Peter Attia· MD
I think the argument that it's it's too late almost fails on first principles when you just consider virtually every other intervention right if you take someone who has diabetes type 2 diabetes and you know you dramatically change the way they eat and exercise it's quite clear what you can do if you take someone who smokes I mean smoking might even be a better example because we have such longitudinal data on risk reduction as time of non-smoking increases after a period of smoking I mean those are that's actuary only mapped up the wazoo and that's a simple enough intervention that you can attribute it to it's actually a very similar intervention right because you would argue that in the individuals who stopped smoking they're more likely to make more positive health decisions for the simple reason that if I'm not going to smoke what else am I going to take seriously in my health and in the end for the purist who says I need a randomized prospective trial to demonstrate this one I don't think you're ever going to get it and I think the reason is we're really at the point where it's going to become unethical to do draconian studies of sleep deprivation or I don't even think it would be ethical to take to do a longitudinal study of depriving people with apnea of CPAP I think the evidence is so overwhelming that yet you're ethically going to be unable to do those things