#385 - AMA #82：在现实生活中应用长寿工具：疾病预防、DEXA扫描、人工甜味剂、损伤恢复、稳定性训练、习惯养成、蛋白质摄入与mTOR激活等

嘿，大家好。

Hey, everyone.

欢迎收听Drive播客的抢先问答环节（AMA）。

Welcome to a sneak peek ask me anything or AMA episode of the drive podcast.

我是你们的主持人，阿提亚。

I'm your host, Attia.

在本短片的结尾，我会告诉你如何完整收听AMA系列节目，以及我们为你准备的其他大量会员权益。

At the end of this short episode, I'll explain how you can access the AMA episodes in full along with a ton of other membership benefits we've created.

或者你现在就可以访问peterattiamd.com/subscribe，了解更多详情。

Or you can learn more now by going to peterattiamd.com forward slash subscribe.

那么，不多说了，以下是今天Ask Me Anything节目的抢先片段。

So without further delay, here's today's sneak peek of the Ask Me Anything episode.

欢迎来到Ask Me Anything AMA第82期。

Welcome to Ask Me Anything AMA episode 82.

在今天的AMA中，我将回答听众提出的广泛主题问题。

In today's AMA, I answer listener questions across a wide range of topics.

更少关注深度剖析，更多探讨我如何思考现实中的权衡，并应用科学与实践。

Less about deep dives and more about how I think through real world trade offs and apply the science and practice.

那么今天我们要讨论什么呢？

So what are we talking about here today?

我们可以谈谈健康优先级和策略如何随着人生不同阶段而变化，哪些慢性病最难管理，以及我如何思考风险的优先级排序；哪些新兴干预措施比运动和可穿戴设备更有前景；哪些消费者指标在实际中真正有用，比如DEXA扫描、最佳筛查间隔时间，以及如何长期解读结果。

We can talk about how health priorities and strategies should shift across different decades of life, which chronic diseases feel toughest to manage and how I think about that hierarchy of risk, which emerging interventions look most promising beyond exercise, wearables, which consumer metrics are actually useful in practice, DEXA scans, what optimal screening intervals look like and how to interpret the results over time.

行为改变：患者在健康习惯中最常遇到的困难，以及如何帮助他们坚持改变。

Behavior change, what patients struggle with most in health routines and how to help changes stick.

针对平衡、稳定性和抗损伤能力的训练，以及一些训练挫折带来的教训。

Training for balance, stability, and injury resilience, and lessons from some training setbacks.

高蛋白饮食与mTOR：如何区分机制与结果。

High protein diets and mTOR, how to think about mechanisms versus outcomes.

无糖饮料和非营养性甜味剂：如何评估它们，坦率地说，该拿它们和什么做比较。

Diet sodas and non nutritive sweeteners, how to evaluate them, and frankly, what to compare them to.

此外还有一些其他听众提问的杂项内容，包括健康潮流、情绪健康和睡眠习惯。

Plus a grab bag of some additional listener questions, including health fads, emotional health and sleep routines.

那么，不多说了，希望你们喜欢第82期问答会。

So without further delay, I hope you enjoy AMA number 82.

彼得，欢迎来到又一期问答会。

Peter, welcome to another AMA.

今天的问答会，我们的目标是覆盖那些频繁出现、最常见的各种话题和问题。

For today's AMA, our goal is to hit a variety of topics and questions that have come through frequently, most commonly.

我们不会对这些话题做深入探讨，而是更多地讨论：如果患者提出这些问题，你会如何与他们交流？你是如何在具体问题上帮助患者的？

And instead of doing deep dives on some of these topics, what we're gonna do is more talk about them, how you would speak with patients about them if they ask these questions or their questions on how you work with your patients on specific issues.

所以我们的目标是少一些深度，多一些实用性和可操作性。

So goal here is to be much less in-depth and much more practical and actionable.

为此，我们将涵盖多个话题，包括随着年龄增长，健康优先事项如何变化；预防痴呆最有效的工具是什么；哪些可穿戴设备数据对你的临床工作真正有用；你如何帮助患者建立持久的健康习惯；如何思考稳定性训练和伤后恢复；关于无糖饮料和mTOR与高蛋白饮食的关系，等等。

And with this, we'll cover a variety of topics, including how priorities around health shift as people age, the best tools we have to prevent dementia, what wearable data do you think is actually useful for your work with patients, how you work with patients to make lasting changes in their health routine, how to think about training for stability, recovering from injuries, question on diet soda, mTOR as it relates to high protein diets, and more.

那么，话不多说，我们直接开始吧。

So with that said, I think we'll just jump right into it.

第一个问题是，当一个人思考自己随着年龄增长的发展轨迹时。

First question being as someone thinks about their trajectory as age.

当一个人从二十岁、四十岁到六十岁及以后，你是如何帮助患者调整他们在不同年龄段的健康优先级、策略和方法的？

So if someone goes from their twenties to forties to sixties and beyond, how do you work with patients around how their health priorities, strategies, tactics should shift across those decades as they age?

嗯，这个问题问得很好，我经常被问到类似的问题，但坦白说，我通常不接诊二十岁左右的患者，因此我对这个年龄段的了解不如对四十岁以上人群那么深入。

Well, I mean, think it's a great question and I get asked this in various forms all the time, but also I think in the spirit of full disclosure, I don't work with 20 year olds typically, and therefore I don't think I have the breadth of experience to really speak intelligently at that age range the way I do, you know, for people in their 40s and above.

因为我估计我的患者中位年龄在五十多岁，四分位间距大约是四十到七十岁。

Because I would bet that the median age of my patient is in the mid 50s with an interquartile range of, call it, 40 to 70.

所以总的来说，我想说的是，二十岁时你可以放纵很多。

So I think broadly what I would say is that you can get away with so much in your 20s.

而且我也不确定我们的听众中有多少人这么年轻，但任何正在听这段内容的二十岁人群，或者任何还记得自己二十岁时候的人——包括我自己——都知道，那时候你能承受的极限简直惊人。

And again, I don't know that much of our audience even skews that young, but anybody listening to this who's in their 20s, or certainly anybody who can remember being in their 20s, and even I can, knows that what you can get away with is just incredible.

比如，我跟我女儿（她还是个青少年）说，这是你可以过度训练、拓展自身能力边界的时期。

So one of the things that I talk about with my daughter, for example, who's a teenager, is look, this is the period of time in which you can overtrain, you can expand the envelope of your capacity.

直到今天，尽管我训练量并不大，但我的最大摄氧量仍然远高于根据我训练量所预测的水平。

I know that the reason to this day, despite the fact that I don't train that hard, I still have a much higher VO2 max than would be predicted I think by my training volume.

这一切都要归功于我年轻时的付出。

I owe that all to what I was doing when I was young.

这是一个例子。

That's one example.

但我认为在二十多岁时努力拼搏能取得很多成就。

But I think we can achieve a lot by pushing in our 20s.

所以我实际上会鼓励十几岁和二十多岁的人稍微去探索一下自己的极限。

So I actually would encourage people in their teens and 20s to kind of find their limits a little bit.

再次强调，这样做所付出的代价不会像你五十或六十岁时那样大。

Again, you're not going to pay the same price that you will in your 50s or 60s in doing so.

当然，这意味着你仍然需要保持理性，不要做可能导致受伤的事情。

Now, obviously that means you still have to be reasonable and don't do things that would cause injuries.

但我觉得，这是一个探索和成长的时期。

But again, I think that's a period of time for exploration and growth.

我认为当人们进入四十多岁后，大多数人开始第一次直面死亡。

I think when people get into their 40s, most people start to have that first brush with mortality.

而这部分原因是来自外界的。

And part of that is external.

你可能会看到父母逐渐老去，或者类似的事情。

You might be watching your parents age or things of that nature.

但我认为，这部分也是内在的，即使你自己的死亡并不明显，但你明显已经不再是过去的自己了。

But I think also part of it is internal, even though it's not your own mortality that is readily apparent, it is apparent that you are not the person you were before.

我想，到了快50岁的时候，这种情况肯定会出现。

Probably, I would say certainly by the late 40s that becomes true.

而且，这种变化会以多种方式表现出来，对吧？

And again, this manifests itself in many ways, right?

比如，病人会说：曾经有一段时间，我每晚能喝三杯酒却毫无感觉，但现在只要喝一点，第二天就会头痛、睡不好、第二天状态也差，诸如此类。

So, example, patients will say, look, there was a day when I could throw down three drinks a night and feel nothing, and now just I have a headache the next day, or I don't sleep well, and I don't perform well the next day, and all of those other things.

所以我认为，这揭示了我们在40多岁和50多岁时身体发生的变化，这表明我们真的需要开始非常有意识地管理自己的身体活动、思维方式，以及对疾病和训练的态度。

And so I think that that's an insight into what's happening to us physiologically in our 40s and 50s, which says we really need to start being very deliberate about what we do physically and how we think about ourselves in terms of disease management and training.

再者，当你观察动脉粥样硬化这类疾病时，它几乎不会在40多岁的人身上突然发作。

Again, when you look at a disease like atherosclerosis, rarely, rarely is it going to brush up against somebody in their 40s.

你见过的40多岁就发生心肌梗死的病例，屈指可数。

You can count the number of cases you see where a person has an MI in their 40s.

但不可否认的是，大多数人在微观层面上，即使存在高风险因素，也尚未表现出明显的疾病负担。

But it is undeniable that most people, at least microscopically, if they're walking around with high risk factors, don't have a burden of disease.

因此，我真的认为，到了40多岁，你就必须认真思考自己在预防方面做了些什么。

And so really I would say that by the time you're in your 40s, you really need to be thinking about what am I doing from a prevention standpoint?

我不想再拖延太久才开始采取这些措施，这意味着要再次关注基本的健康要素。

You know, I don't want to wait too much longer to start taking those steps, and that means, again, looking after the fundamentals and the basics.

那么，我的代谢健康状况如何？

So, am I metabolically healthy?

因为对许多人来说，这正是他们开始失控的阶段。

Because for many people this is when they start to go off the rails.

我是否仍然面临血脂异常，或者高血压是否开始悄然上升？

Am I still faced with dyslipidemia, or you know, is hypertension starting to creep up?

所有这些其他问题。

All of those other things.

当然，我总是喜欢把话题拉回到身体活动和锻炼上。

And of course, I always like to bring it back to physical and exercise.

这正是你不能开始错过锻炼的时候。

This is really a time where you don't want to start missing workouts.

我知道这对一些人来说很难，但比起长时间中断后再试图一鸣惊人，频繁地坚持锻炼、不养成中断的习惯要好得多。

And I know that that's, you know, some people it's hard to do, but you're better off doing something very frequently and not getting out of the habit than you are taking long periods of time off and then coming back trying to be heroic.

现在我认为，一旦你进入60岁及以后，如果你之前做得不错，那么目标就是维持现状。

Now I think once you get into your 60s and beyond, the name of the game is maintenance if you've done a good job until that point.

但好消息是，如果你之前没做好，仍然有巨大的成长空间。

But the good news is if you haven't, there's still an enormous opportunity for growth.

我认为这是一个重要的区别。

I think that's an important distinction.

所以，如果你进入人生的第七或第八个十年时并不健康，这绝不应该成为你放弃的理由，觉得一切都已定局。

So if you've come into the seventh and eighth decade of your life not particularly healthy, that should not be viewed as a scenario by which you decide, well, the dye's been cast and away I go.

相反，你应该说：不，我仍然可以在这里取得进步。

Rather it would be, no, look, I can still make gains here.

我们见过一些患者，他们在60多岁时进入我们的诊所，VO2 max只有十几到二十出头。

We've seen patients that come into our practice in their 60s with a VO2 max in the high teens, low 20s.

这并不会阻止我们训练他们，让他们在两三年内达到更高的健康水平。

That doesn't prevent us from training them and getting them to a much higher level of fitness within two or three years.

阻力训练和其他类似项目也是如此。

The same is true with resistance training and things like that.

当然，预防慢性病的措施永远都不算太晚。

And of course, it's never too late to start taking the preventive steps around chronic disease.

相反，当一个人进入六七十岁且状态极佳时，我们的目标是不造成伤害，对吧？

Alternatively, when a person comes into their 60s and 70s in great shape, our goal is do no harm, right?

我们该如何尽可能长久地维持这种状态？

It's how do we preserve this for as long as possible?

这可能意味着我们在训练中要更加谨慎，适当减少他们的一些训练量，并加入不同类型的训练。

And that might mean being a little bit more deliberate in some of the training that we do, maybe trimming a little bit of the work that they do off and adding different types of work to it.

但总体而言，这会是我的做法。

But I would say broadly speaking, would be my approach.

由此延伸，下一个问题涉及你所说的四大主要慢性疾病。

Jumping off that, the next question we got touches on the kind of major chronic diseases, or as you call them, the four horsemen.

在我们回答这个问题之前，你能不能快速给大家介绍一下这四大疾病是什么？

Do you want to just run people through real quick what those four are before we get to the question?

是的，它们是慢性病领域中的四大主要杀手。

Yeah, they're sort of the big four killers in chronic disease land.

第一是动脉粥样硬化性心血管和脑血管疾病，第二是癌症，第三是所有神经退行性疾病和痴呆症，而这一切的基础是代谢性疾病，这是一个广义术语，涵盖从胰岛素抵抗到脂肪肝，直至2型糖尿病的所有问题。

So atherosclerotic cardiovascular and cerebrovascular disease being one, cancer, all of the neurodegenerative diseases and dementing diseases is the third, And then the foundation upon which these all lie is metabolic disease, which is a broad term that encompasses everything from insulin resistance through fatty liver disease up until type two diabetes.

这个问题显然很难一概而论，因为我知道它因人而异，但有一个有趣的问题是：在这几大慢性病中，你觉得哪一种最难应对？或者在与患者打交道时，你最担心的是哪一种？

And the question which obviously is going be a little hard to answer in general, right, because I know it can vary from person to person, but it was an interesting question around of those major chronic diseases, which do you find the toughest to combat Or which do you worry about the most when working with your patients?

那我先反过来说，尼克，我最不担心的是哪一种？

Well, I'll start with the opposite question, Nick, which is which do I worry about the least?

我最不担心的是代谢性疾病以及心血管和脑血管疾病，因为第一，我们对这些疾病的诱因已经有了相当好的理解。

And I worry the least about metabolic disease and cardiovascular and cerebrovascular disease because one, we have a pretty good handle on the drivers of those diseases.

事实上，我们对这些疾病的诱因掌握得非常透彻。

In fact, we have an exceptional handle on the driver of those diseases.

而这就已经解决了问题的一半。

And that's half of the equation.

问题的另一半是对它的回应。

The other half of the equation is in response to that.

我们还有非常有效的工具来应对这些疾病。

We also have incredible tools for how to combat them.

因此，在降低糖尿病和心血管疾病风险，甚至在它们发生时进行治疗方面，我们知道该怎么做，也拥有相应的工具。

So when it comes to reducing the risk of diabetes and cardiovascular disease, or even treating them when present, we know what to do, we've got the tools.

现在让我们重点关注另外两种疾病。

So now let's really focus on the other two.

另外两种疾病相当有趣，我们一个一个来讨论。

Now, the other two are kind of interesting and so we'll take them one at a time.

就癌症而言，你面对的是一种具有两个非常明确且被充分理解的环境诱因或行为风险因素的疾病。

In the case of cancer, you're dealing with a disease that has two very clear and well understood what we would call environmental triggers or behavioral risk factors.

第一个是吸烟，第二个是肥胖。

The first is smoking, and the second is obesity.

尽管我以前多次说过，在我看来，肥胖只是胰岛素抵抗相关一系列问题的替代指标。

Although as I've said many times before, obesity is simply a proxy, in my view, for the constellation of things that accompanies insulin resistance.

当然，这两者之间有很高的重叠，但我认为真正推动这一风险的是常伴随肥胖出现的高胰岛素血症和炎症，尽管并非总是如此。

So there's a high overlap, of course, between those, but really I think it's the hyperinsulinemia inflammation that often, though not always accompanies obesity, that is driving risk there.

所以，谈到癌症，第一步显然是缓解这两点，对吧？

So, obviously when it comes to cancer, step one is mitigate those two things, right?

不要吸烟，并尽可能保持代谢健康。

Don't smoke and be as metabolically healthy as possible.

但任何听这段话的人都知道，即使你做到了这两点，也绝不意味着你不会被诊断出癌症。

But as anybody listening to this knows, just because you've done those two things does not for a moment guarantee you're not going to be diagnosed with cancer.

我认为，这在很大程度上解释了为什么癌症是一种令人恐惧的疾病，因为据我所知，至少有百分之五十的癌症病例发生在没有任何明显风险因素的人身上。

And I think that's in many ways what makes cancer a very frightening disease, is that as far as I can tell, at least fifty percent of cases of cancer arise in individuals for which there is no observable risk factor.

正如伯特·沃格尔斯坦多年前在一篇当时颇具争议的论文中所言——我相信那篇论文发表在《科学》杂志上——这纯粹是运气不好。

And as Bert Vogelstein, you know, put it many years ago in a then very controversial paper that I believe was in Science, it's simply about bad luck.

基因一直在发生突变，DNA也一直在发生突变。

And that genes are constantly undergoing mutation, DNA is constantly undergoing mutation.

大多数情况下，这些突变都会被修复。

Most of the time it is being repaired.

如果这些未被修复的DNA突变没有被清除，大多数情况下，发生这些突变的细胞会被淘汰。

If it is not being repaired, most of the time the cells that undergo those non repaired DNA mutations are being weeded out.

但偶尔，这类细胞中会形成一个克隆群体，逃避免疫系统的监视，最终发展为癌症。

But every once in a while a population, a clonal population of these will emerge and will evade the immune system and will ultimately become a cancer.

我认为，这种情况大约发生在百分之五十的情况下，这再次把我们的注意力引向了筛查。

And again, I think that's happening about fifty percent of the time, which again turns our attention then to screening.

这就是为什么筛查如此重要，因为它就像在左轮手枪里装了三颗子弹玩俄罗斯轮盘赌。

This is why screening is so important, because it's sort of like playing Russian roulette with three rounds in the chamber.

所以，尼克，我认为这对我来说非常可怕——无论是关乎我的健康、家人的健康，还是我的病人、朋友以及我关心的任何人的健康。

So I would argue that that's pretty scary to me, Nick, when it comes to my health and the health of my family and the health of my patients and friends and anybody that I care about.

在神经退行性疾病方面，我基本上将其分为两类。

On the neurodegenerative side, I kind of divide these into two categories, frankly.

在痴呆症方面，我们可以通过基因进行很大程度的分层，因此一个人的基因在风险中起着相当重要的作用，而ApoE4基因显然是其中最突出的。

On the dementia side, we can really stratify a lot based on genes, and so a person's genes will play a pretty significant role in risk, and obviously the ApoE4 gene is the most obvious of these.

但不幸的是，这里还涉及其他一些基因，这些基因虽然罕见，但外显率极高，且不像ApoE4那样可以被干预。

But unfortunately, there are other genes that are involved here that are fortunately rare, but unfortunately highly highly penetrant and highly unmodifiable in the way that ApoE4 is modifiable.

因此，在这个谱系上，随着遗传风险的增加，我的担忧也随之加剧。

So across that spectrum, of course, my concern increases as the genetic risk increases.

好消息是，我认为如今我们在预防方面能为患者提供的东西，比五年前、十年前要多得多，这得益于我们认知的进步。

The good news is I feel we have a lot to offer patients there in terms of prevention today that we didn't have five years ago and ten years ago in terms of our understanding.

因此，有趣的是，我发现相比五年前和十年前，我对这个问题的担忧反而稍微减轻了。

So interestingly, I find myself slightly less concerned about this than I was concerned five and ten years ago.

现在，对于那些不属于痴呆类的神经退行性疾病，我也觉得它们同样令人恐惧。

Now, on some of the neurodegenerative diseases outside of the dementing diseases, I find these to be also terrifying.

在这里，我想到了帕金森病、卢·格里克病，当然还有亨廷顿病，这是一种由明确基因突变引发的遗传性疾病。

So here I'm thinking about diseases like Parkinson's disease or Lou Gehrig's disease, Huntington's disease, of course, which is a genetic condition that arises from a very clear genetic mutation.

而且，你知道，在这些疾病中，至少对于肌萎缩侧索硬化症（ALS）而言，我知道它们的发病率相当低，这让我感到些许安慰。

And, you know, here I find these, you know, I take some comfort in knowing that at least in the case of, you know, ALS, the prevalence of these are quite low.

但同样，我们仍然完全不清楚是什么在驱动这些疾病。

But again, we still have no earthly clue what's driving them.

是的，可能有一些病例是由遗传风险引起的，但事实是我们真的并不清楚。

Yes, there are probably some cases that arise from genetic risk, but the truth of the matter is we just don't really know.

同样，对于帕金森病，我们确实了解一些影响风险的遗传因素，但这并不能解释全部问题，因此我对此仍感到担忧。

Again, with Parkinson's disease we certainly are familiar with some of the genetic things that are driving risk, but that doesn't answer all of it, and therefore I have concern about those.

但我同时也意识到，我们有一些事情是能够掌控的。

But I also realize that we have certain things under our control.

正如认知储备能帮助我们抵御认知衰退，运动储备也同样能为我们提供某种保护机制，让我们在面对影响运动功能的神经退行性疾病时更具韧性。

And just as cognitive reserve allows us to maintain resilience against cognitive decline, so too does movement reserve give us some manner in which we can protect ourselves or at least be resilient towards the neurodegenerative diseases that tackle movement.

我想再深入探讨几个方面。

And just to double click on a few things.

关于心血管疾病和代谢性疾病，你刚才回答这个问题的方式是，哪些疾病最难应对、最令人担忧。

On the cardiovascular disease and metabolic diseases, just because you kind of how you answer this question was which ones are the toughest to combat, most worry about.

即使这些疾病相对更容易应对，也不意味着人们可以忽视它们，因为心血管疾病仍然是导致死亡的首要原因。

Just because those diseases are easier to combat, that doesn't necessarily mean that people should ignore those because they're still number one killer in cardiovascular disease.

代谢性疾病在很大程度上推动了其他所有疾病的发展，对吧？

And metabolic disease hugely drives everything else, correct?

完全正确。

Absolutely, yeah.

我的意思是，如果我们这个播客只谈论心血管疾病以及我们应当如何筛查和预防它，可能就能挽救比谈论其他任何话题更多的生命。

I mean, if we did nothing else on this podcast but talk about cardiovascular disease and all of the ways that we should be screening for it and preventing it, we would probably save more lives than talking about anything else.

因此，当我得知有人因心血管疾病去世时，我依然感到心碎，包括我一位导师最近突然离世——他是个极其健康的人，却在70岁左右因突发心肌梗死猝然离世。

And so yeah, I am still heartbroken when I learn of the death of anybody due to cardiovascular disease, including actually a mentor of mine who died suddenly, somewhat recently, and you know, insanely healthy individual who just dropped dead of a sudden MI at about the age of 70.

这个人平时看起来就像52岁一样活力充沛，却突然倒下离世。

This is a guy who functioned like he was about 52, and then just dropped dead suddenly.

是的，我总是后悔自己没有更坚决地强迫他去做那些我认为本可以改变结果的筛查项目。

Yeah, I'll always kick myself for not being more of a hardliner about forcing him to do some of the screening stuff that I that I think would have made a difference.

我们会在节目笔记中附上关于心血管疾病的各类内容链接，包括播客、问答直播和通讯等。

And we'll link in the show notes to various content, podcasts, AMAs, newsletters, etcetera on cardiovascular disease.

接下来要跟进的第二个问题是，我们收到的一个问题，与你刚才谈到的内容非常契合：在预防痴呆方面，除了运动——你已明确表示这是降低风险最有效的方法之一——还有什么方法对你来说最有前景？

The second one to follow-up on, which is a question we got, which fits really well with what you just talked about is for dementia prevention, besides exercise, which you've openly talked about as one of the best ways to reduce the risk of that, what looks most promising to you?

感谢您收听《The Drive》今日的抢先版AMA节目。

Thank you for listening to today's sneak peek AMA episode of The Drive.

如果您想收听这个AMA的完整版，您需要成为高级会员。

If you're interested in hearing the complete version of this AMA, you'll want to become a premium member.

对我来说，提供所有这些内容而不依赖付费广告至关重要。

It's extremely important to me to provide all of this content without relying on paid ads.

为此，我们的工作完全依赖于我们的会员支持。

To do this, our work is made entirely possible by our members.

作为回报，我们提供仅限会员的独家内容和福利，远超免费内容的范围。

And in return, we offer exclusive member only content and benefits above and beyond what is available for free.

因此，如果你想将你对这一领域的知识提升到下一个层次，我们的目标是确保会员获得的回报远超订阅费用。

So if you wanna take your knowledge of this space to the next level, it's our goal to ensure members get back much more than the price of the subscription.

高级会员包含多项福利。

Premium membership includes several benefits.

首先，提供详尽的播客节目笔记，涵盖每一集中讨论的每一个主题、论文、人物和事项。

First, comprehensive podcast show notes that detail every topic, paper, person, and thing that we discuss in each episode.

据外界传言，没有人能比得上我们的节目笔记。

And the word on the street is nobody's show notes rival hours.

其次，每月一次的问答环节（AMA）节目。

Second, monthly ask me anything or AMA episodes.

这些节目由对订阅者问题的详细回应组成，通常聚焦于单一主题，旨在为会员特别感兴趣的话题提供充分的清晰度和细节。

These episodes are comprised of detailed responses to subscriber questions typically focused on a single topic and are designed to offer a great deal of clarity and detail on topics of special interest to our members.

当然，您还将获得这些节目的节目笔记。

You'll also get access to the show notes for these episodes, of course.

第三，我们会发送由我们专职研究分析团队制作的高级通讯。

Third, delivery of our premium newsletter, which is put together by our dedicated team of research analysts.

这份通讯涵盖与长寿相关的广泛主题，内容比我们的免费周报更加详尽。

This newsletter covers a wide range of topics related to longevity and provides much more detail than our free weekly newsletter.

第四，您可以访问我们的私人播客源，从中获取所有节目内容，包括不含您现在所听的这段介绍的AMA节目，与您常规播客源中的内容不同。

Fourth, access to our private podcast feed that provides you with access to every episode including AMA's sans the spiel you're listening to now and in your regular podcast feed.

第五，Qualys，这是我们为会员特别制作的额外播客，相当于精选集，汇集了《Drive》往期节目的精彩片段。

Fifth, the Qualys, an additional member only podcast we put together that serves as a highlight reel featuring the best excerpts from previous episodes of the drive.

这是无需逐个回听每期节目就能快速回顾往期内容的绝佳方式。

This is a great way to catch up on previous episodes without having to go back and listen to each one of them.

最后，还有一些陆续新增的其他福利。

And finally, other benefits that are added along the way.

如果你想了解更多并获取这些会员专属权益，可以前往 peterattiamd.com/subscribe。

If you wanna learn more and access these member only benefits, you can head over to peterattiamd.com slash subscribe.

你也可以在 YouTube、Instagram 和 Twitter 上关注我，用户名都是 PeterAttiaMD。

You can also find me on YouTube, Instagram, and Twitter, all with the handle PeterAttiaMD.

你还可以在 Apple Podcasts 或你使用的任何播客平台为我们留下评价。

You can also leave us a review on Apple Podcasts or whatever podcast player you use.

本播客仅用于一般信息目的，不构成医学、护理或其他专业医疗服务，包括医疗建议的提供。

This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice.

并未建立任何医患关系。

No doctor patient relationship is formed.

使用本信息及本播客所链接的材料，风险由用户自行承担。

The use of this information and the materials linked to this podcast is at the user's own risk.

本播客的内容不应用于替代专业的医疗建议、诊断或治疗。

The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

用户不应忽视或延迟寻求针对自身健康状况的专业医疗建议，应咨询其医疗保健专业人员以获得相关帮助。

Users should not disregard or delay in obtaining medical advice from any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions.

最后，我非常重视所有利益冲突问题。关于我所有的披露信息以及我投资或提供咨询的公司，请访问 peterattiamd.com/about，那里会保持一份最新且活跃的全部披露清单。

Finally, I take all conflicts of interest very seriously For all of my disclosures and the companies I invest in or advise, please visit peterattiamd.com/ about where I keep an up to date and active list of all disclosures.