Attia calls exercise the most powerful ‘medicine’ and recommends a mix of easy endurance work (zone 2) and short, intense efforts.
He emphasises strength training and stability to prevent falls and frailty, and talks about a personal ‘Centenarian Decathlon’.
Attia believes cholesterol (measured as ApoB) should be tackled at a younger age, more strictly than many current guidelines.
He discusses rapamycin as promising based on animal studies, but points out himself that hard data in healthy people are lacking.
The ‘What does the science say?’ rating is an estimate by the Engy editors based on the cited source and the wider research. Not medical advice.
Critics point out that some of his advice relies on observational research, which shows associations but does not prove cause and effect. On lowering ApoB in young, healthy people, he goes further than most guidelines.
His approach, with extensive testing and personal coaching, is expensive and out of reach for most people. He has also revised some of his own positions, for example on prolonged fasting, because it can come at the expense of muscle mass.
