Logo
    Search

    Podcast Summary

    • Improving Metabolic Health for LongevityUnderstanding and improving metabolic health through lifestyle interventions can help prevent and manage major diseases of aging, leading to better overall well-being and longevity.

      Metabolic disease is a significant contributor to the major diseases of aging, such as cardiovascular disease, cancer, and neurodegenerative disease. It is a diverse range of conditions that include obesity and type 2 diabetes. Understanding and improving metabolic health is crucial in preventing and managing these diseases. While traditional blood metrics like HbA1c are commonly used, there are other important indicators to consider. By assessing factors beyond the typical annual physical, individuals can gain a more comprehensive understanding of their metabolic health. Lifestyle interventions, including nutrition, sleep, and exercise, play a significant role in improving metabolic health. Taking proactive steps to optimize metabolic health can have a substantial impact on overall well-being and longevity.

    • Understanding Metabolic Syndrome: Impact on Chronic Diseases and Overall Well-beingMonitoring and improving metabolic health is crucial, as even minor changes can greatly benefit overall well-being and reduce the risk of chronic diseases.

      Metabolic syndrome, characterized by trunkle obesity, elevated triglycerides, low HDL cholesterol, elevated blood pressure, and elevated glucose levels, is a remarkable predictor of chronic diseases such as cardiovascular disease, cancer, and neurodegenerative disease. Even though metabolic syndrome is defined as having three or more of these signs, having just one is still worse than having none, and having two is worse than having one. Therefore, it is essential to assess one's metabolic health and strive to improve it, as even minor improvements can have a significant impact. Metabolic syndrome, when left unaddressed, can fuel the development and progression of these other diseases, showcasing the interconnectedness of our metabolic health and overall well-being.

    • The Risks of Metabolic Syndrome: Cardiovascular Disease, Cancer, and Neurodegenerative DiseasesMetabolic syndrome increases the risk of cardiovascular disease, various cancers, and neurodegenerative diseases like Parkinson's and Alzheimer's, highlighting the importance of addressing the syndrome for overall health management.

      Metabolic syndrome significantly increases the risk of various health problems. Research consistently shows that individuals with metabolic syndrome have a higher likelihood of developing cardiovascular disease, cancer, and neurodegenerative diseases like Parkinson's and Alzheimer's. The risk of cardiovascular disease and mortality increases by significant percentages, while the risk of certain cancers, such as endometrial, esophageal, gastric, liver, and kidney cancer, is also elevated. Metabolic syndrome is even considered the second biggest environmental trigger for cancer, following smoking. When it comes to neurodegenerative diseases, the risk of Parkinson's disease is about 24% higher in those with metabolic syndrome, while the risk of Alzheimer's disease increases by around 10%. However, it's important to note that abdominal obesity seems to play a protective role against Alzheimer's, potentially due to reverse causality. Overall, these findings underscore the importance of addressing metabolic syndrome to prevent and manage a range of serious health conditions.

    • The limitations of weight and BMI in assessing metabolic health.Weight and BMI alone are insufficient to determine metabolic health. Healthcare professionals should consider other factors, such as body composition and insulin sensitivity, to accurately assess an individual's metabolic health.

      Body weight and BMI are not reliable indicators of someone's metabolic health. While these metrics are commonly used at a population level, they fail to account for important factors such as body composition and insulin sensitivity. As highlighted by the data analysis, a significant portion of individuals with metabolic syndrome are not obese. This suggests that relying solely on BMI can lead to misleading conclusions about an individual's metabolic health. Instead, healthcare practitioners should focus on other metrics, such as DEXA scans, to obtain a more accurate understanding of their patients' metabolic health. By utilizing these metrics, healthcare providers can better identify and address underlying metabolic issues on an individual basis, rather than relying on broad population-level indicators.

    • Biomarker tests, imaging studies, and their importance in health assessment.Understanding different biomarker tests and imaging studies can provide valuable insights into one's health and help individuals take steps to improve their overall well-being.

      There are various biomarker tests and imaging studies that can provide valuable insights into one's health. These include blood tests such as uric acid, homocysteine, triglycerides, HDL cholesterol, fasting glucose, insulin, hemoglobin A1c, and liver function tests. Functional tests like resting and fasting lactate levels, zone 2 output, C PET testing, oral glucose tolerance tests, continuous glucose monitoring, and whole-body respiratory suites can also provide important information. Imaging studies like DEXA scans can measure visceral adipose tissue, muscle mass, and body fat percentage. However, it's important to note that some tests like CT scans for visceral fat are not recommended for clinical practice. Additionally, liver ultrasound and algorithms combining ultrasound with blood tests can help assess fibrosis scores and detect fatty liver disease. While some tests mentioned are not commonly done in clinical practice, they hold significance in research studies. Understanding these different tests and their ranges can help individuals take steps to improve their health metrics.

    • Unlock Exclusive Benefits and Expand Your Knowledge with Peter Attia's Premium MembershipGain access to exclusive show notes, monthly AMA episodes, a premium newsletter, and a member-only podcast to enhance your understanding of longevity and health-related topics.

      Becoming a premium member of Peter Attia's content provides numerous exclusive benefits, offering an in-depth understanding of longevity and health-related topics. Premium membership includes comprehensive show notes for each episode, monthly AMA episodes with detailed responses, a premium newsletter with in-depth research analysis, access to a private podcast feed, and a member-only podcast called "The Qualys" featuring highlights from previous episodes. These benefits go beyond what is available for free and aim to provide members with much more value than the price of their subscription. By joining as a premium member, individuals can enhance their knowledge in this space and gain access to a wealth of valuable content. Visit peteratiamd.com/subscribe to learn more about these member-only benefits. However, it is important to note that the content of this podcast does not substitute professional medical advice.

    Recent Episodes from The Peter Attia Drive

    Zone 2 training: impact on longevity and mitochondrial function, how to dose frequency and duration, and more | Iñigo San-Millán, Ph.D. (#201 rebroadcast)

    Zone 2 training: impact on longevity and mitochondrial function, how to dose frequency and duration, and more | Iñigo San-Millán, Ph.D. (#201 rebroadcast)

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    Iñigo San-Millán is an internationally renowned applied physiologist and a previous guest on The Drive. His research and clinical work focuses on exercise-related metabolism, metabolic health, diabetes, cancer metabolism, nutrition, sports performance, and critical care. In this episode, Iñigo describes how his work with Tour de France winner Tadej Pogačar has provided insights into the amazing potential of elite athletes from a performance and metabolic perspective. He speaks specifically about lactate levels, fat oxidation, how carbohydrates in food can affect our lactate and how equal lactate outputs between an athlete and a metabolically unhealthy individual can mean different things. Next, he discusses how Zone 2 training boosts mitochondrial function and impacts longevity. He explains the different metrics for assessing one’s Zone 2 threshold and describes the optimal dose, frequency, duration, and type of exercise for Zone 2. Additionally, he offers his thoughts on how to incorporate high intensity training (Zone 5) to optimize health, as well as the potential of metformin and NAD to boost mitochondrial health. Finally, he discusses insights he’s gathered from studying the mitochondria of long COVID patients in the ICU.

    We discuss:

    • The amazing potential of cyclist Tadej Pogačar [2:00];
    • Metrics for assessing athletic performance in cyclists and how that impacts race strategy [7:30];
    • The impact of performance-enhancing drugs and the potential for transparency into athletes’ data during competition [16:15];
    • Tadej Pogačar’s race strategy and mindset at the Tour de France [23:15];
    • Defining Zone 2, fat oxidation, and how they are measured [26:00];
    • Using fat and carbohydrate utilization to calculate the mitochondrial function and metabolic flexibility [35:00];
    • Lactate levels and fat oxidation as it relates to Zone 2 exercise [39:15];
    • How moderately active individuals should train to improve metabolic function and maximize mitochondrial performance [51:00];
    • Bioenergetics of the cell and what is different in elite athletes [56:30];
    • How the level of carbohydrate in the diet and ketogenic diets affects fuel utilization and power output during exercise [1:07:45];
    • Glutamine as a source for making glycogen—insights from studying the altered metabolism of ICU patients [1:14:15];
    • How exercise mobilizes glucose transporters—an important factor in diabetic patients [1:20:15];
    • Metrics for finding Zone 2 threshold—lactate, heart rate, and more [1:24:00];
    • Optimal Zone 2 training: dose, frequency, duration, and type of exercise [1:40:30];
    • How to incorporate high intensity training (Zone 5) to increase VO2 max and optimize fitness [1:50:30];
    • Compounding benefits of Zone 2 exercise and how we can improve metabolic health into old age [2:01:00];
    • The effects of metformin, NAD, and supplements on mitochondrial function [2:04:30];
    • The role of lactate and exercise in cancer [2:12:45];
    • How assessing metabolic parameters in long COVID patients provides insights into this disease [2:18:30];
    • The advantages of using cellular surrogates of metabolism instead of VO2 max for prescribing exercise [2:25:00];
    • Metabolomics reveals how cellular metabolism is altered in sedentary individuals [2:33:00];
    • Cellular changes in the metabolism of people with diabetes and metabolic syndrome [2:38:30]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    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

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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.

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    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

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    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

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this “Ask Me Anything” (AMA) episode, Peter delves into the often misunderstood concept of inflammation. He first defines inflammation and differentiates between acute inflammation and chronic inflammation, the latter of which is linked to aging and a plethora of age-related diseases. Peter breaks down the intricate relationship between chronic inflammation, obesity, and metabolic health, and highlights the signs that might suggest someone may be suffering from chronic inflammation. From there, the conversation centers on actionable advice and practical steps one can take to manage and minimize chronic inflammation. He explores how diet plays a crucial role, including the potential benefits of elimination diets, and he examines the impact of lifestyle factors such as exercise, sleep, and stress management. Additionally, he discusses the relevance of food inflammatory tests and concludes by examining the potential benefits and drawbacks of drugs and supplements in managing inflammation.

    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 #59 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • Defining inflammation (and the cultural impact of Napoleon Dynamite) [1:45];
    • Acute vs chronic inflammation [8:00];
    • The connection between chronic inflammation, aging, and age-related diseases [11:00];
    • The impact of inflammation on metabolic health [18:30];
    • Understanding and diagnosing chronic inflammation: blood tests and other approaches, and challenges with measurement [20:00];
    • Factors that contribute to low-level chronic inflammation [28:00];
    • Minimizing inflammation through diet [29:45];
    • The important role of fiber for gut health and inflammation [33:45];
    • A closer look at the impact of trans fats and saturated fats on overall health [34:45];
    • Why Peter prefers dietary fiber from food sources over supplements [38:30];
    • Debunking “superfoods”: emphasizing proven methods over marketing claims for reducing inflammation [39:00];
    • Is there any value in over-the-counter food inflammatory tests? [42:30];
    • Food elimination diets: how they work, symptoms and markers to watch, challenges and limitations [45:15];
    • Identifying dietary triggers for gut-related symptoms through low-FODMAP diets like the “carnivore diet” [51:15];
    • Dairy: the complex role of dairy on inflammation and individual responses [55:00];
    • Wheat: the complexities and conflicting evidence around wheat's inflammatory effects [57:45];
    • How exercise influences inflammation [1:02:00];
    • How sleep quality and duration impacts inflammation [1:07:00];
    • The potential impact of chronic psychological stressors on inflammation [1:13:00];
    • The impact of oral health on inflammation and overall well-being [1:15:00];
    • The role of medications in managing chronic inflammation [1:18:15];
    • Supplements: evaluating the efficacy of various anti-inflammatory supplements [1:22:15];
    • Parting thoughts and takeaways [1:27:00]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    The Peter Attia Drive
    enMay 13, 2024

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

    View the Show Notes Page for This Episode

    Become a Member to Receive Exclusive Content

    Sign Up to Receive Peter’s Weekly Newsletter

    In this special edition celebrating 300 episodes of The Drive, Peter discusses a variety of popular topics and health interventions and classifies them based on their level of evidence and relevance using the following categories: proven, promising, fuzzy, noise, and nonsense. Peter first delves into the topic of geroprotective molecules, covering rapamycin, metformin, NAD and its precursors, and resveratrol. Next, he explores the significance of metrics like VO2 max and muscle mass, as well as emerging concepts like blood flow restriction and stem cells. The conversation extends to nutrition, addressing questions surrounding long-term fasting, sugar consumption, sugar substitutes, and the contentious role of red meat in cancer. Peter not only provides his current stance on each topic—most of which have been covered in great detail in the previous 300 episodes—but also reflects on how his opinion may have evolved over the years.

    We discuss:

    • Defining the categories of “proven, promising, fuzzy, noise, and nonsense” [3:15];
    • Rapamycin [9:30];
    • Metformin [17:00];
    • NAD and its precursors [24:30];
    • Resveratrol [32:45];
    • The importance of VO2 max, muscle mass, and muscular strength for lifespan [38:15];
    • Blood flow restriction (BFR) training [44:00];
    • Using stem cells to treat osteoarthritis or injury [51:30];
    • Fasting as a tool for longevity (and why Peter stopped his fasting protocol) [55:45];
    • The energy balance theory [1:06:30];
    • The idea that sugar is poison [1:12:00];
    • The idea that sugar substitutes are dangerous [1:22:15];
    • The debate on red meat and cancer [1:28:45]; and
    • More.

    Connect With Peter on TwitterInstagramFacebook and YouTube

    Related Episodes

    How This Gut-Protective Bacteria Can Help Prevent And Treat Chronic Disease

    How This Gut-Protective Bacteria Can Help Prevent And Treat Chronic Disease

    This episode is brought to you by Rupa University, Pique, and Super Simple Grassfed Protein.


    Our gut bacteria regulate many of our bodily functions, from creating vitamins to regulating our immune system, our brain function, and of course, our metabolism and weight. They are critical to our long-term health. One such bacteria is Akkermansia muciniphila, which accounts for 1%–5% of our gut microbiome—or at least it’s supposed to! 


    In today’s episode of my series I’m calling Health Bites, I dive into Akkermansia—what it is, what role it plays in chronic disease prevention, and what you can do to increase it.


    This episode is brought to you by Rupa University, Pique, and Super Simple Grassfed Protein.


    If you’re a healthcare provider who wants to learn more about Functional Medicine testing, go to rupauniversity.com to sign up for a free live class or a boot camp!


    For a limited time, get up to 12% off plus an exclusive gift on Pique’s Fasting Tea bundle. Just go to Piquelife.com/farmacyfasting today.


    Right now, you can get 10% off Super Simple Grassfed Protein by heading to drhyman.com/protein and using code protein10.


    Here are more details from our interview (audio version / Apple Subscriber version):

    • Healing my own gut and recovering my health (4:12 / 2:46) 
    • What is Akkermansia, and how does it work? (7:54 / 5:12) 
    • Akkermansia and chronic disease prevention (13:48 / 11:46)
    • Foods that increase Akkermansia (24:26 / 22:20)


    Mentioned in this episode

    Pendulum Akkermansia




    Hosted on Acast. See acast.com/privacy for more information.


    #108 Metabolic Health: What You Need to Know with Dr. Brian Lenzkes

    #108 Metabolic Health: What You Need to Know with Dr. Brian Lenzkes

    In this episode of Hart2Heart, host Dr. Mike Hart sits down with Dr. Brian Lenzkes, an internal medicine doctor and host of the low-carb MD podcast, to discuss the often misunderstood world of metabolic health. Together they discuss the benefits of intermittent fasting and ketogenic diets to the pitfalls of traditional healthcare, Dr. Lenzkes shares his journey toward a more personalized approach to medicine. They explore the root causes of metabolic diseases, the importance of lifestyle changes, and the limitations of relying solely on medication. 

    Show Notes:

    [0:00] Welcome back to the Hart2Heart Podcast with Dr. Mike Hart. Dr. Hart welcomes guest, Dr. Brian Lenzkes to the listeners.    

    [0:30] Low-Carb MD Podcast 

    [1:00] Question: Can you tell the listeners a bit about yourself?

    [2:00] The shift to direct primary care is discussed

    [3:45] Question: Can you explain what being metabolically healthy means and why are we doing such a poor job of it?

    [4:40] Five key factors for a long, healthy life

    [7:30] Question: When someone is metabolically unhealthy, what are they mostly at risk of acquiring?

    [10:00] The dangers of visceral fat are explained

    [12:15] Parameters for metabolic health

    [15:30] What is CRP

    [19:00] The role of statin drugs in managing cardiovascular health

    [26:00] The value and importance of a sense of community in medical practice 

    [29:40] Metformin and Berberine 

    [34:30] The crucial role stress and sleep play in one's metabolic health

    [41:25] Muscle mass and metabolic health

    [52:10] The link between testosterone and metabolic health

    [56:00] Men's Health vs. Women's Health with Dr. Jaime Seeman aka Dr. Fit and Fabulous

    [58:00] Connect with Dr. Brian Lenzkes on twitter @BrianLenzkes, on IG @blenzkes at his website https://sandiegometabolichealth.com/brian-lenzkes-md/, and his podcast  Low-Carb MD Podcast

    ---

    Dr. Mike Hart is a Cannabis Physician and Lifestyle Strategist. In April 2014, Dr. Hart became the first physician in London, Ontario to open a cannabis clinic. While Dr. Hart continues to treat patients at his clinic, his primary focus has shifted to correcting the medical cannabis educational gap which exists in the medical community. 

    Social Links:

     

    Sleep Duration and Health: Are We All Doomed? | Greg Potter (Solo Episode)

    Sleep Duration and Health: Are We All Doomed? | Greg Potter (Solo Episode)

    Welcome to the podcast about how to use reason and science to live a long, healthy, decent life.

    Subscribe to join the host, Greg Potter, as he unveils the latest science and the secrets of some of the most brilliant people, including scientists, coaches, entrepreneurs, and many others.

    You can also find the Reason & Wellbeing on YouTube here.

     

    People and resources featured in this episode:

    Simon Marshall’s gofundme page

    Greg Potter, PhD. Follow Greg on Instagram here

    Podcast: What Is Healthy Sleep? | Greg Potter (Solo Episode)

    Podcast: Your Body Clock: How to Align Your Circadian Rhythms for Better Health and Performance | Greg Potter (Solo Episode)

    Podcast: How to Build Healthier Habits | Simon Marshall, Behavioural Scientist and BAFTA-Winning Screenwriter

     

    Disclaimer: This podcast is for informational purposes only. The podcast does not constitute the practice of medicine or any other professional healthcare service. The use of information on this podcast or materials linked from this podcast is exclusively at the listener’s own risk. The contents of this podcast are not intended to substitute for professional medical advice, diagnosis, or treatment. Listeners should not wait to obtain or disregard medical advice for any medical conditions they have and should seek the assistance of their healthcare professionals for such conditions. Under no circumstances shall Greg Potter, Greg Potter PhD Limited, or any guests or contributors to the podcast be responsible for damages arising from the use of the contents of this podcast.

    #197 Improving metabolic health and insulin resistance

    #197 Improving metabolic health and insulin resistance

    In today’s solo episode and I’ll be talking about insulin resistance, how this impacts your risk of disease and why insulin resistance could drive many chronic conditions and why certain lifestyle measures work for improving metabolic health.


    By the end of the episode you will understand:


    The relationship between IR and disease

    The importance of sugar balance in the body

    What insulin is and how insulin works

    What happens when we become resistant to insulin

    What are the causes of IR

    What we can do to become more insulin sensitive and ultimately prevent disease


    🎬 Watch the podcast on YouTube here

    📱 Download The Doctor’s Kitchen app for free


    You can download The Doctor’s Kitchen app for free to get access to all of our recipes, with specific suggestions tailored to your health needs and new recipes added every month. We’ve had some amazing feedback so far and we have new features being added all the time - check it out with a 14 day free trial too.


    🥗 Join the newsletter and 7 day meal plan

    📷 Follow on Instagram

    🐦 Tweet me


    References:

    4 grams of glucose - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636990/

    IR Overview - https://www.ncbi.nlm.nih.gov/books/NBK507839/

    Insulin resistance Mechanisms - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831809/

    Insulin resistance, genes and mitochondria - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341556/

    Obesity Insulin and cancer - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214048/

    Insulin resistance from euglycaemic clamps - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379600/

    Sleep debt and Insulin resistance - https://pubmed.ncbi.nlm.nih.gov/10543671/

    Increased snacking with poor sleep - https://pubmed.ncbi.nlm.nih.gov/19056602/

    Impact of sleep disorders on endocrine systems - https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-015-0018-3

    Shorterm sleep restruction reduces insulin sensitivity in young healthy adults - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557027/



    Hosted on Acast. See acast.com/privacy for more information.


    #119 TRT, Heart Health, and Hair Loss with James O’Hara

    #119 TRT, Heart Health, and Hair Loss with James O’Hara

    In this episode of Hart2Heart with host Dr. Mike Hart. Dr. Mike Hart sits down with James O'Hara to discuss topics including testosterone replacement therapy (TRT), cardiovascular risk, managing cholesterol, SSRIs, risk factors of birth control, and treatments for hair loss. 

    Guest Bio and Links:

    James O’Hara is a Nurse Practitioner practicing with Dr. Kyle Gillett in Kansas City. He co-hosts the Gillett Health Podcast and shares health insights on Instagram @jamesoharanp 

    Resources: 

    Adverse Events Associated with Testosterone Administration

    https://examine.com/ 

    Show Notes:

    • [0:00] Welcome back to the Hart2Heart Podcast with Dr. Mike Hart. Dr. Hart introduces James O’Hara to the listeners   

    • [0:55] Adverse Events Associated with Testosterone Administration

    • [2:00] In-depth analysis of TRT and cardiovascular health

    • [8:00] The role of testosterone in managing blood pressure and cholesterol

    • [15:00] Types of fibers to use to help lower your LDL 

    • [24:00] Viagra or Cialis… verdict is in

    • [26:30] The versatility of Cialis beyond erectile dysfunction

    • [29:00] SSRIs and sexual health

    • [34:15] Long-term effects of birth control pills

    • [37:30] Benefits of Boron 

    • [44:00] Approaches to hair loss treatments and DHT's role 

    • [51:30] Latanoprost for eyelash growth 

    ---

    Dr. Mike Hart is a Cannabis Physician and Lifestyle Strategist. In April 2014, Dr. Hart became the first physician in London, Ontario to open a cannabis clinic. While Dr. Hart continues to treat patients at his clinic, his primary focus has shifted to correcting the medical cannabis educational gap which exists in the medical community. 

    Connect on social with Dr. Mike Hart:

    Social Links: