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    #17 - Mike Trevino: life-lessons from ultra-endurance, mindset, hard work, and removing limitations

    enSeptember 24, 2018

    Podcast Summary

    • Mike Trevino: From Amateur to World Record HolderMike Trevino's achievements in endurance sports show that valuable lessons learned from extreme challenges can be applied to all aspects of life, and that human connection is significant in outdoor activities.

      Mike Trevino's accomplishments as an endurance athlete are truly remarkable. Despite being an amateur, he has set world records in running and cycling. While his achievements may seem unimaginable to the average person, there are valuable lessons to be learned from his experiences. Mike demonstrates that the lessons he learns from extreme endurance challenges can be applicable to all aspects of life, including personal goals in endurance sports. Whether you're looking to improve from a 5k to a 10k or a half marathon to a full marathon, adopting some of Mike's strategies can be beneficial. Additionally, the bond between Mike and Peter, formed through their weekly bike rides, highlights the significance of human connection in outdoor activities.

    • Understanding Individual Differences in Physical FitnessEveryone has their own starting point in fitness, and training extensively can help individuals excel. Despite differences, valuable principles can be applied to various fitness pursuits. Mental and physical endurance are powerful tools.

      Physical fitness and performance can vary greatly among individuals. Peter Attia, a highly fit individual, was surprised to see his friend Mike, who hadn't been on a bike in a year, keeping up with him during a cycling session. This realization made Peter reflect on his own fitness journey and acknowledge that some individuals are naturally at a different level and train extensively to excel. Despite the differences in goals and abilities, there are valuable principles and lessons that can be applied to various fitness pursuits. Additionally, the story highlights Mike's incredible accomplishment of running 43 miles on his 43rd birthday with no calories consumed during the run, showcasing the power of mental and physical endurance.

    • The role of fat adaptation and hydration in endurance activities.Fat adaptation allows the body to tap into its energy stores instead of relying on glycogen, while proper hydration helps maintain a consistent pace and allows for a smoother endurance experience.

      Fat adaptation and proper hydration play crucial roles in endurance activities. Mike Trevino, while discussing his long runs, mentioned how he wasn't even hungry after completing a demanding workout. Peter Attia explained that this is a result of fat adaptation, where the body taps into its energy stores instead of relying solely on glycogen. Additionally, Trevino emphasized the importance of staying hydrated during his runs, using handheld water bottles and strategically planning water stops along his route. By maintaining a consistent pace and staying hydrated, Trevino was able to keep moving without the need for frequent stops, allowing for a smoother and more enjoyable experience.

    • From Power Athlete to Ultra-Endurance: Mike Trevino's Unexpected TransformationFollowing your passion and embracing new opportunities can lead to unexpected transformations that shape your abilities and outcomes.

      Mike Trevino's transition from being a power athlete to an ultra-endurance athlete was not planned, but it was driven by his passion and circumstances. He initially wanted to play Notre Dame Football and was a football player and wrestler in high school. However, during college, he focused more on studying and working, which led him to quit football and play rugby instead. Through playing rugby in Germany, he discovered his love for trail running and lost weight. This eventually led him to transition from running to cycling, with the ultimate goal of competing in the Race Across America. Mike's transformation highlights the importance of following one's passions and adapting to new opportunities, ultimately shaping our physical abilities and outcomes.

    • Mike's Relentless Pursuit of Running GoalsMike's determination and commitment in his pursuit of running goals enabled him to achieve great feats and overcome challenges, setting course records and transitioning to longer distances.

      Mike Trevino's dedication and unique abilities have allowed him to achieve great feats in running. Despite the challenges and monotony of running on a quarter-mile track for 24 hours, Mike pushed himself and set course records. He recounts the difficulty of carrying a water bottle and a Sony Walkman for the entire duration, highlighting his determination and commitment. It is revealed that the track run was the culmination of Mike's first significant year in ultra-distance running, where he had transitioned from marathons to tackle longer distances. His ultimate goal was to qualify for the prestigious Western States 100 race, and he applied for the Badwater race as an alternative. This conversation showcases Mike's relentless pursuit of his running goals and the milestones he achieved along the way.

    • The Challenges and Lessons of Endurance SportsThorough planning, mental resilience, and realistic expectations are vital in endurance sports. A reliable crew and smart decision-making are crucial for success.

      Endurance sports require careful planning and preparation. Mike Trevino shares his experience of participating in the Badwater race, a grueling 135-mile race starting in Death Valley and ending at Whitney Portals. He talks about the extreme temperatures and challenging terrain, highlighting the need to adapt to different ecosystems along the way. This story emphasizes the importance of having a reliable crew and making smart decisions during the race. Peter Attia also narrates his own experience of swimming across Lake Tahoe, where he faced difficulties due to poor planning and an unreliable boat captain. Both stories underscore the significance of thorough training, mental resilience, and making realistic expectations in endurance sports.

    • Lessons Learned from Endurance Training and ChallengesEndurance training and challenges like RAM teach us the importance of perseverance, independence, problem-solving, teamwork, planning, and adaptability, while offering opportunities for personal growth and understanding difficult goals.

      Endurance training and challenges like the Race Across America (RAM) can provide valuable life lessons. Mike Trevino, a participant in RAM, shares that the most memorable stories and growth come from the training and preparation, rather than the actual race itself. These experiences, filled with difficulties and unexpected obstacles, can be mentally demoralizing and humbling. They teach us the importance of perseverance, independence, and problem-solving skills. Moreover, RAM is not just about the individual cyclist, but also about the entire crew and logistics involved. This highlights the significance of teamwork, planning, and adaptability. Endurance challenges like RAM offer opportunities for personal growth and understanding the complexities of achieving a difficult goal.

    • Importance of Preparation and Teamwork in Challenging EndeavorsThorough preparation and strong teamwork are essential for navigating demanding situations successfully, and diverse teams with trust in leadership can overcome overwhelming logistics and achieve success.

      Preparation and teamwork are crucial for success in challenging endeavors. Whether it's participating in a long-distance race or crewing for a swimmer, the logistics involved can be overwhelming. From bike equipment to crew dynamics, there are numerous variables to control for. Like building a company, problem-solving is best achieved through a diverse team that represents different functional areas. Trust in the crew chief is vital, as they make critical decisions that ensure the safety and well-being of the athlete. The responsibility placed on the crew chief is immense, and their role is comparable to the cornerman in a boxing match. Despite the hardships faced during such intense races, it's important to remember that these are first-world challenges and to maintain perspective. Overall, the key takeaway is that thorough preparation and strong teamwork are essential for successfully navigating demanding situations.

    • The importance of strategic decision-making and adaptability in achieving success in extreme circumstances.Being prepared for unexpected challenges and making quick decisions can give you an edge over competitors and contribute to achieving your goals.

      Strategic decision-making and adaptability are crucial in achieving success, even in extreme circumstances. Mike Trevino's experience during the race demonstrates the importance of seizing opportunities and making quick decisions. When he felt the tailwind, he immediately recognized the advantage and pushed his team to put him back on the bike, ultimately gaining an edge over his competitors. Additionally, this incident highlights the significance of being prepared for unexpected challenges, such as the storm that the rest of the field encountered. Trevino's ability to navigate these obstacles and stay ahead ultimately contributed to his successful performance in the race. This story serves as a reminder that flexibility and strategic thinking can often make a significant difference in achieving one's goals.

    • Mental Strength and Adaptability in Endurance SportsEndurance athletes need mental fortitude to overcome obstacles and adapt their strategies in real time. Success in endurance sports requires both physical and mental resilience.

      Endurance athletes require mental strength and adaptability in order to succeed. Mike Trevino, a rookie athlete, defied expectations by participating in a grueling race and facing challenges along the way. Despite being off his projected pace and experiencing sleep deprivation, Trevino persevered and continued to push himself. He even encountered accusations of cheating from a fellow competitor's team, but ultimately proved them wrong. This highlights the importance of mental fortitude in endurance sports, as athletes must overcome physical and mental obstacles to achieve their goals. Additionally, the conversation emphasizes the significance of adaptability, as athletes must be able to adjust their strategies and mindset in real time to stay competitive.

    • Overcoming Challenges: The Power of Resilience and Determination.Perseverance, tough decisions, and a supportive network are crucial in overcoming obstacles and achieving success.

      Resilience and determination are crucial in overcoming challenges. Despite experiencing setbacks and feeling demoralized during the race, Mike Trevino made the choice to continue and push forward. He found solace in running, which helped him regain mental clarity and reminded him of his purpose. By setting conditions for himself and recommitting to the race, Mike showed his unwavering dedication and commitment to his team. Additionally, the support from race official Johnny Boswell played a significant role in keeping Mike motivated. This story emphasizes the importance of perseverance, making tough decisions, and surrounding oneself with a supportive network in order to overcome obstacles and achieve success.

    • Maximizing Performance and Endurance in Endurance Races: The Importance of Sleep, Nutrition, and Race StrategyStrategic sleep, proper nutrition, and an effective race strategy are key factors in achieving success in endurance races like RAM, allowing athletes to maximize their performance and sustain their energy levels.

      Optimizing sleep and maintaining a sustainable pace are crucial for achieving success in endurance races like RAM (Race Across America). By strategically timing their sleep and waking up during the non-REM stage, athletes can feel rested even with only a couple of hours of sleep. By doing so, they can maximize their performance and avoid feeling groggy or fatigued. Additionally, maintaining a steady "all day speed" on the bike after depleting muscle glycogen is essential for sustained performance. Athletes also pay close attention to their nutrition and hydration, aiming for nutrient-dense calories and staying hydrated without overloading their digestive system. Therefore, winning RAM involves engineering various aspects such as sleep, training, race strategy, and even optimizing bikes for peak performance.

    • Breaking Age Barriers: Unleashing the Physical Potential WithinAge should never be a barrier to achieving extraordinary physical feats. With proper training, dedication, and strategy, anyone can surpass expectations and achieve their fitness goals at any age.

      Age should not limit our physical capabilities. The story highlights the impressive endurance and strength of a mid-sixties cyclist who was able to climb a steep 26% grade hill and reach a max heart rate of 180, far exceeding what is expected for his age group. This demonstrates that with proper training, dedication, and a well-planned strategy, individuals can push their bodies to achieve extraordinary feats. The conversation also emphasizes the importance of comprehensive preparation, including factors such as sleep, nutrition, training plans, and race strategies. While not everyone may aspire to extreme endurance events like the Race Across America (RAM), the lessons learned from these experiences can be applied to any personal fitness goal, such as running a marathon or completing an Ironman.

    • Unlocking Our Potential and Achieving Remarkable FeatsBelieve in your own potential, challenge your limits, be open to new possibilities, manage your time efficiently, stay determined, and take care of your body to achieve remarkable goals.

      Everyone has the physical ability to achieve great things. While some may have better genetics or biomechanics, it is important to believe in our own potential. We should challenge the limits we have set for ourselves and change our mindset. There are no sacred cows when it comes to our goals. It is crucial to check our assumptions at the door and open our minds to new possibilities. Additionally, the story emphasizes the importance of efficient time management and dedication. Even while working 60 hours a week, the individual in the story followed a strict routine, including early morning runs and specific nutritional choices. This demonstrates that with focus and determination, we can accomplish remarkable feats. Taking care of our bodies, such as paying attention to electrolyte balances, also plays a significant role in achieving our goals.

    • The Importance of Fat Adaptation for Ultra Distance AthletesBeing fat adapted improves endurance performance for ultra distance athletes. Experimentation, listening to one's body, and borrowing principles from other sports can optimize performance.

      Being fat adapted is crucial for ultra distance athletes. While it doesn't necessarily mean being in nutritional ketosis, it is important to have a high level of fat adaptation. Experimentation and checking assumptions helped Mike Trevino discover the benefits of being fat adapted. He realized that the common advice of limiting marathons didn't apply to him as he was doing one every day as part of his training. He also recognized the negative effects of car bloating and listened to his body's indicators, such as resting heart rate, to determine if he was adapted or not. Being disciplined and objective with oneself is essential for consistent performance in endurance sports. Additionally, Trevino borrowed principles from mountaineering, such as turning back if not in the right condition, to optimize his performance.

    • Challenging Assumptions and Discovering New Approaches to Optimal Health and Performance.Overcoming traditional beliefs and experimenting with alternative methods can lead to a more fulfilling and successful life by optimizing the body's capabilities and finding personalized strategies for health and performance.

      Traditional thinking and assumptions about the human body's capabilities can often be wrong. Mike Trevino's experiences in mountaineering and endurance activities taught him that simple, intentional living can lead to a more fulfilling life. He also discovered that metabolizing the body at high altitudes requires a different approach, such as consuming oil instead of carbohydrates. Additionally, he learned that fat is not necessarily bad and that sugar can be detrimental during long events due to insulin response and energy crashes. Moreover, his personal journey of overcoming parasites through a 10-day fast demonstrated the power of alternative methods in healing the body. Thus, it is important to challenge existing beliefs and experiment to find what works best for individual performance and well-being.

    • The Surprising Benefits and Risks of Fasting for Performance and Medical TreatmentsFasting can enhance physical performance and aid in medical treatments, but it is important to consider the risks and balance them with potential benefits when engaging in extreme activities.

      Fasting can have surprising benefits for both physical performance and medical treatments. Mike Trevino shares his personal experience with fasting, explaining that it helped him overcome exercise-induced asthma and allergies. He accidentally discovered that fasting, combined with ketosis, enhanced his performance and made him feel fantastic. Peter Attia agrees, mentioning that fasting has been shown to increase the efficacy of chemotherapy and that many athletes have experienced positive effects after fasting. However, the conversation also highlights the risks involved in extreme sports, such as long-distance cycling, where death rates can be high. Both participants emphasize the importance of considering the potential downsides and balancing risks when pursuing challenging activities.

    • The Tragic Consequences of Accidents Involving Cyclists and VehiclesStaying alert while driving and prioritizing safety for both drivers and cyclists is crucial to prevent accidents and ensure road safety.

      Accidents involving cyclists and vehicles can have tragic consequences. Peter Attia recounts a shocking incident where his friend Nick was killed by a distracted driver on a bike path. This highlights the importance of staying alert and focused while driving, especially around vulnerable road users like cyclists. It also emphasizes the need for cyclists to prioritize safety and take precautions. Mike Trevino, who himself had a close call with a negligent driver, shares that accidents on mountain bikes are usually the cyclist's fault and result in less severe injuries compared to road accidents. This conversation serves as a reminder for both drivers and cyclists to prioritize safety and be mindful of each other on the road.

    • Achieving Personal Goals: A Journey of Curiosity and DeterminationDream big, work hard, and stay resilient in the face of challenges – personal goals are achievable with determination and passion.

      Setting and achieving personal goals can be incredibly fulfilling and rewarding. Mike Trevino explains how his childhood curiosity and desire to push his limits led him to attempt various cycling challenges, such as the bike ride across Iowa and the Trans Iowa event. He shares how these experiences became bucket list items for him, and he worked towards accomplishing them with determination and passion. Despite facing obstacles like accidents and equipment challenges, Mike remained resilient and committed to his goals. Ultimately, he achieved success by setting a new speed record across Iowa. This story teaches us the importance of having dreams and working towards them, even when they seem challenging or unconventional.

    • Mike Trevino: Cycling Champion and Passionate Sport EnthusiastMike Trevino's cycling achievement showcases his exceptional talent and dedication in the sport, even without the use of performance-enhancing drugs.

      Mike Trevino achieved an incredible feat in his cycling journey, covering his home state in 10 and a half hours. Despite not having a power meter at the time, Peter Attia estimated that Trevino was averaging 310 to 320 watts for the entire duration, putting him in a different league as a professional cyclist. Trevino's FTP (functional threshold power) was likely around 380 to 400 watts, which is a professional level of performance. It is worth noting that without the use of performance-enhancing drugs, an FTP of over 5 watts per kilo is considered incredible. Moreover, Trevino's commitment to cycling as a personal pursuit rather than a professional endeavor, and his willingness to forego the use of drugs, highlight his dedication and passion for the sport.

    • Enhancing Performance with Modafinil: Balancing Benefits and Ethical ConsiderationsModafinil offers a safe and effective way to boost cognitive abilities, but users must weigh the potential benefits against ethical concerns and personal values when deciding to utilize performance-enhancing substances.

      Modafinil is a highly effective drug for maintaining long-term performance, especially in situations where sleep is limited or jet lag is a factor. It can enhance cognitive abilities without the negative side effects often associated with stimulants like caffeine or Adderall. However, it is important to consider the ethical implications of using substances to enhance performance, as it can be seen as unnatural and may raise questions about the fairness of competition. Different individuals have different views on what is considered natural or acceptable, with some athletes opposing the use of interventions like intravenous treatments, while others rely on them for optimal performance. Overall, the choice to use performance-enhancing substances is personal and must be carefully considered.

    • Exploring the Mental Impact of Extreme Endurance ActivitiesEngaging in extreme endurance activities can lead to mental states such as illusions and paranoia, highlighting the abnormality of these endeavors. It raises questions about the motivations behind pushing oneself beyond normal limits.

      Extreme endurance activities can lead to a progression of mental states, including illusions, hallucinations, and delusions. Mike Trevino shares his experience during a race where sleep deprivation and extreme output caused him to become truly delusional and paranoid. He couldn't recognize familiar people and concocted a story about being chased. This highlights the abnormality of engaging in such extreme endeavors. Despite this, Mike acknowledges that it is his normal and questions what motivates him and others who participate in these activities. This raises a deeper question about the underlying motivations driving individuals to push themselves beyond normal limits and what they may be seeking to numb or escape.

    • Running as an Escape and Source of Comfort for Mike TrevinoRunning provided Mike Trevino with solace and self-improvement, helping him cope with his lifestyle and personal obstacles, while also challenging himself and proving that anything is possible.

      Running became an escape and a source of comfort for Mike Trevino. Feeling tired of his lifestyle in New York City, he found solace in staying with friends who would bring home beer every night. Wanting to find a way out, he started training for the 1998 New York marathon, using it as an excuse to not drink and focus on self-improvement. Running also helped him cope with a difficult breakup. As he continued participating in marathons and improving his times, he found that running became a meditative experience, a time to work through past and present issues. It became his happy place, where he felt normal and at peace. While others may have seen his commitment to running as a sacrifice, Mike saw it as a privilege and a way to challenge himself, refusing to accept limitations and proving that anything is possible.

    • Evolution of PrioritiesReevaluating priorities periodically and finding a balance between personal and professional obligations is crucial for overall well-being and happiness.

      Priorities can shift over time, and it is important to reevaluate what truly matters to you. Mike Trevino's story highlights how he used to prioritize his professional goals and was highly focused on saying no to distractions. However, the encounter with his wife changed his perspective and made him realize the importance of family. This transition allowed him to prioritize his family first and his company second. It is a reminder that our priorities can evolve, and it is crucial to reassess them periodically. Balancing personal and professional obligations is essential for overall well-being and happiness. So, take the time to reflect on what truly matters to you and make adjustments accordingly.

    • Unexpected Encounters and Life-Changing ConnectionsLove and genuine connections can greatly impact our lives, bringing fulfillment beyond any achievement or goal. Be open to new experiences and find someone who understands and supports your passions and goals.

      Sometimes in life, unexpected encounters can lead to meaningful connections and life-changing decisions. Mike Trevino shares the story of how he met his wife and how she became his source of inspiration and support. What started as a chance meeting during a workout session turned into a deep connection and partnership. This highlights the importance of being open to new experiences and embracing the unexpected. It also emphasizes the power of finding someone who truly understands and supports you in pursuing your passions and goals. Ultimately, the key takeaway is that love and genuine connections can greatly impact our lives and bring fulfillment beyond any achievement or goal.

    • Teaching the Value of Hard Work and PerseveranceInstilling discipline, pride, and responsibility in children, and leading by example, is essential in teaching them the importance of hard work and perseverance in all aspects of life.

      Hard work and perseverance come in many forms. Mike Trevino emphasizes the importance of teaching his children the value of both physical and mental effort. He wants them to see that hard work can be seen in everyday tasks such as taking care of the yard or fixing a faucet, and that no job is beneath him. He believes in leading by example and instilling a sense of discipline and pride in their accomplishments. The conversation also highlights the idea of not outsourcing everything and taking responsibility for one's own work. Whether it's in sports, family, or running a company, the key lesson is to never give up and keep pushing forward.

    • Perseverance and Intelligence: The Winning Combination for Success in Physical TrainingSuccess in physical training requires mental toughness, smart strategies, and continuous learning from mistakes. Balancing personal goals with other responsibilities is crucial for long-term success and enjoyment.

      Perseverance and intelligence are essential when it comes to achieving your goals in any field, particularly in physical training. Mike Trevino emphasizes the importance of not giving up, even in the face of adversity. He also highlights the significance of training smart and being purpose-driven in your approach. Additionally, he shares the value of learning from mistakes and not trying to make up for missed opportunities or setbacks. Peter Attia acknowledges the role of intelligence and knowledge in training effectively, suggesting that codifying this knowledge would greatly benefit individuals seeking to balance their personal goals with other responsibilities. Overall, the key message is to combine mental toughness with a strategic and intelligent approach to maximize success while enjoying the process.

    • Embracing simplicity and finding joy in the absence of constant data analysis.Sometimes, the most valuable moments come from simplifying our lives and finding joy in the simple pleasures, free from the pressure of data analysis.

      Sometimes we get caught up in collecting data and tracking our every move, but it's important to remember the value of simplicity and enjoyment. Mike, who doesn't use power meters or heart rate monitors, emphasizes the joy of cycling without the pressure of constant data analysis. This prompts Peter to question the need for all the data he collects and realizes that it may have become an unnecessary artifact of the past. Their Sunday rides, devoid of tracking devices, have become a cherished tradition. Additionally, they discuss their shared love for a particular beer that Mike introduced to Peter years ago. This beer serves as a reminder that sometimes, simple pleasures can bring immense joy, even in moderation.

    • The Coveted Judgment Day: A Unique Beer ExperienceJudgment Day is a highly-prized, experimental beer with a dense and rich taste that has gained immense popularity, making it harder to find and prompting secrecy among its admirers.

      There is a limited, highly sought-after beer made by an authentic brewery in Belgium. The brewery takes pride in their low-volume production and their willingness to experiment and try different things. While not all their beers may be great, this particular beer, known as Judgment Day, is described as fantastic. It is a strong Belgian quad with a dense and rich taste, and it has impressed both beer drinkers and non-drinkers alike. However, due to its limited availability, the speaker is hesitant to reveal the specific name of the beer out of fear that it will become even harder to find. The beer is so cherished that label removal is necessary to share it without arousing attention.

    • The Power of Consumer Demand and Vocal SupportExpressing interest and demand for a product or service can influence its availability and success, showing the importance of consumer voices in shaping the market.

      The speaker, Peter Attia, and his friend, Mike Trevino, are passionately discussing their favorite beer and the struggle to find it. They emphasize the importance of demand in influencing the availability of a product. They suggest that if enough people express their interest and demand for the beer, stores like BevMo may start stocking it again. The conversation also highlights the unique skill set and expertise that Mike possesses, which could be valuable in the field of coaching. Overall, the key takeaway is that consumer demand and vocal support can have a significant impact on the availability and success of a product or service.

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    The Peter Attia Drive
    enJuly 08, 2024

    #308 - AMA #61: Sun exposure, sunscreen, and skin health: relationship between sun exposure and skin cancer, vitamin D production, and photoaging, how to choose a sunscreen, and more

    #308 - AMA #61: Sun exposure, sunscreen, and skin health: relationship between sun exposure and skin cancer, vitamin D production, and photoaging, how to choose a sunscreen, and more

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    In this “Ask Me Anything” (AMA) episode, Peter delves into two topics that have generated a lot of questions over the years: skin cancer and sunscreen. He begins by exploring the basics of UV radiation, discussing its effects on vitamin D conversion, photoaging, and its role in skin cancer. He examines various skin types, discussing their implications for sun exposure and vitamin D levels, as well as how to determine where you fall on the skin type scale. He then delves into the various types of skin cancer, with a particular emphasis on melanoma, exploring its complex relationship with UV exposure and other contributing risk factors. Additionally, he covers tanning beds, the importance of early skin cancer detection through regular skin checks, and the often confusing topic of sunscreen. He explains how sunscreen affects UV radiation and skin cancer risk, what SPF levels to choose, the differences between organic and mineral sunscreens, and what to consider when selecting the best sunscreen for your needs.

    If you’re not a subscriber and are 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 our website at the AMA #61 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • The impact of UV radiation on the skin [2:00];
    • Understanding solar UV: from the electromagnetic spectrum to skin health [3:45];
    • The role of sunlight in vitamin D production [8:30];
    • Factors contributing to vitamin D deficiency: insufficient UV exposure, magnesium levels, and more [9:45];
    • Sun exposure needs for different skin types, and the limitations of current studies in defining vitamin D deficiency [12:45];
    • The acute and long-term effects of excessive UV exposure: sunburn, photoaging, and the increased risk of skin cancer [15:30];
    • Types of skin cancer and associations with UV exposure [17:45];
    • The complex relationship between melanoma and UV exposure [22:15];
    • Why UV exposure alone doesn’t necessarily explain the risk for melanoma [25:15];
    • Other risk factors for melanoma [29:15];
    • Tanning beds and skin cancer risk [34:45];
    • Balancing sun exposure: benefits and risks [38:15];
    • Tattoos and sun exposure [40:30];
    • The importance of regular skin checks, dermatologists, and emerging technologies showing promise for early detection of cancer [41:45];
    • Self-skin checks: what to look for [46:30];
    • Prevalence of skin cancer and the importance of early detection [49:30];
    • Summary of the major risk factors for melanoma [54:15];
    • The role of sunscreen in reducing skin cancer risk [55:45];
    • How sunscreen works, the differences between chemical and mineral sunscreens, an explanation of SPF, and more [58:30];
    • How to determine the appropriate sunscreen SPF to use based on the UV index [1:04:45];
    • Choosing the right sunscreen for your individual needs [1:07:00];
    • The impact of water and perspiration on sunscreen effectiveness [1:12:00];
    • Chemical vs. mineral sunscreens: safety concerns and recommendations [1:14:00];
    • Concerns about hormone effects from chemical sunscreens [1:19:15];
    • Sunscreen summary: skin types, key considerations, recommended brands, and more [1:23:15]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJuly 01, 2024

    #307 ‒ Exercise for aging people: where to begin, and how to minimize risk while maximizing potential | Peter Attia, M.D.

    #307 ‒ Exercise for aging people: where to begin, and how to minimize risk while maximizing potential | Peter Attia, M.D.

    View the Show Notes Page for This Episode

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    In this special episode, Peter addresses the common questions about starting or returning to an exercise routine over the age of 50. Individuals in this age group have frequently reached out with questions about whether it's too late to start exercising and often express concern over a lack of prior training, a fear of injury, or uncertainty about where to begin. Peter delves into the importance of fitness for older adults, examining all four pillars of exercise, and provides practical advice on how to start exercising safely, minimize injury risk, and maximize potential benefits. Although this conversation focuses on people in the “older” age category, it also applies to anyone of any age who is deconditioned and looking to ease into regular exercise.

    We discuss:

    • Key points about starting exercise as an older adult [2:45];
    • Why it’s never too late to begin exercising and incorporating the four pillars of exercise [5:45];
    • The gradual, then sharp, decline in muscle mass and activity level that occur with age [10:00];
    • The decline of VO2 max that occurs with age [15:30];
    • Starting a training program: exercise variability, movement quality, realistic goals, and more [18:30];
    • Improving aerobic capacity: the malleability of the system, the importance of consistency, and setting long-term fitness goals [25:15];
    • Starting cardio training: base building, starting with low volume, and zone 2 training [30:45];
    • The critical role of VO2 max in longevity [36:45];
    • How to introduce VO2 max training to older or deconditioned individuals [46:15];
    • Options for performing zone 2 and VO2 max training [53:45];
    • The ability to make gains in strength and muscle mass as we age [57:00];
    • How to implement strength training for older individuals [1:01:00];
    • Advice for avoiding injury when strength training [1:07:30];
    • Risk of falls: the devastating consequences and the factors that increase fall risk [1:12:15];
    • Mitigating fall risk: the importance of foot and lower leg strength, ankle mobility, and balance [1:19:45];
    • Improving bone mineral density through resistance training [1:24:30];
    • The importance of protein in stimulating muscle protein synthesis, especially in older adults [1:31:00];
    • Parting advice from Peter [1:34:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 24, 2024

    #306 - AMA #60: preventing cognitive decline, nutrition myths, lowering blood glucose, apoB, and blood pressure, and more

    #306 - AMA #60: preventing cognitive decline, nutrition myths, lowering blood glucose, apoB, and blood pressure, and more

    View the Show Notes Page for This Episode

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    In this “Ask Me Anything” (AMA) episode, Peter provides insights on a broad range of important topics. He delves into the prevention of cognitive decline, the link between cardiovascular disease and Alzheimer's disease, and methods to lower blood glucose, insulin, and apoB. He also addresses nutrition-related queries, exploring the impact of dietary habits on weight loss and longevity, how a person can identify the best diet for themselves, and common nutrition myths. Additional discussions include optimal blood pressure, daily step goals, the benefits of standing versus sitting desks, and much more.

    If you’re not a subscriber and are 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 our website at the AMA #60 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • Overview of topics and episode format [1:40];
    • Preventing cognitive decline [5:00];
    • How to lower blood glucose and insulin [13:30];
    • The relationship between lipids, CVD, and Alzheimer’s disease, and whether statins can increase the risk of neurodegenerative disorders and AD [23:15];
    • Reducing apoB levels through exercise and diet [31:45];
    • Pharmacological options for lowering apoB [38:00];
    • How nutrition impacts longevity via metabolic health, muscle mass, BMD and more [40:15];
    • How can someone determine the best diet for themselves? [43:45];
    • Nutrition myth: All weight loss is good [46:45];
    • Nutrition myth: Metabolic rates are dramatically different among individuals based on genetics [49:00];
    • Nutrition myth: Losing weight after a brief period of overeating is impossible [53:45];
    • Nutrition myth: GLP-1 agonists are a replacement for a healthy lifestyle [57:45];
    • Nutrition myth: There is a single best diet for weight loss [1:03:00];
    • Nutrition oversimplification: All calories are created equal [1:05:45];
    • Daily step goals [1:06:45];
    • The benefits of standing versus sitting throughout the day [1:10:45];
    • How to identify the most impactful and easiest-to-implement ways to improve your health [1:12:30];
    • The critical importance of emotional health [1:14:30];
    • Why supplements should be considered as supportive aids rather than primary solutions in one’s strategy to improve longevity [1:18:00];
    • Strategies for reducing high blood pressure [1:20:45];
    • Peter’s biggest frustrations with "mainstream health advice" [1:28:00];
    • Peter’s chaotic, yet cherished, morning routine [1:31:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 17, 2024

    #305 ‒ Heart rate variability: how to measure, interpret, and utilize HRV for training and health optimization | Joel Jamieson

    #305 ‒ Heart rate variability: how to measure, interpret, and utilize HRV for training and health optimization | Joel Jamieson

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    Joel Jamieson is a conditioning expert who developed Morpheus to give people a smarter way to build their conditioning regimen and improve their recovery. In this episode, Joel dives deep into the world of heart rate variability (HRV), explaining its scientific foundation, how it measures the balance between the sympathetic and parasympathetic nervous systems, the various methods of measurement, and how it can guide healthier lifestyle choices and improved training performance. He explores the nuances of HRV calculation, the impact of aging on HRV, and the roles of genetics, exercise, and other lifestyle factors in this process. He also covers Morpheus, the innovative training tool that won Peter over after his initial skepticism, highlighting its practicality and effectiveness in guiding training and optimizing fitness outcomes.

    We discuss:

    • Heart rate variability (HRV): evolution, science, and practical applications of HRV in athletic training [4:00];
    • Methods of measuring HRV: EKG, wrist-based sensors, and more [11:30];
    • How HRV is calculated from the data [22:30];
    • The role of the autonomic nervous system (ANS) in regulating HRV [25:45];
    • The decline in HRV with age, and the mitigating effects of fitness and other lifestyle factors [33:30];
    • The role of genetics in HRV, the modifiability of HRV, and a comparison of VO2 max and HRV as predictors of mortality [37:00];
    • How aging affects HRV and sympathetic drive, and the importance of spontaneous movement and exercise in maintaining the body's adaptability [43:30];
    • How Morpheus measures HRV using RMSSD and normalizes it to a 100-point scale for easier interpretation [49:45];
    • The Morpheus system: development, integration with various metrics, and personalized daily training recommendations to optimize fitness and recovery [51:30];
    • The benefits of morning HRV readings for assessing daily readiness compared to overnight HRV measurements [1:03:00];
    • Why Morpheus recommends using a chest strap rather than an arm band [1:10:00];
    • The impact of consistent exercise, stress, alcohol, and other lifestyle factors on HRV [1:11:15];
    • Optimizing zone 2 training with Morpheus [1:18:15];
    • Using heart rate recovery (HRR) as an indicator of athletic conditioning and the balance between aerobic and anaerobic systems [1:22:45];
    • The importance of tracking HRV trends over time rather than focusing on data from a given day [1:29:00];
    • Effect of GLP-1 agonists on heart rate and HRV [1:34:45];
    • Where HRV belongs in the hierarchy of health metrics [1:42:00];
    • Parting thoughts [1:46:30]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 10, 2024

    #304 – NEW: Introducing quarterly podcast summaries - Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

    #304 – NEW: Introducing quarterly podcast summaries - Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

    View the Show Notes Page for This Episode

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    In this quarterly podcast summary (QPS) episode, Peter introduces a new format aimed at summarizing his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from each episode, covering diverse topics such as protein and muscle building with Luc van Loon, toe strength with Courtney Conley, VO2 max with Olav Aleksander Bu, liquid biopsies for cancer with Alex Aravanis, gut health and probiotics with Colleen Cutcliffe, and road safety with Mark Rosekind. Additionally, Peter shares any personal behavioral adjustments or modifications to his patient care practices that have arisen from these engaging discussions.

    If you’re not a subscriber and are 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 our website at the episode #304 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • How Peter keeps track of his takeaways from each podcast episode [5:15];
    • Luc van Loon episode: fat utilization, muscle protein synthesis, dietary protein, aging and inactivity, and more [8:45];
    • Behavioral changes that have come about from the conversation with Luc van Loon [23:45];
    • Courtney Conley episode: importance of toe strength and the impact of dedicated foot training [26:45];
    • Olav Aleksander Bu episode: the importance of VO2 max for lifespan, and the practicalities of measuring and improving VO2 max [36:45];
    • Behavioral changes that have come about from the conversation with Olav [56:00];
    • Alex Aravanis episode: liquid biopsies for cancer detection [1:01:30];
    • Colleen Cutcliffe episode: the importance of gut bacteria balance, and the potential therapeutic uses of probiotics, particularly Akkermansia [1:16:45];
    • Mark Rosekind: the significant issue of road fatalities and injuries, their causes, and practical safety measures to reduce risks [1:27:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enJune 03, 2024

    #303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

    #303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

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    Dena Dubal is a physician-scientist and professor of neurology at UCSF whose work focuses on mechanisms of longevity and brain resilience. In this episode, Dena delves into the intricacies of the longevity factor klotho: its formation and distribution in the body, the factors such as stress and exercise that impact its levels, and its profound impact on cognitive function and overall brain health. Dena shares insights from exciting research in animal models showing the potential of klotho in treating neurodegenerative diseases as well as its broader implications for organ health and disease prevention. She concludes with an optimistic outlook for future research in humans and the potential of klotho for the prevention and treatment of Alzheimer’s disease.

    Disclosure: Peter is an investor in Jocasta Neuroscience, a company working to develop klotho as a therapy for people with Alzheimer’s disease.

    We discuss:

    • Dena’s fascination with aging and how she came to study klotho [3:30];
    • Biological properties of klotho: production, regulation, decline with age, and factors influencing its levels [11:45];
    • Potential benefits of klotho on brain health [22:00];
    • The relationship between soluble klotho protein, platelet factors, and cognitive enhancement [33:45];
    • The role of platelet factor 4 (PF4) and it’s interaction with GluN2B in mediating cognitive enhancement [46:45];
    • Benefits of klotho observed in a mouse model of Parkinson’s disease [55:45];
    • Benefits of klotho observed in a mouse model of Alzheimer’s disease [1:03:00];
    • Promising results of klotho in primate models, and the importance of finding an appropriate therapeutic dose before moving to human trials [1:08:00];
    • Speculating why a single klotho injection has such long-lasting effects [1:25:30];
    • Potential cognitive benefits of klotho in humans, the impact of the KL-VS genetic variant on klotho levels, and the need for human trials to confirm these effects [1:27:45];
    • The interaction between the KL-VS genetic variant and APOE4 and how it impacts risk of Alzheimer’s disease [1:34:45];
    • The significance of klotho levels: studies linking lower levels to increased mortality and the broader implications for organ health and disease prevention [1:47:15];
    • Measuring klotho levels and determining an individual’s KL-VS status [1:52:15];
    • The promising potential of klotho for Alzheimer’s disease treatment, and the importance of philanthropy for funding research [1:58:00]; and
    • More.

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    The Peter Attia Drive
    enMay 27, 2024

    #302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

    #302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

    View the Show Notes Page for This Episode

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    Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease.

    We discuss:

    • Julia’s training, the importance of liver health, and the challenges and innovations of hepatology [3:15];
    • The complex and crucial functionality of the liver, its four most essential functions, and more [8:45];
    • Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15];
    • How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45];
    • Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30];
    • The poisonous nature of ethanol to the liver [40:30];
    • Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15];
    • Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30];
    • Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15];
    • Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45];
    • Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45];
    • Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30];
    • Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30];
    • The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45];
    • Practical strategies for managing MAFLD [1:45:30];
    • The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45];
    • The potential of GLP-1 agonists for the treatment of MASLD [1:57:45];
    • How the four stages of liver disease have evolved [2:00:30];
    • Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15];
    • Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15];
    • Peter’s major takeaways [2:18:45]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enMay 20, 2024

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