The Peter Attia Drive will feature guests and experts that will offer advice and insight to help you optimize performance, health, longevity, critical thinking, and life. It’s hosted by Stanford M.D., TED speaker, and longevity expert Dr. Peter Attia, founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City.
#57 – Rick Rubin, legendary music producer: collaborating with sensitive psyche of greatest living musicians, and his personal story of weight loss and spiritual quest
In this episode, Rick Rubin, legendary music producer and co-founder of Def Jam Records and American Recordings, discusses his early foray into music production which started as a hobby as a teenager and ultimately turned into a Grammy award-winning career that produced revolutionary changes in the music industry. Rick has worked with the likes of the Beastie Boys, Red Hot Chili Peppers, and Johnny Cash, just to name a small fraction. Rick talks about the pain and suffering that sometimes drives music and the cycle of drug addiction and how he has been able to help artists through those struggles to make space for their creative genius. We also get into Rick’s own personal health journey including his battle with depression, his struggle with obesity, and ultimately his extraordinary transformation. Finally, Rick shares a really significant health scare which required emergency heart surgery, and how that experience has impacted him. We discuss: Early career, and the birth of hip hop [7:15]; Early success of Def Jam Recordings, and working with LL Cool J [13:15]; Revolutionary changes in music: LL Cool J, Beastie Boys, and Run DMC [19:30]; Partnership with Columbia Records, and leaving Def Jam [26:45]; The success of Licensed to Ill: how it took off, and how it changed things [36:00]; American Recordings: Rick’s transition to rock and roll [39:15]; Working with the Red Hot Chili Peppers, and the poetic nature of music [45:45]; Rick’s favorite music that he did NOT produce [53:00]; Prevalence of drug use and emotional pain in musicians: Rick’s experience with helping artists through their struggles [57:20]; NYC vs. LA hip hop [1:05:30]; Rick’s battle with depression [1:10:00]; Coping with the death of artists that Rick worked with [1:22:00]; Working with Johnny Cash [1:26:45]; Working with Rage Against the Machine [1:34:30]; The digital age of music: Have we lost something? [1:37:45]; Rick’s health journey and battle with obesity [1:42:45]; Radical weight loss: How Rick was finally able to shed the weight [2:00:15]; Total transformation: Exercise and training with Laird Hamilton [2:11:00]; Emergency surgery: Rick’s frightening heart condition [2:25:30]; Methylene blue and exogenous ketones: Are they neuroprotective? [2:46:15]; The most profound thing Rick learned about himself from his heart condition and major surgery? [2:52:30]; What life lessons does Rick wish to impart on his son? [2:57:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#56 - Jocko Willink, retired Navy SEAL, Part II of II: Sleep, fasting, raising kids, discipline, taking ownership, and the impact of war
In the second installment of this 2 part series, Jocko shares his sleep routine and attitude towards sleep, we talk about his meals (and occasional indulgences), his experience with fasting, and touch briefly on his workout routine. Jocko explains his approach to leading a family, instilling values in his kids, and working with others who may not share your same principles. We also find out what prompted Jocko to make discipline the underpinning principle of his life, when it might make sense to quit, and the philosophical topics such as free will, mindset, and whether or not you can change someone. We also discuss 9/11 and the war in Iraq and Afghanistan, the future of warfare, and perhaps more importantly, how Jocko’s experience in combat has shaped and impacted his life to this day. We discuss: Where was Jocko when the 9/11 attack occurred? What did he think? [5:45]; How SEAL teams are structured, and which teams Jocko was on [10:45]; War in Afghanistan: Unique challenges, how it differs from Iraq, and the lessons learned [13:00]; Iraq War: Differing public opinions on war, Jocko’s experiences in Iraq, strategic mistake of ISIS, and the Saddam regime [19:15]; The future of warfare: machine technology in war and medicine [27:30]; Raising kids, instilling values, and leading a family [33:45]; Sleep: Jocko’s habits, routine, and attitude towards sleep [40:15]; When it makes sense to quit [53:30]; What makes Jocko different, the existence of free will, and whether or not you can change people [1:01:45]; How to work with people with a bad attitude and opposing mindset [1:07:45]; Does Jocko ever indulge? Favorite foods and treats [1:11:00]; Fasting and meal timing [1:16:30]; Olivia (Peter’s daughter) interviews Jocko [1:21:45]; What prompted Jocko to start prioritizing discipline in his life? [1:22:15]; What does Jocko do in his workouts? [1:23:30]; Where did the nickname, Jocko, come from? [1:24:20]; Jocko’s favorite book, his best advice, and secret to getting up early [1:25:50]; The impact that war had on Jocko [1:28:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#55 - Jocko Willink, retired Navy SEAL, Part I of II: objective, strategy & tactics, leadership, protocols, dealing with death, and applying the many lessons learned from war
In part 1 of this 2 part series, Jocko Willink, retired Navy SEAL, discusses some of his most important lessons learned from his time commanding some of the world’s most expert special forces operators including the importance of understanding the objective and strategy (and then tactics) of a mission, why humility is the greatest trait a leader can have (and certain times when it’s not), as well as the necessity of having proper protocols in place to deal with whatever comes your way. We also talk about how Jocko prioritizes his military and family obligations with his love for jiu-jitsu, as well as how to decipher what really matters in life. Finally, we go through the US history with respect to various wars from World War I, all the way forward, and much much more. We discuss: Objective, strategy, and tactics [6:00]; Training compared to actual combat [20:30]; The importance of humility in leadership, business, and life [33:00]; The dichotomy of human traits: Can you be too humble? [49:00]; Why many leaders lack humility [52:30]; Why Jocko wanted to be a Navy SEAL [55:00]; Jocko’s attitude toward death, and dealing with the death of a soldier [58:45]; The vital importance of protocols [1:03:45]; Protocol for losing a child (or anyone close to you) [1:15:00]; Protocol for getting dumped, and some relationship advice [1:18:00]; How to differentiate between things that matter and things that don’t [1:24:30]; Jocko shares his experience during BUD/S [1:35:45]; How Jocko prioritizes his family and SEALs obligations: Would Jocko come out of retirement and go back to war? [1:48:30]; America’s lost sense of connectedness and purpose since WWII [1:59:00]; How warfare has evolved over the decades since WWI [2:05:40]; Obeying orders and the obligation to dissent [2:09:00]; WWI and WWII, the beginnings of “decentralized command” [2:15:00]; The American warrior mentality, and the impact of freedom on a society [2:20:45]; What impact can an individual president really have? [2:25:00]; The Korean war [2:29:15]; Lessons learned from Vietnam [2:31:10]; First Gulf War, Iraq War, and The War in Afghanistan [2:35:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram. In part 1 of this 2 part series, Jocko Willink, retired Navy SEAL, discusses some of his most important lessons learned from his time commanding some of the world’s most expert special forces operators including the importance of understanding the objective and strategy (and then tactics) of a mission, why humility is the greatest trait a leader can have (and certain times when it’s not), as well as the necessity of having proper protocols in place to deal with whatever comes your way. We also talk about how Jocko prioritizes his military and family obligations with his love for jiu-jitsu, as well as how to decipher what really matters in life. Finally, we go through the US history with respect to various wars from World War I, all the way forward, and much much more.
#54 – Kevin Sayer, CEO of Dexcom: Continuous glucose monitors – impact of food, sleep, and stress on glucose, the unmatched power of CGM to drive behavioral change, and the exciting future of CGM
In this episode, Kevin Sayer, CEO of Dexcom, discusses the remarkable benefits of a continuous glucose monitor for the diabetes population. Peter shares his own invaluable insights he’s learned from wearing a CGM including the impact of sleep and stress on glucose as well as the unmatched power of a CGM to drive behavioral change. Kevin also reveals some of the exciting partnerships and future advancements of their products benefiting not only those with type 1 and 2 diabetes, but also for the growing community of people interested in optimizing health and wellness. We discuss: How they met, and Kevin’s path to becoming CEO of Dexcom [7:00]; How CGM technology works, and what makes Dexcom’s G6 the best model yet [15:15]; Challenges of working in the US healthcare system and getting CGM insured [21:45]; Developing an even smaller, more user-friendly, and less costly product while maintaining performance and accuracy [33:15]; Next thing on the horizon for type 1 diabetes patients [43:30]; The incredible accuracy of the G6, recommended over-the-counter glucose meters, and the unmatched power of CGM to drive behavioral change [48:15]; Software improvements for type 2 diabetics, and the remarkable benefits of real-time feedback for driving behavioral change [58:15]; Dexcom vs. the competitors, the less invasive options, and the fundamental problems needing to be solved with CGM technologies [1:07:00]; The cost of CGM, why you need a prescription, and when might there be a OTC option? [1:12:00]; Smartwatch integration, bluetooth technology, and exciting collaborations and partnerships [1:22:00]; Future places for CGM: Hospitals, nutrition apps, general health and wellness, and more [1:27:15]; Dexcom’s unique company culture [1:34:15]; Parenting advice from Kevin [1:37:30]; Lessons learned through failures and success [1:38:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#53 - AMA #6: Fasting framework, vitamin supplementation, antioxidants, time management, problem-solving, and more
In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from readers and podcast listeners. Bob Kaplan, Peter’s head of research, asks the questions. If you’re listening on a podcast player, you’ll be able to hear a preview of the AMA. If you’re a subscriber, you can watch or listen to this full episode on our website at the AMA #6 show notes page. PLEASE NOTE: We are currently building a private RSS feed that will allow subscribers to listen uninterrupted on the podcast player of their choice. This will be released shortly. Questions are pulled from the AMA section on the website (peterattiamd.com). Any subscriber is welcome to submit questions. We discuss: Vitamin supplementation: Is it necessary if you eat a balanced diet? [2:00]; Antioxidants: What does current science have to say about antioxidants in food and supplements? [9:00]; How do you break a fast of more than three days? [17:15]; Does a morning black coffee break a fast? In other words, does black coffee raise insulin levels? [22:15]; When intermittent fasting, does the placement of the “feeding window” matter? [25:30]; Is it better to fast before or after a planned food binge (e.g., Thanksgiving)? [28:30]; Fasting protocol: Do you have a specific protocol to recommend? [31:30]; Time management: How do you manage your time between work, family, and your many personal interests? [35:45]; Problem solving: Can you breakdown your process of problem-solving? [46:45]; For those looking to gain a better understanding of biochemistry, pharmacology, etc., do you have any good textbooks or (online) resources to recommend? [49:00]; What are some of your favorite podcasts that you listen to? [51:15]; What is your favorite animal? [54:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#52 - Ethan Weiss, M.D.: A masterclass in cardiovascular disease and growth hormone - two topics that are surprising interrelated
In this episode, Ethan Weiss, Hopkins trained preventative cardiologist at UCSF, discusses two topics that on the surface may seem unrelated which is cardiovascular disease, and the role of growth hormone and IGF in disease. Ethan provides a masterclass in everything from acute coronary syndrome to all of the complex nuances around stent placement, as well as how calcium scores and results from CT angiograms shape his treatment of patients. He also shares how his idea to study the sex differences in blood clotting as it relates to coronary disease lead him to pursue the field of endocrinology, and specifically what he found with respect to the effect of growth hormone and IGF on the liver, the brain, and overall human longevity. We discuss: Mutual love for hockey [7:15]; Ethan’s background and interest in cardiology [13:15]; Clinical definitions of a heart attack, clotting, and plaque: What causes the acute event? [24:15]; Defining coronary disease and myocardial infarction: The evolving nomenclature [32:00]; What happens when someone comes to the ER with a STEMI (ST elevation myocardial infarction)? [47:15]; Stents [54:45]; Treatment protocol for both acute and chronic coronary artery disease: History, controversy, and important distinctions [1:06:30]; Using stents to treat stable angina: What we learned from the COURAGE AND ORBITA trials [1:15:30]; The “art” of longevity: The challenge of preventative medicine and understanding risk [1:31:45]; Understanding CAC scores, and CT angiogram results [1:40:15]; How sex differences in clotting and heart disease got Ethan interested in growth hormone and IGF [2:01:00]; Impact of growth hormone on the liver [2:07:00]; Growth hormone and insulin sensitivity [2:18:00]; The role of GH and IGF on chronic disease and cancer [2:23:30]; Will taking growth hormone promote longevity? [2:32:30]; GH and IGF as a treatment for early stage dementia? [2:34:30]; What happens to IGF while fasting and what about fasting improves longevity? [2:35:15]; The importance of becoming scientifically literate and making science more exciting for future generations [2:38:30]; Ethan’s new company: Keyto [2:43:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
The Ayrton Senna Episode (re-release): Celebrating the greatest driver in Formula 1 history and the cautionary tales of driven individuals
To celebrate the life of the legendary Formula 1 driver Ayrton Senna, 25 years to the day of his tragic death, we are re-releasing this bonus episode. In this episode, Peter and med school colleague (and brilliant psychiatrist) Paul Conti reminisce on their favorite moments in Formula 1 history, their deep admiration for the late Ayrton Senna, and the remarkable careers of their favorite drivers. Paul also helps to illuminate the psychological components that made the luminary drivers great, and the cautionary lessons we can take from their incredible lives. We discuss: Who is Ayrton Senna? [3:47]; How Senna’s death changed the sport [9:52]; The 80s & 90s: a remarkable era of Formula 1 [12:57]; Hypothesizing what caused Senna’s fatal crash [17:47]; Comparing Stewart and Senna, their incredible bravery, and what lessons we can learn from them [23:32]; Best documentaries on racing, and some of Senna’s best moments [31:02]; Gilles Villeneuve, Stefan Bellof, and some of the other greats [39:17]; Why Senna is widely acknowledged as the best of all time [46:17]; Great rivalries and personalities [49:32]; Rendezvous, a high-speed drive through Paris [56:52]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#51 - Robert Sapolsky, Ph.D.: The pervasive effect of stress - is it killing you?
In this episode, Robert Sapolsky, Ph.D., discusses the widespread impact of stress on our physical and emotional health as well as the mechanisms by which it can precipitate chronic illness, dementia, depression, and more. He also provides insight into the factors that contribute to the stress response (and our ability to handle it) such as social rank, personality, environment, and genetics. Lastly, we discuss how our behavior is altered in the face of stress and how that not only has a pervasive effect on a personal level, but also on society as a whole in how we interact with each other. We discuss: Background, interest in stress, and Robert’s time in Kenya studying baboons [7:00]; Physiology of a stress response, and why it’s ingrained in our DNA [14:00]; Individual variation in the response to stress, and how everyone has a different optimal level [24:00]; How social rank and personality differences affect our stress response [30:15]; What’s happening in the brain when faced with stressful situations? [39:15]; What makes the human brain different than all other species? [48:15]; Imprinting stress to your kids epigenetically [52:00]; The role of stress on memory and the consequences of hypercortisolemia [57:15]; The impact of subjective socioeconomic status and social media on stress levels and health [1:01:45]; Tips for managing stress in the modern world [1:17:45]; What Robert learned about himself studying the social behavior of baboons [1:29:30]; The multilayered factors behind every human behavior, the context of “good and bad,” and exploring the human capacity of the wild extremes of violence and altruism from moment to moment [1:34:30]; PMS: How two women with identical hormone levels can have completely different emotional experiences [1:39:00]; How much of a role do genes play in depression and other emotional states? [1:42:45]; Why is cortisol elevated under sleep deprivation? [1:50:15]; The impact of stress on cancer [1:54:30]; The impact of stress on atherosclerosis, dementia, addiction, and depression [2:01:15]; Impulsiveness, impaired judgement, and lack of empathy in times of stress [2:05:45]; What advice would Robert give his 25-year-old self? [2:12:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#50 - AMA #5: calcium scores, centenarian olympics, exercise, muscle glycogen, keto, and more
In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from readers and podcast listeners. Bob Kaplan, Peter’s head of research, asks the questions. If you’re listening on a podcast player, you’ll be able to hear a preview of the AMA. If you’re a subscriber, you can watch or listen to this full episode on our website at the AMA #5 show note’s page. PLEASE NOTE: We are currently building a private RSS feed that will allow subscribers to listen uninterrupted on the podcast player of their choice. This will be released shortly. Questions are pulled from the AMA section on the website (peterattiamd.com). Any subscriber is welcome to submit questions. We discuss: Coronary calcium score: what it means and how to interpret your results [1:15]; How to train for the “centenarian olympics” [18:00]; Explaining the blood glucose response to various types of exercise [35:30]; The Tabata protocol [43:15]; Exercising on a ketogenic (or low-carb) diet: performance, muscle glycogen, adaptation, and more [49:30]; The work of Dr. Gabor Maté and its impact on Peter [54:15]; What's the best book you've read in the past year? [55:45]; What is “pattycakes?” [59:00]; What is the latest and greatest of egg boxing [59:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#49 – Matthew Walker, Ph.D., on sleep – Part III of III: The penetrating effects of poor sleep from metabolism to performance to genetics, and the impact of caffeine, alcohol, THC, and CBD on sleep
In the final part of this 3 part series, Matthew Walker, professor of neuroscience at UC Berkeley and expert on sleep, discusses the omnipresent effects of insufficient sleep on everything from metabolism, appetite, athletic performance, decision-making, productivity, leadership, mental health, genetics, memory, and more. We also discuss the impact of caffeine and alcohol on sleep quality, the efficacy of sleep aids such as THC and CBD, and much more. We discuss: Sleep and insulin resistance [6:15]; Epigenetic changes with insufficient sleep, and the reversibility of lost sleep [18:00]; Sleep’s impact on exercise performance, appetite, and food choices [28:15]; Decision making, workplace production, leadership qualities, physical attractiveness, and more [43:15]; The broken water pipe analogy [49:30]; The negative effect of caffeine, alcohol, and high carb meals on sleep quality [53:30]; The efficacy of THC and CBD as sleep aids [1:05:30]; Sleep and mental health: A two-way street [1:16:45]; How sleep impacts memory, and Matthew’s current and upcoming projects [1:24:00]; Sleep’s impact on athletes: Looking at Formula One drivers [1:32:45] Translating the science to clinical application [1:57:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#48 – Matthew Walker, Ph.D., on sleep – Part II of III: Heart disease, cancer, sexual function, and the causes of sleep disruption (and tips to correct it)
In part 2 of this 3 part series, Matthew Walker, professor of neuroscience at UC Berkeley and expert on sleep, describes the preponderance of evidence linking poor sleep to cardiovascular disease, cancer, and sexual function. He also details the impact of cortisol on our nervous system contributing to sleep disturbances and insomnia as well as the efficacy and risks associated with the most common sleeping pills. Matthew also describes the sleep needs of teenagers and urgently lays the case that we should reconsider school start times. We also get into the effect of electronics at night, the efficacy of napping, the general impact of modern society on our sleep habits, and what changes we can make to course correct. We discuss: Sleep and cardiovascular disease [6:00]; Fuel partitioning and dieting while sleep deprived [16:45]; Sleep and the reproductive function: testosterone, sperm count, FSH, menstrual cycles, and fertility [19:45]; The biological necessity of sleep, the lack of a “safety net”, sleep debt, and ways to course correct sleep problems [23:45]; Fighting cancer and improving immune function with sleep [34:30]; The medical profession: A culture that devalues sleep [47:30]; The sleep needs of children, the travesty of early school start times, electronics at night, and advice for parents [1:04:45]; How exposure to light affects sleep, and how modern society has changed our sleep habits [1:26:15]; Is napping helpful? [1:36:00]; The effect of cortisol levels on sleep [1:41:15]; Are sleeping pills doing more harm than good? [1:52:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#47 – Matthew Walker, Ph.D., on sleep – Part I of III: Dangers of poor sleep, Alzheimer's risk, mental health, memory consolidation, and more.
In part 1 of this 3 part series, Matthew Walker, professor of neuroscience at UC Berkeley and expert on sleep, describes the different stages and cycles of sleep, including what he calls the 4 pillars of sleep, and how they contribute to memory consolidation and numerous important pathways to mental health. We also get into the dangers of chronic sleep deprivation, such as the development of dementia, and the more acute dangers of sleep deprivation like fatal car crashes which are most often caused by drowsy driving. We also discuss the different and important roles of REM vs. non-REM sleep, and the impact that bad sleep habits can have specifically on those sleep stages. We discuss: Matthew’s background and interest in sleep [6:03]; Sleep and Alzheimer’s disease, and the 4 pillars of sleep [12:18]; Stages of sleep, sleep cycles, and brain waves [41:18]; Memory and sleep, and the risk of insufficient REM sleep [55:48]; Evolutionary reasons to sleep [1:02:03]; The early riser vs. the night owl, and tips for overcoming jet lag [1:10:18]; Is there one type or stage of sleep that is most important? [1:17:33]; The dangers of drowsy driving [1:28:48]; The timeliness of Matthew’s book, and how the conversation of sleep has changed over the past several years [1:35:18]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#46 - Chris Masterjohn, Ph.D.: Navigating the many pathways to health and disease - NAD and sirtuins, methylation, MTHFR and COMT, choline deficiency and NAFLD, TMAO, creatine, and more
In this episode, Chris Masterjohn, entrepreneur, independent researcher, and doctorate in nutrition, elucidates the latest research on the risk and benefits of NAD supplements, and shares his personal intuition on the topic. We also dive deep into choline deficiency and its role in the rising prevalence of nonalcoholic fatty liver disease. From there, Chris enlightens us on the importance of methylation, a simple yet profoundly important biochemical process affecting our physical and mental health. He also describes the variations of the genes MTHFR and COMT, enzymes which play important roles in methylation and which have profound impacts on our well-being. We discuss: Chris’s background, falling in love with biochemistry, and decision to pursue research over medicine [7:45]; Choline: what it is, why it is important, and how a deficiency can cause non-alcoholic fatty liver disease [11:45]; NAFLD: increasing prevalence and potential causes [25:00]; TMAO: Should we be worried about the TMAO content in choline and our foods? [39:15]; Types of fatty acids: How they may predispose us to different types of illnesses [53:30]; Why don’t we see low VLDL in patients with NAFLD? [59:45]; Understanding flux, and how machine learning may affect medicine in the near future [1:03:15]; NAD: How it works, supplements, sirtuins, and the central role of the liver [1:09:30]; Intravenous NAD [1:33:00]; Oral NR: Is it the optimal way to get more NAD? [1:38:30]; What is the possible harm of taking an NAD precursor? [1:47:15]; The MTHFR gene [1:49:45]; The methylation pathway [1:58:15]; The COMT gene [2:04:30]; Creatine: The uses and benefits and its important role in methylation [2:10:15]; Dietary strategies for MTHFR: choline, creatine, folate, and glycine [2:16:45]; How to mitigate the negative effects of NAD supplements [2:23:45]; A case study of a person with high homocysteine [2:28:00]; What is the level of evidence that you need to take action? [2:32:15]; Does Chris supplement with NAD precursors? And can it improve symptoms of rosacea? [2:35:45]; Decision making in the face of inconclusive data, and trying to disentangle the placebo effect [2:39:00]; What does Chris believe to be true that very few people would agree with him about? [2:43:15]; How to follow Chris’s work [2:48:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#45 - AMA #4: sleep, jet lag protocol, autophagy, metformin, and more
In this “Ask Me Anything” (AMA) episode, the first subscriber-only edition, Peter answers a wide range of questions from readers and podcast listeners. Bob Kaplan, Peter’s head of research, asks the questions. As a reminder, AMAs are for subscribers only. If you want to subscribe, you can learn more about the benefits at https://peterattiamd.com/subscribe. If you are a subscriber, you can watch or listen to this in full on the show notes portion of our website. If you are listening to this on a podcast player, you will hear a sneak peek of this AMA and then will have to finish listening or watching on the website. All questions are pulled from the AMA section on the website (https://peterattiamd.com/ask-me-anything/). Any subscriber is welcome to submit questions. We discuss: Blue light blockers and how they improve sleep [1:30]; How to minimize jet lag and sleep disruption while traveling [6:45]; How to treat symptoms of PMS, the female hormone cycle, testosterone in women, and estrogen in men [15:45]; Autophagy: what it is, why it matters, and how can we enhance it [26:15]; The two-minute drill (and a bonus Patriots and Tom Brady tangent) [41:15]; Has Peter thought about having CME accredited content for people in the medical field? [44:15]; How does one find good doctors that are somewhat up to date on the latest research, primary care, etc.? [45:45]; What values would Peter be interested in monitoring continuously if the tech existed? [47:15]; How to annoy Peter [49:15]; If I'm interested in longevity, should I do a Ph.D. or M.D.? [50:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#44 - Jeremy Schaap, ESPN journalist: upsets, doping, triumphs, and the importance of sports
In this episode, Jeremy Schaap, preeminent journalist at ESPN, discusses two of the most incredible upsets in boxing history, both of which Jeremy has expertly covered during his illustrious career, most recently culminating in the 30 for 30 special, 42 to 1. We also discuss his infamous Bobby Knight interview, his coverage of the doping scandals in baseball and cycling, as well as the pressures of following in his father’s enormous footsteps who taught him the importance of fairness in journalism. Additionally, we discuss the deeper meaning of sports, what it teaches us, and how he uses sports as a platform to bring light to greater societal issues. We discuss: Jeremy and Peter’s shared obsession with boxing history [5:15]; Cinderella Man: The incredible upset of Max Baer by James Braddock, and the rise of the great Joe Louis [9:00]; 42 to 1: Buster Douglas beats Mike Tyson for one of the most unlikely upsets in the history of sports [23:30]; Contrasting fighting styles from “destroyers” to “artists”, and comparing the auras of the all-time greats [36:30]; Mike Tyson’s take on the Douglas fight, what went wrong for Buster Douglas following his victory, and other incredible upsets in sports history [45:30]; Ranking the greatest boxers since the 1960s [54:00]; Jeremy’s famous Bobby Knight interview: A career defining moment [57:00]; The pressures of following his father’s career path, and what it means to be a fair journalist [1:01:30]; The meaning of sports: how it brings us together and gives us a platform for bigger discussions [1:11:00]; Jeremy’s biggest regret in reporting, the 1998 home run chase, and the doping scandals of baseball and cycling [1:17:30]; The biggest and most underreported stories in sports [1:26:45]; Best 30 for 30 episodes: Jeremy and Peter pick their favorites [1:31:30]; Baseball: Steroids and the hall of fame [1:34:30]; Final thoughts on what makes sports so special [1:37:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#43 - Alan Bauman, M.D.: The science of male and female hair restoration - how to protect, enhance, and restore the appearance and health of the hair and scalp
In this episode, Alan Bauman, certified hair transplantation surgeon and hair restoration expert, discusses both male and female pattern hair loss, the science behind what drives it, and what that tells us about prevention and restoration. Having treated over 20,000 patients, Alan shares his invaluable insights into what works and what doesn’t in terms of the non-surgical treatment options. We also go into great detail about the more invasive approaches like PRP, and of course, hair transplantation, a procedure which Alan has refined over the years into a proprietary method that seems to produce unbelievable results. Additionally, Alan provides tips for maintaining scalp health, which is vital for hair growth, as well as the importance of choosing a hair specialist who has the tools, expertise, and patience to develop a compassionate and encompassing approach to hair restoration. We discuss: Alan’s unique path, and how he became interested in hair transplantation [7:15]; The prevalence of hair loss, types of hair loss, and the different patterns in men vs. women [15:45]; The role of genetics in hair loss, and when does it start [19:00]; Female hair loss: the role of hormones, pregnancy related hair loss, and what it means to have thinning and shedding [22:30]; Primary drivers of male hair loss, finasteride as a treatment, and the potential side effects [26:15]; Common treatments - Proscar, Propecia, Rogaine, and more - how they all came about and what you need to know [29:45]; Primary drivers of female hair loss, potential treatments, and the different types of hair follicles [33:15]; What are some of the unproven/snake oil methods of hair treatments being pushed to the public? [37:15]; Preventative steps to take if you’re worried about future hair loss [42:00]; Medications that may negatively affect hair quality [45:30]; The importance of seeing a hair specialist [47:15]; Impact of scalp health and inflammation on hair growth, how to pick and apply shampoo and conditioner, and how to avoid and treat hair breakage [50:15]; Treatment options - finasteride, minoxidil, laser caps - how they work and what you need to know [57:15]; PRP treatment: How it works, details of the procedure, and Alan’s proprietary protocol [1:11:45]; The hair transplant procedure [1:29:30]; Risks involved with a hair transplant procedure [1:44:00]; Is a donor hair susceptible to the forces of the implant site that caused the hair loss? Can a hair follicle grow anywhere on the body? [1:47:45]; Age appropriate procedures, how far the field has come, and why Alan loves his work [1:51:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#42 - Avrum Bluming, M.D., and Carol Tavris, Ph.D.: Controversial topic affecting all women—the role of hormone replacement therapy through menopause and beyond—the compelling case for long-term HRT and dispelling the myth that it causes breast cancer
In this episode, Avrum Bluming, hematologist, medical oncologist, and emeritus clinical professor at USC and Carol Tavris, social psychologist and author of Mistakes Were Made (But Not By Me), discuss their collaboration on their recent book, Estrogen Matters. Their book takes on the very polarizing and confusing topic of hormone replacement therapy for women suffering with symptoms of menopause. In many ways, the story and history of HRT is in striking parallel to the bad science that led up to the dietary guidelines being set forth in 1980. Carol and Avrum make a compelling case that most women benefit greatly from being on postmenopausal hormone replacement therapy, and can do so without increasing their risk of breast cancer. We also cover the history of HRT, the impact of the Women's Health Initiative, and take a deep dive into each of the clinical conditions for which HRT should be considered, such as cardiovascular disease, neurodegenerative disease, and osteoporosis, to name a few. We discuss: The background of Carol and Avrum, and the impetus for writing Estrogen Matters [8:45]; The sad early history of hormone replacement therapy, treatments for prostate and breast cancer, and the difference between the treatment of women vs. men [14:00]; What hormones do, and why they drop off rapidly in women compared to gradually in men [20:15]; Mistreatment of women leading to great skepticism [23:45]; Breast cancer vs heart disease: Comparing the incidence and mortality in women [27:00]; Case studies of women suffering symptoms of menopause [30:00]; What are Carol and Avrum’s true motivations in this endeavor? [32:45]; The changing perceptions of HRT, the impact of the Women’s Health Initiative (WHI), and the problems with the WHI [37:45]; Is this one big conspiracy? The uncanny resemblance of the story of HRT and how the dietary guidelines were created [46:00]; Why people (falsely) think estrogen causes a 25% increase in breast cancer, and a lesson in absolute vs. relative risk [57:15]; The truth about progesterone and cancer risk, and the best types of estrogen and progesterone to be taking [1:09:00]; The Women’s Health Initiative: the reported findings, walking back their bold claims, and their hesitance to admit they were wrong [1:17:45]; Brain benefits of HRT, Alzheimer’s disease in women, and estrogen as a preventative treatment for AD [1:22:45]; The impact of HRT on heart disease, the ideal time to start HRT, and the risks associated with HRT [1:26:45]; The benefits of estrogen on bone health, and the incidence and mortality of hip fractures [1:33:15]; Colon cancer: Can HRT reduce the risk of colon cancer? [1:38:15]; Diabetes: Can HRT reduce the risk of developing diabetes? [1:40:30]; The downsides of hormone replacement therapy (HRT) [1:41:30]; How to approach your doctor who may already have a very strong point of view about HRT [1:42:15]; What kind of research needs to be done to answer the remaining questions about the benefits and risks of HRT? [1:48:30]; Cancer: Our evolving understanding and the future of treatment [1:59:15]; Welcoming the critics: Avrum and Carol want to start a conversation [2:02:00]; Are there racial differences in benefits and risks with HRT? [2:04:15]; The reactions to Estrogen Matters, and why it is a must read [2:09:15]; HRT after a diagnosis of breast cancer [2:13:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#41 - Jake Kushner, M.D.: How to thrive with type 1 diabetes and how everyone can benefit from the valuable insights
In this episode, Jake Kushner, pediatric endocrinologist specializing in helping people with type 1 diabetes, discusses the best strategies to live and thrive with T1D, especially as it relates to diet and exercise. We also discuss why many patients who control their blood sugar with high amounts of exogenous insulin are at a substantially higher risk than people who can control their blood sugar at lower levels of insulin. This concept has great implications for non-diabetics as well considering the increasing prevalence of diseases related to insulin resistance. We also cover some of the basics, the history, the increasing prevalence of type 1 diabetes, and more importantly, what we can do to help kids with this disease, and their families. We discuss: How Jake became interested in type 1 diabetes [5:30]; The pathophysiology of type 1 diabetes, the increase in prevalence, and the role of beta cells [17:00]; The role of body weight and BMI in the risk of developing T1D [27:00]; Genetics of T1D and the risk of inheritance [32:00]; Hemoglobin A1c [36:15]; Insulin: the amazing story of its discovery, its effect on cellular metabolism and IGF-1, and why the hell it’s so expensive [39:15]; Diabetes Control and Complication Trial: blood glucose and the complications associated with diabetes [54:45]; Cognitive impairment, epigenetic changes, and other dangers associated with high, peak blood glucose, and big swings in blood glucose levels [1:09:15]; Depression, anxiety, and other challenges of living with T1D [1:15:30]; Jake’s realization that the current standard of care of T1D is inadequate [1:26:15]; Managing diabetes with exercise [1:30:15]; The Bernstein method, and protein’s impact on glucose and insulin [1:36:15]; Jake radically changes his approach to treating patients [1:45:00]; What other tools are there for controlling T1D? [1:49:45]; Is the ketogenic diet appropriate for those with T1D? [1:52:45]; The most important lessons that can be applied by the non-diabetic population [1:59:00]; The two dream measurements Peter wishes were available [2:04:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#40 - Tom Catena, M.D.: The world’s most important doctor – to nearly a million patients – saving countless lives in the war-torn and remote villages of Sudan
In this episode, Tom Catena, a missionary physician who runs Mother of Mercy Hospital in the Nuba Mountains in Sudan, describes some of his extraordinary work as the only doctor in a remote, war-torn region of Africa. In terms of individual lives saved, you could argue that there is no other person on the front lines doing more than Tom. Additionally, we explore the manner in which the Nuba people die, which is in striking contrast the ubiquity of chronic disease and self-harm in the west, despite the extreme poverty and unimaginable suffering experienced by the Nuba people. Lastly, we discuss the lessons to be gleaned from the Nuba people, who despite their suffering, live so harmoniously, happily, and resiliently. To support Tom’s mission please visit www.amhf.us. We discuss: Background, medical training, and early days of missionary work in Africa [9:00]; Tom arrives at Mother of Mercy Hospital in the Nuba Mountains of Sudan, civil war breaks out, and his staff evacuates [15:45]; Learning surgery on the job and earning the trust of the community [40:45]; The amazing people of Nuba, and why Nuba feels like home to Tom [51:30]; NY Times article about Tom’s work, and Tom’s new venture on the board of Aurora Prize Foundation bringing awareness and funding to other missionaries doing great work [1:03:30]; Tom’s mind-blowing ability to deal with chaos while seeing hundreds of patients per day [1:15:45]; The most afraid Tom has ever been, and how he copes with the emotional trauma of his daily experiences [1:23:30]; The basic tools, technologies, and medicines that Tom is lacking that could save many lives [1:33:30]; The logistical challenge of helping Tom’s hospital, and what Tom really needs [1:39:15]; Diseases in the adult population [1:42:30]; Living without possessions, finding meaning, and being a missionary [1:59:30]; Sense of purpose, happiness, and suicide: Contrasting the US with Nuba [2:11:00]; Other than donations, is there a way people can help Tom and other similar causes? [2:19:15]; The food in Nuba [2:22:30]; Tom’s annual bout of malaria [2:27:30]; Patients that Tom will never forget [2:29:45]; Resources for people wanting to get involved in helping Tom’s work [2:34:45]; Peter tells a story that defines Tom [2:36:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#39 - Ted Schaeffer, M.D., Ph.D.: How to catch, treat, and survive prostate cancer
In this episode, Ted Schaeffer, Professor and Chair of the Department of Urology at Northwestern (youngest chairman in the country), presents the roadmap for the best way to screen for, and treat, prostate cancer. We also get into the “mass screening” controversy and all the risks involved with treatment. In addition, we discuss our evolving understanding of cancer and the most exciting areas of research to come. We discuss: Ted’s unique path to get his PhD [5:15]; The exciting transition in science during Ted’s PhD in the 1990s [15:30]; Ted’s advice to MD-PhD students, and why he choose urology and Johns Hopkins [23:45]; History of prostate surgery, and Pat Walsh’s legendary work in prostate cancer [36:15]; Prostate surgery and the risks involved with treatment [53:00]; Screening for prostate cancer [58:00]; The “mass screening” controversy [1:12:45]; Biopsies and MRI: important things to know [1:25:30]; Why urology such a great field of medicine, and why Peter wants a goat [1:34:45]; Ted’s work with Ben Stiller [1:39:00]; Gleason grading system [1:43:45]; Testosterone, DHT and the prostate cancer controversy [1:53:15]; The metabolism of the prostate [2:03:00]; The most exciting areas of research in prostate cancer [2:08:00]; Benign issues involving the prostate: pelvic pain, infections and treatments [2:11:15]; Video of Ted’s surgeries, the latest technology, and males contraceptive options [2:18:00]; Watches and cars [2:23:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#38 - Francisco Gonzalez-Lima, Ph.D.: Advancing Alzheimer’s disease treatment and prevention – is AD actually a vascular and metabolic disease?
In this episode, Francisco Gonzalez-Lima, a Professor of Neuroscience and Pharmacology & Toxicology, explains the vascular hypothesis of Alzheimer’s disease which says the central problem is a progressive neuronal energy crisis of impaired blood flow to the brain and impaired mitochondrial respiration. He walks us through the ways we can intervene in this process and also shares details of the exciting future of Alzheimer’s treatment and prevention. We discuss: Background and interest in the brain [5:15]; The unique nature of the human brain [9:15]; Why we’ve made so little progress in Alzheimer’s research [23:00]; The amyloid beta hypothesis [28:30]; Hypometabolism in the brain leading to cognitive decline [39:30]; Early signs of AD, and deciphering between age-related decline versus something pathologic [47:45]; The vascular hypothesis of Alzheimer’s disease [54:00]; The relationship between mitochondria, cytochrome c oxidase, and Alzheimer’s disease [1:08:00]; Chronic inhibition of cytochrome c oxidase leads to chronic neurodegenerative disease [1:22:45]; Major risk factors for AD, head trauma, and other forms of dementia [1:33:45]; Methylene blue for treating and preventing neurodegeneration [1:38:15]; Current standard of care for AD, and the reasons for a lack of advancement [2:01:45]; Near infrared light as a targeted treatment for cognitive decline [2:05:30]; The ketogenic diet as a treatment and preventative measure [2:13:15]; Exciting future research coming from Francisco [2:13:00]; Methylene blue for traumatic brain injuries [2:25:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#37 - Zubin Damania, M.D.: Revolutionizing healthcare one hilariously inspiring video at a time
In this episode, Zubin Damania, a.k.a. Zdogg MD, a Stanford trained physician and founder of Turntable Health, discusses his evolution from disillusioned doctor suffering burnout to leading the charge for a radical shift in how we practice medicine. We also go down the rabbit hole on all sorts of juicy topics from meditation to nutrition to the nature of consciousness itself. We discuss: Med school antics [7:00]; Hierarchies in healthcare, physician burnout, and a broken system [20:15]; Why Zubin left medicine, and what lead to the ZdoggMD persona [31:30]; Peter’s tough decision to leave medicine [44:00]; Benefits and challenges of meditation [54:15]; Zdogg’s theory of consciousness [1:11:30]; Nutrition: Peter’s current strategy with patients [1:31:00]; The anti-vaccine dispute [1:38:15] The common thread of all “diets”, the obesity epidemic, and Peter’s dream experiment [1:44:30]; Do we have free will? And how do we make better decisions and learn from our mistakes? [1:55:15]; Peter’s current obsessions: fasting and rapamycin, measuring autophagy, and becoming a kickass 100-year-old [2:03:15]; Reforming the healthcare payment model [2:14:45]; How to find doctors like Peter and Zubin in your area [2:28:15]; Zdogg’s amazing videos [2:31:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#36 - Eric Chehab, M.D.: Extending healthspan and preserving quality of life
In this episode, Dr. Eric Chehab, orthopedic surgeon and sports medicine specialist, explains the measures we can take to live better and maintain our physical health through exercise and the avoidance of common injuries that prove to be the downfall for many. He also provides valuable insight for those weighing their treatment options from physical therapy to surgery to stem cells. We discuss: Favorite bands, musicians, and concerts [3:30]; Eric’s upbringing, biggest influences, college life, and teaching overseas [12:45]; Eric’s training, fellowship with the New York Giants, and the risk vs. reward of playing football [39:15]; The knee joint: common injuries, knee replacements, and proper exercise [1:00:00]; Best exercise for orthopedic health and bone density [1:10:00]; Most common injuries: knee, hip, shoulder, elbow, ankle, foot [1:20:45]; Physical therapy vs. surgery, and the meniscus surgery controversy [1:28:30]; PRP, stem cells, sham surgeries, and the placebo effect [1:41:00]; Back injuries: when does surgery make sense? [1:54:15]; How to find the right orthopedic surgeon for you [2:01:45]; How to cope with complications and maintain quality of life through adaptation [2:09:15]; Dr. Bukk Teef [2:26:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
In this episode, Nir Barzilai, director of the Institute for Aging Research and expert in the genetics of longevity, discusses the evidence that metformin and rapamycin have anti-aging properties and how his TAME study aims to support this hypothesis in humans. Additionally, he describes the role of genetics in lifespan/healthspan and how it might affect important pathways such as IGF and insulin sensitivity. We discuss: Nir’s background and interest in aging and endocrinology [3:30]; History of metformin, and understanding the mechanism [11:15]; Attempting to define insulin resistance [21:15]; Metformin as a possible anti-aging drug [48:45]; The TAME trial: Targeting Aging with MEtformin [57:45]; Why Nir believes metformin can slow aging [1:16:30]; The genetic gift of centenarians [1:28:00]; IGF/GH and its impact on aging and chronic diseases [1:34:15]; Genetics/epigenetics of centenarians, gene sequencing, CETP-VV, Lp(a) [1:49:15]; Should you be taking HGH? [2:05:30]; NAD and NAD precursors (NR and NMN) [2:30:00]; Parting thoughts on metformin [2:36:15]; Possible blind spots in Nir and Peter’s thinking? [2:43:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#34 - Sam Harris, Ph.D.: The transformative power of mindfulness
In this episode, Sam Harris, neuroscientist, author, and host of the Waking Up Podcast, walks us through the profound, yet practical, ways that meditation can transform our lives. Additionally, he helps to define the types of meditation and clarifies potential misconceptions with terms like happiness, pain, and suffering. We discuss: The transformative moment that led to Peter reaching out to Sam [3:45]; Comparing the two broad types of meditation, and Peter’s favorite meditation apps [7:45]; The pleasure of a concentrated mind, meditating with pain, and the difference between pain and suffering [13:15]; What it means to be happy, and how to break out of our default state [23:15]; The disease of distraction, why humans suffer, the limitation of happiness, and letting go of anger with mindfulness [31:00]; The challenge of learning mindfulness, the benefit of silent retreats, and Sam’s first experience in solitude as a teenager [54:15]; Sam’s life-altering experience with MDMA [1:03:00]; Mettā meditation a.k.a. loving-kindness, and the concept of ‘moral luck’ [1:14:00]; Overcoming grief and dread with meditation [1:34:45]; The wrong way to practice mindfulness, and the difference between Vipassana and Dzogchen [1:44:45]; Sam’s commitment to never lie, honesty in politics, and Sam’s viewpoint on the Trump phenomenon [2:06:00]; Teaching kids to be more mindful [2:18:30]; Sam’s current book projects, the consequences of a politically correct environment, and the potential of neuroscience to cure psychopathy [2:25:30]; How you can follow Sam’s work [2:39:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#33 - Rudy Leibel, M.D.: Finding the obesity gene and discovering leptin
In this episode, Dr. Rudy Leibel, an expert in Clinical Molecular Genetics and Genomics at Columbia University, discusses his role in the remarkable scientific story of discovering leptin. He also gets into the genetics of obesity, as well as a broader discussion of the causes and effects of obesity, energy expenditure, and metabolism. We discuss: Rudy’s background, interest in obesity, and trying to understand the role and impact of adipose tissue [4:15]; Finding the first evidence of leptin by studying obese mice [23:30]; Zucker rats, and the push/pull theories of obesity [34:45]; A breakthrough in obesity research, and closing in on leptin [45:45]; Understanding leptin in humans [1:03:30]; What Prader–Willi syndrome teaches us about body weight regulation [1:09:45]; Leptin and the broad condition of obesity, metabolic consequences of weight reduction, and Peter’s self-experiments [1:18:00]; How is appetite being regulated? [1:29:45]; Are there epigenetic consequences of being obese? [1:37:00]; What makes low-carb diets so effective at obesity reduction? [1:46:15]; What did Rudy believe 10 years ago that he no longer believes to be true? [1:55:15]; Rudy’s dream study of the FTO gene [1:57:15]; What the hell does insulin resistance actually mean? [2:08:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#32 - Siddhartha Mukherjee, M.D., Ph.D.: new frontiers in cancer therapy, medicine, and the writing process
In this episode, Siddhartha Mukherjee, oncologist, researcher, and author of the Pulitzer Prize-winning book “The Emperor of All Maladies: A Biography of Cancer,” discusses his writing process, his thoughts about medicine, cancer, immunotherapy, and his recent collaboration on a study combining a ketogenic diet with a drug in mice that provided remarkable and encouraging results. We discuss: Sid’s background [5:00]; How Sid and Peter met [6:00]; Sid’s Pulitzer Prize-winning book: The Emperor of All Maladies [8:00]; Sid’s writing process: the tenets of writing [12:30]; Our struggle to find preventable, human, chemical carcinogens of substantial impact [23:30]; The three laws of medicine — Law #1: A strong intuition is much more powerful than a weak test [26:30]; Law #2 of medicine: “Normals” teach us rules; “outliers” teach us laws [32:00]; Law #3 of medicine: For every perfect medical experiment, there is a perfect human bias [35:00]; The excitement around immunotherapy [38:15]; The story of Gleevec [46:00]; How does the body's metabolic state affect cancer? [49:30]; Can a nutritional state be exploited and/or a drug sensitivity be exploited through a nutritional intervention? [52:00]; How does Sid balance his family, writing, research, laboratory, and patients? [1:00:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#31 - Navdeep Chandel, Ph.D.: metabolism, mitochondria, and metformin in health and disease
In this episode, Nav Chandel, a professor of medicine and cell and molecular biology at Northwestern University, discusses the role of mitochondria and metabolism in health and disease. Nav also provides insights into the mitochondria as signaling organelles, antioxidants, and metformin’s multifaceted effects on human health, among many topics related to well-being. We discuss: What got Nav interested in mitochondria [5:00]; Reactive oxygen species (ROS) [16:00]; Antioxidants: helpful or harmful? [20:00]; Mitochondria as signaling organelles [22:00]; Hydrogen peroxide (H2O2) [25:00]; Mitochondrial DNA [28:00]; Mitochondria and aging [45:00]; Metformin [52:45]; Metformin and the gut microbiome [54:00]; Metformin as complex I inhibitor and the importance of the NADH/NAD ratio [1:01:00]; Anticancer benefits of metformin [1:07:45]; Mitochondrial function is necessary for tumorigenesis [1:15:00]; Are somatic mutations the result of mitochondrial dysfunction? [1:31:30]; Vitamins and antioxidants [1:37:00]; Targeting inflammation in disease [1:43:00]; NAD precursors [1:45:45]; MitoQ [1:52:00]; Metabolite toxicity [1:56:30]; Cortisol and healthy aging [2:02:00]; Nav turns the tables and asks Peter how he deals with the “So what should I eat?” question during social encounters [2:09:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#30 - Thomas Seyfried, Ph.D.: Controversial discussion—cancer as a mitochondrial metabolic disease?
In this episode, Thomas Seyfried, a cancer researcher and professor of biology at Boston College, discusses a controversial view of cancer as a mitochondrial metabolic disease. Many topics related to the causes, treatments, and prevention of cancer are covered in this in-depth conversation. We discuss: How Tom got interested in cancer research [9:00]; Calorie-restricted ketogenic diets, fasting, and epileptic seizures [18:30]; Otto Warburg and the Warburg effect [30:45]; Germline mutations, somatic mutations, and no mutations [42:00]; Mitochondrial substrate level phosphorylation: Warburg’s missing link [51:30]; What is the structural defect in the mitochondria in cancer? [1:02:00]; Peter’s near-death experience with the insulin suppression test while in ketosis [1:06:30]; Insulin potentiation therapy and glutamine inhibition [1:13:15]; The macrophage fusion-hybrid theory of metastasis [1:39:30]; How are cancer cells growth dysregulated without a mutation? [1:47:00]; What is the dream clinical trial to test the hypothesis that we can reduce the death rates of cancer by 50%? [2:03:15]; How can the hypothesis be tested rigorously that structural abnormalities in the mitochondria impair respiration and lead to compensatory fermentation? [2:26:30]; Case studies of GBM survivors [2:32:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#29 - Apolo Anton Ohno: 8-time Olympic medalist – extreme training, discipline, pursuing perfection, and responding to adversity
In this episode, 8-time Olympic medalist, Apolo Ohno, discusses the lessons he’s learned from his remarkable career in speed skating and the extreme physical and mental training — and determination — required to reach greatness. We discuss: Apolo’s childhood with his single dad, early success in sports, and falling in love with skating [7:30]; The differences between inline and ice skating, and short- & long-track speed-skating, and the evolution of the clap skate [21:00]; The mental game and the physical game: intense training and mindset [29:30]; Apolo’s early success in short-track that led to an amazing opportunity and his reluctance to go for it [40:15]; Early days at Lake Placid, first experience on the world stage, and a little self-sabotage [56:45]; Tough love parenting, making a commitment, training like Rocky, and developing the mindset of a fighter [1:17:30]; 2002 Olympics, winning his first medal, and rising above the sport [1:32:45]; Apolo’s evolving training and body composition throughout his Olympic career [2:05:15]; Going into the Lion’s Den to learn from Korean skaters and making a radical and risky change that led to his most successful Olympic games [2:12:45]; Apolo’s tumultuous relationship with South Korea, from hatred to respect to admiration [2:29:00]; Applying lessons learned through training, adjusting to life after skating, and the struggles many athletes face transitioning to retirement [2:46:30]; The final years of Apolo’s career: intense focus, crazy training, mental fortitude, and resiliency [2:57:30]; Officially retiring and contemplating a comeback [3:16:15]; Where does Apolo want to be in 10 years? [3:22:45]; The pursuit of perfection and flow states [3:29:30]; Where you can follow Apolo [3:35:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#28 - Mark and Chris Bell: steroids, powerlifting, addiction, diet, training, helping others, documentaries, and living your best life
In this episode, Mark and Chris Bell discuss their love of powerlifting, their unbelievable personal records, and what prompted the making of their now iconic film, Bigger, Stronger, Faster. They also very openly discuss steroid use, their tragic family history with addiction, the many inspirations that lead to their multifaceted success, and their dedication to having a positive impact on others in fitness and life. We discuss: The impact of Bigger, Stronger, Faster, how it got made, and how it challenged Peter’s set of beliefs regarding steroids [4:45]; Chris’s personal story of addiction and how he’s using his experience to help others [17:30]; Importance of sharing your struggle, and the danger of comparing yourself to others [28:00]; Early life, their love of pro wrestling and what motivated Brothers Bell to be great? [33:45]; How they got started lifting weights, powerlifting vs Olympic lifting, and personal records [43:30]; Lifting weights: the importance of challenging yourself, how to avoid injury, monitoring progress, and staying motivated [1:02:30]; Chris on how changing his diet changed his performance and life [1:09:15]; Best resources for those wanting to get started lifting weights effectively and safely [1:14:00]; Teaching kids strength training early in life, the negative impact of sitting and how we can minimize it [1:18:30]; Benefits of bodybuilding, Mark’s prep for his first competition, and the role of the ketogenic diet [1:27:15]; The steroid controversy: Mark’s use of them and Peter’s perspective [1:42:15]; Testosterone: Peter’s approach to improving it in patients, and the impact of sleep, cortisol, and statins on production [1:51:00]; Upcoming nutrition documentary [2:03:00]; Parting advice from Mark [2:05:00]; Kratom, a powerful plant with the potential to help opioid addiction and more [2:06:15]; The many resources and ways to follow Mark and Chris [2:07:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#27 - David Sinclair, Ph.D.: Slowing aging – sirtuins, NAD, and the epigenetics of aging
In this episode, David A. Sinclair, Ph.D., a Professor in the Department of Genetics at Harvard Medical School and co-Director of the Paul F. Glenn Center for the Biological Mechanisms of Aging, provides insight into why we age and how to slow its effects based on his remarkable work on the role of sirtuins and NAD in health and diseases. He also presents the case that stabilizing the epigenetic landscape may be the linchpin in counteracting aging and disease. We discuss: How and why David moved from Australia to Leonard Guarente’s lab at MIT [7:30]; Sirtuins and aging [15:00]; A series of experiments elucidating the mechanisms of sirtuins [20:45]; How are sirtuins activated? [25:30]; NAD and sirtuin activation [31:00]; Nicotinamide, sirtuin inhibition, andPNC1 [39:00]; Resveratrol [43:00]; The NIH/ITP studies on resveratrol [55:45]; Does David take any compounds for longevity? [1:00:15]; NAD precursors (NR, NMN) and pterostilbene [1:02:45]; Female fertility and NAD precursors [1:14:45]; A unifying theory of aging [1:20:30]; Waddington’s epigenetic landscape [1:23:00]; If David had unlimited resources, what is the experiment he would do? [1:28:25]; Testing combinations to extend lifespan [1:31:30]; What made David aware of his mortality at such a young age? [01:33:45]; What is David’s book going to cover? [01:37:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#26 - AMA #3: supplements, women’s health, patient care, and more
In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from readers and podcast listeners. Bob Kaplan, Peter’s head analyst, asks the questions. This also marks the first video release of the podcast. You can find it on YouTube (https://youtu.be/kzs7GgxR_FQ) and the website (peterattiamd.com/ama03). If you have any questions for the next AMA, please submit them to the AMA section on the website (peterattiamd.com). We discuss: What references ranges does Peter consider too broad on lab tests? [5:30]; What aspect of women’s health is the least studied/understood? [21:15]; What are your thoughts on fasting and ketosis for females? [31:30]; Advice for medical students and residents, how to get through it, and optimize their time while in med school [38:00]; What is Peter’s opinion on the best way to monetize a podcast to make it sustainable? [47:45]; What are you looking to achieve and monitor with your blood glucose monitor? [57:15]; Thoughts on lithium supplementation? [1:08:15]; Insights about berberine? [1:16:00]; Why does Peter take a baby aspirin? What does the science say? [1:19:20]; How do you use HR variability as a metric in your practice and/or in your own personal use? Sleep, pre/post exercise, pre/post eating, every morning readiness? [1:23:25]; With the emergence of “the coconut oil is pure poison” article, can you shed some light on saturated fat in the literature and the types of studies done specifically on coconut oil? [1:38:45]; Would you discuss the recent meta studies that claim that moderate carbohydrate intake may be best for health? [1:40:45]; What is the number one recommendation/habit you would suggest every person add to their daily regimen (besides physical activity) for wholesome health? [1:42:45]; What does it mean if your body has a harder time getting into ketosis via fasting than it used to (testing using a Precision Xtra)? [1:44:15]; Why are you taking Zetia and Lipitor? Are you mitigating risk based on your APOE4? Or is there something else going on? [1:46:10]; What will your book be about and what is the expected release date? [1:47:45]; What are your thoughts on nicotinamide riboside supplementation for longevity? [1:49:30]; Which brand of supplements have you found to be effective? [1:54:30]; Are you currently accepting new patients? And how do I find a ‘Peter Attia clone’ in my area? [1:56:20]; Bob’s personal experience with Peter as a doctor [1:58:45]; Can you tell us more about the latest and best of APOE4? [2:06:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook| Twitter| Instagram.
#25 - Scott Harrison: transformation, finding meaning, and taking on the global water crisis
We discuss: How Scott and Peter met [3:45]; Scott’s tragic family story that shaped his life and altered his trajectory [8:00]; High school years, rebellion, and music [30:30]; Life as a club promoter, drug use, soul-searching, and a change of heart [41:30]; Mercy Ships [1:15:00]; The amazing transformations of Mercy Ships and the parallels to his own transformation [1:28:00]; Leveraging the art of storytelling to raise money and awareness while fighting temptations to fall into his previous life [1:33:30]; Discovering the water crisis that lead to charity: water [1:46:45]; How the lack of trust in nonprofits can cripple charities [1:54:00]; The four pillars of charity: water that helped it overcome the stigma of nonprofits and become successful [2:01:00]; Where to learn more about Scott’s work and charity: water [2:12:30]; Scott’s book recommendations [2:14:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#24 - Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more
In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part V, Peter and Tom talk about inflammation, endothelial health, and oxidative stress as they pertain to cardiovascular disease, and our attempts to monitor them using biomarkers. They also discuss a couple of very important risk factors that too few people (and doctors) know about. Tom closes the five-part series with a tragic story about his good friend that is likely all-too-common for many practicing physicians, that both haunts and motivates Dr. Dayspring to learn as much as he can about the number one killer in the United States. We discuss: Lp(a) [2:30]; Inflammation [17:15]; Oxidative stress markers: Lp-PLA2 and oxLDL [20:45]; Endothelial health markers: ADMA and SDMA [34:30]; Remnants [43:45]; Omega-3 fatty acids (EPA and DHA) and apoC-III [55:30]; Red blood cells and cholesterol transport [1:07:45]; Tom's friend Earl [1:10:00]; Peter's friend JP [1:18:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#23 - Tom Dayspring, M.D., FACP, FNLA – Part IV of V: Statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and the brain
In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part IV, Peter and Tom review the history and current use of drugs to prevent cardiovascular disease. They also discuss why some drugs appear to be more effective than others, an in-depth conversation about niacin, cholesterol and brain health, and the futility of using CKs (creatinine kinase) and liver function tests to identify adverse effects in statins, to name a few topics in this episode. We discuss: Bile acid sequestrants and statins [2:00]; Ezetimibe (Zetia) [15:00]; PCSK9 inhibitors [27:30]; Fibrates [41:00]; Fish oil, DHA, and EPA [1:01:00]; Niacin [1:05:15]; PCSK9 inhibitors [1:23:45]; Cholesterol, statins, and the brain [1:30:00]; Elevated creatine kinase (CK) and liver function tests (LFTs) on statins [1:50:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#22 - Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipoproteins
In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part III, Peter and Tom dig into HDL, why "reverse cholesterol transport" is a lot more nuanced than what most of us are taught, lipid transport, apolipoproteins, and more. In addition, this episode highlights the complexity of HDL and a discussion about the CETP inhibitor trials. We discuss: Reverse cholesterol transport [1:40]; Lipid transportation, apolipoproteins, VLDL, IDL, and LDL particles [11:00]; Remnant lipoproteins and apoC-III [16:45]; Particles having sex: lipid exchange [28:00]; Cholesteryl Ester Transfer Protein (CETP) and CETP inhibitors [40:45]; 2006 CETP inhibitor trial: torcetrapib (Pfizer) [54:45]; 2012 CETP inhibitor trial: dalcetrapib (Hoffmann–La Roche) [56:15]; 2017 CETP inhibitor trials: evacetrapib (Eli Lilly) and anacetrapib (Merck) [58:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#21 - Tom Dayspring, M.D., FACP, FNLA – Part II of V: Lipid metrics, lipid measurements, and cholesterol regulation
In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. In Part II, Tom provides a 101 on lipids and lipoproteins. Tom and Peter also discuss the history and techniques used to measure lipoproteins, and more. We discuss: Lipoprotein basics [1:30]; Gofman and the ultracentrifuge [5:15]; Lipoprotein structure, function, metabolism [6:45]; Lipoprotein and cholesterol measurement, and NMR technology [15:15]; LDL-C vs LDL-P and apoB [30:45]; Sterols and cholesterol synthesis [39:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#20 - Thomas Dayspring, M.D., FACP, FNLA – Part I of V: an introduction to lipidology
In this five-part series, Thomas Dayspring, M.D., FACP, FNLA, a world-renowned expert in lipidology, and one of Peter's most important clinical mentors, shares his wealth of knowledge on the subject of lipids. Part I serves as an introduction to Tom, his work, and an overview of lipid terminology. We discuss: Tom’s recent and remarkable physical transformation [6:30]; The moving stories behind Tom’s obsessions: firefighting, hockey, and, of course, lipids [20:30]; Tom’s medical background [39:30]; Producing some of the most accessible diagrams on lipids [50:00]; What are the different kinds of lipids, what do they do, and how are they transported? [57:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#19 - Dave Feldman: stress testing the lipid energy model
In this episode, Dave Feldman, discusses his journey from software engineer to n=1 experimenter, his experience with low-carbohydrate diets, and his hypothesis that cholesterol levels are influenced by energy metabolism. We discuss: Peter’s synthesis of Dave’s energy model [5:00]; Dave’s journey from software engineer to cholesterol enthusiast [15:00]; Standard blood panels, sterol panels, and what moves the needle when it comes to particle numbers [18:30]; Hyper-responders [20:00]; Lipoprotein transport [33:45]; The lean mass hyper-responder phenotype [47:30]; The progression of atherosclerosis, CAC, and CIMT [52:30]; Testing for oxidized LDL [55:30]; All-cause mortality and clinical endpoints [1:01:15]; What does “LDL as causal” mean? [1:05:15]; Dave’s low carb cholesterol challenge and drug & genetic study qualifications [1:13:15]; If all other markers are in an healthy range, but LDL-P is high, is the patient at risk? A couple of case studies, and a self-experiment [1:27:30]; Peter’s three-day exercise and ketosis experiment [1:41:00]; What are remnant lipoproteins? [1:45:00]; What might cause lean mass hyper-responders to have higher LDL particle numbers? [1:53:30]; A case study from Dave of a lean mass hyper-responder [1:56:30]; Mass balance and cholesterol flux [2:05:30]; Can a higher degree of cholesterol explain the lean mass hyper-responder phenotype? [2:10:00]; Peter’s LDL during his keto-fast-keto experiment [2:13:30]; Does substituting saturated fats with monounsaturated fats lower LDL-P and LDL-C? [2:15:45]; Dave’s carb-swap experiments [2:22:15]; Dave’s carotid intima-media thickness tests [2:41:15]; Looking for studies that stratify for high HDL-C and low TG alongside low and high LDL-C [2:53:00]; and More Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#18 - Richard Isaacson, M.D.: Alzheimer’s prevention
In this episode, Richard Isaacson, a neurologist and director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian, discusses strategies for staving off Alzheimer’s disease. Richard shares a wealth of insight for people who want to know more about Alzheimer’s and what you can do to help yourself and your loved ones – starting today and continuing throughout the entire lifespan. We discuss: Richard’s fun-facts (and alter egos): “bling” phones, Doogie Howser, and DJ Rush [8:00]; Richard’s impetus to focus on Alzheimer’s disease: Uncle Bob [18:20]; Starting an Alzheimer’s Prevention Clinic [27:00]; How Alzheimer’s is diagnosed [30:00]; Short-term memory, processing speed, executive function and how they’re tested [35:45]; Prevention vs reduction of Alzheimer’s [44:00]; What is the prevalence of Alzheimer’s in America? [49:30]; How do people actually die from Alzheimer’s or dementia? [51:30]; How can people do everything right and still get Alzheimer’s? It’s all about AGE [55:15]; The APOE gene [58:15]; Why is the risk of Alzheimer’s higher for women? [1:13:00]; How many different paths lead to Alzheimer’s? [1:15:45]; What role does MTHFR play in Alzheimer’s? [1:19:45]; What are the “ABCs” of Alzheimer’s prevention? [1:26:45]; Baptists, Tauists, Syners, and Apostates [1:36:30]; Concerns with statin use for high-risk patients [1:45:00]; The use of Theracurmin [1:48:45]; What are the five actionable things one can do to reduce the risk for Alzheimer’s today? [1:54:30]; The cognitive reserve [2:14:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#17 - Mike Trevino: life-lessons from ultra-endurance, mindset, hard work, and removing limitations
In this episode, ultra-endurance athlete and entrepreneur, Mike Trevino, discusses the lessons he’s learned from his remarkable athletic feats, and the training required to reach them. Not only is Mike’s advice practical for those looking to take their endurance training to the next level, but his lessons and insight are extraordinarily applicable to living everyday life. We discuss: Mike’s background, his crazy birthday tradition, and his transition from power to endurance [6:30]; Mike’s breakthrough year: setting a course record, and completing the Badwater 135 [16:00]; Race Across America (RAAM), perseverance, and extreme sleep deprivation [25:30]; Mindset, nutrition, fasting, and other advice from Mike for those looking to take the next step in their training [49:00]; What getting a parasite taught Mike about fasting [59:45]; The risks involved with cycling [1:03:00]; Mike setting the trans-Iowa (RAGBRAI) record [1:10:15]; PEDs, stimulants, and their effect on performance [1:15:00]; What motivates Mike (and others) to do this extreme stuff? What led him to eventually pull back? [1:22:00]; Life-lessons learned from training, and how to impart them to his kids, and others [1:35:30]; The greatest beer in the world remains a mystery [1:46:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#16 - Formula 1 (with Paul Conti): the best drivers, Ayrton Senna, and the cautionary tales of driven individuals
In this bonus episode, Peter and med school colleague (and brilliant psychiatrist) Paul Conti reminisce on their favorite moments in Formula 1 history, their deep admiration for the late Ayrton Senna, and the remarkable careers of their all-time favorite drivers. Paul also helps to illuminate the psychological components that made the luminary drivers great, and the cautionary lessons we can take from their incredible lives. We discuss: Ayrton Senna [3:45]; How Senna’s death changed the sport [9:50]; The 80s & 90s: a remarkable era of Formula 1 [12:55]; Hypothesizing what caused Senna’s fatal crash [17:45]; Comparing Stewart and Senna, their incredible bravery, and what lessons we can learn from them [23:30]; Best documentaries on racing, and some of Senna’s best moments [31:00]; Gilles Villeneuve, Stefan Bellof, and some of the other greats [39:15]; Why Senna is widely acknowledged as the best of all time [46:15]; Great rivalries and personalities [49:30]; Rendezvous, a high-speed drive through Paris [56:50]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#15 - Paul Conti, M.D.: trauma, suicide, community, and self-compassion
In this episode, psychiatrist Paul Conti, M.D. discusses the impact of untreated trauma, the rising rate of suicide, and the influence of modern society on mental health, to name a few important topics covered. Paul also talks about how to deal with these challenges for yourself, your loved ones, and the community at large. We discuss: Paul’s background, and what drove him to psychiatry [5:00]; How silent bravado and incessant striving can lead to a functional (and actual) death, and why Paul is critical of the current state of psychiatry [14:45]; Psychedelics, psychotherapy and the dissolution of the ego [20:30]; How current society may be contributing to the increasing amount of suffering [25:00]; The ubiquity and impact of untreated trauma [31:45]; The rising rate of suicide, parasuicide, and “accidental” death [35:30]; Types of trauma, why we minimize it, and Peter’s introduction to Bridge to Recovery [44:00]; Triggering shame and fear, childhood trauma, and why trauma doesn’t care about time [48:00]; The impact of the brain on the body, and overcoming trauma with self-awareness [55:00]; How to recognize and stop the cycle of shame transference [1:04:30]; Peter’s profound experience at Bridge to Recovery, and the importance of finding shared experiences with others [1:11:15]; How to identify and deal with our own personal trauma [1:19:00]; Finding meaning in struggle, why we are less happy than ever, and the impact of an isolated society [1:25:30]; What steps can we take as a society to make an appreciable impact on the rising sense of desperation and misery? [1:43:15]; Resources, book recommendations, and things you can do [1:56:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#14 - Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system
In this episode, Rob Lustig — a researcher, an expert in fructose metabolism, and a former pediatric endocrinologist — discusses what’s wrong with the current food environment, and what we can do to reduce our chances of becoming part of the obesity, diabetes, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) epidemics. Rob recently earned a Master of Studies in Law because he believes that educating people about sugar from a scientific standpoint is only half the equation: the other half involves changing policy, which he explains in this episode. We discuss: What’s the difference between glucose and fructose? [7:00]; Do we have biomarkers that can give us some indication of average exposure to fructose over a given period of time? [14:20]; What’s the difference between ALT and AST? [18:45]; Inflammation, endothelial function, and uric acid [21:30]; Is there something that fructose does better than glucose? [23:45]; For children that undergo a remarkable shift from metabolic health to metabolic derangement, is there a concern that these kids suffer an epigenetic hit that makes it harder for them later in life? [26:15]; How many times do you have to introduce a savory food vs a sugary food to an infant before they will accept it? [29:30]; How are alcohol and fructose similar in how they affect the brain? [33:51]; Advice for parents and kids for creating a sustainable environment that's going to prevent them from running into metabolic problems [40:30]; Why do some populations have a higher risk for NAFLD? [45:42]; What causes NAFLD? [48:45]; Is insulin resistance the result of NAFLD or is NAFLD the result of insulin resistance? [56:00]; HRV, cortisol, and norepinephrine [1:00:30]; What are the actual mechanisms that links metabolic syndrome, insulin resistance, fatty liver, and type 2 diabetes? [1:03:00]; Is the food industry still saying that all calories contribute equally to adiposity and insulin resistance? [1:09:00]; What is the difference between soluble and insoluble fiber and why do you need both? [1:13:00]; How can we change the food system when 10 companies control almost 90 percent of the Calories we consume in the US? [1:15:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#13 - Brett Kotlus, M.D.: How to look younger while you live longer
This episode explores the question of how we can maintain a naturally youthful look as we get older. Brett — a New York City oculofacial plastic surgeon who specializes in both non-surgical and surgical cosmetic and reconstructive procedures of the eyes and face — shares some remarkably practical advice on everything from the most extensive procedural options, down to the simple steps one can do themselves, starting today, that can make a tremendous impact. Brett also discusses how to pick a provider you trust while you’re sorting through the ever-growing list of facial treatments and cosmetic procedures. We discuss: History of medical training that led to Brett’s current interests [5:00]; What changes occur that make skin look older over time? [8:00]; How to avoid the “unnatural” look associated with cosmetic surgery [17:00]; Facial augmentation, fixing eye-bags, and picking the right provider [22:15]; Common botox mistakes, and how to do it right [37:30]; Protect and rejuvenate your skin with these 3 main tools [46:30]; Latest trends in cosmetic industry, botox, cryolipolysis, the various forms of facials, and PRP [1:05:00]; Importance of picking a provider you trust, rather than a device you want [1:31:30]; Future of the cosmetic field [1:33:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#12 - Corey McCarthy: Overcoming trauma, dealing with shame, finding meaning, changing the self-narrative, redemption, and the importance of gratitude
Corey and Peter met when they visited North Kern State Prison in California together as volunteers for Defy Ventures. Peter was moved by Corey’s remarkable story, who is a former inmate himself, and realized he had to have him on the podcast to share his experiences with a wider audience. You’ll almost assuredly take away something very important from listening to this episode. Understanding how your experiences can define you, what forgiveness means of both yourself and others, and how good people can do bad things, are just a few of the takeaways. We discuss: How Corey and Peter met through Defy Ventures [4:00]; How Corey’s prison experience has shaped his life story [13:30]; Corey’s early life, and the traumatic event that changed everything [16:00]; Early adolescence years, beginnings of addiction, and overwhelming shame [23:00]; The 5 ways to classify wounds, and the relationship between trauma and addiction [39:00]; Turbulent high school years, the struggle of parenting a troubled child, and more trauma further shaping the self-narrative [46:00]; Post high school years, spiraling out of control, and giving up on himself [1:02:00]; Navigating prison life, and why a desire to change often isn’t enough to make it happen [1:19:00]; The turning point and eventual road to recovery [1:48:00]; 12 step programs: Pros and Cons [1:54:00]; Final days in prison, getting released, and routines Corey has kept [1:54:00] Corey’s new perspective on life, takeaways from the visit to Kern prison [2:12:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#11 - AMA #2: the Nothingburger — results from Peter’s week-long fast between two weeks of nutritional ketosis — and answering questions on all things fasting
Consider this episode a cross between an ask me anything (AMA) and a show-and-tell. Peter discusses his fasting experiment in great detail and answers questions from listeners and readers. We discuss: Why Peter did a one-week fast and the rationale for front- and back-ending it with a week-long ketogenic diet [6:30]; What Peter’s typical diet, exercise, sleep, stress management, and supplementation looks like [11:00]; What labs (e.g., glucose, ketones, lipids, inflammation and oxidation markers, thyroid- and sex hormones) Peter checked for the experiment [22:00]; Peter’s results after a week on a ketogenic diet [29:30]; Peter’s results after a week on a water-only fast [48:45]; Peter’s results after a week on a ketogenic diet following a week of fasting [58:30]; Peter’s “Top 6” surprises from the fasting experiment [1:08:30]; Different fasting-mimicking diet (FMD) protocols [1:29:20]; What is the optimal protocol, frequency, and duration for fasting? [1:33:00]; How to break a fast without GI distress? [1:38:00]; “Am I breaking the fast if…?” [1:41:30]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#10 - Matt Kaeberlein, Ph.D.: rapamycin and dogs — man’s best friends? — living longer, healthier lives and turning back the clock on aging, and age-related diseases
Matt is someone who is deeply interested in understanding the biology of aging. Why do we age? What happens to us as we age? What are the things we can do to slow the aging process? How can we delay or prevent the onset of age-related diseases? These are all questions that Matt thinks deeply about, and explores these questions with his research at the University of Washington. He is currently investigating many of these questions through the Dog Aging Project and the compound rapamycin—the only known pharmacological agent to extend lifespan all the way from yeast to mammals—across a billion years of evolution. We talk about cancer, heart disease, Alzheimer’s disease, healthspan, lifespan, and what we can do to provide longer, healthier lives for both people and dogs. We discuss: Matt’s early years and his a-ha moment on aging [4:00]; Studying dogs [6:30]; Dogs, rapamycin, and its effects on lifespan and healthspan [15:30]; An unexpected finding in presumably healthy dogs [36:00]; Rapamycin in cancer treatment [50:00]; Why isn’t there a rapamycin trial for Alzheimer’s disease (AD)? [1:01:30]; If Matt could do a definitive study on life extension in dogs, with resources not being a concern, what does that experiment look like? [1:16:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#09 - David Sabatini, M.D., Ph.D.: rapamycin and the discovery of mTOR — the nexus of aging and longevity?
In this episode, my good friend David Sabatini delves into his extensive work with the mechanistic target of rapamycin—better known as mTOR—and rapamycin. The compound rapamycin is the only known pharmacological agent to extend lifespan all the way from yeast to mammals—across a billion years of evolution. David, a professor of biology and a member of the Whitehead Institute at MIT, shares his remarkable journey and discovery of mTOR in mammalian cells and its central role in nutrient sensing and longevity. Fasting, rapamycin, mTOR, autophagy, gedankenexperiments: having this conversation with David is like being the proverbial kid in the world’s greatest candy store. We discuss: mTOR and David’s student years [4:30]; Rapamycin and the discovery of mTOR [8:15]; The connection between rapamycin, mTOR, and longevity [30:30]; mTOR as the cell’s general contractor [34:45]; The effect of glucose, insulin, and amino acids on mTORC1 [42:50]; Methionine sensing and restriction [49:45]; An intermittent approach to rapamycin [54:30]; Rapamycin’s effects on cancer, cardiovascular disease, and neurodegeneration [57:00]; Gedankenexperiment: couch potatoes on rapamycin vs perfectly behaved humans [1:03:15]; David’s dream experiment with no resource constraints [1:07:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#08 - Tom Bilyeu: nutrition, fasting, meditation, mindset, immortality, and the secret formula of fulfillment
Tom Bilyeu is the founder of Impact Theory and a co-founder of Quest Nutrition. In this episode, among the highlights, Tom provides powerful insight he’s gained through his pursuit of fulfillment which led to a billion-dollar company in Quest Nutrition. Tom makes a compelling case that it starts with a growth mindset and he’s determined to impart this knowledge into as many people as possible. We discuss: Tom’s history with dieting and his changing views on fat [4:00]; Tom’s dream of immortality [10:00]; Life leading to Quest Nutrition and how “mindset” made the difference [18:45]; Why Tom helped start Quest Nutrition and what made it a success [27:00]; Why Tom started Impact Theory [35:00]; Money and motivation [44:00]; What Tom learned interviewing every employee at Quest, and the one question everyone answers exactly the same [54:15]; Tom’s secret formula of fulfillment and the ubiquity of suicide [1:00:00]; Nutrition, fasting, sleep, meditation, and other routines Tom uses to function at his best [1:13:15]; and More Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#07 - Deep Dive: Lp(a) — what every doctor, and the 10-20% of the population at risk, needs to know
Pronounced, el-pee-little-a, this lipoprotein is simply described as a low density lipoprotein (LDL) that has an apoprotein “a” attached to it...but Lp(a) goes far beyond its description in terms of its structure, function, and the role that it plays in cardiovascular health and disease. Affecting about 1-in-5 people, and not on the radar of many doctors, this is a deep dive into a very important subject for people to understand. A quick primer on lipoproteins [7:30]; Intro to Lp(a) [11:00]; Lab tests for Lp(a) and reference ranges [20:00]; The physiologic functions of Lp(a) [31:00]; The problems associated with high Lp(a) [34:15]; Lipid-lowering therapies of Lp(a) [44:45]; Lp(a) modification through lifestyle intervention [1:00:45]; High LDL-P on a ketogenic/low-carb-high-fat diet [1:05:30]; and More Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#06 - D.A. Wallach: music, medicine, cancer screening, and disruptive technologies
D.A. Wallach is a true polymath: recording artist, songwriter, essayist, investor, and so much more. In this episode, among the highlights, D.A. provides compelling and colorful insight into how the music industry works today vs the past, liquid biopsies, how to approach healthspan, cancer screening, and how we can reach a “singularity” in medicine. We discuss: How to learn music as a kid and an adult [7:30]; Chester French’s early struggles and ultimate success [16:45]; Learning to learn, fostering curiosity in kids, and balancing creativity with structure [31:30]; D.A.’s musical inspirations [44:30]; History of the music industry, Spotify, and other disruptive technologies [50:00]; The past, present, and future of medicine, hospitals, and healthcare [1:05:30]; Investing in health [1:16:30]; What D.A. is most excited about in the future of medicine [1:22:00]; Liquid biopsies, how to make sense of the morass of sensitivity, specificity, positive predictive value, negative predictive value, true negatives, false positives, false negatives, and true positives in cancer screening...and the swiss cheese metaphor [1:33:00]; The immune system, inflammation, and allergies [2:05:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#05 - Dom D’Agostino, Ph.D.: ketosis, n=1, exogenous ketones, HBOT, seizures, and cancer
Dom digs deep into the research and application of ketogenic diets, exogenous ketones, hyperbaric oxygen treatment, and treating cancer with a metabolic approach. Plus, we lost track of the number of n=Dom experiments mentioned in this episode. We discuss: Dom’s early medical training in hyperbaric chambers [7:00]; Effect of ketones on cancer cells [20:00]; Ketones and oxygen toxicity seizures [32:00]; HBOT & its many applications [40:00]; Ketones, MCTs, and exogenous ketones [59:15]; How ketones affect blood glucose [1:20:00]; Ketone esters, salts, enantiomers vs. racemic BOHB [1:38:00]; Dom’s ketone tolerance test [1:56:00]; The metabolic management of cancer with a Press-Pulse approach [1:59:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#04 - AMA #1: alcohol, best lab tests, wearables, finding the right doc, racing, and more
In his first “Ask Me Anything” episode, Peter answered your questions submitted to him via Twitter. We discuss: What are Peter’s thoughts on alcohol consumption and health? [4:00] What are the best lab tests to request from your PCP, and what are the best markers for longevity? [14:00] What are the best wearables and why, and why does Peter use a continuous glucose monitor? [35:00] How does one select the right physician as a patient? [47:00] Why does Peter race cars and what’s the hardest thing to learn as a new driver? [54:30] What is Peter’s current exercise regimen and what are his thoughts on exercise for improving lifespan and healthspan? [1:20:15] What is Peter’s strategy for learning something deeply? [1:33:00] What is Peter’s process for forming his beliefs? [1:53:30] What does Peter’s diet look like these days? [1:57:45] And more. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.
#03 - Ron Krauss, M.D.: a deep dive into heart disease
Whenever I’m stumped on a patient case or in my thinking about lipids, Ron is one of the first people I turn to for insight. Ron is recognized globally for his research into lipidology and has worn many hats in his career, including clinician, lipidologist, nutrition, genetics, and drug research. In this episode, we explore heart disease at its origins before diving into the highly discussed, largely misunderstood, role of LDL and inflammation in atherosclerosis. Ron also shares his insights on the evidence for and against statins and other lipid-lowering therapies. My hope is that both the curious patient and the physician can get a lot out of this episode by being more informed about dyslipidemia and the interventions used to reduce the risk of atherosclerotic disease. We covered a lot of ground on this critically important topic. We discuss: The pathogenesis of atherosclerosis [7:00]; How early atherosclerosis begins [12:40]; Ron’s motivation for getting into lipidology [43:00]; How reading an article series in the NEJM in 1967 had a profound impact on him and his career [43:30]; How PCSK9 inhibitors work and why they may be under-utilized [47:00]; Mendelian randomization: nature’s randomized trial [49:15]; The “battle” between particle size and particle number [52:00]; The use of statins [1:04:45]; The role of chronic inflammation in atherosclerosis [1:24:15]; Why niacin may have been unjustly dismissed as a therapeutic option [1:40:45]; The HDL paradox: why drugs that raise HDL-C seem to raise (or have little impact on) heart disease risk [1:43:00]; Lp(a) [1:47:45]; And more. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram
#02 - Rhonda Patrick, Ph.D.: the performance and longevity paradox of IGF-1, ketogenic diets and genetics, the health benefits of sauna, NAD+, and more
Rhonda and I go on a Nerd Safari into the jungle of health, nutrition, fitness, performance, and longevity. We visit IGF-1 and whether there’s a tradeoff of having high or low levels. We discuss the PPARs (receptor proteins) and genetic polymorphisms. Does Rhonda think there’s any benefit in a NAD+ booster for health and longevity? Can saunas lower the risk of heart disease, dementia, and all-cause mortality? Rhonda is a wealth of knowledge on so many topics and was the perfect companion to dig into so many fun topics in this episode. She puts a ton of thought into her research and it really shows in this conversation. We discuss: What Rhonda believes differently today than she did a few years ago [5:40]; The paradox of GH/IGF-1 in performance and longevity [21:00]; The role of PPAR in fat metabolism and ketogenic diets [23:00]; The possible genetic explanations for why some patients don’t respond well to a ketogenic diet [31:00]; The health benefits of heat and cold exposure [1:12:30]; NAD+ [1:32:45]; And more. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram
#01 - Tim Ferriss: depression, psychedelics, and emotional resilience
Excited to kick off the podcast with special guest and close friend Tim Ferriss, lifehacker, podcaster extraordinaire, and author of multiple best-selling books that includes The 4-Hour Workweek, The 4-Hour Body, Tools of Titans, and Tribe of Mentors. In this podcast we cover mental health, depression, and our mutual interest in psychedelics as potential therapeutic agents. Tim talks both experientially and from his own deep dive into the literature of psychedelics and mental health. Tim is shifting his focus from investing in startups to funding experiments that he hopes will establish more reliable knowledge and therapeutic options for those suffering from anxiety, depression, and addiction. Tim also shared his list of acquired wisdom he returns to most reliably, which might be worth the price of admission alone. We discuss: Tim’s history of depression and his TED Talk on his close call with suicide [11:15]; The type of thinking that triggers Tim’s downward spirals [17:15]; Tim’s transformative experience with ayahuasca [48:45]; How Tim’s experience and research has led him to focus on furthering the science on psychedelics and mental health [53:00]; What some of the meditation modalities, and meditation apps, are out there, why meditation can be so hard to do, but also worthwhile to stick with [1:13:00]; Why Tim made a big commitment (more than $1 million) to funding scientific research, and to psilocybin and MDMA research, in particular [1:31:00]; From all the habits and tools that Tim has learned, the five things that he returns to most reliably [2:33:00]; And more. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram
Welcome to a special sneak peek of The Peter Attia Drive. The Peter Attia Drive will feature guests and experts that will offer advice and insight to help you optimize performance, health, longevity, critical thinking, and life. It’s hosted by Stanford M.D., TED speaker, and longevity expert Dr. Peter Attia, founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.