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What Makes You So Smart, Peter Attia?

Noah Davis talks to the president of the Nutrition Science Initiative about exercising way too much.
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In high school, Peter Attia planned to be a professional boxer. He trained for six hours a day, meticulously tracking his progress on a daily basis. A teacher altered his trajectory, and the Canadian ended up with undergraduate degrees in math and engineering, an M.D. from Stanford, a stint at McKinsey, and his current position as president and co-founder of the Nutrition Science Initiative. He still works out like crazy, too. Attia spoke with Pacific Standard about the value of intense exercise, the path from screw up to success, and why he doesn't read fiction.

Was there a time when you realized you were one of the smartest people in the room?
I'm probably different from most of the people you interview. I actually was not a great student in the traditional sense until my very last year of high school. In fact, I was pretty much a screw-up and really had no plans to go to college. My ambition was to become a professional boxer, and that was all I pursued. Most of my teachers varied somewhere between thinking I was a complete idiot and, on the positive side, someone who had potential but wasn't living up to it.

That changed for me in grade 12 when I had a really great teacher who got me to reconsider my decision to not go to university. I had a complete 180 and set all these outrageous goals about graduating first in my class and graduating first in my class at university. Even though I went on to do all those things, I never actually had the feeling that I was the smartest guy in the room. I always had the feeling that I was going to outwork everybody two-to-one. In undergrad, I did two degrees—math and mechanical engineering—simultaneously. The summer before my freshman year, I bought all the textbooks for math and physics and did them on my own. When we were in class, I got to do it for the second time. I did the same thing the next summer. I felt like I was really lucky because I got to do every course in college twice and, therefore, I got to do it at a much deeper level than my classmates.

You must have some innate ability, though. Math and mechanical engineering aren't the easiest disciplines. Did you think of yourself as a smart person?
I think I was really lucky in that despite all of my flails growing up, my parents just consistently told me how smart I was. When I was a kid, I had an IQ test, and I tested very high. For a year when I was seven or eight, I was put into a program for gifted kids. I think two kids from every school in Toronto were pulled out one day a week to go to this special school. My mother described it as the most wonderful educational experience I had in school. I don't remember it much to be honest with you, but when the program folded and I was put back into regular school, it sounds like I got a little bored.

But I remember that my mom and dad always made it clear to me that I was really smart and that I was my own worst enemy. You're probably right in that I had whatever innate tools anybody needed, but for whatever reason—probably insecurity—I actually gravitated toward this belief that I could outwork anybody. That really stemmed from boxing. That's where the desire to always outwork the opponent came in.

How close to becoming a professional boxer did you get?
I grew up in Canada, and we don't have a Golden Gloves tournament, so your typical path is being a top amateur, which is the Olympics, and then turning pro from there. My style of boxing was not suited to the amateur style. I was much more interested in being a professional boxer, so I trained much more as a professional. I trained with pros. I could have turned pro at any time, certainly by the time I was 18. Would I have been successful? Statistically speaking, no. I think I would have ended up pumping gas for the rest of my life. Becoming the middleweight champion of the world is akin to winning a lottery ticket. I would argue that I made the right choice by going to college instead.

Why did you choose mechanical engineering and math?
I was a little bit conflicted when I was leaving high school. I loved math just immensely, and I knew that engineering was basically an applied form of science. Those two things appealed to me, but I wanted to preserve the optionality. I suspected at the time that I wanted to do a Ph.D. in aerospace engineering, so I thought that the best path to get there would be to study mechanical engineering and applied mathematics. That way I could do a Ph.D. in applied math, a Ph.D. in any engineering discipline, or pursue aerospace. It was a really good fit for me. If I had just done engineering, I think I would have felt really unfulfilled. In engineering, you're not concerned with the theory of how the math came to be. You're just concerned with the answer. It's very practical. I think if I had just done mathematics, I would have been a little bit unfulfilled because I would have wanted to apply the theory to making a robot do x or y. In many ways, it was one of those rare experiences where the stars aligned and I couldn't have picked a better couple of subjects to study in my life.

Are you a planner? It sounds like you have very specific long-term goals and set smaller ones along the way to get there.
I think that was the only thing that allowed me to make the transition from wanting to be a professional boxer to wanting to be an engineering student. Even while I was training six hours a day, which is what I did in high school, I was relentless with my goals. I have no idea why—it's not something I observed in my parents—but starting about when I was 13, I would write down my goals on a piece of paper every day.

Back then, they were only physical goals. I broke the world of fitness into five categories: power, anaerobic fitness, aerobic fitness, flexibility, and muscular endurance. I had specific goals under each of those. I wrote them down every day on a large post-it and stuck it on my dresser. Each day, I would re-evaluate them. Some days I would write them out verbatim, but it was this process of always re-evaluating them. As new information became available, I would start to adjust the goals. I didn't realize it at the time, but that was Bayesian. In the Myers-Briggs scale, I'm pretty strong on all four of the dimensions that I choose, but I would say that none is stronger than my tendency toward being a J versus a P.

Do you still have very specific goals?
Yeah, I do. I'm still rubric-list about that kind of thing with myself. It's weird for people around me because you don't normally get a 40-year-old who is a normal, irrelevant guy pursuing something like he's training for the Olympics. It's sort of laughable. Nobody actually cares, but yet my coach and I email each other every day with my results from my workouts. What can I do better? It's kind of amazing.

"It actually wouldn't surprise me if the way that I exercise is doing more harm than good to me personally in the long term. It's quite likely. Maybe it's neutral. I don't know that it's healthy, but it's very difficult for me to go a day without doing that."

How about in your professional life?
It's less about me as a person and more about what I do now. Definitely for Nutrition Science Initiative, we're just incredibly metric driven. Even though we are a non-profit, we function more like a for-profit does in the sense that we ask our board to hold us accountable for things. We have very short-term goals that are largely not that interesting but something like in this quarter we want to raise this much money. Obviously, we have a major goal, an overarching goal, which is the reason I do what I do. That is returning the United States to a level of health and wellness that we believe is achievable, given that it was once achieved, if we could just figure out what people should be eating.

I've talked to a couple other people for this column who worked at McKinsey. They didn't love it. In some of your posts, you've written about what a positive experience it was. Can you talk a little bit about working there?
The McKinsey alums I talk to fall into three categories. Some alums say it was a horrible experience. I don't think there are too many of those. I think there are a lot of people in the middle bucket who didn't like it too much when they were there but are really glad they did it. I think there are people like me who are glad they did it and enjoyed every moment of it. I would say it was the professional highlight of my life. Certainly, it was the most amazing experience I've been a part of in terms of there being clarity about it being a meritocracy and a great system of values. For me, above all else, it was the most amazing mentorship experience you could have outside of a traditional apprenticeship. I left surgery to go to McKinsey. I loved my residency. There were many elements I didn't love or I wouldn't have left, but one of the things I did love was the feeling of mentorship. There were all these amazing surgeons at Johns Hopkins, which is the best hospital in the world, and this was my playground. I got to be trained by these people who mentored me. When I was leaving that, I was really worried that I wouldn't thrive in an environment where I didn't have that.

At McKinsey, I got to be a part of two practices, which was pretty usual for an M.D. Typically, M.D.s get absorbed into the health care practice, but I had the math background so I also got absorbed more heavily into the credit risk modeling practice. I'm working for banking clients. I'm the only doctor in the room, but that's irrelevant. What's relevant is that I can model Basel II credit risks well enough. And I'm getting mentored on both fronts. To this day, I'm still close with the two people who mentored me the most. One of them is a member of our board of directors at NuSI.

What do you read?
I read a lot, but I'm embarrassed to say that I haven't read a work of fiction since 1999.

What was it?
Fight Club. I made a conscious decision in medical school that I didn't have enough time to read fiction anymore. There were too many things I wanted to know, and I had to devote myself to non-fiction. It makes me sound like a heathen, but I am constantly cycling through non-fiction. Some of it is like textbook reading. The current book on my nightstand is by Dr. Richard Bernstein about diabetes. There are those kind of books where I'm trying to learn something very technical. Other books I tend to read are things that help me in life. Before that book, I read Delivering Happiness, which is written by Tony Hsieh, the Zappos founder.

Do you use fitness to clear your mind and help you think?
This might sound crazy, but I don't think there's any scientific evidence to suggest that the level of and intensity at which I go about doing exercise is healthy. It actually wouldn't surprise me if the way that I exercise is doing more harm than good to me personally in the long term. It's quite likely. Maybe it's neutral. I don't know that it's healthy, but it's very difficult for me to go a day without doing that.

I think there are three reasons why I have to be doing what I'm doing exercise-wise. The first is that being an introvert, I really crave silence and solitude. Even if it's two hours on my bike with my heart beating out of my throat, the fact that that's the only sound I hear is an amazing solace for me. The second is that it's another way for me to play this ridiculous game I play with myself of goals. It's a place where I can set goals and try to chase them down. I'm actually more obsessed with the process than I am the outcome. If you asked me for the last 10 goals I set and met, I would have a hard time remembering them, but I could certainly describe the processes. The third one is a neurochemical one. I do believe that there are some people, myself included, who really depend heavily on the endorphins and other neurotransmitters that are released when you exercise at a certain intensity. I think I'm a better person when I'm exposed to those endorphins than when I'm not.

Even if it's slowly killing you?
Yeah, probably. It's a cliché but I think it's more about the quality of our life than the length of our years. You could make the argument that maybe I could be smoking and get the same endorphins. [Laughs] I'll pick my poison. And I guess the poison I'm picking is intense exercise.

Who should I talk to next?
I can’t think of one “smartest” person I know. It’s sort of like, “best athlete” or something else. In the case of latter, it’s very sport specific. No one would attempt to compare Muhammad Ali to Babe Ruth to Michael Jordan to Wayne Gretzky to Eddy Merckcx, though each were arguably the best at what they did. But it I were to list out the smartest people I know, Denis Calabrese would be on the list. He's one of my closest friends, greatest mentors, and main provocateur.

What Makes You So Smart? is an ongoing Q&A series.