The Peter Attia Drive

Latest Episodes:

#58 – AMA with sleep expert, Matthew Walker, Ph.D.: Strategies for sleeping more, sleeping better, and avoiding things that are disrupting sleep Jun 17, 2019

Show notes

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];
Performance, accuracy, and minimizing the damage of shift work [55:30];
Bed partners: How to sleep in separate beds and retain a good relationship [59:30];
Can we use sound machines and electrical stimulation to improve sleep? [1:02:40];
Will we ever be able to "supercharge" our sleep stages using technology? [1:08:30];
Why sleep is the best insurance policy for lifespan and healthspan [1:11:45];
Melatonin: How (and how not) to use it for sleep improvement [1:19:00];
The dangers of sleeping pills, useful alternatives, and cognitive behavioral therapy for insomnia [1:28:30];
Can CBD and THC be used for sleep? [1:43:30];
Why haven't we been able to develop a really effective sleeping aid? [1:50:40];
Can you get too much sleep? [1:55:50];
What to do (and not do) immediately following a terrible night of sleep? [2:09:15];
Why a consistent wake up time is king [2:14:30];
Does poor sleep speed up the aging process? [2:16:00];
Can different people be more (or less) resilient to sleep deprivation? [2:22:50];
Finding your optimal sleep schedule and determining your sleep chronotype [2:27:45];
Defining sleep efficiency and how to improve it [2:33:25];
Correcting insomnia: A counterintuitive approach [2:35:45];
How can parents improve the sleep of their kids? [2:41:30]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#57 – Rick Rubin, legendary music producer: collaborating with sensitive psyche of greatest living musicians, and his personal story of weight loss and spiritual quest Jun 10, 2019

Show notes

In this episode, Rick Rubin, legendary music producer and co-founder of Def Jam Records and American Recordings, discusses his early foray into music production which started as a hobby as a teenager and ultimately turned into a Grammy award-winning career that produced revolutionary changes in the music industry. Rick has worked with the likes of the Beastie Boys, Red Hot Chili Peppers, and Johnny Cash, just to name a small fraction. Rick talks about the pain and suffering that sometimes drives music and the cycle of drug addiction and how he has been able to help artists through those struggles to make space for their creative genius. We also get into Rick's own personal health journey including his battle with depression, his struggle with obesity, and ultimately his extraordinary transformation. Finally, Rick shares a really significant health scare which required emergency heart surgery, and how that experience has impacted him.

We discuss:

Early career, and the birth of hip hop [7:15];
Early success of Def Jam Recordings, and working with LL Cool J [13:15];
Revolutionary changes in music: LL Cool J, Beastie Boys, and Run DMC [19:30];
Partnership with Columbia Records, and leaving Def Jam [26:45];
The success of Licensed to Ill: how it took off, and how it changed things [36:00];
American Recordings: Rick's transition to rock and roll [39:15];
Working with the Red Hot Chili Peppers, and the poetic nature of music [45:45];
Rick's favorite music that he did NOT produce [53:00];
Prevalence of drug use and emotional pain in musicians: Rick's experience with helping artists through their struggles [57:20];
NYC vs. LA hip hop [1:05:30];
Rick's battle with depression [1:10:00];
Coping with the death of artists that Rick worked with [1:22:00];
Working with Johnny Cash [1:26:45];
Working with Rage Against the Machine [1:34:30];
The digital age of music: Have we lost something? [1:37:45];
Rick's health journey and battle with obesity [1:42:45];
Radical weight loss: How Rick was finally able to shed the weight [2:00:15];
Total transformation: Exercise and training with Laird Hamilton [2:11:00];
Emergency surgery: Rick's frightening heart condition [2:25:30];
Methylene blue and exogenous ketones: Are they neuroprotective? [2:46:15];
The most profound thing Rick learned about himself from his heart condition and major surgery? [2:52:30];
What life lessons does Rick wish to impart on his son? [2:57:30]; and
More.

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#56 - Jocko Willink, retired Navy SEAL, Part II of II: Sleep, fasting, raising kids, discipline, taking ownership, and the impact of war Jun 03, 2019

Show notes

In the second installment of this 2 part series, Jocko shares his sleep routine and attitude towards sleep, we talk about his meals (and occasional indulgences), his experience with fasting, and touch briefly on his workout routine. Jocko explains his approach to leading a family, instilling values in his kids, and working with others who may not share your same principles. We also find out what prompted Jocko to make discipline the underpinning principle of his life, when it might make sense to quit, and the philosophical topics such as free will, mindset, and whether or not you can change someone. We also discuss 9/11 and the war in Iraq and Afghanistan, the future of warfare, and perhaps more importantly, how Jocko's experience in combat has shaped and impacted his life to this day.

We discuss:

Where was Jocko when the 9/11 attack occurred? What did he think? [5:45];
How SEAL teams are structured, and which teams Jocko was on [10:45];
War in Afghanistan: Unique challenges, how it differs from Iraq, and the lessons learned [13:00];
Iraq War: Differing public opinions on war, Jocko's experiences in Iraq, strategic mistake of ISIS, and the Saddam regime [19:15];
The future of warfare: machine technology in war and medicine [27:30];
Raising kids, instilling values, and leading a family [33:45];
Sleep: Jocko's habits, routine, and attitude towards sleep [40:15];
When it makes sense to quit [53:30];
What makes Jocko different, the existence of free will, and whether or not you can change people [1:01:45];
How to work with people with a bad attitude and opposing mindset [1:07:45];
Does Jocko ever indulge? Favorite foods and treats [1:11:00];
Fasting and meal timing [1:16:30];
Olivia (Peter's daughter) interviews Jocko [1:21:45];
What prompted Jocko to start prioritizing discipline in his life? [1:22:15];
What does Jocko do in his workouts? [1:23:30];
Where did the nickname, Jocko, come from? [1:24:20];
Jocko's favorite book, his best advice, and secret to getting up early [1:25:50];
The impact that war had on Jocko [1:28:00]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#55 - Jocko Willink, retired Navy SEAL, Part I of II: objective, strategy & tactics, leadership, protocols, dealing with death, and applying the many lessons learned from war May 27, 2019

Show notes

In part 1 of this 2 part series, Jocko Willink, retired Navy SEAL, discusses some of his most important lessons learned from his time commanding some of the world's most expert special forces operators including the importance of understanding the objective and strategy (and then tactics) of a mission, why humility is the greatest trait a leader can have (and certain times when it's not), as well as the necessity of having proper protocols in place to deal with whatever comes your way. We also talk about how Jocko prioritizes his military and family obligations with his love for jiu-jitsu, as well as how to decipher what really matters in life. Finally, we go through the US history with respect to various wars from World War I, all the way forward, and much much more.

We discuss:

Objective, strategy, and tactics [6:00];
Training compared to actual combat [20:30];
The importance of humility in leadership, business, and life [33:00];
The dichotomy of human traits: Can you be too humble? [49:00];
Why many leaders lack humility [52:30];
Why Jocko wanted to be a Navy SEAL [55:00];
Jocko's attitude toward death, and dealing with the death of a soldier [58:45];
The vital importance of protocols [1:03:45];
Protocol for losing a child (or anyone close to you) [1:15:00];
Protocol for getting dumped, and some relationship advice [1:18:00];
How to differentiate between things that matter and things that don't [1:24:30];
Jocko shares his experience during BUD/S [1:35:45];
How Jocko prioritizes his family and SEALs obligations: Would Jocko come out of retirement and go back to war? [1:48:30];
America's lost sense of connectedness and purpose since WWII [1:59:00];
How warfare has evolved over the decades since WWI [2:05:40];
Obeying orders and the obligation to dissent [2:09:00];
WWI and WWII, the beginnings of "decentralized command" [2:15:00];
The American warrior mentality, and the impact of freedom on a society [2:20:45];
What impact can an individual president really have? [2:25:00];
The Korean war [2:29:15];
Lessons learned from Vietnam [2:31:10];
First Gulf War, Iraq War, and The War in Afghanistan [2:35:45]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#54 – Kevin Sayer, CEO of Dexcom: Continuous glucose monitors – impact of food, sleep, and stress on glucose, the unmatched power of CGM to drive behavioral change, and the exciting future of CGM May 20, 2019

Show notes

In this episode, Kevin Sayer, CEO of Dexcom, discusses the remarkable benefits of a continuous glucose monitor for the diabetes population. Peter shares his own invaluable insights he's learned from wearing a CGM including the impact of sleep and stress on glucose as well as the unmatched power of a CGM to drive behavioral change. Kevin also reveals some of the exciting partnerships and future advancements of their products benefiting not only those with type 1 and 2 diabetes, but also for the growing community of people interested in optimizing health and wellness.

We discuss:

How they met, and Kevin's path to becoming CEO of Dexcom [7:00];
How CGM technology works, and what makes Dexcom's G6 the best model yet [15:15];
Challenges of working in the US healthcare system and getting CGM insured [21:45];
Developing an even smaller, more user-friendly, and less costly product while maintaining performance and accuracy [33:15];
Next thing on the horizon for type 1 diabetes patients [43:30];
The incredible accuracy of the G6, recommended over-the-counter glucose meters, and the unmatched power of CGM to drive behavioral change [48:15];
Software improvements for type 2 diabetics, and the remarkable benefits of real-time feedback for driving behavioral change [58:15];
Dexcom vs. the competitors, the less invasive options, and the fundamental problems needing to be solved with CGM technologies [1:07:00];
The cost of CGM, why you need a prescription, and when might there be a OTC option? [1:12:00];
Smartwatch integration, bluetooth technology, and exciting collaborations and partnerships [1:22:00];
Future places for CGM: Hospitals, nutrition apps, general health and wellness, and more [1:27:15];
Dexcom's unique company culture [1:34:15];
Parenting advice from Kevin [1:37:30];
Lessons learned through failures and success [1:38:45]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#53 - AMA #6: Fasting framework, vitamin supplementation, antioxidants, time management, problem-solving, and more May 13, 2019

Show notes

In this "Ask Me Anything" (AMA) episode, Peter answers a wide range of questions from readers and podcast listeners. Bob Kaplan, Peter's head of research, asks the questions. If you're listening on a podcast player, you'll be able to hear a preview of the AMA.

If you're a subscriber, you can watch or listen to this full episode on our website at the AMA #6 show notes page.

PLEASE NOTE: We are currently building a private RSS feed that will allow subscribers to listen uninterrupted on the podcast player of their choice. This will be released shortly.

Questions are pulled from the AMA section on the website (peterattiamd.com). Any subscriber is welcome to submit questions.

We discuss:

Vitamin supplementation: Is it necessary if you eat a balanced diet? [2:00];
Antioxidants: What does current science have to say about antioxidants in food and supplements? [9:00];
How do you break a fast of more than three days? [17:15];
Does a morning black coffee break a fast? In other words, does black coffee raise insulin levels? [22:15];
When intermittent fasting, does the placement of the "feeding window" matter? [25:30];
Is it better to fast before or after a planned food binge (e.g., Thanksgiving)? [28:30];
Fasting protocol: Do you have a specific protocol to recommend? [31:30];
Time management: How do you manage your time between work, family, and your many personal interests? [35:45];
Problem solving: Can you breakdown your process of problem-solving? [46:45];
For those looking to gain a better understanding of biochemistry, pharmacology, etc., do you have any good textbooks or (online) resources to recommend? [49:00];
What are some of your favorite podcasts that you listen to? [51:15];
What is your favorite animal? [54:45]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#52 - Ethan Weiss, M.D.: A masterclass in cardiovascular disease and growth hormone - two topics that are surprising interrelated May 06, 2019

Show notes

In this episode, Ethan Weiss, Hopkins trained preventative cardiologist at UCSF, discusses two topics that on the surface may seem unrelated which is cardiovascular disease, and the role of growth hormone and IGF in disease. Ethan provides a masterclass in everything from acute coronary syndrome to all of the complex nuances around stent placement, as well as how calcium scores and results from CT angiograms shape his treatment of patients. He also shares how his idea to study the sex differences in blood clotting as it relates to coronary disease lead him to pursue the field of endocrinology, and specifically what he found with respect to the effect of growth hormone and IGF on the liver, the brain, and overall human longevity.

We discuss:

Mutual love for hockey [7:15];
Ethan's background and interest in cardiology [13:15];
Clinical definitions of a heart attack, clotting, and plaque: What causes the acute event? [24:15];
Defining coronary disease and myocardial infarction: The evolving nomenclature [32:00];
What happens when someone comes to the ER with a STEMI (ST elevation myocardial infarction)? [47:15];
Stents [54:45];
Treatment protocol for both acute and chronic coronary artery disease: History, controversy, and important distinctions [1:06:30];
Using stents to treat stable angina: What we learned from the COURAGE AND ORBITA trials [1:15:30];
The "art" of longevity: The challenge of preventative medicine and understanding risk [1:31:45];
Understanding CAC scores, and CT angiogram results [1:40:15];
How sex differences in clotting and heart disease got Ethan interested in growth hormone and IGF [2:01:00];
Impact of growth hormone on the liver [2:07:00];
Growth hormone and insulin sensitivity [2:18:00];
The role of GH and IGF on chronic disease and cancer [2:23:30];
Will taking growth hormone promote longevity? [2:32:30];
GH and IGF as a treatment for early stage dementia? [2:34:30];
What happens to IGF while fasting and what about fasting improves longevity? [2:35:15];
The importance of becoming scientifically literate and making science more exciting for future generations [2:38:30];
Ethan's new company: Keyto [2:43:45]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

The Ayrton Senna Episode (re-release): Celebrating the greatest driver in Formula 1 history and the cautionary tales of driven individuals May 01, 2019

Show notes

To celebrate the life of the legendary Formula 1 driver Ayrton Senna, 25 years to the day of his tragic death, we are re-releasing this bonus episode. In this episode, Peter and med school colleague (and brilliant psychiatrist) Paul Conti reminisce on their favorite moments in Formula 1 history, their deep admiration for the late Ayrton Senna, and the remarkable careers of their favorite drivers. Paul also helps to illuminate the psychological components that made the luminary drivers great, and the cautionary lessons we can take from their incredible lives.

We discuss:

Who is Ayrton Senna? [3:47];
How Senna's death changed the sport [9:52];
The 80s & 90s: a remarkable era of Formula 1 [12:57];
Hypothesizing what caused Senna's fatal crash [17:47];
Comparing Stewart and Senna, their incredible bravery, and what lessons we can learn from them [23:32];
Best documentaries on racing, and some of Senna's best moments [31:02];
Gilles Villeneuve, Stefan Bellof, and some of the other greats [39:17];
Why Senna is widely acknowledged as the best of all time [46:17];
Great rivalries and personalities [49:32];
Rendezvous, a high-speed drive through Paris [56:52]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#51 - Robert Sapolsky, Ph.D.: The pervasive effect of stress - is it killing you? Apr 29, 2019

Show notes

In this episode, Robert Sapolsky, Ph.D., discusses the widespread impact of stress on our physical and emotional health as well as the mechanisms by which it can precipitate chronic illness, dementia, depression, and more. He also provides insight into the factors that contribute to the stress response (and our ability to handle it) such as social rank, personality, environment, and genetics. Lastly, we discuss how our behavior is altered in the face of stress and how that not only has a pervasive effect on a personal level, but also on society as a whole in how we interact with each other.

We discuss:

Background, interest in stress, and Robert's time in Kenya studying baboons [7:00];
Physiology of a stress response, and why it's ingrained in our DNA [14:00];
Individual variation in the response to stress, and how everyone has a different optimal level [24:00];
How social rank and personality differences affect our stress response [30:15];
What's happening in the brain when faced with stressful situations? [39:15];
What makes the human brain different than all other species? [48:15];
Imprinting stress to your kids epigenetically [52:00];
The role of stress on memory and the consequences of hypercortisolemia [57:15];
The impact of subjective socioeconomic status and social media on stress levels and health [1:01:45];
Tips for managing stress in the modern world [1:17:45];
What Robert learned about himself studying the social behavior of baboons [1:29:30];
The multilayered factors behind every human behavior, the context of "good and bad," and exploring the human capacity of the wild extremes of violence and altruism from moment to moment [1:34:30];
PMS: How two women with identical hormone levels can have completely different emotional experiences [1:39:00];
How much of a role do genes play in depression and other emotional states? [1:42:45];
Why is cortisol elevated under sleep deprivation? [1:50:15];
The impact of stress on cancer [1:54:30];
The impact of stress on atherosclerosis, dementia, addiction, and depression [2:01:15];
Impulsiveness, impaired judgement, and lack of empathy in times of stress [2:05:45];
What advice would Robert give his 25-year-old self? [2:12:45]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

#50 - AMA #5: calcium scores, centenarian olympics, exercise, muscle glycogen, keto, and more Apr 22, 2019

Show notes

If you're a subscriber, you can watch or listen to this full episode on our website at the AMA #5 show note's page.

PLEASE NOTE: We are currently building a private RSS feed that will allow subscribers to listen uninterrupted on the podcast player of their choice. This will be released shortly.

Questions are pulled from the AMA section on the website (peterattiamd.com). Any subscriber is welcome to submit questions.

We discuss:

Coronary calcium score: what it means and how to interpret your results [1:15];
How to train for the "centenarian olympics" [18:00];
Explaining the blood glucose response to various types of exercise [35:30];
The Tabata protocol [43:15];
Exercising on a ketogenic (or low-carb) diet: performance, muscle glycogen, adaptation, and more [49:30];
The work of Dr. Gabor Maté and its impact on Peter [54:15];
What's the best book you've read in the past year? [55:45];
What is "pattycakes?" [59:00];
What is the latest and greatest of egg boxing [59:30]; and
More.

Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

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