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The Peter Attia Drive

Expert insight on health, performance, longevity, critical thinking, and pursuing excellence. Dr. Peter Attia (Stanford/Hopkins/NIH-trained MD) talks with leaders in their fields.

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

In this episode, Luke Bennett, Medical and Sports Performance Director for Hintsa Performance, explains the ins and outs of Formula 1 with a focus on the behind-the-scenes human element, and what makes it so emotionally, cognitively, and physically demanding for the drivers as well as the many team members. Luke first talks about his fascinating background with the Royal Flying Doctor Service in Australia, which lead to his current position with Hintsa working closely with F1 drivers to improve their health and performance despite jet-lag and sleep constraints due to an unrivaled travel schedule. Luke also sheds light on the underappreciated level of sheer physical strength and endurance it takes to drive an F1 car combined with the extreme cognitive aptitude, spatial awareness, and ability to navigate a socially complex environment that is needed to be successful as a driver. Additionally, Luke gives an overview of how the F1 season and races work, the incredible advances in car technology and safety measures, and what Luke and Hintsa hope to bring in the near future to the unique and special sport that is Formula 1. We discuss: What it’s like to be a “flying doctor” in Australia, and how Luke ended up working in Formula 1 with Hintsa [3:10]; Behind the scenes of Formula 1—crazy travel, jet lag, massive teams, and fascinating human storylines [10:45]; The incredible physical strength and cognitive aptitude needed to be a F1 driver [19:00]; The technological leap to hybrid electric engines [29:30]; The trend towards younger drivers in F1 [32:30]; Advancements in safety—the history and recent upgrades [36:00]; How Hintsa manages the athletes through the incredible social complexity of the sport [41:45]; Explaining the difference between F1, F2, F3, and F4, and the path to reaching the F1 [47:30]; Comparing F1 in the 60s & 70s to today—Incidences of deaths, number of crashes, physicality of driving, new regulations, and more [53:45]; Women in F1—Past, present, and future [1:06:10]; How F1 teams manage their cars and engine over the season, & some new regulations coming in 2021 [1:09:15]; What insights has Luke taken from his time as a triathlete to working with F1 drivers? [1:12:50]; How Luke survived cancer, and gained an increased sense of empathy [1:15:45]; How Luke manages his health against the brutal travel and lifestyle that comes with working in Formula 1 [1:19:40]; New training techniques, technology to monitor the physiology of drivers, and other things Luke is hoping to bring to Formula 1 [1:22:40]; How long does it take a driver to learn a new circuit? [1:27:45]; The incredible emotional control needed to be a successful F1 driver [1:30:00]; Which F1 teams are showing signs of competing in future seasons? [1:32:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/lukebennett Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

1hr 38mins

2 Mar 2020

Rank #1

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

Gerald Shulman is a Professor of Medicine, Cellular & Molecular Physiology, and the Director of the Diabetes Research Center at Yale. His pioneering work on the use of advanced technologies to analyze metabolic flux within cells has greatly contributed to the understanding of insulin resistance and type 2 diabetes. In this episode, Gerald clarifies what insulin resistance means as it relates to the muscle and the liver, and the evolutionary reason for its existence. He goes into depth on mechanisms that lead to and resolve insulin resistance, like the role of diet, exercise, and pharmacological agents. As a bonus, Gerald concludes with insights into Metformin’s mechanism of action and its suitability as a longevity agent. We discuss: Gerald’s background and interest in metabolism and insulin resistance (4:30); Insulin resistance as a root cause of chronic disease (8:30); How Gerald uses NMR to see inside cells (12:00); Defining and diagnosing insulin resistance and type 2 diabetes (19:15); The role of lipids in insulin resistance (31:15); Confirmation of glucose transport as the root problem in lipid-induced insulin resistance (40:15); The role of exercise in protecting against insulin resistance and fatty liver (50:00); Insulin resistance in the liver (1:07:00); The evolutionary explanation for insulin resistance—an important tool for surviving starvation (1:17:15); The critical role of gluconeogenesis, and how it’s regulated by insulin (1:22:30); Inflammation and body fat as contributing factors to insulin resistance (1:32:15); Treatment approaches for fatty liver and insulin resistance, and an exciting new pharmacological approach (1:41:15); Metformin’s mechanism of action and its suitability as a longevity agent (1:58:15); More. Learn more: https://peterattiamd.com/ Show notes page for this episode:  https://peterattiamd.com/geraldshulman  Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 8mins

7 Dec 2020

Rank #2

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

In part 1 of this 3 part series, Matthew Walker, professor of neuroscience at UC Berkeley and expert on sleep, describes the different stages and cycles of sleep, including what he calls the 4 pillars of sleep, and how they contribute to memory consolidation and numerous important pathways to mental health. We also get into the dangers of chronic sleep deprivation, such as the development of dementia, and the more acute dangers of sleep deprivation like fatal car crashes which are most often caused by drowsy driving. We also discuss the different and important roles of REM vs. non-REM sleep, and the impact that bad sleep habits can have specifically on those sleep stages.  We discuss: Matthew’s background and interest in sleep [6:03]; Sleep and Alzheimer’s disease, and the 4 pillars of sleep [12:18]; Stages of sleep, sleep cycles, and brain waves [41:18]; Memory and sleep, and the risk of insufficient REM sleep [55:48]; Evolutionary reasons to sleep [1:02:03]; The early riser vs. the night owl, and tips for overcoming jet lag [1:10:18]; Is there one type or stage of sleep that is most important? [1:17:33]; The dangers of drowsy driving [1:28:48]; The timeliness of Matthew’s book, and how the conversation of sleep has changed over the past several years [1:35:18]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

1hr 43mins

1 Apr 2019

Rank #3

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

In this episode, Bill Harris, Ph.D. in human nutrition and expert on omega-3 fatty acids, sets the table by clearly defining the families of fatty acids (saturated, monounsaturated, polyunsaturated) before diving into the current landscape of polyunsaturated fat (omega-6 and omega-3) with a particular focus on EPA and DHA (the two main elements of fish oil supplements). Bill gives a historical overview, updates us on the latest science related to the health benefits, and provides plenty of insights as to how we should think about increasing our EPA and DHA intake. We discuss: Bill’s long history of studying fatty acids [6:30]; Defining the fatty acids—SFA, MUFA, PUFA, omega-3, omega-6, and more [9:45]; What is the significance of fatty acids? Why should we care? [19:45]; History of fat phobia, saturated fat, and does PUFA reduce cholesterol? [23:45]; Breaking down the conversion process of omega-6 and omega-3 fatty acids including how we get to EPA and DHA [28:00]; Takeaway from Bill’s 1980 study looking at how salmon oil affected cholesterol and triglyceride levels [36:15]; History of our understanding of omega-3 and its effect on LDL cholesterol [45:00]; Prescribed fish oil drugs vs. OTC supplements—Differences and recommended brands [52:00]; Health benefits of EPA [57:45]; Potential benefits of ALA and how it compares to taking EPA and DHA directly [1:12:45]; Health benefits of DHA [1:17:15]; Cell membrane omega-3 index—What is it, the role of genetics, how to increase it, and a recommended target [1:19:00]; Is EPA or DHA neuroprotective? Can it help with depression? [1:23:30]; Recommended fish to eat for EPA and DHA - Any mercury concerns? [1:25:45]; Can omega-3 mitigate risks associated with smoking? [1:29:15]; The problem with the omega-6 to omega-3 ratio [1:30:00]; The problem with labeling any kind of fatty acid as “bad” [1:36:00]; Why increasing EPA and DHA intake matters more than reducing omega-6 intake [1:38:00]; Important takeaway from the VITAL study [1:46:30]; Importance of testing your omega-3 index [1:53:00]; Exciting study coming out soon, and why you need to take your fish oil with food [1:57:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/billharris Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 2mins

9 Dec 2019

Rank #4

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

In this episode, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and author of Deadliest Enemy: Our War Against Killer Germs, provides an overview on the COVID-19 pandemic in regards to what has happened to date, what we’ve learned about how the disease spreads, and his optimism and pessimism about what potentially lies ahead. Michael gives his take on the true case fatality rate, why it differs around the world, and which underlying conditions, such as obesity, impact risk of severe illness and death. We also discuss the outlook regarding vaccines, repurposed drugs/antivirals for treatment, and Michael’s growing concern about supply chain limitations with respect to drugs, vaccines, n95 masks, and testing kits. We discuss: Recapping the brief history of COVID-19 and what potentially lies ahead [2:15]; Some positive news about immunity and reinfection [10:45]; Case fatality rate—The challenge in finding the true rate, difference by country, and the impact of age, underlying conditions, and obesity [13:00]; What has to be true for less than 100,000 Americans to die from COVID-19? [24:30]; How do we best protect healthcare workers? [29:45]; Concerns about testing capability—Reagent shortfall and a supply chain problem [39:30]; Vaccines and antivirals—The outlook, timing, and challenges [47:45]; Long term health of survivors of COVID-19 [56:45]; The impact of comorbidities—Diabetes, obesity, and immunosuppressed patients [59:30]; Understanding R0 and how the disease spreads [1:01:30]; The challenge of forecasting with so many unknown [1:08:00]; What explains the difference in cases and fatalities in different parts of the world? [1:14:30]; Repurposed drugs/antivirals being considered for treatment options—any optimism? [1:16:45]; A parting message from Michael about what lies ahead [1:18:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/michaelosterholm Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

1hr 22mins

31 Mar 2020

Rank #5

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

In this episode, Rick Johnson, Professor of Nephrology at the University of Colorado, explains how his research into the causes of blood pressure resulted in a change of research direction to focus more on how fructose has such profound metabolic effects. Rick discusses the relationship between salt and high blood pressure, provides a masterclass into uric acid, and expertly reveals the mechanisms and pathways by which sugar (specifically fructose) can profoundly impact metabolic health. From there, he explains how he applies this information to real life patients, as well as touches on some of the most promising ideas around pharmacotherapy that are being developed in response to the epidemics of fatty liver, insulin resistance, diabetes, and obesity. Furthermore, Rick gives his take on artificial sweeteners compared to real sugar, discusses cancer’s affinity for fructose, and much more. We discuss:  The connection between blood pressure and fructose that shifted Rick’s professional focus [4:00]; The relationship between salt and blood pressure (and the role of sugar) [5:45]; Defining fructose, glucose, and sugar [19:30]; An ancient mutation in apes that explains why humans turn fructose into fat so easily [23:00]; The problems with elevated uric acid levels, and what it tells us about how sugar causes disease [31:30]; How sugar causes obesity—explaining the difference in glucose vs. fructose metabolism and the critical pathway induced by fructose [40:00]; Why drinking sugar is worse than eating it [50:00]; Unique ability of sugar to drive oxidative stress to the mitochondria, insulin resistance, and diabetes [54:00]; Why cancer loves fructose [1:00:15]; The many areas of the body that can use fructose [1:05:00]; Fructokinase inhibitors—a potential blockbuster? [1:07:15]; Treating high uric acid levels—Rick’s approach with patients [1:10:00]; Salt intake—what advice does Rick give his patients? [1:16:30]; How excess glucose (i.e., high carb diets) can cause problems even in the absence of fructose [1:21:00]; Artificial sweeteners vs. real sugar—which is better? [1:29:15]; Umami, MSG, alcohol, beer—do these have a role in metabolic illness? [1:33:45]; Fructose consumption—Is any amount acceptable? Is fruit okay? Where does Rick draw a hard line? [1:38:45] How does Rick manage the sugar intake of his young kids? [1:43:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/rickjohnson Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

1hr 50mins

6 Jan 2020

Rank #6

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

In this episode, David Sinclair, Ph.D., a Professor in the Department of Genetics at Harvard Medical School and co-Director of the Paul F. Glenn Center for the Biological Mechanisms of Aging, returns to the podcast to discuss the content of his new book, Lifespan: Why We Age - and Why We Don’t Have To. This conversation focuses on the biological mechanisms involved in what David terms the Information Theory of Aging which provides insights into the “clock” that determines our aging and to what degree it can be manipulated. Our discussion on aging of course leads us into interconnected topics of epigenetics, sirtuins, cellular senescence, as well as what compounds David is personally taking for his own longevity. Additionally, we discuss the most up to date information related to NAD and longevity by looking at the potential benefits (if any) of supplemental agents (NAD precursors, NR, NMR, etc.) that pose a promise of increasing NAD. We discuss: SIR genes and cellular identity [8:45]; Sirtuins regulate gene expression [14:30]; DNA is methylated at the deepest layer of the epigenome [17:45]; Methylation pattern and determining cellular age [20:15]; Cellular reprogramming [33:45]; Yamanaka factors to push cells "back in time”  [41:00]; Human cellular reprogramming viability [57:00]; Measuring the rate of aging [1:02:45]; Cellular reprogramming for longevity [1:14:45]; Compounds David takes for his own longevity [1:29:15] NAD precursors (NR, NMN) and pterostilbene [1:40:00]; The current field of sirtuin activators [2:03:15]; David’s artistic work [2:05:15] and; More. Learn more: https://peterattiamd.com/ Show notes page for this episode:https://peterattiamd.com/davidsinclair2/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 10mins

9 Sep 2019

Rank #7

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

In this episode, Dr. Debra Kimless and Steve Goldner share their knowledge on the science, policy, and market evolution of medicinal cannabis. We start with the differences between THC and CBD, how they work in the body, and how they act on the brain. We discuss the many potential benefits of using CBD, THC, hemp in the various forms of administration (smoking, vaping, edibles, oils, etc.) as well as some of the safety issues including the recent uptick in incidents of hospitalization and death linked to vaping. Debra and Steve are both involved with the company, Pure Green—Debra the Chief Medical Officer and Steve the founder and CEO—whose aim is to create the safest, most efficacious form of delivery of cannabis. Their bigger mission is to shift the perception of the cannabis plant, garner acceptance of its medicinal benefits, and ultimately get it descheduled on a federal level so more people can access cannabis for a range of chronic ailments. We discuss: Debra and Steve’s background reason for their interest in medical cannabis [7:00]; The history of medical use of cannabis [11:15]; How THC, CBD, and other cannabinoids work [16:00]; Hemp—What it is, special uses, and the 2018 farm bill [22:45]; The legal status of CBD, Deb and Steve’s clinical trial, and how CBD differs from THC [30:15]; The safety profile of THC [35:00]; Is marijuana as a gateway drug? [45:30]; Smoking vs. vaping vs. edibles—Benefits, risks, and mechanistic differences [53:30]; Can you build up a tolerance to the effects of THC? [1:15:00]; What do people generally want to get from using marijuana? [1:17:15]; Cannabinoid synthetics [1:22:30]; Efficacy of CBD oils as a sleep aid [1:25:00]; Pure Green Cannabis [1:30:30]; Anecdotal evidence and managing the hype surrounding cannabis in medical treatment [1:38:45]; Aspirations for the future of medicinal cannabis, and the legal challenges that await them [1:45:15]; Descheduling cannabis: A human rights issue [2:04:00] and; More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/debrakimless-stevegoldner/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 11mins

25 Nov 2019

Rank #8

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

In this episode, Marty Makary, Johns Hopkins surgeon and NYT bestselling author, discusses his ambitious attempt to fix the broken U.S. healthcare system through educating the public, changing the lexicon, encouraging radical transparency in pricing, and more. We go in detail into the main drivers of inflated health care costs, the money games being played making it hard to understand, and the unfortunate system structure that has resulted in one in five Americans finding themselves in medical debt collections which can ruin the lives of people and families seeking basic medical care. Marty also shares some very practical advice and tips if you find yourself a victim of predatory pricing and stuck with an outrageous medical bill. In the end, despite the current state of the system, Marty discusses the many exciting trends gaining traction in healthcare and why he is very optimistic and hopeful about the future. We discuss: The science of delivering healthcare, how we need to do better as a system, and why no single person or entity fully to blame [10:15]; The stories that prompted Marty to write his first book (Unaccountable) [19:15]; The Surgery Checklist [26:15]; The problem is with the system (not any one person or entity) and the misaligned interests of all the parties involved [28:15]; Patients crave honesty and transparency, and the story of Peter’s back surgery gone wrong [33:00]; Today’s med students and young doctors have less tolerance for predatory pricing and healthcare industry BS [44:30]; Funny stories about John Cameron (legendary surgeon at Johns Hopkins) [48:00]; How doctors are trained to internalize traumatic experiences which can result in a misunderstood form of “burnout” [57:40]; The beat down of med students with traditional medical education and some exciting innovations to medical education [1:07:00]; Exciting trends in healthcare and an optimistic view of the future [1:11:30]; The Price We Pay (Marty’s new book), an attempt to illuminate the blackbox that is the US healthcare system [1:21:00]; Why it’s not always in the best interest of the insurance company to negotiate the best price [1:28:30]; Who is actually paying for medical costs, and Marty’s frustration with the healthcare lexicon [1:32:00]; Pros and cons of a single payer system [1:37:00]; How to fight outrageous medical bills and predatory pricing (and make a dent in the wasteful healthcare spending for the country) [1:49:30]; Disrupting the healthcare industry with private healthcare facilities with market demanded transparency [2:05:45]; The people hurt the worst by the current US healthcare system, the sad breast cancer statistic, and the importance of knowing that medical bills are negotiable [2:09:30]; The healthcare industry bubble [2:14:00]; Increased costs from unnecessary tests and procedures [2:16:30]; Malpractice concerns due to the litigious culture in America: What influence does it have on unnecessary testing, healthcare costs,  and overall quality of treatment  [2:22:00]; Drug pricing, price gouging, middle-men money games, kickbacks, and other drivers of healthcare costs [2:27:45]; How can we possibly fix the healthcare system? [2:34:30]; Helpful resources [2:46:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode:https://peterattiamd.com/martymakary/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 49mins

26 Aug 2019

Rank #9

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

Phil Maffetone is an author, health practitioner, and coach with decades of experience helping everyone from amateurs to world-class athletes optimize their health and performance. In this episode, Phil explains the importance of developing the aerobic system, defines maximum aerobic function (MAF), and explains how to determine your MAF heart rate. He then demonstrates how to integrate that into a training protocol which is designed to help people move faster at a sub maximum heart rate and increase fat utilization as the primary source of fuel—emphasizing the importance of nutrition on one's capacity to oxidize fat. Phil also extracts training insights from the amazing feats of world-class marathoners, explores the impact of a low-carb diet on one’s capacity for high intensity exercise and anaerobic performance, and explains the downstream effects of being “overfat.” We discuss: Phil’s background in running, and training insights from a six-day race (2:30); The difference between being “fit” and being “healthy” (11:00); Defining the aerobic and anaerobic systems, and why VO2 max doesn’t predict performance (18:15); Defining maximum aerobic function (MAF), determining your MAF heart rate with Phil’s 180 Formula, and why a strong aerobic system is crucial to health and performance (24:00); Using the MAF test to track and improve your aerobic fitness (37:30); How increasing your sub-max pace at a given heart rate can increase your maximum pace (40:00); The impact of nutrition on one’s ability to use fat as fuel while exercising (43:00); Phil’s nutritional approach with patients, the concept of “carbohydrate intolerance” (51:45); Assessing the impact of a low-carb diet on high intensity exercise and anaerobic performance (58:00); Extracting insights from world-class marathoners (1:04:45); How being “overfat” affects health and performance, and ways to decrease excess body fat (1:13:30); and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: http://peterattiamd.com/PhilMaffetone Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

1hr 22mins

11 Jan 2021

Rank #10

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

In this special episode, Matthew Walker returns for his third AMA episode to provide his expert insight into numerous sleep-related questions directly from listeners. He explains how he adjusted his hypotheses on topics like blue light and caffeine, and why he is more bullish on the importance of REM sleep. Matt also answers questions about sleep wearables, how fasting affects sleep, how sleep deprivation impacts gut health, and magnesium as a sleep aid. Finally, Matt reveals what he believes is the next evolution in sleep science and technology. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website on the show notes page. We discuss: Matt’s framework for changing his mind when faced with new information [1:30]; Blue light—How Matt shifted his thinking [5:45]; Caffeine—How Matt has adjusted his hypothesis [12:00]; REM sleep—Why Matt is more bullish on the importance of dream sleep [16:30]; How to increase REM sleep [27:30]; Sleep tracking wearables—criteria for evaluation, and why Matthew favors Oura [35:00]; Does the electromagnetic force of devices have any impact on sleep? [40:15]; The relationship between fasting and sleep [46:15]; Restless leg syndrome [58:10]; Magnesium supplementation as a sleep aid [1:03:00]; The relationship between sleep deprivation and gut health [1:08:30]; The next evolution in sleep science and technology [1:16:30]; Questions Matt would like to explore if money was no issue [1:24:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/matthewwalkerama3 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

15mins

7 Sep 2020

Rank #11

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

In this special episode, Matthew Walker returns for his second AMA episode where he provides his expert insight on numerous sleep-related questions directly from listeners. He answers a wide range of questions from the gene that causes the short sleeping phenotype, to the ideal sleeping position, to the optimal temperature for best sleep, to how fasting affects sleep, plus a full dissertation on sleep apnea, and much, much more. We discuss: DEC2—A genetic mutation that produces a short sleeping phenotype [11:00]; What is the best position to sleep in? [22:45]; Should you consider a “sleep divorce” with your partner? [27:00]; The challenge of kids wanting to sleep in bed with their parents [28:45]; Is there an ideal type of pillow? [32:30]; Any data on hammock sleeping? Should adults be rocked to sleep like a baby? [34:45]; The optimal room temperature and body temperature for the best sleep [38:30]; Do humidifiers help? [50:40]; How do high altitudes affect sleep? [53:15]; What is the data on weighted blankets (e.g., the Gravity blanket)? [57:00]; Caffeine—How much, and in what way, does it affect sleep? [58:15]; How does sexual activity relate to sleep quality? [1:04:00]; Should we be sleeping in two phases? First sleep & second sleep? [1:06:30]; Napping—Is there ideal duration? Should we be napping or not? [1:08:30]; Advice for new parents dealing with sleep deprivation [1:12:00]; Understanding your sleep chronotype [1:16:15]; If you drink too much alcohol in a given night, is there anything you can do to make sure your sleep isn’t wrecked? [1:20:45]; How postmenopausal women can manage their sleep problems with (and without) hormone replacement therapy [1:23:00]; Could a daily practice of Wim Hof's breathing method help or hinder quality of sleep? [1:29:15]; Why do some people paradoxically feel more tired the more they sleep? [1:31:15]; Sleep apnea—How to know if you have it, the different types, the causes, and helpful resources [1:33:15]; Is there such a thing called “sleep eating”? [1:45:00]; If Matt was “sleep czar”, what changes would he make to society to improve sleep? [1:46:15]; Catch up sleep: Explaining the difference between retrospective damage and prospective benefit [1:48:45]; Does poor sleep really speed up the aging process? [1:50:30]; Is medicated sleep better than no sleep? [1:53:00]; Does vivid dreaming disrupt the sleep cycle? [1:56:45]; Is there potential benefit to using “binaural beats” or some type of sound to induce better sleep? [1:57:45]; How is sleep affected by fasting and time-restricted eating? [1:59:45]; Is there any evidence that polyphasic sleep (e.g., "Uberman") works? [2:03:30]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode: peterattiamd.com/matthewwalkerama2/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

29mins

28 Oct 2019

Rank #12

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

In this episode, Jason Fung, nephrologist and best-selling author, shares his experiences utilizing an individualized approach to fasting to successfully treat thousands of overweight, metabolically ill, and diabetic patients, and why being a doctor who specializes in kidney disease gives him a unique insight into early indications of metabolic disease. We also have a great discussion on insulin resistance where Jason makes the case that we should actually think of hyperinsulinemia as the underlying problem. We also discuss the difference between time-restricted feeding, intermittent fasting, and dietary restriction (e.g., low-carb) and how they can be used to attack the root cause of T2D, metabolic syndrome, and obesity. We also have a fascinating discussion about the limitations of evidence-based medicine which leads to a conversation where we compare and contrast the scientific disciplines of medicine and biology to theoretical physics.    We discuss: Comparing scientific disciplines: Medicine and biology versus physics [7:25]; The limitations of evidence-based medicine [12:30]; Early signs of metabolic disease: How specializing kidney disease gives Jason a unique insight into early indications of illness [20:50] Insulin resistance, hyperinsulinemia, and the overflow paradigm [29:30]; Why the common treatments for type 2 diabetes seem to make things worse [42:30]; How hyperinsulinemia (not insulin resistance) drives metabolic syndrome [53:15]; Insulin and weight gain, and using fasting to empty the cells of glucose [59:30]; The two step process of developing type 2 diabetes and how they are both manifestations of hyperinsulinemia [1:03:15]; NAFLD and hyperinsulinemia: A vicious cycle [1:08:30]; Are the features and symptoms of diabetes actually protective? [1:12:15]; Is obesity causing insulin resistance or is it the other way around? [1:17:30]; What role does inflammation play in obesity? [1:21:45]; CVD and cancer: Diseases of too much growth? [1:27:30]; How to reduce proliferation with rapamycin, nutrition, exercise, fasting, and manipulating hormones [1:32:45]; Getting patients to fast: How Jason and Peter utilize fasting in their practice, and how their approach differs [1:40:15]; Comparing bariatric surgery to fasting as a treatment for type 2 diabetes [1:48:00]; Why people think that fasting is bad for you [1:55:15]; Time-restricted feeding and intermittent fasting: Defining terms, and how Jason applies them in his practice [1:58:30]; A fasting case study: A diabetic patient with a non-healing foot ulcer [2:04:00]; Keys to a successful fast [2:12:45]; Muscle loss during fasting, and why Jason isn’t worried  [2:24:45]; Will fasting help a healthy person live longer? [2:31:30]; Does fasting cause gallstones? [2:38:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

2hr 42mins

24 Jun 2019

Rank #13

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

In this episode, Jason Fried, co-founder of Basecamp, shares his beliefs around achieving business success in a modern world which tends to disproportionately focus on the massive success stories (the outliers). Jason gives his honest take on companies like WeWork, Uber, and Lyft that may give off the appearance of wild success but may instead provide an example of the dangers of perverse incentives. We get into Jason’s backstory, and how his affinity for optimizing efficiency and production in the workplace culminated with the creation of Basecamp, his very successful web-based project management software business. Perhaps most importantly, we get really deep into all aspects of work-life balance and what it really means to “work hard” (Stay tuned for an AMA-style deep dive into the topic of work-life balance with Jason in the near future). In addition, Jason provides many more valuable nuggets including thoughts on some common mistakes made by businesses today, the value of giving employees autonomy, how to take the right types of risks, why he doesn’t set any goals, and much, much more. We discuss: Jason’s background and his early entrepreneurial spirit [9:45]; Views on completing higher education and the notion of hard work [24:00]; Beliefs around success in business [35:00]; WeWork, Uber, and Lyft: Poor business practices and the dangers of perverse incentives [41:30]; Jason’s early career: his redesign approach and personal motivation [56:00]; The genesis of Basecamp [1:10:00]; Why Jason does not set goals but instead focuses on a vision [1:12:15]; Workplace motivation and hiring practice [1:20:30]; The importance of luck and not overworking [1:32:00]; A framework to work less and optimize for workplace autonomy [1:38:00]; The importance of saying ‘no’ more often (and tips for doing so) [1:55:00]; A shared passion for watches [2:03:30]; Guarding against the perils of phone addiction [2:08:45]; Jason’s views on email and chat for communication [2:15:00] and; More. Learn more: https://peterattiamd.com/ Show notes page for this episode:peterattiamd.com/jasonfried Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 24mins

7 Oct 2019

Rank #14

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

In this episode, Sasha Cohen, former US Olympic figure skater, discusses the most challenging things about life as an Olympian—the pressures, the expectations, years of sacrifice, but worst of all a loss of identity post-career resulting in many former Olympians suffering from depression. We begin by talking about everything that led up to her unforgettable moment from the 2006 Olympics, and how she handled herself so beautifully in the face of disaster. Most importantly, we talk about post-skating life when she shares many insights such as the downside of constantly striving for a moment, the hollowness of achievement, and the importance of redefining our definition of success. We discuss: Sasha’s mindset going into the 2006 Olympics as the favorite [6:30]; Figure skating basics, scoring, short program vs. long program, etc. [13:40]; Sasha’s unforgettable performance at the 2006 Olympics [18:10]; Win, lose, or draw, why many Olympians suffer from a loss of identity [32:30]; Dealing with the disappointment of “losing the gold” [40:30]; The tiny window of opportunity for Olympians, and the overwhelming pressure to meet expectations [49:30]; Sasha’s unique childhood, finding figure skating, and channeling her hyperactive personality into becoming an amazing skater [1:01:30]; The consequences of extreme training at a young age, and trying to control the uncontrollable [1:10:00]; What is driving extreme athletes and Olympians to be the best? [1:18:30]; Why many former Olympians and athletes struggle with depression [1:25:00]; Refining success—How Sasha overcame her own loss of identity [1:32:30]; What advice would Sasha give her 15-year-old self? [1:40:45]; Lessons we can learn from watching the rapid downfall of many former Olympians [1:45:00]; Advice for people who are tying their identity to being “successful” or striving to be “the best” [1:56:00]; Life lessons Sasha wants to apply to being a mother to her baby boy she is expecting [2:05:00]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode:https://peterattiamd.com/sashacohen Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

2hr 13mins

4 Nov 2019

Rank #15

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

In this episode, Nir Barzilai, director of the Institute for Aging Research and expert in the genetics of longevity, discusses the evidence that metformin and rapamycin have anti-aging properties and how his TAME study aims to support this hypothesis in humans. Additionally, he describes the role of genetics in lifespan/healthspan and how it might affect important pathways such as IGF and insulin sensitivity. We discuss: Nir’s background and interest in aging and endocrinology [3:30]; History of metformin, and understanding the mechanism [11:15]; Attempting to define insulin resistance [21:15]; Metformin as a possible anti-aging drug [48:45]; The TAME trial: Targeting Aging with MEtformin [57:45]; Why Nir believes metformin can slow aging [1:16:30]; The genetic gift of centenarians [1:28:00]; IGF/GH and its impact on aging and chronic diseases [1:34:15]; Genetics/epigenetics of centenarians, gene sequencing, CETP-VV, Lp(a) [1:49:15]; Should you be taking HGH? [2:05:30]; NAD and NAD precursors (NR and NMN) [2:30:00]; Parting thoughts on metformin [2:36:15]; Possible blind spots in Nir and Peter’s thinking? [2:43:00]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

2hr 47mins

7 Jan 2019

Rank #16

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#48 – Matthew Walker, Ph.D., on sleep – Part II of III: Heart disease, cancer, sexual function, and the causes of sleep disruption (and tips to correct it)

In part 2 of this 3 part series, Matthew Walker, professor of neuroscience at UC Berkeley and expert on sleep, describes the preponderance of evidence linking poor sleep to cardiovascular disease, cancer, and sexual function. He also details the impact of cortisol on our nervous system contributing to sleep disturbances and insomnia as well as the efficacy and risks associated with the most common sleeping pills. Matthew also describes the sleep needs of teenagers and urgently lays the case that we should reconsider school start times. We also get into the effect of electronics at night, the efficacy of napping, the general impact of modern society on our sleep habits, and what changes we can make to course correct.  We discuss: Sleep and cardiovascular disease [6:00]; Fuel partitioning and dieting while sleep deprived [16:45]; Sleep and the reproductive function: testosterone, sperm count, FSH, menstrual cycles, and fertility [19:45]; The biological necessity of sleep, the lack of a “safety net”, sleep debt, and ways to course correct sleep problems [23:45]; Fighting cancer and improving immune function with sleep [34:30]; The medical profession: A culture that devalues sleep [47:30]; The sleep needs of children, the travesty of early school start times, electronics at night, and advice for parents [1:04:45]; How exposure to light affects sleep, and how modern society has changed our sleep habits  [1:26:15]; Is napping helpful? [1:36:00]; The effect of cortisol levels on sleep [1:41:15]; Are sleeping pills doing more harm than good? [1:52:15]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

2hr 4mins

8 Apr 2019

Rank #17

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

Dom digs deep into the research and application of ketogenic diets, exogenous ketones, hyperbaric oxygen treatment, and treating cancer with a metabolic approach. Plus, we lost track of the number of n=Dom experiments mentioned in this episode. We discuss: Dom’s early medical training in hyperbaric chambers [7:00]; Effect of ketones on cancer cells [20:00]; Ketones and oxygen toxicity seizures [32:00]; HBOT & its many applications [40:00]; Ketones, MCTs, and exogenous ketones [59:15]; How ketones affect blood glucose [1:20:00]; Ketone esters, salts, enantiomers vs. racemic BOHB [1:38:00]; Dom’s ketone tolerance test [1:56:00]; The metabolic management of cancer with a Press-Pulse approach [1:59:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.

2hr 43mins

16 Jul 2018

Rank #18

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

In this episode, Kyle Kingsbury, retired UFC fighter and director of human optimization at Onnit, discusses the purpose and meaning that football and MMA gave him but which also acted as a distraction from his inner demons. Kyle opens up about his use of PEDs (steroids, testosterone, HGH) in college and talks about some of the misconceptions around them. Next, Kyle talks about his battle with depression and a close call with suicide that lead to life-changing experiences with psilocybin and ayahuasca—which really became the turning point in his own journey towards being more emotionally healthy, finding inner peace, and being a better husband and father. *DISCLAIMER: The substances spoken about in this episode are illegal and by no means are we advocating for anyone to use them or experiment with them. There are physical, physiological, psychological, and legal risks around the use of these plants. This conversation is purely informational only. We discuss: Growing up in a volatile home [6:30]; Playing college football at ASU, and letting go of NFL aspirations [15:45]; Kyle’s experience taking anabolics (steroids/testosterone), misunderstood science, and fear mongering [23:15]; Kyle’s experience with taking HGH [35:30]; The Whizzinator [36:45]; Struggles with depression and drugs, and a lack of meaning after football [41:00]; Kyle’s close call with suicide, and a spiritual experience [47:15]; Finding refuge with mixed martial arts, and Kyle’s early success in cage fighting [52:30]; Lessons from Kyle’s first loss in fighting, and training for the UFC [59:45]; First experiences with psilocybin and ayahuasca, quieting the monkey mind, and finding inner peace [1:07:15]; Overt vs. covert depression, depression in men vs. women, and the transition from adaptive to maladaptive behaviors [1:16:00]; Peeling back the layers with ayahuasca: Kyle tells stories about the most transformative experiences with psychedelics [1:19:00]; Does Kyle feel like he has lost his “edge” as a result of his journey? [1:26:15]; Where would Kyle be had he not discovered the power of psychedelic medicines? [1:29:45]; Parenting: Stopping the cycle of trauma, reconnecting to our ancestral roots, and Kyle’s opinion on ayahuasca as a potential tool for kids [1:31:40]; Relationship with parents, blind spots, compassion, and forgiveness [1:37:15]; and More. Learn more: https://peterattiamd.com/ Show notes page for this episode:peterattiamd.com/kylekingsbury/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

1hr 41mins

21 Oct 2019

Rank #19