#134 - James O’Keefe, M.D.: Preventing cardiovascular disease and the risk of too much exercise.

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 26 October 2020

⏱️ 129 minutes

🔗️ Recording | iTunes | RSS

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Summary

James O’Keefe is a preventative cardiologist and bestselling author of The Forever Young Diet and Lifestyle. In this episode, James discusses cardiac physiology and what makes the human heart susceptible to disease. He provides evidence for what supports his approach to exercise--elucidating both positive and negative kinds of exercise for heart health. He also discusses the role of nutrition, specific nutrients, and pharmacological interventions to support heart and brain longevity.

We discuss:

James’ background and why he favors a preventative approach to cardiology [3:15];
Understanding atherosclerosis and the misconception that it’s a “plumbing problem” [10:15];
The danger in excessive exercise—a reverse J-shaped mortality curve [21:15];
The story of Micah True—A case study of excessive exercise [49:15];
The best kinds of exercise for longevity—The Copenhagen City Heart Study [53:00];
Being a more balanced athlete and finding the right exercise intensity [58:45];
Heart rate during exercise, resting heart rate, and other important metrics [1:04:00];
Nutrition for cardiovascular health [1:09:45];
Important nutrients: Magnesium, potassium, calcium, sodium, and collagen [1:19:30];
SGLT2 inhibition for diabetes, cardio-protection, and general longevity [1:24:15];
GLP-1 agonists for weight loss and reducing cardiovascular risk [1:34:15];
Statins—Mechanism of action, safety, and useful alternatives [1:37:25];
A 40-year view on cardiovascular risk, and the possibility of reversing arterial calcification [1:45:45];
Evidence for high dose EPA and DHA for the reduction of cardiovascular disease risk [1:53:30];
The impact of omega-3, curcumin, and other compounds on mental health and dementia [1:59:00];
James’ focus beyond cardiology [2:02:15]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Drive Podcast.
0:13.0	I'm your host, Peter Atia.
0:14.8	This podcast, my website, and my weekly newsletter, all focus on the goal of translating
0:18.7	the science of longevity into something accessible for everyone.
0:22.4	Our goal is to provide the best content in health and wellness, full stop, and we've
0:26.6	assembled a great team of analysts to make this happen.
0:29.4	If you enjoy this podcast, we've created a membership program that brings you far more
0:33.2	in-depth content if you want to take your knowledge of the space to the next level.
0:37.2	At the end of this episode, I'll explain what those benefits are, or if you want to learn
0:41.0	more now, head over to peteratiamd.com forward slash subscribe.
0:46.2	Now, without further delay, here's today's episode.
0:51.2	My guess this week is Dr. James O'Keefe.
0:54.0	James is a cardiologist and medical director of the Charles and Barbara Dubok Cardio Health
0:59.7	and Wellness Center at St. Luke's Mid-American Heart Institute, an enormous practice of
1:06.3	more than 60 cardiologists in the middle of this lovely country.
1:11.3	He is also a professor of medicine at the University of Missouri, Kansas City.
1:16.0	James has authored best-selling cardiovascular books for health professionals, including
1:20.2	the Complete Guide to EKGs, Dislippidemia Essentials, and Diabetes Essentials.
1:26.5	James has also co-authored with his wife, Joan, the best-selling consumer health book,
1:31.4	the Forever Young Diet in Lifestyle.
1:34.1	He has actively involved in patient care and research and has published numerous peer-reviewed
1:39.2	articles, which honestly, I feel like I'm reading at least one every couple of weeks.
	...

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