Peter Attia Says This Overlooked Health Metric Influences Every Major Chronic Disease

Among all the health metrics people obsess over—cholesterol, body fat percentage, VO2 max—Peter Attia, M.D., argues that one factor influences nearly every major chronic disease: metabolic health. Attia, a physician best known for his work on longevity and disease prevention, spoke with Men’s Journal about why this overlooked metric deserves much more attention.

First of all, it’s important to understand what metabolic health even means. Attia describes it as being "very insulin sensitive." Simply put, being metabolically healthy means your body can efficiently convert food into energy without unhealthy blood sugar or insulin spikes.

Attia refers to cardiovascular disease, cancer, neurodegenerative disease, and metabolic dysfunction (type 2 diabetes and fatty liver disease) as the "four horsemen" of chronic disease. And while all four threaten lifespan and quality of life, Attia emphasizes that metabolic health plays a unique role compared to the others.

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"The good news is that metabolic health, not only is it the fourth horseman, but it's also the one that feeds into all the other three," Attia says. "So if you're putting outsized effort into making sure that you're metabolically healthy, you're not only reducing your risk of diabetes and fatty liver disease and all these other things, but you're also reducing your risk of cardiovascular disease, cancer, and dementia."

To assess this, Attia suggests tests, like a CPET, which shows how your heart and lungs respond to exercise and measures metabolic flexibility.

To improve metabolic health, Attia says targeted action is required. Taking interventions in nutrition, exercise, sleep, stress management, and, when appropriate, pharmacologic therapy are among the best practices.

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