contribute to cardiovascular disease, even the metabolic guys (guys like Bilken and his anti statin stance). The reality is it's a complex and interwoven process but no question insulin resistance and metabolic dysfunction plays a huge role.

Ultimately (imo) cardiovascular disease as well as the main things likely to kill you come down to 4 things and these are the 4 things our model targets using a relationship-based care model (cardiometabolic medicine is probably the best term for it)

1. Identify and treat your cardiac risk factors -> lipids, blood pressure, etc
2. Identify and treat the insulin resistance pathway -> IR, pre-diabetes, diabetes
3. Maintain and sustain an ideal body weight
4. Increase your strength and cardiorespiratory fitness (VO2 max)

If someone nails those 4 things in their 30s-40s and maintains that through their 50-60s, then that's their best bet at longevity.. 99% of the longevity medicine stuff is podcast nonsense imo. I do think Attia sums it up well though.