Does Dr Peter Attia’s program actually work?
On a gray Tuesday in Austin, a patient in his late fifties practices getting up off the floor using one hand. It’s a humble drill with a lofty aim: to be able to do the same move at 90. That little test captures the appeal of Peter Attia’s “Medicine 3.0”—a more aggressive, data-soaked form of prevention that tries to lengthen the years we spend healthy, not just alive.
So, does it work?
What’s clearly supported
Cardiorespiratory fitness is medicine. If there’s one pillar that needs no mystique, it’s aerobic capacity. Large cohorts show that higher fitness—especially into the “high” and “elite” ranges—is associated with sharply lower mortality, with a dose-response relationship that holds across age groups. That’s the strongest plank under Attia’s emphasis on Zone 2 work (moderate steady cardio) plus a weekly session to push VO₂ max.
Strength training matters on its own. Lifting isn’t just for vanity; meta-analyses link 30–60 minutes a week of resistance training with reduced all-cause and cardiovascular mortality, independent of aerobic exercise. That aligns with the “don’t lose muscle” drumbeat in Attia’s playbook.
Lower atherogenic lipoproteins, lower risk. Across statins, ezetimibe, and PCSK9 inhibitors, every ~39 mg/dL (1 mmol/L) reduction in LDL is associated with ~20% fewer major vascular events—consistently across starting LDL levels and patient subgroups. Translation: if your risk is measurable, earlier and sustained LDL lowering pays off. JAMA Network+1
Treat obesity like the high-risk disease it is. The SELECT trial (patients with obesity and cardiovascular disease, but without diabetes) showed semaglutide reduced major cardiovascular events vs. placebo—proof that, for the right patient, modern weight-loss pharmacotherapy is a prevention tool, not a vanity play.
Screen smart, not maximal. Attia leans on risk-stratification tools with good evidence—coronary artery calcium (CAC), for example—to sharpen cardiovascular prevention in the middle decades of life. CAC reclassifies risk meaningfully in primary prevention and is endorsed in guidelines for selected patients where the decision to treat is uncertain.
On brain health, a prudent shift in language. Attia co-authored a 2018 review outlining a multi-modality “risk-reduction” approach for Alzheimer’s (glucose control, blood pressure, sleep, exercise, etc.). The field is careful to say risk reduction, not “prevention,” but the blueprint mirrors what public-health commissions advise. PMC
Protein for aging muscle—yes, within reason. For older adults, consensus papers recommend ~1.0–1.2 g/kg/day (higher with illness or intense training). Attia often pushes higher; the center of gravity in the literature is more conservative but compatible with robust intakes for active, healthy kidneys. PubMed+1
What’s promising but not settled
Rapamycin (and other “geroprotectors”). mTOR inhibition extends lifespan in animals; small human trials suggest immune benefits in older adults, but definitive trials on hard outcomes aren’t in yet. Attia’s cautious personal use matches the state of the evidence: intriguing, not standard of care. media.jamanetwork.com
Continuous glucose monitors for the non-diabetic. Outside diabetes, CGMs can reveal individual glucose responses to meals and may help some people change habits, but randomized evidence for durable clinical benefit in otherwise healthy people is thin. Recent reviews call the signal “emerging” rather than conclusive. PMC+1
Sauna. Observational studies from Finland associate frequent sauna use with lower cardiovascular and all-cause mortality; they’re hypothesis-generating but not causal. Enjoy it, just don’t mistake it for a statin or a brisk walk. American College of Cardiology+1
Where enthusiasm can outrun evidence
Full-body MRI for everyone. Boutique clinics now sell whole-body scans to asymptomatic people. Professional bodies and academic centers argue evidence is insufficient; false positives and cascades of follow-up are common. Targeted screening for high-risk groups is different; routine WB-MRI for the average person isn’t supported. PMC+1
Maximal screening vs. right-sized screening. Good prevention means following proven programs (vaccines, colon, breast, and cervical screening at the right ages) and reserving advanced tests for the right risk profiles. The art here is restraint, not just escalation. USPSTF
So…does it work?
If “it” means the core pattern—train your engine and your muscles, treat lipids and blood pressure early, manage weight aggressively when indicated, sleep consistently, and screen thoughtfully—then yes, the center of Attia’s approach is well supported and widely endorsed in mainstream guidelines and high-quality studies. The mortality gradient with fitness alone is formidable; add smart lipid management and judicious use of obesity pharmacotherapy, and you’ve captured most of the preventable cardiovascular risk that shortens life and healthspan.
If “it” means longevity drugs for all, wearable telemetry for every variable, and routine whole-body imaging, the evidence is not there. Some of those tools may mature into standards; today they’re best treated as research-adjacent options for selected people who accept uncertain benefit and clear trade-offs.
A practical, evidence-forward plan (you can start now)
Cardio: Aim for 180–240 minutes/week of moderate “you can talk in sentences” work plus ~1 short high-effort session. Your goal is to push VO₂ max up and keep it there; it’s the strongest single predictor you control.
Strength: Two to three total-body sessions/week; prioritize legs, pulling, and grip. Even modest weekly volume moves the mortality needle.
Lipids & blood pressure: Know your apoB (or LDL-C), CAC if treatment is uncertain, and treat to risk—earlier is better.
Weight: If lifestyle isn’t enough and risk is high, evidence-based medications (including GLP-1s) can improve outcomes, not only the scale.
Sleep: Keep a stable schedule; consistency predicts outcomes more reliably than chasing gadgets.
Protein & produce: Older or highly active? Target ~1.0–1.2 g/kg/day protein alongside an unglamorous abundance of plants; adjust higher only with reason and monitoring.
The accessibility question
Much of this can be done with a park, a barbell, a blood pressure cuff, and a primary-care doctor who will order apoB and discuss CAC. The boutique version—ten-hour training weeks, quarterly panels, advanced imaging, concierge clinics—delivers more touch and data than proven outcome, at a price only a few can pay. The durable lesson is not the concierge trappings; it’s the prioritization.
A quiet nudge for readers who want the organized version
If you’re serious about corralling your labs, wearables, and prevention plan into one place (and getting updates as the science moves), there’s a new waitlist at moccet that’s aimed at exactly that kind of long-horizon, evidence-first self-care. No promises, just an option if you want help turning intentions into an operating plan.