Behaviors

Recommended during alcohol reduction and for post-alcohol anxiety or stress. He refers broadly to behavioral, nutritional, supplement-based, and exercise-based tools for stress modulation that do not involve alcohol.

He cautions that aspirin, Tylenol, Advil, and related drugs can affect the liver, immune system, and gut microbiome, and may not be a great idea after drinking.

Avoid using alcohol to treat a hangover, as it may temporarily relieve symptoms but can delay recovery and worsen the hangover.

Maintain proper electrolyte levels before drinking. While drinking alcohol, drink water—preferably 2 glasses per alcoholic drink—and water with electrolytes is even better for helping the next day.

Recommended because different alcoholic beverages differ in expected hangover severity.

Absolute recommendation; no alcohol is considered safe during pregnancy.

Applies regardless of sex; based on alcohol increasing aromatization of testosterone to estrogen.

Get screened early in life; Attia specifically says even a 20-year-old should be checked. Include Lp(a), which is genetically determined, a major driver of atherosclerosis risk, and generally only needs to be checked once.

If a blood marker comes back looking bad, recheck it before reacting; blood tests are snapshots and may need confirmation.

When making interventions or monitoring changes, Attia says patients may check blood two to four times per year to see whether a drug or other intervention had the desired outcome.

Use body weight tracking between annual DEXA scans to get a sense of changes over time.

Use measurable targets such as VO2 max, strength, and stability when backcasting from desired late-life function.

Higher muscle mass is associated with much lower all-cause mortality compared with low muscle mass.

Strength is emphasized as even more important than muscle mass for lowering all-cause mortality risk.

Attia says people should not obsess over supplements or diet nuances until VO2 max is at least at the 75th percentile for age and sex.

Used as a strength benchmark; clinic standard is about 2 minutes at age 40 for both men and women.

If formal testing is unavailable, use online estimators based on running, biking, or rowing performance.

Used as part of strength and power assessment, including jumping off a box.

Exercise regularly for brain health and Alzheimer’s prevention; meaningful benefit requires more than minimal public-health recommendations. In the discussed context, increasing activity from sedentary to about 15 MET-hours per week—roughly three 1-hour brisk walks per week—was associated with about a 50% lower risk.

Attia prefers yearly endometrial ultrasound in women on HRT to monitor uterine lining.

Attia says women on HRT should be having a pap smear every year.

Attia sometimes has men cycle testosterone on and off; one example protocol given is 8 weeks on testosterone, then 8 weeks on HCG, alternating endogenous and exogenous support.

Do the real prehab and rehab work rather than relying on shortcuts. After shoulder surgery, dedicate about 1 hour to shoulder rehab 3–4 days per week.

To enable an earlier morning work block or add a third ultradian block, wake earlier and use hydration, caffeine, brief high-intensity exercise, and light exposure to shift the cortisol pulse earlier. Example exercise options given were 10-15 minutes of skipping rope, jumping jacks, or a brief jog. In his example, this could mean waking around 5:30 a.m.; if doing this consistently, also go to sleep earlier.

For bilingualism or trilingualism, earlier is better, ideally before age 12 if one hopes to avoid an accent later. Learning improves with more intense, immersive exposure over longer periods, but early exposure must be maintained or it can be lost. Real human interaction is preferred over passive recordings alone.

Better to address stuttering early in life when neuroplasticity is robust. Therapy is described as the typical route, including working through the problem and using strategies to create conditions that help words come out, especially for initiation-related stuttering involving difficulty starting the initial vowel or consonant.

Running or swimming are given as examples. The exercise is framed primarily as beneficial for mental state rather than physical reasons; missing it for even a day or two affects mood, performance, and interactions with others.

Nicotine is generally a bad idea before workouts or for enhancing physical performance because it impairs the neuromuscular state needed for coordinated movement.

A specific clinical hypnosis protocol can be used for smoking cessation; one session was described as producing complete cessation in about 23% of people.

Use one nicotine replacement method for about a week, then switch to another for about a week, then another; intended to vary nicotine absorption kinetics and reduce expectation of a fixed dopamine pattern.