#88 - Paul Grewal, M.D.: Treating metabolic disease and strategies for long-term health

#00 - Sneak Peek: The Peter Attia Drive

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.

#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 meditati…

#02 - Rhonda Patrick, Ph.D.: the performance and longevity paradox of IGF-1, ketogenic diets and genetics, the health b…

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

#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: n…

#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.

#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.

#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…

#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.

#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.

#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 hum…

#10 - Matt Kaeberlein, Ph.D.: rapamycin and dogs — man’s best friends? — living longer, healthier lives and turning bac…

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…

#11 - AMA #2: the Nothingburger — results from Peter’s week-long fast between two weeks of nutritional ketosis — and an…

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.

#12 - Corey McCarthy: Overcoming trauma, dealing with shame, finding meaning, changing the self-narrative, redemption, …

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…

#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 th…

#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 sav…

#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 exp…

#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.

#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…

#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 …

#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…

#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.

#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.

#22 - Tom Dayspring, M.D., FACP, FNLA – Part III of V: HDL, reverse cholesterol transport, CETP inhibitors, and apolipo…

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.

#23 - Tom Dayspring, M.D., FACP, FNLA – Part IV of V: Statins, ezetimibe, PCSK9 inhibitors, niacin, cholesterol and th…

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.

#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 Pe…

#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.

#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 i…

#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…

#28 - Mark and Chris Bell: steroids, powerlifting, addiction, diet, training, helping others, documentaries, and living…

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 starte…

#29 - Apolo Anton Ohno: 8-time Olympic medalist – extreme training, discipline, pursuing perfection, and responding to …

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];…

#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 im…

#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 …

#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? [5…

#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…

#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 b…

#35 - Nir Barzilai, M.D.: How to tame aging

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 Pe…

#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…

#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 an…

#38 - Francisco Gonzalez-Lima, Ph.D.: Advancing Alzheimer’s disease treatment and prevention – is AD actually a vascula…

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 n…

#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 excitin…

#40 - Tom Catena, M.D.: The world’s most important doctor – to nearly a million patients – saving countless lives in th…

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 v…

#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 expens…

#42 - Avrum Bluming, M.D., and Carol Tavris, Ph.D.: Controversial topic affecting all women—the role of hormone replace…

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…

#43 - Alan Bauman, M.D.: The science of male and female hair restoration - how to protect, enhance, and restore the app…

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, …

#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 up…

#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 …

#46 - Chris Masterjohn, Ph.D.: Navigating the many pathways to health and disease - NAD and sirtuins, methylation, MTHF…

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?…

#47 – Matthew Walker, Ph.D., on sleep – Part I of III: Dangers of poor sleep, Alzheimer's risk, mental health, memory c…

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 …

#48 – Matthew Walker, Ph.D., on sleep – Part II of III: Heart disease, cancer, sexual function, and the causes of sleep…

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 [4…

#49 – Matthew Walker, Ph.D., on sleep – Part III of III: The penetrating effects of poor sleep from metabolism to perfo…

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 appli…

#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 th…

#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 cons…

The Ayrton Senna Episode (re-release): Celebrating the greatest driver in Formula 1 history and the cautionary tales of…

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…

#52 - Ethan Weiss, M.D.: A masterclass in cardiovascular disease and growth hormone - two topics that are surprising in…

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 coronar…

#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., Thanksg…

#54 – Kevin Sayer, CEO of Dexcom: Continuous glucose monitors – impact of food, sleep, and stress on glucose, the unmat…

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 t…

#55 - Jocko Willink, retired Navy SEAL, Part I of II: objective, strategy & tactics, leadership, protocols, dealing wit…

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 o…

#56 - Jocko Willink, retired Navy SEAL, Part II of II: Sleep, fasting, raising kids, discipline, taking ownership, and …

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 war…

#57 – Rick Rubin, legendary music producer: collaborating with sensitive psyche of greatest living musicians, and his p…

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 l…

#58 – AMA with sleep expert, Matthew Walker, Ph.D.: Strategies for sleeping more, sleeping better, and avoiding things …

In the first three parts of our series with sleep expert Matthew Walker, Matt revealed the many reasons why we need sleep as well as the many short- and long-term dangers of not sleeping enough. In this special AMA episode, Matt comes back to provide a dissertation on listener’s questions about HOW to sleep. He answers questions from subscribers that largely focus on the practical and tactical ways we can improve our sleep in terms of duration, quality, consistency, and avoidance of the common things that are standing in the way the best sleep possible.   We discuss: Matthew’s TED Talk, and his favorite public speakers [7:45];   How good are the current sleep trackers like Oura, Fitbit, etc.? [10:45]; Is it bad to eat food too close to bedtime? [15:30]; How does exercise impact sleep? [17:30]; How is appetite affected by our sleep quality? [21:30]; Anxiety, cortisol, and weight gain: An awful feedback loop of sleep deprivation [23:30]; How to optimize your wind down routine: lights, temperature, & relaxation [26:10]; How alcohol disrupts sleep (and contributes to Alzheimer’s disease) [46:00]; Sleep’s impact on sex hormones, and romantic relationships [50:00]; Perform…

#59 - Jason Fung, M.D.: Fasting as a potent antidote to obesity, insulin resistance, type 2 diabetes, and the many symp…

In this episode, Jason Fung, nephrologist and best-selling author, shares his experiences utilizing an individualized approach to fasting to successfully treat thousands of overweight, metabolically ill, and diabetic patients, and why being a doctor who specializes in kidney disease gives him a unique insight into early indications of metabolic disease. We also have a great discussion on insulin resistance where Jason makes the case that we should actually think of hyperinsulinemia as the underlying problem. We also discuss the difference between time-restricted feeding, intermittent fasting, and dietary restriction (e.g., low-carb) and how they can be used to attack the root cause of T2D, metabolic syndrome, and obesity. We also have a fascinating discussion about the limitations of evidence-based medicine which leads to a conversation where we compare and contrast the scientific disciplines of medicine and biology to theoretical physics.    We discuss: Comparing scientific disciplines: Medicine and biology versus physics [7:25]; The limitations of evidence-based medicine [12:30]; Early signs of metabolic disease: How specializing kidney disease gives Jason a unique insight …

#60 - Annie Duke, decision strategist: Poker as a model system for life—how to improve decision making, use frameworks …

In this episode, former World Series of Poker champion and author, Annie Duke, explains how poker is a pertinent model system for decision making in the real world, a system which blends imperfect information with some unknown percentage of both luck and skill. We go through the decision-making matrix, and how we spend most of our energy focusing on just one of the four quadrants at the expense of the learning opportunities that come from the other 75% of situations. Annie also shares how this evaluation of only the bad outcomes (and our tendency to judge others more harshly than ourselves in the face of a non-status quo decision), leads individuals, leaders, and teams to avoid bad outcomes at all costs. This avoidance is at the cost of the types of decisions which lead to progress and innovation both personally, and societally, across many realms from poker to sports to business to medicine. We also dive deep into a framework for learning, and the levels of thought required to rise to the top of a given domain. Finally, we talk about something that resonated deeply with me in terms of how I think about extending healthspan, which is the concept of “backcasting”. We discuss: …

The one-year anniversary episode with Olivia Attia: Reflecting on the past year and looking forward to exciting times a…

In this anniversary episode, Olivia, Peter's daughter who initially kicked off The Drive podcast with her sneak peek episode, returns to ask Peter the tough questions on how the podcast is going, what he has learned along the way (and how he plans to make it better), what exciting things are in store for the future, and plenty more.

#61 - Rajpaul Attariwala, M.D., Ph.D.: Cancer screening with full-body MRI scans and a seminar on the field of radiology

In this episode, radiologist/engineer, Raj Attariwala, explains how he was able to apply his engineering background to create a unique MRI scanner that is capable of constructing whole-body images with a resolution that is unmatched in the industry. Peter and Raj discuss the implications of such a robust, radiation-free imaging tool on the early detection of cancer. They dive deep into cancer screening and define terms such as sensitivity and specificity that are necessary to really understand this complex space. They then describe the biggest risks involved in this type of screening (false positives) and how Raj’s unique technology and process might drive down this risk substantially. But before that, they discuss all the common imaging technology from X-ray, to CT scan, to PET scans, to ultrasound, to MRI, and more. They touch on the history of each, how they work, the usefulness and limitations of each of them, as well as the varying risks involved such as radiation exposure. If you are interested in cancer screening and/or you’ve ever wondered how any radiology tool works, this episode is for you. We discuss: Raj’s road from engineering to radiology [7:45]; How X-ray works…

#62 - Keith Flaherty, M.D.: Deep dive into cancer—History of oncology, novel approaches to treatment, and the exciting …

In this episode, Keith Flaherty, director of clinical research and targeted cancer therapy at Massachusetts General Hospital, shares his vast wealth of knowledge in cancer starting with the history of treatment from chemotherapy to radiation to surgical therapy and where those methodologies seemed to have leveled off. He also walks us through the timeline of advancements (and lack there of) from when the War on Cancer was declared in the 1970s, through the sequencing of the entire human genome, and all the way to today. Keith dives into the topic of immunotherapy, probably the most exciting recent development in cancer therapy, and also provides us a rundown of his notion of a different approach to cancer that attacks all the essential pillars of cancer growth and survival. Finally, we talk a little bit about liquid biopsies, we discuss the roles of CRISPR and other potentially over-hyped therapies with respect to cancer. We also touch on stem cell therapy a bit, as well as some other common cancer-related questions such as the role of vitamin D and sun exposure in melanoma, and much more. We discuss: Growing up around medicine, and finding a career that you love [7:30]; Medicin…

#63 - AMA #7: Exercise framework, deadlifting, lower back pain, blood pressure, nootropics, CGM, and more

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from subscribers. Bob Kaplan, Peter’s head of research, asks the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed. You can also watch (or listen) to this full episode on our website at the AMA #7 show notes page. Questions continue to be pulled from the AMA section on the website, and any subscriber is welcome to submit questions for future AMAs.   We discuss: What can I do to prevent/reduce interruptions in sleep due to needing to get up to urinate at night? [3:00]; Peter’s note card system for organizing his to-do lists [7:15]; How do I get smarter at reading/understanding the studies (or the media's interpretation of them) that get the headlines on health and/or disease? [11:15]; How can I obtain a continuous glucose monitor (CGM) as a non-diabetic individual? [11:55]; What is the most effective way to bring blood pressure down? [15:00]; Does Peter use any nootropics? [28:10]; Peter’s thoughts pertaining to concussions and head tr…

#64 - Zol Kryger, M.D.: Navigating the sometimes shady world of plastic surgery—understanding potential complications o…

In this episode, board-certified plastic surgeon, Zol Kryger, enlightens us about the frighteningly loose laws regulating the industry of plastic surgery, paving the way for a majority of cosmetic procedures being performed by doctors that are not board-certified plastic surgeons. We talk about some of the very serious complications that can occur even in “minimally invasive” procedures, where the incidence rate is only increased by the flood of non-certified doctors who want to offer these procedures to augment their income. Fortunately, Zol provides listeners with a very specific list of important questions to ask a surgeon when considering any of the many cosmetic procedures available. We then go into the specifics of the most common procedures and the risk of complications for each of them, including breast augmentation, tummy tucks, liposuction, Brazilian butt lifts, botox and fillers, facial peels and lasers, and more. By the end of this episode, you'll have a really clear understanding of what these risks are and how you can go about reducing those risks by choosing the right physician. We discuss: Why Zol chose plastic surgery [7:30]; The shockingly high percentage of pl…

#65 - Rick Doblin, Ph.D.: MDMA— the creation, scheduling, toxicity, therapeutic use, and changing public opinion of wha…

In this episode, Rick Doblin, founder and executive director of MAPS, discusses MDMA, a molecule that has (at a minimum) revolutionary therapeutic benefits for PTSD, but arguably could have, at the highest order, a lasting impact on humanity’s ability to peacefully coexist. Rick details the history of MDMA, what lead to its unfortunate criminalization, and his lifelong work trying to protect MDMA (and other psychedelics) from criminalization (and his subsequent attempt to decriminalize it). Through his founding of MAPS, Rick has made enormous progress in debunking many of the exaggerated risks being claimed against MDMA (neurotoxicity, memory loss, depression, Parkinson’s, etc.), and is very close to getting FDA approval for a psychotherapy technique using MDMA. Additionally, in this discussion, you will learn about the history of LSD, psilocybin, and other psychedelics and how the combination of the misunderstanding of them with the crackdown on drug use in the 1970s lead to their designation of schedule 1 substances. But it’s important to note that you will also realize from this discussion just how different MDMA is compared to the average psychedelic. We end this discussion wi…

Qualy #1 - What are Peter's thoughts on alcohol consumption and health?

Today's episode of The Qualys is from podcast #04 – AMA #1: alcohol, best lab tests, wearables, finding the right doc, racing, and more. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD   

#66 - Vamsi Mootha, M.D.: Aging, type 2 diabetes, cancer, Alzheimer’s disease, and Parkinson’s disease – do all roads l…

In this episode, Dr. Vamsi Mootha, an expert in mitochondrial biology and investigator at the Howard Hughes Medical Institute, shares his breadth of knowledge on the mitochondrion organelle: its history, function, genome architecture, and his research of rare mitochondrial dysfunction. Vamsi is currently focused on finding clinical treatments for the 300-some identified rare disorders, but in this work there is a wealth of potential implications in the context of longevity and chronic disease. In this conversation, Vamsi elucidates how the latest research could give insight into conditions related to aging, including but not limited to Alzheimer’s disease, Parkinson’s disease, insulin resistance and type 2 diabetes, cancer, and much more. We also explore some of the most exciting potential therapies for mitochondrial diseases such as hypoxia (oxygen deprivation), how exercise affects the mitochondria, the use of hyperbaric chambers for cancer therapy, and the mechanisms by which Metformin might confer longevity benefits in a non-diabetic individual. We discuss: The Broad Institute of MIT and Harvard [8:00]; Vamsi’s academic background [10:30]; Advice for college students and med…

Qualy #6 - What are the best lab tests to request specifically for longevity

Today's episode of The Qualys is from podcast #04 – AMA #1: alcohol, best lab tests, wearables, finding the right doc, racing, and more. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#67 - AMA #8: DNA tests, longevity genes, metformin, fasting markers, salt, inflammation, and more

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from subscribers. Bob Kaplan, Peter’s head of research, asks the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed. You can also watch (or listen) to this full episode on our website at the AMA #8 show notes page. Questions continue to be pulled from the AMA section on the website, and any subscriber is welcome to submit questions for future AMAs. We discuss: Do DNA kits provide actionable info for cancer, CVD, diabetes, Alzheimer’s, nutrition, or exercise? [1:45]; What genes increase longevity? And do those genes show up on genetic tests like 23andMe? [12:00]; Who are some people that Peter would like to have as guests on The Drive? [15:00]; Inflammation: Is CRP a useful marker? What can one do to reduce it? And what other inflammatory markers can I look at to gauge health? [18:30]; What lipid test does Peter now use on his patients? What are the three best cardiovascular laboratories? [28:00]; Metformin for longevity: What considerations …

Qualy #9 - The importance of exercise for brain health

Today's episode of The Qualys is from podcast #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. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#68 - Marty Makary, M.D.: The US healthcare system—why it’s broken, steps to fix it, and how to protect yourself

In this episode, Marty Makary, Johns Hopkins surgeon and NYT bestselling author, discusses his ambitious attempt to fix the broken U.S. healthcare system through educating the public, changing the lexicon, encouraging radical transparency in pricing, and more. We go in detail into the main drivers of inflated health care costs, the money games being played making it hard to understand, and the unfortunate system structure that has resulted in one in five Americans finding themselves in medical debt collections which can ruin the lives of people and families seeking basic medical care. Marty also shares some very practical advice and tips if you find yourself a victim of predatory pricing and stuck with an outrageous medical bill. In the end, despite the current state of the system, Marty discusses the many exciting trends gaining traction in healthcare and why he is very optimistic and hopeful about the future. We discuss: The science of delivering healthcare, how we need to do better as a system, and why no single person or entity fully to blame [10:15]; The stories that prompted Marty to write his first book (Unaccountable) [19:15]; The Surgery Checklist [26:15]; The problem i…

Qualy #16 - How much does cognitive activity ward off cognitive decline?

Today's episode of The Qualys is from podcast #18 – Richard Isaacson, M.D.: Alzheimer’s prevention. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#69 - Ronesh Sinha, M.D.: Insights into the manifestation of metabolic disease in a patient population predisposed to m…

In this episode, Dr. Ronesh Sinha, a physician, author, and educator based in Silicon Valley, shares his many insights into metabolic illness that he has gleaned from his South Asian patient population. In this conversation we focus on hyperinsulinemia, insulin resistance, metabolic dysregulation, inflammation, blood pressure, obesity, etc. and ways to address them with nutrition, sleep, exercise, stress management, and more. We also take a deep dive into insulin resistant phenotypes, evolutionary theory and geographic determinants of insulin resistance which provides insight into the genetic architecture and pathophysiology of metabolic syndrome. Additionally, we discuss the surprisingly interrelated topic of stress, and how we might be inadvertently passing this on to our children, leading to mental and physical sickness down the road. We discuss: How a stubborn case of insulin resistance connected Peter with Ronesh [7:15]; Ronesh’s clinical treatment focus of metabolic illnesses in South and East Asian patient populations [8:45]; The distinction between visceral fat and subcutaneous fat stores [15:00]; Shortcomings of a body mass index (BMI) calculator for evaluating metabolic…

Qualy #19 - A unifying theory of aging

Today's episode of The Qualys is from podcast #27 – David Sinclair, Ph.D.: Slowing aging – sirtuins, NAD, and the epigenetics of aging.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#70 - David Sinclair, Ph.D.: How cellular reprogramming could slow our aging clock (and the latest research on NAD)

In this episode, David 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, returns to the podcast to discuss the content of his new book, Lifespan: Why We Age - and Why We Don’t Have To. This conversation focuses on the biological mechanisms involved in what David terms the Information Theory of Aging which provides insights into the “clock” that determines our aging and to what degree it can be manipulated. Our discussion on aging of course leads us into interconnected topics of epigenetics, sirtuins, cellular senescence, as well as what compounds David is personally taking for his own longevity. Additionally, we discuss the most up to date information related to NAD and longevity by looking at the potential benefits (if any) of supplemental agents (NAD precursors, NR, NMR, etc.) that pose a promise of increasing NAD. We discuss: SIR genes and cellular identity [8:45]; Sirtuins regulate gene expression [14:30]; DNA is methylated at the deepest layer of the epigenome [17:45]; Methylation pattern and determining cellular age [20:15]; Cellular reprogramming [33:45]; …

Qualy #24 - What are the “ABCs” of Alzheimer’s prevention?

Today's episode of The Qualys is from podcast #18 – Richard Isaacson, M.D.: Alzheimer’s prevention.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#71 - Katherine Eban: Widespread fraud in the generic drug industry

In this episode, Katherine Eban, investigative journalist and author of Bottle of Lies, illuminates the prevalence of fraud in generic drug manufacturing which brings into question the idea that generics are identical to brand-name drug as we are lead to believe. Katherine walks us through how this widespread corruption came to be, including the shocking story of one particularly egregious (and unfortunately not uncommon) example of an Indian drug company, Ranbaxy, whose business model was completely dependent on falsifying data in their drug applications to the FDA. We then discuss the subsequent investigation into Indian and Chinese drug manufacturing plants which revealed that nearly 80% of them are tainted with fraud. We conclude this discussion on a positive note with i) how individuals can investigate their own drugs to protect themselves ii) an innovative pharmacy attempting to disrupt the market and iii) some ideas on how to reform to the regulations around generic drugs, the FDA, and more.   We discuss: How Peter found Katherine’s book, and what convinced her to investigate the generic drug industry [5:45]; Branded vs. generic drugs: Why they aren’t the same thing [11:15…

Qualy #26 - What is Peter looking to achieve and monitor with his blood glucose monitor?

Today's episode of The Qualys is from podcast #26 – AMA #3: supplements, women’s health, patient care, and more.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD   

#72 - Dan Harris: 10% happier – meditation, kindness, and compassion

In this episode, Dan Harris, correspondent for ABC News and co-founder of the Ten Percent Happier meditation app, speaks openly about his struggles with self-centeredness, addiction, depression, emotional volatility, and the deep-rooted insecurities that drove him to career success. He tells the story of how a panic attack on live TV lead him down a path of self-discovery culminating in a meditation practice which has since transformed his life—in terms of his own personal suffering, his relationships with those closest to him, and his ability to be kind and compassionate (which has its own selfish advantages). Dan also shares some very practical advice and tips for new meditators, dispels some of the myths around meditation, and gives people some things to look forward to as they progress with their practice. Last but not least, we talk about the importance of not passing shame and trauma to our kids and the role that mindfulness and meditation plays in that. Dan’s meditation book, and the panic attack on live TV that started it all [8:00]; Addiction: the spectrum of addiction, the socially acceptable forms, and Dan’s own battle with addiction and depression [13:30]; Dan’s drive…

Qualy #29 - Fasting as a powerful drug in the toolbox of medicine (sneak peek of Paul Grewal's upcoming episode)

Today's episode of The Qualys is a special sneak peek of our yet to be released episode with Paul Grewal.     The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#73 - AMA #9: NAD & metformin, fat-burning zone, creatine, estrogenization of men, emergency kit for cold & flu, and mo…

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from subscribers. Bob Kaplan, Peter’s head of research, asks the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed. You can also watch (or listen) to this full episode on our website at the AMA #9 show notes page. Questions continue to be pulled from the AMA section on the website, and any subscriber is welcome to submit questions for future AMAs. We discuss: The story of how Peter almost worked for Theranos [2:00]; The trend of lower testosterone and higher estrogen in men: Why is it happening and what to do about it? [10:00]; Takeaways from Peter’s recent hunting trip in Hawaii [14:45]; What books are you currently reading/listening to? [21:30]; What advice would you give to the 25 year-old Peter? [24:00]; What is your emergency protocol if you start getting sick? [27:45]; How have your thoughts changed on NAD precursors, and also on metformin, in the past year or so? [30:30]; What are your thoughts on “fat burning” zones for cardio worko…

Qualy #33 - How silent bravado and incessant striving can lead to a functional (and actual) death, and why Paul is cri…

Today's episode of The Qualys is from podcast #15 – Paul Conti, M.D.: trauma, suicide, community, and self-compassion. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#74 – Jason Fried: Optimizing efficiency and work-life balance

In this episode, Jason Fried, co-founder of Basecamp, shares his beliefs around achieving business success in a modern world which tends to disproportionately focus on the massive success stories (the outliers). Jason gives his honest take on companies like WeWork, Uber, and Lyft that may give off the appearance of wild success but may instead provide an example of the dangers of perverse incentives. We get into Jason’s backstory, and how his affinity for optimizing efficiency and production in the workplace culminated with the creation of Basecamp, his very successful web-based project management software business. Perhaps most importantly, we get really deep into all aspects of work-life balance and what it really means to “work hard” (Stay tuned for an AMA-style deep dive into the topic of work-life balance with Jason in the near future). In addition, Jason provides many more valuable nuggets including thoughts on some common mistakes made by businesses today, the value of giving employees autonomy, how to take the right types of risks, why he doesn’t set any goals, and much, much more. We discuss: Jason’s background and his early entrepreneurial spirit [9:45]; Views on compl…

Qualy #38 - Finding meaning in struggle and why we are less happy than ever (David Foster Wallace)

Today's episode of The Qualys is from podcast #15 – Paul Conti, M.D.: trauma, suicide, community, and self-compassion. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#75 - David Light: Zantac recall due to cancer concerns – what you need to know

In this episode, David Light, CEO of Valisure (the company which alerted the FDA to the Zantac cancer concerns), explains the story behind the recent recalls by manufacturers of ranitidine, a common heartburn medication, sold under the trade name Zantac, due to a potential link to increased cancer risk. David breaks down all the evidence, the role of his unique pharmacy company which tests all its drugs before being dispensed to consumers, and the reason behind the FDA’s tempered reaction to the alarming study results. David makes the argument that Zantac/ranitidine is an inherently unstable molecule which explains the grossly excessive amounts of NDMA (a probable human carcinogen) as opposed to just a contamination for which there could be numerous causes. Finally, David and Peter both provide recommendations for what to do if you or someone you know is currently taking Zantac/ranitidine. We discuss: The impetus for starting Valisure, a unique online pharmacy that tests all its medications [6:45]; The story behind the recall of valsartan, and the role which Valisure played [24:30]; Testing Zantac: The shocking results from Valisure’s initial testing with major potential cancer i…

Qualy #43 - What are Peter’s thoughts on fasting and ketosis for females?

Today's episode of The Qualys is from podcast #26 – AMA #3: supplements, women’s health, patient care, and more. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#76 - Kyle Kingsbury: Finding meaning, depression, and psychedelics

In this episode, Kyle Kingsbury, retired UFC fighter and director of human optimization at Onnit, discusses the purpose and meaning that football and MMA gave him but which also acted as a distraction from his inner demons. Kyle opens up about his use of PEDs (steroids, testosterone, HGH) in college and talks about some of the misconceptions around them. Next, Kyle talks about his battle with depression and a close call with suicide that lead to life-changing experiences with psilocybin and ayahuasca—which really became the turning point in his own journey towards being more emotionally healthy, finding inner peace, and being a better husband and father. *DISCLAIMER: The substances spoken about in this episode are illegal and by no means are we advocating for anyone to use them or experiment with them. There are physical, physiological, psychological, and legal risks around the use of these plants. This conversation is purely informational only. We discuss: Growing up in a volatile home [6:30]; Playing college football at ASU, and letting go of NFL aspirations [15:45]; Kyle’s experience taking anabolics (steroids/testosterone), misunderstood science, and fear mongering [23:15]; K…

Qualy #46 - Rapamycin’s effects on cancer, cardiovascular disease, and neurodegeneration

Today's episode of The Qualys is from podcast #09 – David Sabatini, M.D., Ph.D.: rapamycin and the discovery of mTOR — the nexus of aging and longevity?. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#77 – AMA #2 with sleep expert, Matthew Walker, Ph.D.: short sleep mutants, optimal sleep environment, sleep apnea, & r…

In this special episode, Matthew Walker returns for his second AMA episode where he provides his expert insight on numerous sleep-related questions directly from listeners. He answers a wide range of questions from the gene that causes the short sleeping phenotype, to the ideal sleeping position, to the optimal temperature for best sleep, to how fasting affects sleep, plus a full dissertation on sleep apnea, and much, much more. We discuss: DEC2—A genetic mutation that produces a short sleeping phenotype [11:00]; What is the best position to sleep in? [22:45]; Should you consider a “sleep divorce” with your partner? [27:00]; The challenge of kids wanting to sleep in bed with their parents [28:45]; Is there an ideal type of pillow? [32:30]; Any data on hammock sleeping? Should adults be rocked to sleep like a baby? [34:45]; The optimal room temperature and body temperature for the best sleep [38:30]; Do humidifiers help? [50:40]; How do high altitudes affect sleep? [53:15]; What is the data on weighted blankets (e.g., the Gravity blanket)? [57:00]; Caffeine—How much, and in what way, does it affect sleep? [58:15]; How does sexual activity relate to sleep quality? [1:04:00]; Should…

Qualy #52 - Insights about berberine

Today's episode of The Qualys is from podcast #26 – AMA #3: supplements, women’s health, patient care, and more. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#78 - Sasha Cohen: The price of achievement, and redefining success

In this episode, Sasha Cohen, former US Olympic figure skater, discusses the most challenging things about life as an Olympian—the pressures, the expectations, years of sacrifice, but worst of all a loss of identity post-career resulting in many former Olympians suffering from depression. We begin by talking about everything that led up to her unforgettable moment from the 2006 Olympics, and how she handled herself so beautifully in the face of disaster. Most importantly, we talk about post-skating life when she shares many insights such as the downside of constantly striving for a moment, the hollowness of achievement, and the importance of redefining our definition of success. We discuss: Sasha’s mindset going into the 2006 Olympics as the favorite [6:30]; Figure skating basics, scoring, short program vs. long program, etc. [13:40]; Sasha’s unforgettable performance at the 2006 Olympics [18:10]; Win, lose, or draw, why many Olympians suffer from a loss of identity [32:30]; Dealing with the disappointment of “losing the gold” [40:30]; The tiny window of opportunity for Olympians, and the overwhelming pressure to meet expectations [49:30]; Sasha’s unique childhood, finding figur…

Qualy #53 - Screening for prostate cancer

Today's episode of The Qualys is from podcast #39 – Ted Schaeffer, M.D., Ph.D.: How to catch, treat, and survive prostate cancer.     The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#79 - Ric Elias: Earning the gift of life

In this episode, Ric Elias, founder of Red Ventures, opens up about the fateful day he knew for certain that he was going to die as a passenger on US Airways Flight 1549. Ric dives deep into how that day impacted his life, greatly changed his perspective, and improved his relationship with his family and the broader community. We also talk about his incredible role as CEO of an enormous company, his remarkable work in philanthropy, and all the wisdom he has acquired in his extraordinary life. We discuss: Ric’s life leading up to the day of the plane crash [5:30]; The plane crash—What it’s like knowing you’re about to die, feelings of regret and sadness [11:15]; The improbable plane landing in the Hudson River [19:00]; Emotions after the safe landing (and a story he’s never told before) [25:45]; A powerful story about Captain Sully [29:30]; Earning his second chance at life, and playing the “infinite game” [38:30]; Why time is the ultimate currency, and how (and why) to say “no” [46:15]; Raising kids in an achievement culture, Ric’s definition of life success, and what Ric wants to instill in his kids [53:00]; What Ric believes is actually worth getting upset, and the organizatio…

Qualy #57 - A primer on NAD+/NADH, its effect on lifespan/healthspan, and a review of the supplements

Today's episode of The Qualys is from podcast #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.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#80 - Celebrity AMA #1: Fasting, rapamycin, performance vs. longevity, and more

In this special, bonus celebrity AMA episode, Peter answers questions from former Olympians and past guests, Apolo Ohno and Sasha Cohen, on a wide range of subjects including fasting, learning, training for performance versus longevity, and much more. This bonus AMA is available in full to everyone. Apolo's questions begin [1:45]; Why women may have a harder time fasting, and tips for those who are struggling [2:10]; Is there any place for fasting as part of a nutritional strategy in adolescents? [6:15]; Tips for learning and retaining large amounts of new information (and the best nutritional approach) [9:15]; Must read books of 2019 [14:45; If you could only keep a few watches for the rest of your life which would they be? [16:45]; What workout would Peter do inside a hotel room? [22:15]; What is Peter’s ultimate gorge meal? [23:45]; How do you foresee fasting as a mechanism for performance in athletes? [25:30]; What is driving Peter to strive for excellence? [33:30]; Sasha's questions begin [38:40]; What are you most excited about in the longevity space? [38:45]; At what point do you see enough data or proof that a new drug, or type of fasting is worth trying it out for yourse…

Qualy #61 - Rapamycin in cancer treatment

Today's episode of The Qualys is from podcast #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.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#81 - Debra Kimless, M.D. & Steve Goldner, J.D.: Cannabis – the latest science on CBD & THC

In this episode, Dr. Debra Kimless and Steve Goldner share their knowledge on the science, policy, and market evolution of medicinal cannabis. We start with the differences between THC and CBD, how they work in the body, and how they act on the brain. We discuss the many potential benefits of using CBD, THC, hemp in the various forms of administration (smoking, vaping, edibles, oils, etc.) as well as some of the safety issues including the recent uptick in incidents of hospitalization and death linked to vaping. Debra and Steve are both involved with the company, Pure Green—Debra the Chief Medical Officer and Steve the founder and CEO—whose aim is to create the safest, most efficacious form of delivery of cannabis. Their bigger mission is to shift the perception of the cannabis plant, garner acceptance of its medicinal benefits, and ultimately get it descheduled on a federal level so more people can access cannabis for a range of chronic ailments. We discuss: Debra and Steve’s background reason for their interest in medical cannabis [7:00]; The history of medical use of cannabis [11:15]; How THC, CBD, and other cannabinoids work [16:00]; Hemp—What it is, special uses, and the 201…

Qualy #65 - The three laws of medicine — Law #1: A strong intuition is much more powerful than a weak test

Today's episode of The Qualys is from podcast #32 – Siddhartha Mukherjee, M.D., Ph.D.: new frontiers in cancer therapy, medicine, and the writing process.    The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#82 - Mark Messier: Leadership, personal growth, and performing under pressure

In this episode, Mark Messier, six-time Stanley Cup champion, shares the most valuable lessons he picked up over 25+ years of professional hockey resulting in one of the longest and most decorated careers in hockey history. Mark shares what lead to his unique brand of humble leadership, how he was able to get talented individuals to effectively work as a team, the importance of maturing and evolving as a person, and how he was able to stay calm and perform at his best under enormous amounts of pressure. Additionally, we go through his favorite moments as a player, what it was like playing with and learning from The Great One, Wayne Gretzky, and much more. We discuss: Overview of Mark’s extraordinary 25+ year professional hockey career [7:15]; The trend towards kids focusing on one sport earlier and earlier—A good or bad thing? [12:00]; Mark’s early passion for hockey, and when he realized it could be his “job” [14:15]; Going pro at age 17 [19:30]; Mark’s favorite experience playing professional hockey [25:45]; Playing with (and learning from) the great Wayne Gretzky [26:40]; A hard lesson learned in his first year as a pro [32:00]; Lessons learned from losing his first Stanley Cu…

Qualy #69 - Advice to parents and kids for creating a sustainable environment that’s going to prevent them from running…

Today's episode of The Qualys is from podcast #14 – Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#83 - Bill Harris, Ph.D.: Omega-3 fatty acids

In this episode, Bill Harris, Ph.D. in human nutrition and expert on omega-3 fatty acids, sets the table by clearly defining the families of fatty acids (saturated, monounsaturated, polyunsaturated) before diving into the current landscape of polyunsaturated fat (omega-6 and omega-3) with a particular focus on EPA and DHA (the two main elements of fish oil supplements). Bill gives a historical overview, updates us on the latest science related to the health benefits, and provides plenty of insights as to how we should think about increasing our EPA and DHA intake. We discuss: Bill’s long history of studying fatty acids [6:30]; Defining the fatty acids—SFA, MUFA, PUFA, omega-3, omega-6, and more [9:45]; What is the significance of fatty acids? Why should we care? [19:45]; History of fat phobia, saturated fat, and does PUFA reduce cholesterol? [23:45]; Breaking down the conversion process of omega-6 and omega-3 fatty acids including how we get to EPA and DHA [28:00]; Takeaway from Bill’s 1980 study looking at how salmon oil affected cholesterol and triglyceride levels [36:15]; History of our understanding of omega-3 and its effect on LDL cholesterol [45:00]; Prescribed fish oil dr…

Qualy #73 - How can we change the food system when 10 companies control almost 90 percent of the calories we consume in…

Today's episode of The Qualys is from podcast #14 – Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#84 - AMA #10: Low testosterone, hypothyroidism, building muscle (and preserving it while fasting)

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of questions from subscribers. Bob Kaplan, Peter’s head of research, asks the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed. You can also listen to this full episode on our website at the AMA #10 show notes page. We discuss: Does testosterone supplementation impact longevity? [2:40]; Under what conditions does Peter decide to treat patients who have low testosterone? [8:50]; Are there risks involved with testosterone replacement therapy? [17:10]; How does Peter diagnose and treat hypothyroidism? [21:30]; How might someone do time-restricted feeding while also adding muscle mass? [26:30]; If building muscle requires higher levels of IGF-1, should we be concerned about longevity? [34:45]; How to preserve muscle mass while fasting [41:45]; Is it possible to simultaneously lose fat and add muscle mass? [46:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ama10 Subscribe to receive exclusiv…

Qualy #80 - The four pillars of charity: water that helped it overcome the stigma of nonprofits and become successful

Today's episode of The Qualys is from podcast #25 – Scott Harrison: transformation, finding meaning, and taking on the global water crisis. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#85 - Iñigo San Millán, Ph.D.: Mitochondria, exercise, and metabolic health

In this episode, Dr. Iñigo San Millán, Assistant Professor at the University of Colorado School of Medicine, explains the crucial role of mitochondrial function in everything from metabolic health to elite exercise performance. Iñigo provides a masterclass into the many different energy system pathways, the various fuel sources (including the misunderstood lactate), the six zones of exercise training, and the parameters he uses to measure metabolic health. Additionally, he highlights the power of zone 2 training in its ability to act as a powerful diagnostic tool, and perhaps more importantly as a treatment for mitochondrial and metabolic dysfunction. We discuss: Iñigo’s background in sports and decision to focus on education [7:15]; Explaining the various energy systems and fuels used during exercise [14:45]; Iñigo qualifies energy systems into six training zones [26:00];  Lactate is an important fuel source [33:00]; Zone 2 training—physiologic characteristics, fuel sources, lactate, and the transition into zone 3 [40:30]; Using blood lactate levels (and zone-2 threshold) to assess mitochondrial function [47:00]; Accessing mitochondrial function by looking at one’s …

Qualy #82 - What is the most common first presentation of heart disease?

Today's episode of The Qualys is from podcast #03 – Ron Krauss, M.D.: a deep dive into heart disease. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#86 - Damon Hill: Overcoming loss, achieving success, and finding one's identity

In this episode, Damon Hill, 1996 Formula 1 World Champion, opens up about his personal struggles with depression, feelings of inadequacy, loss of identity, and his ultimate path to healing following his remarkable racing career. Damon’s life was given a tragic jolt at 15 years of age when his father and legendary F1 driver Graham Hill died suddenly—the common string that ties together so much of his life and has forged so much of who he is to this day. We discuss Damon’s unique and remarkable racing career including his legendary battles with Michael Schumacher as well as Damon's firsthand account of what happened that tragic day on May 1st, 1994, when his teammate, Ayrton Senna, died at Imola. But this is not just about racing; rather it’s a human story that's cloaked in a racing one. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/damonhill/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

Qualy #85 - The past, present, and future of medicine, hospitals, and healthcare

Today's episode of The Qualys is from podcast #06 – D.A. Wallach: music, medicine, longevity, and disruptive technologies. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#87 - Rick Johnson, M.D.: Fructose—The common link in high blood pressure, insulin resistance, T2D, & obesity?

In this episode, Rick Johnson, Professor of Nephrology at the University of Colorado, explains how his research into the causes of blood pressure resulted in a change of research direction to focus more on how fructose has such profound metabolic effects. Rick discusses the relationship between salt and high blood pressure, provides a masterclass into uric acid, and expertly reveals the mechanisms and pathways by which sugar (specifically fructose) can profoundly impact metabolic health. From there, he explains how he applies this information to real life patients, as well as touches on some of the most promising ideas around pharmacotherapy that are being developed in response to the epidemics of fatty liver, insulin resistance, diabetes, and obesity. Furthermore, Rick gives his take on artificial sweeteners compared to real sugar, discusses cancer’s affinity for fructose, and much more. We discuss:  The connection between blood pressure and fructose that shifted Rick’s professional focus [4:00]; The relationship between salt and blood pressure (and the role of sugar) [5:45]; Defining fructose, glucose, and sugar [19:30]; An ancient mutation in apes that explains why humans turn…

Qualy #89 - Cortisol and healthy aging

Today's episode of The Qualys is from podcast #31 – Navdeep Chandel, Ph.D.: metabolism, mitochondria, and metformin in health and disease.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#88 - Paul Grewal, M.D.: Treating metabolic disease and strategies for long-term health

In this episode, Paul Grewal, internal medicine physician and co-author of Genius Foods, discusses what has got him so focused on lifestyle changes for metabolic health which was partly brought on by his own experience of losing almost 100 pounds at two points in his life. Paul and Peter discuss how the results from a NuSI-funded study has impacted their feelings about the supposed “metabolic advantage” of a low-carb diet. Paul then makes the case for what he calls the “active poisoning” of the American food supply, defines his five phenotypes of obesity manifestation, as well as lays out his nutritional and training approach with his patients (as well as himself personally). Overall, this discussion is a treasure trove of topics from endocrinology, insulin resistance, caloric restriction, fasting, exercise, causes of obesity, LDL and heart disease, and much more. We discuss: Paul’s health story—two instances of major weight loss [3:15]; The multiplication of adipocytes after weight loss, and why an obese adult that was overweight in childhood is harder to treat than adult-onset obesity [7:30]; Low-carb diets—Is there a metabolic advantage in energy expenditure? (And Peter’s take…

Qualy #94 - Comparing the two broad types of meditation, and Peter’s favorite meditation apps

Today's episode of The Qualys is from podcast #34 – Sam Harris, Ph.D.: The transformative power of mindfulness.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#89 - AMA #11: All things fasting

In this “Ask Me Anything” (AMA) episode, Peter answers a wide range of fasting-specific questions from subscribers. Peter starts by defining the various fasting protocols, details his own personal fasting regimen, explains his revised plan for 2020, and provides a ton of value to anyone interested in fasting. Once again, Bob Kaplan, Peter's head of research, will be asking the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #11 show notes page. We discuss: Defining the various fasting protocols [1:00]; Why Peter plans to switch to a 3-day fast once per month in 2020 [11:00]; How Peter uses his CGM to gain insights into the depth of fast [13:15]; Peter’s supplement protocol during fasting, and why he eats a ketogenic diet leading up to a prolonged fast [17:00]; Peter’s exercise regimen during a fast [23:30]; Peter’s hunger levels during a typical 7-day fast [26:45]; Fasting observations—Core body temperature and thyroid hormone [30:30]; Fasting observations—Glucose, BHB, and hunger levels …

Qualy #99 - The steroid controversy: Mark’s use of them and Peter’s perspective

Today's episode of The Qualys is from podcast #28 – Mark and Chris Bell: steroids, powerlifting, addiction, diet, training, helping others, documentaries, and living your best life.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#90 - Ryan Holiday: Stillness, stoicism, and suffering less

In this episode, Ryan Holiday, author of Stillness is the Key, shares the profound impact that stoic philosophy has had on his personal life and his career as a successful writer. Ryan stresses the importance of stillness in a modern world set up to encourage the opposite and lays out the best strategies to develop stillness in your life. He also explains the destructive nature of being driven by ego, as well as the perils of jealousy and anger, and provides practical steps you can take to avoid those harmful states. We discuss: Has a more connected world improved or worsened our lives? [2:15]; Consequences of an overly secure life, living in the present, & the misconception of unlimited time [5:45]; Stoicism 101: The definition and origins of stoic philosophy [15:45]; Ryan’s career transition into writing, and his take on what makes a book or business successful [26:45]; Storytelling—The upside and downside of telling stories and self-narrative [36:15]; Does achieving success have to come from a place of craving and proving others wrong? And what are the costs of building a legacy? [38:45]; Ego—confusing ego with confidence, signs your ego is showing, & antidotes to the negative…

Qualy #102 - Is the food industry still saying that all calories contribute equally to adiposity and insulin resistance?

Today's episode of The Qualys is from podcast #14 – Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#91 – Eric Topol, M.D.: Can AI empower physicians and revolutionize patient care?

In this episode, Dr. Eric Topol, founder and director of the Scripps Research Translational Institute, shares how artificial intelligence and deep learning is currently impacting medicine and how it could transform the healthcare industry, not only in terms of the technological advancements, but also in restoring the patient-doctor relationship for better patient outcomes and experiences. We also discuss Eric’s rich and fascinating career in cardiology as well as his involvement as one of the first outspoken researchers to question the cardiovascular safety of Vioxx. We discuss: Eric’s background and his source of interest in cardiology [3:15]; The US medical field’s resistance to technological change and learning from other healthcare models [11:15]; Eric’s mission at the Cleveland Clinic [20:15]; How Eric helped to elucidate the issues with Vioxx (and why he came to regret it) [29:45]; How Eric came to found one of the most influential research centers in the world [47:30]; How AI and deep learning is currently impacting medicine, and the future possibilities [56:30]; Gut microbiome—Its role in health, impact on glycemic response and fuel partitioning, and how deep learning cou…

Qualy #106 - Does LDL cause heart disease?

Today's episode of The Qualys is from podcast #03 – Ron Krauss, M.D.: a deep dive into heart disease.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

92 - AMA #12: Strategies for longevity (which don't require a doctor)

In this “Ask Me Anything” (AMA) episode, Peter explains the various levers one can pull to affect longevity with a specific focus on the strategies and tactics one can implement that do not require the help of a physician. Once again, Bob Kaplan, Peter's head of research, will be asking the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #12 show notes page. We discuss: The five levers you can pull to affect longevity [1:15]; Nutritional biochemistry: Framework, 3 nutritional interventions, and how to approach your goals, and what you should be tracking [4:30]; Exercise for brain health, and the 4 components of exercise [20:45]; Exercise component—Stability [24:30]; Exercise component—Strength [29:00]; What is Peter optimizing for with his exercise? [30:30]; Exercise components—Zone 2 and zone 5 training [33:15]; More about DNS, and why we need to be careful with rushing kids through neuromuscular development stages [45:00]; Sleep: How to improve quantity and quality [48:…

Qualy #109 - How does one select the right physician as a patient?

Today's episode of The Qualys is from podcast #04 – AMA #1: alcohol, best lab tests, wearables, finding the right doc, racing, and more.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#93 - AMA with Jason Fried: Work-life balance, avoiding burnout, defining success, company culture, and more

In my first interview with Jason Fried, Jason explained his overall philosophy about work-life balance and how exactly he optimizes for efficiency. For this special follow-up AMA, we've decided to release the full episode to everyone (including non-subscribers), so all can hear Jason answer questions from listeners that dive deeper into topics such as work-life balance, the role of luck versus hard work in success, specifics around Basecamp’s unique process-oriented approach to projects, 4-day work weeks, practical tips for people searching for the right company culture, tips on writing and parenting, and a whole bunch more. If Jason had taken his own advice about work-life balance at the start of his career, would he have achieved the same level of success? [2:05]; What is Jason’s definition of success, and what is he optimizing for? [10:10]; Basecamp’s policy on email and expectations for a quick response, and why Jason believes in sleeping on big decisions [14:30]; How Jason implements “true” work-life balance in his life and at Basecamp [19:15]; Does work and life have to be separated in order to have balance? [32:00]; How Jason makes time the fixed component to av…

Qualy #116 - Dealing with anger in spots where you know it’s coming

Today's episode of The Qualys is from podcast #34 – Sam Harris, Ph.D.: The transformative power of mindfulness.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#94 - Mark Hyman, M.D.: The impact of the food system on our health and the environment

In this episode, Mark Hyman, M.D., director of the Cleveland Clinic Center for Functional Medicine and the author of Food Fix, discusses that if we can fix the food system, we can solve many big problems—namely the chronic disease/obesity epidemic, the rising costs of healthcare, as well as the big problems facing the environment. Mark first briefly lays out the health consequences of processed food with a focus on the gut microbiome. From there, Mark discusses the environmental consequences of industrial farming and lays out how we can affect change on the individual level, through policy and regulations, and perhaps most importantly through regenerative agriculture. Additionally, Mark talks about the potential health risks of consuming GMO foods, herbicides, and other chemicals used in industrial farming as well as the environmental consequences, such as the loss of soil, caused by those same fertilizers and methods of farming. We discuss: The negative consequences of the existing food environment [3:25]; What makes processed food so unhealthy? [9:00]; The gut microbiome: Inflammation from gut permeability and how to measure gut health [18:30]; Steps to fixing a bad gut—The Fiv…

Qualy #120 - What is the difference between ketone salts and esters?

Today's episode of The Qualys is from podcast #05 – Dom D’Agostino, Ph.D.: ketosis, n=1, exogenous ketones, HBOT, seizures, and cancer.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#95 - Luke Bennett, M.D.: The emotional, cognitive, and physical demands that make Formula 1 a unique and special sport

In this episode, Luke Bennett, Medical and Sports Performance Director for Hintsa Performance, explains the ins and outs of Formula 1 with a focus on the behind-the-scenes human element, and what makes it so emotionally, cognitively, and physically demanding for the drivers as well as the many team members. Luke first talks about his fascinating background with the Royal Flying Doctor Service in Australia, which lead to his current position with Hintsa working closely with F1 drivers to improve their health and performance despite jet-lag and sleep constraints due to an unrivaled travel schedule. Luke also sheds light on the underappreciated level of sheer physical strength and endurance it takes to drive an F1 car combined with the extreme cognitive aptitude, spatial awareness, and ability to navigate a socially complex environment that is needed to be successful as a driver. Additionally, Luke gives an overview of how the F1 season and races work, the incredible advances in car technology and safety measures, and what Luke and Hintsa hope to bring in the near future to the unique and special sport that is Formula 1. We discuss: What it’s like to be a “flying doctor” in Australi…

Qualy #121 - The “art” of longevity: the challenge of preventative medicine and understanding risk

Today's episode of The Qualys is from podcast #52 – Ethan Weiss, M.D.: A masterclass in cardiovascular disease and growth hormone – two topics that are surprising interrelated.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#96 - David Epstein: How a range of experience leads to better performance in a highly specialized world

In this episode, David Epstein, best-selling author of Range and The Sports Gene, discusses the evidence around the most effective ways to improve long-term performance and learning in our specialties, our sports, our careers, and our lives. David makes a compelling case that a range of experiences and skills are more likely to lead to expert performance compared to early specialization, and offers an in-depth critique of the much-publicized 10,000-Hour Rule. David also provides insights into our role as parents in the process of encouraging exposure to many things, the concepts of when to push them, when to give them space, and when to allow them to quit. Furthermore, David goes into many other fascinating topics such as the role of talent, genetics, and practice in reaching expert status, what differentiates a kind vs. wicked learning environment, the importance of “informal training,” and many case studies that suggest strategies for short-term success may not be best for long-term development. We discuss: A shared interest in Ayrton Senna, and pondering the value in participating in sports [2:30]; Examining the 10,000-Hour Rule, and the importance of questioning existing d…

Qualy #125 - Hierarchies in healthcare, physician burnout, and a broken system

Today's episode of The Qualys is from podcast #37 – Zubin Damania, M.D.: Revolutionizing healthcare one hilariously inspiring video at a time.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD

#97 - Peter Hotez, M.D., Ph.D.: COVID-19: transmissibility, vaccines, risk reduction, and treatment

In this episode, Dr. Peter Hotez M.D., Ph.D., Dean for the National School of Tropical Medicine Baylor College of Medicine, shares his expertise on viral disease and how it applies specifically to the coronavirus disease (COVID-19) and the virus that causes it (SARS-CoV-2). Dr. Hotez informs us about the current state of disease progression, which has many unknowns, but has thus far been greatly determined by the delayed response time and lack of testing. Moreover, we discuss what we can do on a country, state, community, and individual level in order to collectively slow transmission of the disease. He shares with us a potential hope in convalescent plasma therapy and underscores the need for US federal involvement - particularly in the creation of a specialty task force to address areas of concern and unknowns. Disclaimer: This is information accurate as of March 13, 2020, when it was recorded. We discuss: The disease and the virus: transmissibility and lethality [04:30]; Disease transmission: US playing catch-up [12:00]; Convalescent plasma coronavirus therapy [16:00]; Remdesivir drug treatment and vaccination challenges [19:45]; Disease mechanism and reported pathology [27:4…

#98 - Peter Attia, M.D. and Paul Grewal, M.D.: Coronavirus (COVID-19) FAQ

In this episode, Dr. Paul Grewal, M.D. joins Peter to discuss what they have learned in the past week in the midst of the rapid changes surrounding the COVID-19 pandemic. Their conversation touches on both optimism and uncertainty: actionable steps we can take to improve the situation with the understanding that it is too late for viral containment. Specifically, Peter and Paul discuss some promising drug treatment, reasons for isolating-behavior adoption, and what they are personally instituting in their own lives. Disclaimer: This is information accurate as of March 13, 2020, when it was recorded. We discuss: When the gravity of Coronavirus (COVID-19) hit home [04:30]; Hospitalization and ICU bed space as an issue [8:15]; Natural history and pathology of COVID-19 [12:00]; Potential drug therapies [22:00]; How thinking has changed from containment to management [30:00]; What Paul and Peter are doing [49:00]; What we know about viral transmission [57:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/covid-19-update-03152020/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscrib…

Qualy #129 - Evolutionary reasons to sleep

Today's episode of The Qualys is from podcast #47 – Matthew Walker, Ph.D., on sleep – Part I of III: Dangers of poor sleep, Alzheimer’s risk, mental health, memory consolidation, and more.   The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

#99 - Peter Hotez, M.D., Ph.D.: Continuing the conversation on COVID-19

In this episode, Dr. Peter Hotez M.D., Ph.D., Dean for the National School of Tropical Medicine Baylor College of Medicine, returns to continue the conversation on COVID-19. Dr. Hotez informs us on how we can gauge the number of infected people, behaviors to reduce the probability of becoming infected, and the inconsistency of hospitalizations among young adults between different countries.  Dr. Hotez underscores the continued uncertainty in many virus-related developments, but ends with some points of optimism. Disclaimer: This is information accurate as of March 19, 2020, when it was recorded. We discuss: How to gauge true number of infected people [5:45] Reducing the probability of getting infected [22:45] Inconsistency by country in infected young people [27:15] Conferred immunity, seasonality, and repurposed therapeutics [30:30] Vaccine development [39:30] Practical behaviors to reduce risk of transmission [46:00] Mental Health resource and funding [51:00] Points of optimism [56:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/peterhotez-2 Subscribe to receive exclusive subscriber-only content: https://p…

#100 - Sam Harris, Ph.D.: COVID-19—Comprehending the crisis and managing our emotions

In this episode, Sam Harris, neuroscientist, author, and host of the Making Sense Podcast, joins Peter to discuss this unprecedented coronavirus (COVID-19) crisis. The discussion includes the important distinction between COVID-19 and influenza, the impact on the economy, the dire situation in New York, and the challenge of creating a safe and effective vaccine. Additionally, Sam brings insights from his extensive meditation practice to help those struggling with stress, anxiety, and fear in this extraordinary situation. We discuss: A time unlike any other—why many people don’t seem to fully grasp the magnitude of this situation [2:00]; Why comparing COVID-19 to influenza is a bad analogy [10:45] The impact on the economy of measures like shelter-in-place—Is the “cure” worse than the disease? [16:45]; Why are some places, like New York, getting hit so much worse? [24:45]; The trickle down effect of an overrun healthcare system on non-COVID-19 related health issues [34:45]; How to calm our minds and manage our emotions during this craziness [38:00]; Talking to kids about this situation without burdening them with undue stress [50:15]; Insights from meditation practice—Recognize a…

#101 - Ryan Holiday: Finding stillness amidst chaos

Ryan Holiday, bestselling author and author of Daily Stoic, discusses practical ways to find stillness and apply the insights of stoic philosophy in the midst of COVID-19 chaos. Ryan discusses the importance of taking back a feeling of control, the benefits of structure and routine, and the idea of being prepared for anything. We discuss: Using times of adversity to evaluate and reflect how you’ve set up and prioritized your life [2:30]; What insights might the famous stoics provide amidst this COVID-19 pandemic? [8:15]; The possible consequences of the socially isolating nature of a pandemic (and why we need good leaders) [13:00]; Stoicism—what it means and how to apply it [18:45]; Lessons taken from the life of Winston Churchill—stillness, structure, routine, hobbies, empathy, forward thinking, and more [23:30]; Alive time vs. dead time—taking control of your time and making it count [38:45]; Auditing how the world (and its leaders) are handling the COVID-19 pandemic through the lens of stoic philosophy [44:15]; Asserting control and using routine to find stillness in an environment not conducive for it [52:15]; Why you should find a way to exercise, especially now [58:30]; How…

#102 - Michael Osterholm, Ph.D.: COVID-19—Lessons learned, challenges ahead, and reasons for optimism and concern

In this episode, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and author of Deadliest Enemy: Our War Against Killer Germs, provides an overview on the COVID-19 pandemic in regards to what has happened to date, what we’ve learned about how the disease spreads, and his optimism and pessimism about what potentially lies ahead. Michael gives his take on the true case fatality rate, why it differs around the world, and which underlying conditions, such as obesity, impact risk of severe illness and death. We also discuss the outlook regarding vaccines, repurposed drugs/antivirals for treatment, and Michael’s growing concern about supply chain limitations with respect to drugs, vaccines, n95 masks, and testing kits. We discuss: Recapping the brief history of COVID-19 and what potentially lies ahead [2:15]; Some positive news about immunity and reinfection [10:45]; Case fatality rate—The challenge in finding the true rate, difference by country, and the impact of age, underlying conditions, and obesity [13:00]; What has to be true for less than 100,000 Americans to die from COVID-19? [24:30]; How do we best protect h…

#103 - Looking back on the first 99 episodes: Strong Convictions, Loosely Held

In this episode, originally recorded to be the 100th episode of The Drive, Peter discusses topics that he has changed his mind about since starting the podcast as a result of preparing for interviews as well as from the actual conversations. Peter also reviews some of his favorite moments from the first 99 episodes, shares what books he’s currently reading, and much more. Initially scheduled to be released as episode 100, this was delayed due to recent podcasts covering COVID-19. We discuss: Definition of “strong convictions loosely held,” and the value in trying to shoot down your own hypotheses [2:20]; Metformin—How Peter’s strong convictions have changed since 2018 [8:00]; Getting a dog—Why Peter caved and how it’s going so far [15:45]; Rapamycin—How Peter’s feelings have evolved, and the questions still needing to be answered [20:45]; Archery, the joy of pursuing mastery, and the importance of stillness [26:50]; Zone 2 training—Why Peter has made it a big component of his exercise regimen [37:30]; Deadlifts—Why Peter now believes it’s extremely beneficial to longevity when done properly [41:45]; Read any good books lately? [50:00]; Baby aspirin for preventing blood clotting—W…

#104 - COVID-19 for kids with Olivia Attia

In this episode, Peter sits down with his daughter to answer questions from her and other kids about COVID-19. We discuss: What is a virus? [1:45]; How did this version of coronavirus (SARS-CoV-2) start? [4:30]; How does COVID-19 compare to SARS and MERS (previous coronaviruses)? [6:00]; Will COVID-19 come back again after we resolve the current issue? [7:15]; When will kids go back to school? [7:45]; How has the US surpassed China in total cases, and how could we have been better prepared for this? [8:30]; Should have we started to quarantine sooner than we actually did? [11:45]; What about herd immunity? Would it be easier if we all just got the virus so we could be immune? [13:45]; Which age groups are the least and most at risk for getting a deadly version of the virus? [15:00]; Why do we have to wipe down packages that are delivered to our homes? [16:30]; How a lack of preparation and discipline led to this troubling situation [18:45]; Is China to blame for all of this? [24:15]; What did Olivia think when her parents pulled her out of school before it was mandated? [26:30]; What's been the hardest part of this for Olivia? [27:50]; What does Olivia appreciate now that she pro…

#105 - Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted

In this episode, psychiatrist Paul Conti, M.D. discusses the impact of the fear and uncertainty surrounding the COVID-19 pandemic and the resulting stress, anxiety, and trauma it may impart on the population. Paul examines how this situation has highlighted the challenges we face at the societal level as well as the individual level, and stresses the importance of seeking absolute truth above personal truth and taking action as individuals as a means to combat many of these pervasive problems. We discuss: Paul’s personal experience with a presumptive case of COVID-19 [2:15]; Through the lens of trauma, Paul’s overall take on the lasting effects of this pandemic on society [4:30]; The imperative to unite as a species given the isolating and suspicious nature of an invisible enemy [8:15]; The indigent population and the affluent population—The commonalities and differences in how both populations have been affected [16:15]; The prevailing feeling of demoralization spanning the population [25:30]; Health care workers—What lingering psychological effects might they suffer from this? [35:00]; Could this pandemic be a catalyst for changing the way people think about science, truth, and…

#106 - Amesh Adalja, M.D.: Comparing COVID-19 to past pandemics, preparing for the future, and reasons for optimism

In this episode, infectious disease and pandemic preparedness expert, Amesh Adalja, M.D., puts the current pandemic into context against previous coronaviruses as well as past influenza pandemics. Amesh also provides his interpretation of the evolving metrics which have contributed to big variations in modeling predictions, whether this will be a seasonally recurring virus, and perhaps most importantly—how we can be better prepared for the inevitable future novel virus. Finally, Amesh explains where he sees positive trends which give him reasons for optimism. We discuss: Amesh’s background in infectious disease [2:40]; When did the virus actually reach the US? And when did Amesh realize it would pose a real threat to the US? [4:00]; Comparing and contrasting COVID-19 to previous pandemics like the Asian flu of 1958 and the Spanish flu of 1918 [8:00]; Will COVID-19 be a recurring seasonal virus every year? [14:00]; Will a future vaccine be specific to this COVID-19 or will it also cover previous coronaviruses as well? [15:15]; What does Amesh think might be the true case fatality rate of SARS-CoV-2? [16:15]; Why did early models over predict infections and deaths by order of milli…

#107 - John Barry: 1918 Spanish flu pandemic—historical account, parallels to today, and lessons

n this episode, John Barry, historian and author of The Great Influenza: The Story of the Deadliest Pandemic in History, describes what happened with the 1918 Spanish flu pandemic, including where it likely originated, how and why it spread, and what may have accounted for the occurrence of three separate waves of the virus, each with different rates of infection and mortality. While the current coronavirus pandemic pales in comparison to the devastation of the Spanish flu, John highlights a number of parallels that can be drawn and lessons to be learned and applied going forward. We discuss: What got John interested in the Spanish flu and led to him writing his book? [2:45]; Historical account of the 1918 Spanish flu—origin, the first wave in the summer of 1918, the death rate, and how it compared to other pandemics [10:30]; Evidence that second wave in the fall of 1918 was a mutation of the same virus, and the immunity immunity protection for those exposed to the first wave [18:00]; What impact did World War I have on the spread and the propagation of a “second wave”? [21:45]; How the government’s response may have impacted the death toll [26:15]; Pathology of the Spanish…

#108 - AMA #13: 3-day fasting, exogenous ketones, autophagy, and exercise for longevity

In this “Ask Me Anything” (AMA) episode, Peter explains some observations he’s noticed since switching to a 3-day fasting cycle from the longer fasts, the various things he’s measuring, and some helpful tips for getting through a prolonged fast. He also discusses the role of exogenous ketones in fasting and ketogenic diets as well as their impact on autophagy, specifically. Finally, Peter provides some practical advice for those looking to fit exercise for longevity into their busy life. Once again, Bob Kaplan, Peter's head of research, will be asking the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #13 show notes page. If you are not a subscriber, you'll be able to listen to a sneak peak of this episode. We discuss: Peter’s observations since switching from a 7-day to a 3-day fasting regimen [1:25]; Ketone measuring devices—blood and breath [7:40]; Can zero-calorie sweeteners affect ketone production? [10:40]; Will there be a continuous insulin monitor anytime soon? [11:55]; Exoge…

#109 - John Dudley: The beauty in archery, the love of practice, and a model system for life

In this episode, professional archer, John Dudley, shares the many insights he’s gleaned through the process of not only becoming an elite competitor of archery but also an exceptional teacher. John describes how his desire for improvement has cultivated a sheer love of practice, and how pursuing mastery helped put into context how archery is an amazing model system for life. Additionally, John discusses the often misunderstood nature of hunting, but also makes the case as to why one should consider trying archery even if there is no desire to hunt.   We discuss: Why John loves archery, and what it means to be a professional archer [4:50]; How John’s love of practice and training led to archery [10:45]; How an intense desire to improve drove John to quit football and pursue archery [22:00]; A traumatic childhood event that changed John’s course from troublemaker to committed athlete [34:15]; The nuts and bolts of archery—Competitive events, types of bows, hunting, etc. [45:30]; The blissful nature of archery, and the uselessness of anger [57:15]; Hyper-focus and flow states—Did John’s ADD and task-driven personality give him an advantage? [1:07:15]; The common traits found in th…

#110 - Lew Cantley, Ph.D.: Cancer metabolism, cancer therapies, and the discovery of PI3K

In this episode, Lew Cantley, Professor of cancer biology and Director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medical College in NYC, walks us through his amazing discovery of phosphoinositide 3-kinase (PI3K) and the implications for the care of patients with cancer. He explains various combinations of therapies being tested and used, including the possibility of pairing prescriptive nutritional therapies to increase the efficacy of drugs like PI3K inhibitors. Lew also explains the metabolic nature of cancer through the lens of his research into the connection between sugar consumption, insulin resistance, and tumor growth. Additionally, Lew provides some details about his exciting new clinical trial that is just now enrolling patients with stage 4 breast cancer and endometrial cancer.   We discuss: Teaching science through the lens of discovery—A better approach to learning science [5:15]; The metabolic nature of cancer, mitochondria, and a more nuanced explanation of the Warburg Effect [8:30]; The observation that convinced Lew to stop eating sugar [20:15]; The connection between obesity, insulin resistance, and cancer [25:30]; Sugar consumption and tumor…

#111 - AMA #14: What lab tests can (and cannot) inform us about our overall objective of longevity

In this “Ask Me Anything” (AMA) episode, Peter explains his framework for understanding what lab tests can (and cannot) inform us as it pertains to overall longevity, with a specific focus on atherosclerosis, cancer, Alzheimer’s disease, and the physical body. Additionally, Peter shares details into two patient case studies around cardiovascular disease, including how the lab results influenced his diagnosis and treatment plan for the patients. Once again, Bob Kaplan, Peter’s head of research, will be asking the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #14 show notes page. We discuss: Important lab tests and reference ranges [2:35]; How lab testing fits into the overall objective of longevity [4:25]; A healthcare system set up to react to a disease rather than prevent it [8:00]; The four pillars of chronic disease, and the three components of healthspan [14:30]; Atherosclerosis—How much can labs tell us about risk? [18:00]; Coronary calcium score (CAC)—Interpreting results based …

#112 - Ned David, Ph.D.: How cellular senescence influences aging, and what we can do about it

Ned David is the co-founder of Unity Biotechnology, a company developing senolytic medicines—molecules that target and destroy senescent cells in the human body. In this episode, Ned explains the science of cellular senescence and how it impacts the aging process. Ned discusses how senolytics may delay, prevent, treat, or even reverse age-related diseases, including cancer, cardiovascular disease, and neurodegenerative disease. As a serial entrepreneur, Ned also provides advice on how to transform a simple idea into the creation of a company.   We discuss: Defining longevity and the principles of aging [2:50]; The control knobs of aging and how we can turn them [15:10]; Role of cellular senescence in aging and cancer [27:00]; History of senescence in scientific study [40:30]; The cellular senescence paradox [46:00]; Developing medicines that target cellular senescence [52:15]; Ned’s lessons on risk analysis in business [1:05:15]; The search for a molecule that could eliminate senescent cells [1:15:15]; Senescent cell elimination example in osteoarthritic knees [1:30:30]; Extending lifespan by removing senescent cells [1:45:00]; Senolytic molecule example in macular degeneration r…

#113: Normative errors—a conversation with my daughter about current events

In this episode, I sit down with my daughter to discuss the brutal death of George Floyd, and the aftermath we are watching unfold. Though I have no expertise in race relations, law enforcement, or police brutality, I do have some knowledge in the training of physicians, and it is that training of doctors that I’ve been thinking about lately as it may offer one small insight into this crisis. In this very short discussion, we speak about three types of errors in medicine (and medical training), how to distinguish between the two variants that are acceptable, and the one that is unacceptable. My question, ultimately, is if such a framework can be applied to law enforcement?   Learn more: https://peterattiamd.com/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

#114 - Eileen White, Ph.D.: Autophagy, fasting, and promising new cancer therapies

In this episode, Eileen White, Chief Scientific Officer at the Rutgers Cancer Institute, describes the fundamental role of autophagy in the maintenance of health and prevention of neurodegeneration, cancer, and other diseases. She also goes into detail about the paradoxical finding that autophagy may benefit an existing cancer cell and help it to survive—a discovery leading to new possibilities in cancer therapy. We also discuss fasting (and molecules that induce autophagy) and the critical need to decode the proper fasting “dose” in order to improve human health. We discuss:   Eileen’s discovery that a specific oncogene blocks apoptosis [3:40]; Defining apoptosis and its role in cancer prevention [10:00]; How cancer cells use the autophagy pathway to survive [17:20]; Stressors that induce autophagy [29:15]; The importance of autophagy in the brain and liver [32:45]; The mechanisms that can trigger autophagy to support longevity [40:00]; Evidence for cancer treatment by blocking autophagy [42:30]; Types of cancer that are most autophagy-dependent [46:45]; The autophagy paradox [52:40]; Finding a molecular signal for autophagy [59:15]; Current knowledge gaps around fasting as a…

#115 - David Watkins, Ph.D.: A masterclass in immunology, monoclonal antibodies, and vaccine strategies for COVID-19

In this episode, David Watkins, professor of pathology at George Washington University, shares how insights from his HIV and Zika virus research could apply to SARS-CoV-2 protection strategies. David introduces monoclonal antibodies as an intervention to prevent and treat COVID-19 infection, and also discusses how they could be used as a hedge to vaccine development. Additionally, David’s immunology tutorial explains the innate and adaptive immune systems and their differentiated responses to viral infection.   We discuss: Background and current interest in immunology [4:30]; Immunology 101—The innate and adaptive immune system [10:15]; Defining antibodies, importance of neutralizing antibodies, and serology testing for COVID-19 [19:00]; B cells—How they fight viruses, create antibodies, and fit into the vaccine strategy [25:00]; T cells—Role in the adaptive immune system and ability to kill infected cells to prevent viral spread [36:15]; Valuable lessons from HIV applied to SARS-CoV-2 [51:00]; Lessons taken from the hepatitis C success story [1:01:30]; Monoclonal antibodies, vaccines, and the most promising strategies for preventing and treating COVID-19 infection [1:04:45]; COV…

#116 - AMA with Dom D’Agostino, Ph.D., Part I of II: Ketogenic diet, exogenous ketones, and exercise

Back by very popular demand for a special AMA episode, ketosis expert Dom D’Agostino joins Bob Kaplan, Peter’s Head of Research, to address many lingering questions about the ketogenic diet, exogenous ketones, and exercise for overall health. Dom also shares valuable insights from his personal experience with training, supplements, intermittent fasting, and other nutritional strategies to optimize his own health and performance. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA.  If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on the website show notes page. We discuss: Dom’s recent and ongoing projects [3:00]; Benefits of a ketogenic diet for an otherwise healthy person [7:00]; Book recommendations to become more knowledgeable about a ketogenic diet [11:30]; Best devices for measuring ketones [13:45]; Genetic factors that influence how someone responds to the ketogenic diet [24:45]; Ketogenic diet for those with the APOE e4 allele [28:15]; Impact of long-term ketogenic diets on thyroid function [34:25]; Low-carb and ketogenic diets for appetite control and weight management […

#117 - Stanley Perlman, M.D., Ph.D.: Insights from a coronavirus expert on COVID-19

In this episode, Stanley Perlman shares insights from his impressive career studying coronaviruses—both the common and more deadly ones, like MERS and SARS. In comparing preceding coronaviruses with SARS-CoV-2, Stanley discusses how other coronaviruses can aid our current understanding of, and be used to infer about, COVID-19. He also gives his thoughts on durable immunity, therapeutic strategies, and future outbreak preparedness.   We discuss: His background and early work with coronaviruses [2:45]; The coronavirus family—various types, common traits, and scientific understanding [9:00]; The origin of viruses, animal to human transmission, R_0, immunity, and more [17:45]; Insights from the 2002 SARS outbreak [28:30]; Insights from the 2012 MERS outbreak [35:00]; Comparing SARS-CoV-2 to MERS, SARS, and other coronaviruses [42:00]; COVID-19 survivor potential for long-term damage [53:30]; Using the current pandemic for lessons on future preparedness [57:00]; Genetic drift and the potential for long-term immunity to COVID-19 [1:07:00]; Prevention and treatment strategies for COVID-19 and future diseases [1:22:30]; Alternative hypothesis to the origin of SARS-CoV-2 [1:32:30]; …

#118 - Lloyd Klickstein, M.D., Ph.D.: Rapamycin, mTOR inhibition, and the biology of aging

Lloyd Klickstein is the Chief Science Officer at resTORbio, a biopharmaceutical company that develops medications to target the biology of aging. In this episode, Lloyd discusses his company’s clinical application of rapamycin and its derivatives. He also elucidates details of his 2014 paper—a paper that greatly influenced Peter’s perspective of rapamycin in the context of longevity. Peter and Lloyd go on to discuss the dose-dependent effect of rapamycin on immune function and compare rapamycin, fasting, and caloric restriction.   We discuss: His background and decision to leave academia for translational medicine [6:15]; Translational medicine—bridging the gap between basic science and clinical medicine [10:30]; What prompted Lloyd to focus on mTOR inhibition? [18:00]; Defining mTOR, TORC1, and TORC2, and the consequences of inhibiting them with rapamycin [21:30]; Dose-dependent impact of rapamycin on immune function, mTOR inhibition, and toxicity [42:15]; Lloyd’s 2014 experiment—mTOR inhibition improves immune function in the elderly [53:00]; Insights into autophagy, antigen presentation, and the pleiotropic benefits of a rapalog, and how it compares to fasting [1:13:00]; Lloy…

#119 - Terry Real: Breaking the cycle of shame, anger, and depression

Terry Real, a renowned family therapist and best-selling author, helps people create the connections they desire in their relationships. In this episode, Terry describes how his upbringing with an abusive father forged his path to become a therapist, develop his Relational Life Therapy (RLT) framework, and write I Don't Want to Talk About It—a book that reveals the hidden legacy of male depression. Terry discusses the link between childhood trauma and the deep-rooted shame, anger, and depression, which can result in feeling disconnected. Using real-life examples, Terry explains how he implements RLT to confront trauma, discover its origin, and teach the skills to break the cycle of pain, in order to live a satisfying life.   We discuss: Terry’s upbringing with a depressed and abusive father [3:15]; The importance of the repair process, after relational disharmony, to break the trauma cycle [15:15]; The impact of a patriarchal society, and relational growth as the next step for feminism [19:00]; Origins of deep-rooted shame, and the difference between feeling ashamed and feeling guilty [27:15]; Preventing the propagation of trauma without over-coddling kids [35:30]; The one-up/one…

#120 - AMA with Dom D’Agostino, Ph.D., Part II of II: Ketosis for cancer and chronic disease, hyperbaric oxygen therapy…

In part 2 of this special AMA episode, ketosis expert Dom D’Agostino once again joins Bob Kaplan, Peter’s Head of Research, to discuss the impact of ketosis on various chronic diseases as well as the latest research on the metabolic management of cancer. Dom also discusses the numerous applications of hyperbaric oxygen therapy, provides insights into the application of ketosis on female health and performance, and much more. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on the website show notes page.   We discuss: Update on Dom’s Press-pulse therapeutic strategy for the metabolic management of cancer [2:05]; Potential role for vitamin C in cancer treatment [12:45]; Glutamine targeting in cancer therapy—evidence that the mitochondria in cancer are damaged? [17:45]; Can a ketogenic diet lessen the toxicity of cancer therapies? [24:45]; 3BP—a promising agent in cancer therapy [26:45]; The relationship between cancer and ketogenic diets [29:30]; Hyperbaric oxygen therapy (HBOT)—primer, protocols, and therapeutic uses [33:30]; I…

#121 - Azra Raza, M.D.: Why we're losing the war on cancer

Azra Raza is a physician, scientist, author, and outspoken advocate for reconfiguring the current model of research in cancer. In this episode, Azra discusses the content of her book, The First Cell, which takes a critical look at the outdated models being used to study cancer resulting in a lack of progress in survival rates for cancer patients. Azra offers a solution which focuses on early detection and prevention, and she concludes with an optimistic outlook for the future of cancer research.   We discuss: Azra’s upbringing, interest in oncology, and the basis for writing her book [3:30]; The lack of progress in cancer treatment over the decades [18:45]; What is holding the oncology field back? [33:15]; Do the purported advances in oncology reflect the billions of dollars spent on cancer research? [40:00]; Economics of new cancer drugs—how small increases in survival come with staggering financial burdens [47:00]; How good intentions can still lead to misaligned incentives and a broken system [1:03:00]; Why 95% of new cancer drugs fail—a critical review of the cancer research model [1:11:15]; Early detection and prevention—a potential solution to the cancer problem [1:22:30];…

#122 - Lori Gottlieb: Understanding pain, therapeutic breakthroughs, and keys to enduring emotional health

Lori Gottlieb is a psychotherapist and the bestselling author of Maybe You Should Talk to Someone. In this episode, Lori extracts important lessons from her experiences as both a therapist and a patient. The stories Lori shares has provided her the material for insights into living a more fulfilling life. In our conversation, Lori also dispels some misconceptions about therapy, explains the process of big therapeutic breakthroughs, and reveals the most important steps for enduring emotional health. We discuss: Lori’s unique path to becoming a therapist [3:00]; Dissecting cadavers—a profound experience during med school [12:30]; The sunk cost fallacy—How Lori was able to walk away from med school [17:15]; Being aware of the gift of life, and other lessons from Lori’s terminally ill patient [24:00]; How underlying pain can manifest in obnoxious behavior [32:45]; Counseling versus therapy [36:15]; The story of John—why men hide their feelings, breaking down his shield, and uncovering his pain [38:30]; “Breaking open”—A shocking revelation about John that tests Lori’s resolve as a therapist [46:30]; Rewriting your story, the recovery process, and the most important step for lasting …

#123 - Joan Mannick, M.D. & Nir Barzilai, M.D.: Rapamycin and metformin—longevity, immune enhancement, and COVID-19

In this episode, Joan and Nir discuss their extensive research into rapamycin (including the category of analogs to rapamycin known as rapalogs) and metformin, respectively. Based on his work with metformin, Nir shares how he believes it could be a pro-longevity drug and the clinical trial he’s leading to test this belief. Joan discusses her work with rapalogs, their ability to suppress the immune system as well as provide immune-enhancement, and the clinical trials she has led that inform her insights. We also talk about the potential beneficial roles of both metformin and rapamycin in reducing mortality from COVID-19, reducing the risk of neurodegenerative diseases, and delaying aging as well as its related diseases.    We discuss: Joan’s career, interest in aging, and work with rapamycin analogs [3:45]; When Nir became convinced metformin could be a pro-longevity agent [15:00]; How metformin and rapamycin impact the hallmarks of aging and extend lifespan [24:15]; Enhancing the immune system with rapalogs and metformin [34:15]; Potential of metformin and rapamycin in reducing mortality from COVID-19 [41:30]; Insights from Joan’s studies investigating the immune-enhancing effect…

#124 - AMA #15: Real-world case studies—metabolic dysregulation, low testosterone, menopause, and more

As a follow up to AMA #14 where Peter explained his framework for analyzing labs, this “Ask Me Anything” (AMA) episode focuses on a number of real-world case studies exploring metabolic dysregulation, low testosterone, menopause, hypothyroidism, elevated uric acid, and more. From the examples discussed, you can follow along how our clinical team goes about interpreting diagnostic measures and applying relevant research findings. Once again, Bob Kaplan, Peter’s head of research, will be asking the questions. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #15 show notes page. We discuss: Should you stop taking supplements before getting a lab test? [2:45]; Family history—Questions to ask and what to look for [5:30]; The purpose of an oral glucose tolerance test (OGTT) [12:15]; Case study—Insufficient muscle mass for proper glucose disposal [17:15]; Why hemoglobin A1c is a relatively unhelpful metric [24:00]; Case study—Exceeding carbohydrate tolerance [26:30]; Case study—Metabolic dysfunction and a framework for metabolic health [33:30]; Peter’s ideal tracking of metabolic health for all his patients [43:30]; …

#125 - John Arnold: The most prolific philanthropist you may not have heard of

John Arnold is widely regarded as the greatest natural gas trader of all time, but in his late 30’s he walked away from it all and turned full-time philanthropist. He and his wife have committed to strategically give away most of their vast fortune in their lifetime and are already doing so at a staggering pace of nearly a half billion dollars a year. In this episode, John explains his quest to address the most challenging social programs plaguing the country, including criminal justice, health care policy, and K-12 education. John also shares self-identified attributes that contributed to his success in natural gas trading and how those same traits have translated to his philanthropic aspirations. We discuss: John’s background, upbringing, and early entrepreneurial tendencies [3:50]; John’s time and rise at Enron [16:45]; Characteristics that made John an exceptional natural gas trader and how they translate to his philanthropic work [27:30]; The collapse of Enron [35:00]; The success of John’s hedge fund, and his early interest in philanthropy [40:30]; The infamous 2006 trade that brought down Amaranth Advisors [55:45]; John’s analytical prowess and emphasis on fundamentals [1:…

#126 – Matthew Walker, Ph.D.: Sleep and immune function, chronotypes, hygiene tips, and addressing questions about his …

In this episode, sleep expert Matthew Walker returns by popular demand to dive deeper into many sleep-related topics, starting with what we’ve learned about sleep through the lens of the COVID-19 pandemic and how sleep impacts the immune system. He then covers topics such as how dreaming affects emotional health, the different sleep chronotypes, the best sleep hygiene tips, and the pros and cons of napping. Matthew finishes by addressing several of the errors that readers have pointed out in his book, Why We Sleep. We discuss: Three ways the coronavirus pandemic impacts sleep [3:30]; The importance of dreaming for emotional health, and how the coronavirus pandemic increases dreaming [11:45]; The impact of alcohol consumption on sleep quality and stress levels [20:00]; Sleep’s impact on the immune system and implications for a future COVID-19 vaccine [27:45]; What determines how much deep sleep and REM sleep you need? [36:30]; Pros and cons of napping, and insights from the sleep habits of hunter-gatherer tribes [42:15]; Sleep hygiene, wind-down routine, and tips for better sleep [56:45]; Understanding sleep chronotypes and how knowing yours can help you [1:06:00]; Night terr…

#127 - AMA #3 with sleep expert, Matthew Walker, Ph.D.: Fasting, gut health, blue light, caffeine, REM sleep, and more

In this special episode, Matthew Walker returns for his third AMA episode to provide his expert insight into numerous sleep-related questions directly from listeners. He explains how he adjusted his hypotheses on topics like blue light and caffeine, and why he is more bullish on the importance of REM sleep. Matt also answers questions about sleep wearables, how fasting affects sleep, how sleep deprivation impacts gut health, and magnesium as a sleep aid. Finally, Matt reveals what he believes is the next evolution in sleep science and technology. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website on the show notes page. We discuss: Matt’s framework for changing his mind when faced with new information [1:30]; Blue light—How Matt shifted his thinking [5:45]; Caffeine—How Matt has adjusted his hypothesis [12:00]; REM sleep—Why Matt is more bullish on the importance of dream sleep [16:30]; How to increase REM sleep [27:30]; Sleep tracking wearables—criteria for evaluation, and why Matthew favors Oura [35:00]; Does the electromagnetic force of devices have any impact on sleep? [40:15]; The relationship between fasting and sl…

#128 – Irene Davis, Ph.D.: The evolution of the foot, running injuries, and minimalist shoes

Irene Davis is the founding Director of the Spaulding National Running Center at the Harvard Medical School. In this episode, Irene describes how her research of biomechanics and clinical work with running injuries, as well as research by others, has shaped her views on maintaining body alignment and foot health. Irene discusses her argument for the role of modern footwear in running-related injuries and how minimalist footwear helps resolve the subsequent biomechanical issues. We discuss: Irene’s path to her Ph.D., her entry into physical therapy, and her interest in biomechanics [3:20]; How Irene’s thinking about the use of orthotics has changed [7:15]; The evolution of the human foot and the transition from walking to running [10:30]; The evolution of shoes and its impact on running injuries [17:30]; An overview of running injuries [26:00]; Cushioned running shoes, heel striking and impact forces [29:30]; Shin splints [33:45]; How heel strike patterns promotes knee stress through rate of loading [35:30]; The critical importance of exercise [42:15]; Impact forces and injury potential [45:45]; How shoe cushioning alters impact forces despite forefoot striking [49:00]; An overvie…

#129 - Tom Dayspring, M.D.: The latest insights into cardiovascular disease and lipidology

World-renowned lipidologist Tom Dayspring returns to give an update on the current thinking in lipidology as a follow-up to his 2018 five-part podcast series. In this episode, Tom discusses the growing consensus that atherogenic lipoproteins are essential drivers of atherosclerotic vascular disease. Tom further emphasizes apolipoprotein B (apoB) and lipoprotein(a) (Lp(a)). He provides insights into risk assessment, including which lab metrics to use, how to interpret them, and the appropriate therapeutic targets. Additionally, Tom discusses the most recent developments in lipid-lowering drug therapies—from the continued evolution of PCSK9 inhibitors, to the latest understanding of EPA and DHA, and the most recent addition of bempedoic acid to the list of therapeutic agents. We discuss: The latest in the field of lipidology and cardiovascular disease [3:45]; Apolipoproteins—the key to understanding lipid biology [9:30]; ApoB as a preferred metric over LDL-P [16:30]; Therapeutic goals for apoB concentration [21:45]; Drivers of atherosclerosis [34:15]; Overview and current thinking on high density lipoproteins (HDLs)—Is it a useful metric? [37:00]; Lipoprotein(a)—the most dangerous …

#130 - Carol Tavris, Ph.D. & Elliot Aronson, Ph.D.: Recognizing and overcoming cognitive dissonance

Renowned social psychologists Carol Tavris and Elliot Aronson are the co-authors of Mistakes Were Made (But Not By Me), a book which explores the science of cognitive biases and discusses how the human brain is wired for self-justification. In this episode, Carol and Elliot discuss how our desire to reconcile mental conflicts adversely affects many aspects of society. The two give real-world examples to demonstrate the pitfalls in attempts to reduce mental conflict, or dissonance. The examples reveal that no one is immune to dissonance reduction behavior, how intellectual honesty can be trained and lastly, how to think critically in order to avoid engaging in harmful dissonant behaviors. We discuss: Carol and Elliot’s respective background, collaboration history, and their decision to write Mistakes Were Made (But Not By Me) [4:00]; The theory of cognitive dissonance, and real examples of dissonance reduction in action [11:15]; How Elliot advanced the theory of cognitive dissonance [23:00]; The evolutionary reason for dissonance reduction, and cultural differences in what causes cognitive dissonance [30:30]; The great danger of smart, powerful people engaging in dissonance reduct…

#131 - Beth Lewis: The Art of Stability: Learning about pain, mitigating injury, and moving better through life

Beth Lewis is a former professional dancer and a self-described “educator of movement” who has an unmatched ability to assimilate information and customize training plans from multiple training systems. In this episode, Beth takes us through how she identifies problematic movement patterns and postures to help individuals relieve pain, avoid injury, and move better within all types of exercise. She explains how movement is in fact a trainable skill and provides suggestions for what people can add to their exercise routine to benefit their health and longevity. We discuss: Beth’s “way of no way” training philosophy [4:45] Beth’s background in dancing and how she ended up in New York City [7:30] Beth’s transition to fitness coaching and how her training philosophy has evolved [12:45]; Functional Range Conditioning and scapular mobility [21:50]; An overview of Postural Restoration Institute and Peter’s squat assessment [35:30]; The important connection between the ribs and breathing [39:45]; The role of sitting and external stress in chronic muscular tension [42:30]; The important role of your toes, minimalist footwear, and toe yoga [44:30]; Dynamic Neuromuscular Stabilization (DNS)…

#132 - AMA #16: Exploring hot and cold therapy

In this “Ask Me Anything” (AMA) episode, Peter and Bob explore the quality of evidence for hot and cold therapy. In the discussion, they evaluate the safety, efficacy, and opportunity costs of various hot and cold therapy protocols, and Peter ultimately considers the addition of dry sauna to his longevity toolkit. Once again, Bob Kaplan, Peter’s head of research, will be asking the questions. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #16 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: How stress can show up as physical pain, and tips for changing time zones [1:45]; Literature overview of heat and cold therapy [7:15]; Cold therapy for delayed onset muscle soreness (DOMS) [12:00]; Quality of evidence for cold therapy for depression or immune enhancement [19:30]; Cold therapy and brown adipose tissue (BAT) [21:15]; Weighing the safety, efficacy, and opportunity cost of cold therapy [28:45]; An overview of heat therapy benefits [40:00]…

#133 - Vinay Prasad, M.D., M.P.H: Hallmarks of successful cancer policy

Vinay Prasad is a practicing hematologist-oncologist who doubles as a “meta-researcher,” studying the quality of medical evidence, health policy, and clinical trials. In this episode, Vinay discusses the differences in clinical treatment from the existing medical evidence, often leading to useless, or even harmful, outcomes for patients. With a focus in oncology, he takes a deep dive into the field’s structural problems, which include the disconnect between progress and funding, drug costs, and financial conflicts of interest. He concludes with his “six hallmarks of successful cancer policy” as a potential roadmap to sustained progress against cancer and a way to avoid repeating the policy and practice mistakes of the past.   We discuss: Vinay’s background and unique perspective [3:15]; Medical reversal—the disconnect between research findings and clinical applications in medicine [10:15]; The uniquely challenging field of oncology [22:45]; The importance of bedside manner with cancer patients [30:00]; Structural problems in oncology—Problem #1: Huge costs for small improvements [37:00]; Structural problems in oncology—Problem #2: Medical reversal—when medical practices ar…

#134 - James O’Keefe, M.D.: Preventing cardiovascular disease and the risk of too much exercise.

James O’Keefe is a preventative cardiologist and bestselling author of The Forever Young Diet and Lifestyle. In this episode, James discusses cardiac physiology and what makes the human heart susceptible to disease. He provides evidence for what supports his approach to exercise--elucidating both positive and negative kinds of exercise for heart health. He also discusses the role of nutrition, specific nutrients, and pharmacological interventions to support heart and brain longevity.   We discuss: James’ background and why he favors a preventative approach to cardiology [3:15]; Understanding atherosclerosis and the misconception that it’s a “plumbing problem” [10:15]; The danger in excessive exercise—a reverse J-shaped mortality curve [21:15]; The story of Micah True—A case study of excessive exercise [49:15]; The best kinds of exercise for longevity—The Copenhagen City Heart Study [53:00]; Being a more balanced athlete and finding the right exercise intensity [58:45]; Heart rate during exercise, resting heart rate, and other important metrics [1:04:00]; Nutrition for cardiovascular health [1:09:45]; Important nutrients: Magnesium, potassium, calcium, sodium, and collagen [1:19:…

#135 - BJ Miller, M.D.: How understanding death leads to a better life

BJ Miller is a hospice and palliative care specialist on a quest to reframe our relationship with death. In this episode, BJ begins with how his own brush with death radically shifted his perspective and ultimately forged his path towards palliative care and helping patients integrate and understand their life in a meaningful way. BJ recounts several moving stories from his patients, which reveal important lessons about overcoming the fear of death, letting go of regret, and what’s most important in life. He discusses the major design flaws of a “death phobic” healthcare system. Furthermore, he makes the case that seeing death as a part of life allows us to live well, as opposed to living to evade death itself. He concludes with a discussion around physician-assisted death as well as his hopes around the use of psychedelics to reduce suffering in end-of-life care.   We discuss: BJ’s accident leading to the loss of his limbs and his experience inside a burn unit [3:00]; Coping with his amputations—being tough, the grieving process, and the healing properties of tears [14:30]; Going from art history to medical school: the value of a diverse background in medicine [28:15]; How BJ’s…

#136 - AMA #17: Body composition methods tour de force, insulin resistance, and Topo Chico

In this “Ask Me Anything” (AMA) episode, Peter and Bob discuss different methods to evaluate body composition. They explore ways of measuring body fat, delineating between subcutaneous and visceral fat, and go over best strategies for improving body composition and optimizing health. They also discuss insulin resistance using a patient case study that highlights interventions capable of reversing the condition. Finally, Peter addresses his level of concern about a recent Consumer Report finding that Topo Chico had the highest levels of a class of synthetic chemicals (PFAS) of all the carbonated bottled waters tested. Peter concludes by sharing if the finding will change his consumption habits. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #17 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.   We discuss: Body mass index (BMI) vs. body fat percentage (BF%) (1:45); Methods of assessing body fat—Magnetic Resonance Imaging (MRI) (6:25); The differe…

#137 - Paul Offit, M.D.: An expert perspective on COVID-19 vaccines

Paul Offit is a pediatrician specializing in infectious diseases and an expert in virology and vaccine development. He currently serves on the FDA committee overseeing and evaluating COVID-19 vaccines. In this episode, Paul discusses the strategies and major companies pursuing a vaccine against the SARS-CoV-2 virus. He gets into the nuances of the vaccine approval process and its implications for COVID-19 vaccine outlook. Paul also explains potential risks, reveals his own confidence level in safety, and gives insight into protection against reinfection with vaccination. Please note that this episode was recorded 11/05/2020, prior to the 11/09/2020 news release of the Pfizer vaccine update.   We discuss: How Paul’s experience as a child in a chronic care hospital as child informed his path in pediatrics and vaccine development (3:30); Addressing the anti-vaccination sentiment and explaining the fraudulent origins of the anti-vaccination movement (8:00); Lessons and insights from 26 years studying rotavirus and creating a successful rotavirus vaccine (17:00); Developing a new vaccine: the different phases of clinical trials, overall timeline, and financial costs (27:15); Operati…

#138 - Lauren Miller Rogen and Richard Isaacson, M.D.: Alzheimer’s disease prevention—patient and doctor perspectives

Peter is joined by writer, director, actress, and founder of HFC, Lauren Miller Rogen, and previous podcast guest and director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian, Dr. Richard Isaacson. In this episode, Lauren tells the heartbreaking story of watching members of her family succumb to Alzheimer’s disease (AD) which motivated her to proactively address her own risk with Richard’s guidance. Richard discusses the various genetic and lifestyle factors that influence the risk of AD and uses Lauren’s unique situation to explain how he diagnoses patients and personalizes care. They go through Lauren’s protocol of preventative measures that have already produced marked results, and end with the uplifting message that one’s genetic predisposition does not seal one's fate. We discuss: Lauren’s deep family history of Alzheimer’s disease (3:10); The influence of genetics, epigenetics, and lifestyle on Alzheimer’s disease risk (13:45); Lauren’s mother’s disease progression and the enormous stress it causes for family members (24:30); The various manifestations of Alzheimer’s disease depending on the location of pathology (29:30); The thre…

#139 - Kristin Neff, Ph.D.: The power of self-compassion

Kristin Neff is a Professor of Educational Psychology at the University of Texas, author, and a leading expert on mindful self-compassion. In this episode, she shares how developing a self-compassion and mindfulness practice was the most effective tool for relieving her own suffering, and provides strategies and tactics to improve self-compassion and well-being. We discuss: The life crisis that turned Kristin to mindfulness and self-compassion (3:30); How mindful self-compassion relieved Kristin’s feelings of self-judgement, and the psychology that says we all have the capacity for self-compassion (9:45); Peter’s history of self-criticism and his personal practice of self-compassion (17:15); The problem with prioritizing self-esteem over self-compassion, and how self-compassion produces a more stable version of self-worth (20:15); An argument for self-compassion over self-criticism for optimizing performance (26:15); How and when to introduce self-compassion to children (31:45); Learning her son had autism—a personal story of how Kristin used mindfulness and self-compassion (36:45); Self-compassion for cases of childhood trauma, PTSD, and overcoming a “fear of compassion” (44…

#140 - Gerald Shulman, M.D., Ph.D.: A masterclass on insulin resistance—molecular mechanisms and clinical implications

Gerald Shulman is a Professor of Medicine, Cellular & Molecular Physiology, and the Director of the Diabetes Research Center at Yale. His pioneering work on the use of advanced technologies to analyze metabolic flux within cells has greatly contributed to the understanding of insulin resistance and type 2 diabetes. In this episode, Gerald clarifies what insulin resistance means as it relates to the muscle and the liver, and the evolutionary reason for its existence. He goes into depth on mechanisms that lead to and resolve insulin resistance, like the role of diet, exercise, and pharmacological agents. As a bonus, Gerald concludes with insights into Metformin’s mechanism of action and its suitability as a longevity agent. We discuss: Gerald’s background and interest in metabolism and insulin resistance (4:30); Insulin resistance as a root cause of chronic disease (8:30); How Gerald uses NMR to see inside cells (12:00); Defining and diagnosing insulin resistance and type 2 diabetes (19:15); The role of lipids in insulin resistance (31:15); Confirmation of glucose transport as the root problem in lipid-induced insulin resistance (40:15); The role of exercise in protecting against…

#141 - AMA #18: Deep dive: sugar and sugar substitutes

In this “Ask Me Anything” (AMA) episode, Peter and Bob talk all about sugar and sugar substitutes and provide a way to think about sugar consumption. The conversation begins by defining the various forms of sugar, delineating between added sugar and naturally occurring sugar, and describing the important variables that determine the potential for metabolic damage from consumption. They then take a dive deep into three main categories of sugar substitutes—non-nutritive sweeteners, alcohol sugars, and leaving allulose, in a class by itself—including the safety profile of each, impact on blood sugar and insulin, side-effects, taste preferences, and more.  If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #18 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.  We discuss: Delineating the various forms of “sugar” (2:00); Added sugar vs. naturally occurring sugar (12:30); Important variables related to sugar consumption: Density, volume, and velocity (17:00);…

#142 - Robert Abbott: The Bobby Knight story—a cautionary tale of unchecked anger, ego, and winning at all costs

Robert Abbott is a six-time Emmy award winner and the director of “The Last Days of Knight,” the behind-the-scenes documentary of legendary coach Bobby Knight, and the events that led to his termination from Indiana University. In this episode, Robert takes us through his investigative journey, which revealed cautionary tales of a winning at all costs environment—how pain often gets left in the wake of unchecked anger, ego, and perfectionism. Robert reflects on Knight’s legacy and extracts lessons in self-awareness and accountability that can be applied to ensure history doesn’t repeat itself. We discuss: Robert’s career covering sports and interesting athletes (2:30); Robert’s early impression of Bobby Knight’s controversial persona (10:15); The journalistic work that uniquely prepared Robert for his Bobby Knight story (13:30); The cost of excellence in sports—cautionary tales of ‘greatness at any cost’ (19:15); Knight’s coaching style, waning success in the 90s, and what put him on Robert’s radar (25:30); Three alarming accounts from a former player (Neil Reed) that launched Robert’s investigation into Bobby Knight (35:15); The “win-first” environment at Indiana that provided …

#143 - John Ioannidis, M.D., D.Sc.: Why most biomedical research is flawed, and how to improve it

John Ioannidis is a physician, scientist, writer, and a Stanford University professor who studies scientific research itself, a process known as meta-research. In this episode, John discusses his staggering finding that the majority of published research is actually incorrect. Using nutritional epidemiology as the poster child for irreproducible findings, John describes at length the factors that play into these false positive results and offers numerous insights into how science can course correct.    We discuss: John’s background, and the synergy of mathematics, science, and medicine (2:40); Why most published research findings are false (10:00); The bending of data to reach ‘statistical significance,’ and the how bias impacts results (19:30); The problem of power: How over- and under-powered studies lead to false positives (26:00); Contrasting nutritional epidemiology with genetics research (31:00); How to improve nutritional epidemiology and get more answers on efficacy (38:45); How pre-existing beliefs impact science (52:30); The antidote to questionable research practices infected with bias and bad incentive structures (1:03:45); The different roles of public, private, and …

#144 - Phil Maffetone: Optimizing health and performance through maximal aerobic function

Phil Maffetone is an author, health practitioner, and coach with decades of experience helping everyone from amateurs to world-class athletes optimize their health and performance. In this episode, Phil explains the importance of developing the aerobic system, defines maximum aerobic function (MAF), and explains how to determine your MAF heart rate. He then demonstrates how to integrate that into a training protocol which is designed to help people move faster at a sub maximum heart rate and increase fat utilization as the primary source of fuel—emphasizing the importance of nutrition on one's capacity to oxidize fat. Phil also extracts training insights from the amazing feats of world-class marathoners, explores the impact of a low-carb diet on one’s capacity for high intensity exercise and anaerobic performance, and explains the downstream effects of being “overfat.”   We discuss:   Phil’s background in running, and training insights from a six-day race (2:30); The difference between being “fit” and being “healthy” (11:00); Defining the aerobic and anaerobic systems, and why VO2 max doesn’t predict performance (18:15); Defining maximum aerobic function (MAF), …

#145 - AMA #19: Deep dive on Zone 2 training, magnesium supplementation, and how to engage with your doctor

In this “Ask Me Anything” (AMA) episode, Peter and Bob take a deep dive into zone 2 training. They begin with a detailed definition of zone 2 and continue by discussing the importance of adding it to your exercise regimen. They talk about how to program zone 2 training, including intensity, frequency, and duration, and metrics for tracking improvement. Additionally, they provide a detailed overview of all things related to magnesium supplementation. The two conclude with insights about how to effectively engage with your doctor in the pursuit of getting your questions answered and considerations for finding a physician that’s right for you. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #19 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Defining zone 2 exercise (3:30); The most effective ways to engage in zone 2 exercise (14:00); The process of training a deconditioned individual with zone 2: Dosage, frequency, and metrics to watch (…

#146 - Guy Winch, Ph.D.: Emotional first aid and how to treat psychological injuries

Guy Winch is a psychologist, author, and co-host of the Dear Therapist podcast. In this episode, Guy speaks to the commonality of the human condition with relatable stories from his decades of therapy sessions as well as his own experience with incessant rumination in the early days of his private practice. He shares insights on what he sees as an epidemic of rumination that leads to career burnout, the consequences of social comparison heightened by social media, and the psychological impact of not recognizing success. He emphasizes the need for a “psychological medicine cabinet” and provides concrete and practical tools for treating emotional injuries. He concludes with a discussion about the widespread impact of the coronavirus pandemic on emotional health and how we can use experienced psychologists in a time when it’s especially needed. We discuss: The unique format and impetus for Guy’s podcast with Lori Gottlieb (3:00); How Guy pieced together the many different schools of thought in psychology to develop his own unique approach (7:45); The most important component of successful therapy, and why it sometimes makes sense to “break the rules” (19:30); Insights extract…

#147 - Hussein Yassine, M.D.: Deep dive into the “Alzheimer’s gene” (APOE), brain health, and omega-3s

Hussein Yassine is a physician and researcher who studies brain lipid utilization in the context of finding preventative measures for cognitive impairment, specifically Alzheimer’s disease (AD). In my conversation with Hussein, we begin with a fundamental coursework in brain biology—including its architecture and energy systems. We go on to discuss what these systems look like when something goes wrong and cognitive decline ensues. We talk about the evolutionary origins of the ApoE genotype, with specific attention to the ApoE4 allele and its association with AD. We spend time discussing ApoE4 implications for the brain’s fuel utilization, notably omega-3 fatty acids: EPA and DHA. We briefly pivot to the implications of recent omega-3 trials for cardiovascular disease and return to what we currently understand about EPA/DHA and brain health; we contemplate potential dietary interventions across the lifespan to preserve and prolong cognitive function. We discuss: Hussein’s Background and introduction to brain composition (3:00); The blood-brain barrier and brain filtration (8:00); Lipids and brain function (13:00); How the brain utilizes energy (18:00); Apolipoprotein E (ApoE…

#148 - Richard Miller, M.D., Ph.D.: The gold standard for testing longevity drugs: the Interventions Testing Program

Richard Miller is a professor of pathology and the Director of the Center for Aging Research at the University of Michigan. He is one of the architects of the NIA-funded Interventions Testing Programs (ITPs) animal study test protocol. In this episode, Rich goes through the results of the long list of molecules tested by the ITP—including rapamycin, metformin, nicotinamide riboside, an SGLT-2 inhibitor called canagliflozin, and more. Many of the discussed outcomes have had surprising outcomes—both positive and negative findings. We discuss: Rich’s interest in aging, and how Hayflick’s hypothesis skewed aging research (3:45); Dispelling the myth that aging can’t be slowed (15:00); The Interventions Testing Program—A scientific framework for testing whether drugs extend lifespan in mice (29:00); Testing aspirin in the first ITP cohort (38:45); Rapamycin: results from ITP studies, dosing considerations, and what it tells us about early- vs. late-life interventions (44:45); Acarbose as a potential longevity agent by virtue of its ability to block peak glucose levels (1:07:15); Resveratrol: why it received so much attention as a longevity agent, and the takeaways from the negat…

#149 - AMA #20: Simplifying the complexities of insulin resistance: how it's measured, how it manifests in the muscle a…

In this “Ask Me Anything” (AMA) episode, Peter and Bob discuss all things related to insulin resistance by revisiting the important points made in the fascinating, yet quite technical, episode of The Drive with Gerald Shulman. They devote the entire discussion to understanding the condition known as insulin resistance, how it’s measured, how it manifests in the muscle and liver, and ultimately, what we can do about it. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #20 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Explaining the format of this AMA: Extracting insights from Gerald Shulman’s masterclass on insulin resistance (2:00); The basics of insulin, defining insulin resistance (IR), and gold-standard methods of quantifying IR in the muscle (7:15); Practical ways to test for insulin resistance in a normal clinical setting (15:45); How insulin resistance manifests in the muscle (23:00); The biochemical block in glycogen synthesi…

#150 - Senator Bill Frist, M.D.: A modern Renaissance man's journey through science, politics, and business

Bill Frist is a nationally acclaimed heart and lung transplant surgeon, former U.S. Senate Majority Leader, and is actively engaged in health policy and education reform. In this episode, Bill takes us through his long and varied career in medicine, politics, and business, which includes establishing the organ transplantation program at Vanderbilt as well as rising from the lowest-ranked member of the U.S. Senate to the Majority Leader in two terms. We discuss some of the most significant moments of his time in the Senate, such as advocating for AIDS prevention programs' funding and addressing complicated issues like stem cell research and the end-of-life issues raised by the Terri Schiavo case. We also hear his first-person account of what happened behind the scenes on September 11, 2001, his frustration with our lack of preparation for the pandemic, and his thoughts about the current state of U.S. politics. Finally, we talk about his current endeavors in health policy and education reform. We discuss: Bill’s decision to pursue medicine and do organ transplants (3:40); The miraculous nature of organ transplants: History, Bill’s work, and the most exciting things to come (12:…

#151 - Alex Hutchinson, Ph.D.: Translating the science of endurance and extreme human performance

Alex Hutchinson is a sports science journalist, author of the book Endure—which explores the science of endurance and the real limits of human performance—and former competitive runner for the Canadian national team. In this episode, Alex tells the story of his “aha moment” during a meaningless track meet that catapulted his running career and seeded his interest in the power of the mind. He then explains the science behind VO2 max, the difference between maximum aerobic capacity and efficiency, and extracts insights from examples of extreme human performance, such as the recent attempts to break the 2-hour mark in the marathon. Finally, he brings it back to what this all means for the everyday person: optimal exercise volume for maintaining health, how to avoid acute and chronic injuries, how to diversify your exercise portfolio, HIIT protocols, and much more.   We discuss: Alex’s background and passion for running (3:00); The power of the mind: Alex’s “aha moment” that catapulted his running career (9:00); Pursuing a Ph.D. in physics while prioritizing his running career, and doing the hardest thing possible (19:00); Career transition to journalism, tips for improving yo…

#152 - Michael Rintala, D.C.: Principles of Dynamic Neuromuscular Stabilization (DNS)

Michael Rintala is a sports medicine chiropractor and one of only 18 international instructors teaching dynamic neuromuscular stabilization (DNS) for the Prague School of Rehabilitation. This episode focuses on understanding DNS, including the foundational principles and how it relates to human motor development. Michael also shares the most common injuries and issues he sees in patients in his practice, such as postural problems and back pain, and how the movements of a DNS program are used to avoid injury, maintain longevity, and improve sports performance. We discuss: Michael’s background in chiropractic sports medicine and rehabilitation (3:15); The Prague School of Rehabilitation, and functional rehabilitation as the foundation of the dynamic neuromuscular stabilization (DNS) program (5:00); Foundational principles of DNS, and the role of the diaphragm in muscular stability (19:00); Types of muscle contractions (28:15); Human motor development through the lens of DNS, and when issues begin to arise (32:30); Common postural syndromes (50:00); Increasing functional threshold to minimize time in the functional gap (56:45); DNS for injuries, pain, pre-habilitation, and performa…