The Peter Attia Drive

Latest Episodes:

#09 - David Sabatini, M.D., Ph.D.: rapamycin and the discovery of mTOR — the nexus of aging and longevity? Aug 13, 2018

Show notes

In this episode, my good friend David Sabatini delves into his extensive work with the mechanistic target of rapamycin—better known as mTOR—and rapamycin. The compound rapamycin is the only known pharmacological agent to extend lifespan all the way from yeast to mammals—across a billion years of evolution. David, a professor of biology and a member of the Whitehead Institute at MIT, shares his remarkable journey and discovery of mTOR in mammalian cells and its central role in nutrient sensing and longevity. Fasting, rapamycin, mTOR, autophagy, gedankenexperiments: having this conversation with David is like being the proverbial kid in the world's greatest candy store.

We discuss:

mTOR and David's student years [4:30];
Rapamycin and the discovery of mTOR [8:15];
The connection between rapamycin, mTOR, and longevity [30:30];
mTOR as the cell's general contractor [34:45];
The effect of glucose, insulin, and amino acids on mTORC1 [42:50];
Methionine sensing and restriction [49:45];
An intermittent approach to rapamycin [54:30];
Rapamycin's effects on cancer, cardiovascular disease, and neurodegeneration [57:00];
Gedankenexperiment: couch potatoes on rapamycin vs perfectly behaved humans [1:03:15];
David's dream experiment with no resource constraints [1:07:00]; and
More.

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#08 - Tom Bilyeu: nutrition, fasting, meditation, mindset, immortality, and the secret formula of fulfillment Aug 06, 2018

Show notes

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

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#07 - Deep Dive: Lp(a) — what every doctor, and the 10-20% of the population at risk, needs to know Jul 30, 2018

Show notes

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

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#06 - D.A. Wallach: music, medicine, cancer screening, and disruptive technologies Jul 23, 2018

Show notes

D.A. Wallach is a true polymath: recording artist, songwriter, essayist, investor, and so much more. In this episode, among the highlights, D.A. provides compelling and colorful insight into how the music industry works today vs the past, liquid biopsies, how to approach healthspan, cancer screening, and how we can reach a "singularity" in medicine.

We discuss:

How to learn music as a kid and an adult [7:30];
Chester French's early struggles and ultimate success [16:45];
Learning to learn, fostering curiosity in kids, and balancing creativity with structure [31:30];
D.A.'s musical inspirations [44:30];
History of the music industry, Spotify, and other disruptive technologies [50:00];
The past, present, and future of medicine, hospitals, and healthcare [1:05:30];
Investing in health [1:16:30];
What D.A. is most excited about in the future of medicine [1:22:00];
Liquid biopsies, how to make sense of the morass of sensitivity, specificity, positive predictive value, negative predictive value, true negatives, false positives, false negatives, and true positives in cancer screening...and the swiss cheese metaphor [1:33:00];
The immune system, inflammation, and allergies [2:05:45]; and
More.

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#05 - Dom D'Agostino, Ph.D.: ketosis, n=1, exogenous ketones, HBOT, seizures, and cancer Jul 16, 2018

Show notes

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

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#04 - AMA #1: alcohol, best lab tests, wearables, finding the right doc, racing, and more Jul 09, 2018

Show notes

In his first "Ask Me Anything" episode, Peter answered your questions submitted to him via Twitter.

We discuss:

What are Peter's thoughts on alcohol consumption and health? [4:00]
What are the best lab tests to request from your PCP, and what are the best markers for longevity? [14:00]
What are the best wearables and why, and why does Peter use a continuous glucose monitor? [35:00]
How does one select the right physician as a patient? [47:00]
Why does Peter race cars and what's the hardest thing to learn as a new driver? [54:30]
What is Peter's current exercise regimen and what are his thoughts on exercise for improving lifespan and healthspan? [1:20:15]
What is Peter's strategy for learning something deeply? [1:33:00]
What is Peter's process for forming his beliefs? [1:53:30]
What does Peter's diet look like these days? [1:57:45]
And more.

Learn more at www.PeterAttiaMD.com

Connect with Peter on Facebook | Twitter | Instagram.

#03 - Ron Krauss, M.D.: a deep dive into heart disease Jul 02, 2018

Show notes

Whenever I'm stumped on a patient case or in my thinking about lipids, Ron is one of the first people I turn to for insight. Ron is recognized globally for his research into lipidology and has worn many hats in his career, including clinician, lipidologist, nutrition, genetics, and drug research.

In this episode, we explore heart disease at its origins before diving into the highly discussed, largely misunderstood, role of LDL and inflammation in atherosclerosis. Ron also shares his insights on the evidence for and against statins and other lipid-lowering therapies. My hope is that both the curious patient and the physician can get a lot out of this episode by being more informed about dyslipidemia and the interventions used to reduce the risk of atherosclerotic disease. We covered a lot of ground on this critically important topic.

We discuss:

The pathogenesis of atherosclerosis [7:00];
How early atherosclerosis begins [12:40];
Ron's motivation for getting into lipidology [43:00];
How reading an article series in the NEJM in 1967 had a profound impact on him and his career [43:30];
How PCSK9 inhibitors work and why they may be under-utilized [47:00];
Mendelian randomization: nature's randomized trial [49:15];
The "battle" between particle size and particle number [52:00];
The use of statins [1:04:45];
The role of chronic inflammation in atherosclerosis [1:24:15];
Why niacin may have been unjustly dismissed as a therapeutic option [1:40:45];
The HDL paradox: why drugs that raise HDL-C seem to raise (or have little impact on) heart disease risk [1:43:00];
Lp(a) [1:47:45];
And more.

Learn more at www.PeterAttiaMD.com

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#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 Jul 02, 2018

Show notes

Rhonda and I go on a Nerd Safari into the jungle of health, nutrition, fitness, performance, and longevity. We visit IGF-1 and whether there's a tradeoff of having high or low levels. We discuss the PPARs (receptor proteins) and genetic polymorphisms. Does Rhonda think there's any benefit in a NAD+ booster for health and longevity? Can saunas lower the risk of heart disease, dementia, and all-cause mortality?

Rhonda is a wealth of knowledge on so many topics and was the perfect companion to dig into so many fun topics in this episode. She puts a ton of thought into her research and it really shows in this conversation.

We discuss:

What Rhonda believes differently today than she did a few years ago [5:40];
The paradox of GH/IGF-1 in performance and longevity [21:00];
The role of PPAR in fat metabolism and ketogenic diets [23:00];
The possible genetic explanations for why some patients don't respond well to a ketogenic diet [31:00];
The health benefits of heat and cold exposure [1:12:30];
NAD+ [1:32:45];
And more.

Learn more at www.PeterAttiaMD.com

Connect with Peter on Facebook | Twitter | Instagram

#01 - Tim Ferriss: depression, psychedelics, and emotional resilience Jul 02, 2018

Show notes

Excited to kick off the podcast with special guest and close friend Tim Ferriss, lifehacker, podcaster extraordinaire, and author of multiple best-selling books that includes The 4-Hour Workweek, The 4-Hour Body, Tools of Titans, and Tribe of Mentors.

In this podcast we cover mental health, depression, and our mutual interest in psychedelics as potential therapeutic agents. Tim talks both experientially and from his own deep dive into the literature of psychedelics and mental health. Tim is shifting his focus from investing in startups to funding experiments that he hopes will establish more reliable knowledge and therapeutic options for those suffering from anxiety, depression, and addiction.

Tim also shared his list of acquired wisdom he returns to most reliably, which might be worth the price of admission alone.

We discuss:

Tim's history of depression and his TED Talk on his close call with suicide [11:15];
The type of thinking that triggers Tim's downward spirals [17:15];
Tim's transformative experience with ayahuasca [48:45];
How Tim's experience and research has led him to focus on furthering the science on psychedelics and mental health [53:00];
What some of the meditation modalities, and meditation apps, are out there, why meditation can be so hard to do, but also worthwhile to stick with [1:13:00];
Why Tim made a big commitment (more than $1 million) to funding scientific research, and to psilocybin and MDMA research, in particular [1:31:00];
From all the habits and tools that Tim has learned, the five things that he returns to most reliably [2:33:00];
And more.

Learn more at www.PeterAttiaMD.com

Connect with Peter on Facebook | Twitter | Instagram

#00 - Sneak Peek: The Peter Attia Drive Jun 19, 2018

Show notes

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.

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