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Kindle Notes & Highlights
by
Peter Attia
Read between
February 16 - August 10, 2025
I strongly urge my patients to limit alcohol to fewer than seven servings per week, and ideally no more than two on any given day,
The power of CGM is that it enables us to view a person’s response to carbohydrate consumption in real time and make changes rapidly to flatten the curve and lower the average. Real-time blood glucose serves as a decent proxy for the insulin response, which we also look to minimize. And, last, I find that it is much more accurate, and more actionable, than HbA1c, the traditional blood test used to estimate average blood glucose over time.
Is their average blood glucose a little bit high? Are they “spiking” above 160 mg/dL more often than I would like? Or could they perhaps tolerate a little bit more carbohydrate in their diet?
Overall, I like to keep average glucose at or below 100 mg/dL, with a standard deviation of less than 15 mg/dL.fn5 These are aggressive goals: 100 mg/dL corresponds to an HbA1c of 5.1 percent, which is quite low.
If you consume more protein than you can synthesize into lean mass, you will simply excrete the excess in your urine as urea.
I typically set 1.6 g/kg/day as the minimum, which is twice the RDA.
typically means eating more olive oil and avocados and nuts, cutting back on (but not necessarily eliminating) things like butter and lard, and reducing the omega-6-rich corn, soybean, and sunflower oils—while also looking for ways to increase high-omega-3 marine PUFAs from sources such as salmon and anchovies.
The original 16/8 model came from a study conducted in mice. This study found that mice fed in only eight hours out of the day, and fasted for the other sixteen, were healthier than mice fed continuously. The time-restricted mice gained less weight35 than the mice that ate whenever they wanted, even though the two groups consumed the same number of calories. This study gave birth to the eight-hour diet fad, but somehow people lost sight of the fact that this is a big extrapolation from research in mice. Because a mouse lives for only about two to three years—and will die after just forty-eight
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Another drawback is that you are virtually guaranteed to miss your protein target with this approach (see “Protein,” above). This means that a person who needs to gain lean body mass (i.e., undernourished or undermuscled), should either abandon this approach completely or consume a pure protein source outside their feeding window (which more or less defeats the purpose of time-restricted feeding).
the type of mindless eating-just-to-eat that the Japanese call kuchisabishii, for “lonely mouth.”
zone 2 aerobic training can have a huge impact on our ability to dispose of glucose safely, and also on our ability to access energy we have stored as fat.
The] decimation of sleep throughout industrialized nations is having a catastrophic impact on our health, our life expectancy, our safety, our productivity, and the education of our children,”
If sleep is so unimportant, he asked, then why hasn’t evolution gotten rid of it?
people who sleep less chronically20 tend to have older-looking, flabbier skin than people their same age who sleep more.
Both poor sleep and high stress activate the sympathetic nervous system, which—despite its name—is the opposite of calming. It is part of our fight-or-flight response, prompting the release of hormones called glucocorticoids, including the stress hormone cortisol.
poor sleep also changes the way we behave around food. Studies by Eve van Cauter’s group26 have found that limiting subjects’ sleep to four or five hours a night suppresses their levels of leptin, the hormone that signals to us that we are fed, while increasing levels of ghrelin, the “hunger” hormone.
Deep sleep is when the brain clears out its cache33 of short-term memories in the hippo-campus and selects the important ones for long-term storage in the cortex, helping us to store and reinforce our most important memories of the day.
When we are young,35 REM sleep is important in helping our brains grow and develop. Even while we are asleep, our brain is forming new connections, expanding our neural network; this is why younger people spend more time in REM.
In adulthood, our REM sleep time tends to plateau, but it remains important, especially for creativity and problem solving.
(We have also had good results with the supplement ashwagandha.)
Turn off the computer and put away your phone at least an hour before bedtime. Do NOT bring your laptop or phone into bed with you.
The overarching point here is that a good night of sleep may depend in part on a good day of wakefulness: one that includes exercise, some outdoor time, sensible eating (no late-night snacking), minimal to no alcohol, proper management of stress, and knowing where to set boundaries around work and other life stressors.
“Religion is for people who are afraid of Hell. Spirituality is for people who have been there.”
Paul is an expert in trauma, and he saw that I displayed all the behavioral signs: anger, detachment, obsessiveness, a need to achieve that was fueled by insecurity.
the Trauma Tree. The idea behind it is that certain undesirable behaviors that we manifest as adults, such as addiction and uncontrolled anger, are actually adaptations to the various types of trauma we suffered in childhood. So while we only see the manifestation of the tree above the ground, the trunk and branches, we need to look underground, at the roots, to understand the tree completely. But the roots are often very well hidden, as they were with me.
Trauma generally falls into five categories: (1) abuse (physical or sexual, but also emotional or spiritual); (2) neglect; (3) abandonment; (4) enmeshment (the blurring of boundaries between adults and children); and (5) witnessing tragic events. Most of the things that wound children fit into these five categories.
This dysfunction is represented by the four branches of the trauma tree: (1) addiction, not only to vices such as drugs, alcohol, and gambling, but also to socially acceptable things such as work, exercise, and perfectionism (check); (2) codependency, or excessive psychological reliance on another person; (3) habituated survival strategies, such as a propensity to anger and rage (check); (4) attachment disorders, difficulty forming and maintaining connections or meaningful relationships with others (check).
Terrence Real’s book10 I Don’t Want to Talk About It, a groundbreaking treatise on the roots of male depression. Once I started, I could not put it down. It was almost creepy that this guy seemed to be writing about me, despite never having met me. His main thesis is that with women, depression is generally overt, or obvious, but men are socialized to conceal their depression, channeling it inward or into other emotions, such as anger, without ever wanting to discuss it.
made sure to spend time with my kids—one on one, no phones—every day that I was home. I would check in with Jill on her experience (not “events”) each day. I limited my phone time and my work hours to a strict window. One day a week, typically Saturday or Sunday, I would refrain from doing any work at all, something that went against decades of ingrained habit. Even more amazing, Jill and I went on an actual vacation for the first time in years, just the two of us, no kids. One
The practice of DBT is predicated on learning to execute concrete skills, repetitively, under stress, that aim to break the chain reaction of negative stimulus → negative emotion → negative thought → negative action.
“your worst enemy cannot harm you as much as your own unguarded thoughts.”
a quote from Paulo Coelho that I think about often: “Maybe the journey isn’t so much about becoming anything,” he writes. “Maybe it’s about unbecoming everything that isn’t really you, so you can be who you were meant to be in the first place.”
“I think people get old when they stop thinking about the future,” Ric told me. “If you want to find someone’s true age, listen to them. If they talk about the past and they talk about all the things that happened that they did, they’ve gotten old. If they think about their dreams, their aspirations, what they’re still looking forward to—they’re young.”
