still drinks occasionally, and he's honest about why. He frames it correctly: "this is a hedonic pleasure that's not good for me, but it's enjoyable." Not health. Enjoyment. He also flags that ApoE4 carriers may be more vulnerable.

Clip: https://leita.io/search?domain=health&video=zkp0DRUQ33g&t=7140

Where this leaves us

The interesting part isn't that they agree. It's what they agree on. None of them says "alcohol is fine in moderation" anymore. The most permissive position in the whole set is Huberman's two-drinks-per-week ceiling, and even he frames it as damage limitation, not benefit.

The old story was "a little is good for you." The current read from the people tracking the research is "less is better, zero is optimal, and if you drink, do it because you enjoy it, not because you think it's helping."

That's a less fun answer than the one I was carrying around. But if you want the current expert consensus instead of the 2010 version, that's it.

Does this mean I poured out my red wine? Absolutely not, but it made me reconsider my weekly amount.

Every claim above links to the exact moment it was said, so you can hear the full context and judge for yourself.

So my bp is generally in 110s/60s and now the omron machines are showing 120s and even 130s/60s and 70s. Even hit 150 after a CCTA yesterday. Got a CCTA yesterday with no blockage but I'm super stressed about my bp. After waking up in the morning it's 116/68. However during the day and evening it's rising.

I checked with a mercury apparatus and steth and it was 10 lower than my Omron at 114/70.

Checked it 15-20 times and mercury is always 10-15 lower consistently than Omron. Sometimes Omron shows 140 and mercury shows 120. Very weird. What do I trust? Diastolic they both agree on but both mercury and manual are consistently showing lower readings.

I went to the doc and the nurse said bp was 120/80 and he measured it from the manual apparatus. Came home and measured it from Omron and it was 135 which was weird.

Im 30 and on telmisartan 40.

My diastolic has always been fine and doc said that even 130s is fine bp but I've heard it's not.

Basically what to trust? Mercury or Automatic? I know I'm measuring correctly with mercury as I listen carefully for the sounds to first appear and stop at 140 for a second or so and deflate slowly and they appear at less than 120 mostly.

I started rosuvastatin three months ago and had great results at the one month and two month mark - ApoB went from 101 to 61; then ticked up to 64; and ticked up again today (at three months) 69. Similar pattern for LDL: went from 149 to 70; then 73; now 79. My diet has been very consistent - no red meat, lots of vegetables, fiber, ultralow saturated fat., etc. Consistent exercise too.

My targets are below 55 for both ApoB and LDL due to high calcium score and CCA showing moderate stenosis (“30 to 49%” acc to CCTA).

Is it possible that I’m developing a “tolerance” for rosuvastatin? (Like some people develop a tolerance for alcohol and need more for the same effect). I do plan on asking my doctor for.Ezetimibe at my next visit - but in the meantime, I’d welcome your thoughts!

Hi everyone,

Due to my schedule it is very difficult for me to do 3 days of cardio per week. What are the pros and cons of doing 3 hours of zone 2 cardio once per week?

addendum - I guess my schedule is not the only thing making me want to do all my cardio in one day/week. I live in England. No car, lots of walking. Car is not a necessity right now. If I go to gym and only lift (even on leg days), I still have a lot of energy to do my daily stuff. But if I do cardio (even 45 minutes zone 2) I am fine in gym but after gym I don't have much energy.

that's why, I want to do do all my cardio on the same day (Sunday) and get over with it for the week.

Thanks

This is to follow up on a question I asked last week. Bottom line: I’m 64, after two tests (but with different methods for free testosterone) it’s looking like I’m at least at the very low end of normal for free T and possibly in clear deficit. (long story on the test methods which I will spare you). I’ve done another blood draw this morning so should have a clearer picture in a week SHBG is not elevated, and total T was low end of normal with both tests but still jn the range. (I’ll put all the numbers below)

But I also have sleep apnea, which had been well controlled with intense aerobic training but has come back the past few months. Mild, but enough so that I wake up feeling pretty wiped out some mornings. So it’s possible that’s the cause and I need to work that through, which I’m doing with a sleep doctor. And I have an endocrinology consult in November, and hoping to find something sooner.

But here’s the thing. I’m in the process of starting a new career out of both financial necessity and interest. But finances are just bad, looking down the road, I own my (small) house, but have precisely zero for retirement— and will be paying off new school loans as well. So I need to get to a point where I’m working at a higher level than now and honestly, I probably will need to sustain that for a decade at least. Since testosterone declines steadily with age, and especially so for free testosterone, I’m increasingly inclined to go with TRT unless things improve markedly in the next couple of months. And even if things do improve, keeping it as an option as I move forward.

I really don’t like the idea of losing my own production of the stuff or of having to take another drug on a regular basis. But given the situation, my reservations are fading fast. Thoughts?

Lab Results

Total T 361 ng/dl
Free T 36.3 pg/ml (equilibrium dialysis/mass spec)
* blood drawn at noon

Total. 339
Free. 28.8 (immunoassay)
SHBG 53
Albumin 4.7
* early morning

**. Also, total T was 550 in 2022.

Got my ApoB from 115 to 77 with lifestyle alone (at 64 now, chasing sub-60) — here's what actually moved it

I'm 39, fairly fit — 8-11% body fat, train regularly — and I genuinely thought I was healthy. Then I did keto for a couple years without watching my saturated fat and my numbers blew up: LDL went 99 to 168, and the first ApoB I ever ran came back 115. Gut punch. My standard panels never really flagged it — I only caught the ApoB because I paid for it myself after going down an Attia rabbit hole.

Here's what I wish someone had told me early: the info isn't the hard part. Everyone here already knows "less sat fat, more fiber." The hard part is doing it consistently for months and actually knowing whether you're hitting your targets or just guessing.

So I made myself the lab rat — tested every quarter and tracked what actually moved:

- Saturated fat. When I first tracked it I was eating 50g+ a day with no idea (corn-fed ribeyes every night will do that). Got it under 15g. Single biggest lever.

- Soluble fiber. The lever I'd been sleeping on — works like a sponge, binds cholesterol and pulls it out before you reabsorb it. Oats, beans, lentils, chia, and a scoop of psyllium before meals. I aim for 38g+ of total fiber a day and load the soluble sources specifically.

- Filtering my coffee. I was a French press die-hard, but unfiltered coffee has cafestol, which raises cholesterol. Switched to a paper filter — one of the biggest single drops I saw. Who would've thought.

It was NOT linear: 115 → 105 → 90s → back up to 105 when I got cocky and eased off → then down to 77 once I locked in again. About a year for the big drop. I'm at 64 now, still chasing sub-60. CAC came back 0, which finally let me sleep at night.

To be clear, I'm not anti-medication at all — statins are great and they work, and none of this is a reason to ignore your doctor. Work any plan through with them. But lifestyle gets underrated. I still lurk here a lot and constantly see people in the mid-160s wondering if it's even worth trying alongside whatever their doctor recommends — and I think it is.

And it's not just me. A buddy and I have helped a couple other people from this sub do the same thing, and they dropped their LDL 25-30% in about a month. Watching it work for people who aren't me is what convinced me these levers aren't some genetics fluke — they work for regular people who stay consistent, keep going when they stumble, and remember why they started.

If you're staring at a scary panel and feeling stuck right now, I hope this is a little proof that you've got way more control than it feels like. You got this 💪

Just had calcium scan done which came back 1.18 which sounded good to me but apparently it’s 71 percentile for female my age. Here is the other jnfo from this AM

LDL: 46
HDL: 74
Triglycerides: 47
BP: 109/63 (on losartan/hctz)
Glucose: 86
ApoB: 71
No diabetes
No smoking
BMI 23
Weight train 3-5x weekly
Zone 2 cardio a few times weekly

Nurse reviewing my results said my PCP may consider statin but my lipid profile has always been good. I need to get an Lp(a) I guess, but should I be concerned? Not sure what more I can do I have a pretty healthy lifestyle

I thought I’d share my results.

My ApoB was hovering around 91. I wanted it to be less than 70. (LDL-C hovered around 120s.). Tried the portfolio diet for three months. It was difficult diet! ApoB remained at 91 (LDL was 110). Stopped the diet. Did ezetimide 10mg. After 3 months, ApoB was now at 77. Near goal but I decided to add rosuvastatin. Dropped my ApoB to 48 and LDL-C to 43.

TLDR:
-portfolio diet did nothing for me.
-ezetimide with 5mg of rosuvastatin dropped AppB from 91 to 48.

Interesting article. Basically explains why the Multi-Cancer Early Detection blood tests aren't useful.

my heart rate is around 60-70 is that to strong of a dose? I’m worried about it. any one have experience

i’m going to be getting a CT angiogram in July and I’m pretty nervous taking Metropol and also the contrast. Anyone have any stories they can share?

I’m in a bit of an odd situation and not sure what to do. I’m looking to supplement with fibre (metamucil, chia, flax etc) but not sure when to take it.

I generally don’t eat breakfast. I can’t take it during lunch as that’s when I have my vitamin stack (fat soluble) and everyone says fibre can mess with vitamin absorption. So that leaves dinner, but common advice is for dinner to be quick digesting and as it can negatively affect sleep if you go to bed full. And fibre slows down digestion.

So when exactly are you supposed to have it?

This one is slipping through the cracks and does not get the attention it deserves. Up regulates klotho (longevity), up regulates cAMP, and normalizes TNF-alpha (reduces inflammaging). This benefit is achieved with 1 pill a day versus the 3 pill a day for micro vascular benefits.

I started taking one 400mg slow release tablet a day. I am in my 3 month. I have experienced zero side effects. No GI issues. No jitters. Nothing. I still drink my coffee as normal.

Anyone else?