Question 17 of 433
Where do you agree with Attia, and where do you differ?
The short answer
I agree on exercise, early cholesterol treatment, protein, sleep, and emotional health. I am more cautious about testing healthy people extensively and about rapamycin.
Where I agree: measure ApoB and Lp(a). Treat risk early. Build muscle. Protect sleep. And I admire his final chapter, in which he writes frankly about his own emotional struggles and concludes that a long life is worth little if you are miserable in it. Few physicians have the courage to say that in print.
Where I am more cautious:
Extremely low cholesterol targets for everyone. Lower is better for people at risk. For a healthy 35-year-old with no plaque, we do not have trials showing that driving ApoB to the floor for fifty years is worth the cost and medication burden.
Very frequent colonoscopy and whole-body MRI for average-risk people. Screening has harms too: false alarms, biopsies, and anxiety. I explain this in Part 16.
Rapamycin. It remains unproven in humans, as you will read in Part 18.
Cost. His full program suits people with a great deal of time and money. Most of the benefit does not require either.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
CLINICAL JUDGMENT — Agreement and disagreement with a public framework, not a tested treatment package.Evidence grade (draft mapping)JClinical judgment / author synthesisPart 2, Q17 · Part sources
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.