213 episodes

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.

The Peter Attia Drive Peter Attia, MD

    • Health & Fitness
    • 5.0 • 21 Ratings

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.

    Steven Rosenberg, M.D., Ph.D.: The development of cancer immunotherapy and its promise for treating advanced cancers

    Steven Rosenberg, M.D., Ph.D.: The development of cancer immunotherapy and its promise for treating advanced cancers

    Steve Rosenberg is the Chief of Surgery at the National Cancer Institute, a position he has held continuously for the past 47 years. Steve is a pioneer in the field of immunotherapies for cancer and a recipient of nearly every major award in science. In this episode, Steve discusses his inspiration for devoting his career to cancer research and describes his keen observation of two cases of spontaneous cancer remission, driving him to learn how to harness the immune system to treat cancer. Steve’s personal story essentially serves as a roadmap for the field of immunotherapy, from the very non-specific therapies such as interleukin-2, the discovery of tumor-infiltrating lymphocytes, checkpoint inhibitors, CAR T-cells, and adoptive cell therapy. Perhaps most importantly, Steve expresses his optimism for what lies ahead, especially in the face of some of the more recent discoveries with respect to tumor antigenicity. Finally, Steve discusses the human side of cancer which helps him to never lose sight of why he chose to become a physician.

    We discuss:

    Steve’s childhood and inspiration to become a physician and medical researcher [3:15];
    Patients that influenced Steve’s thinking about cancer and altered the course of his career [13:15];
    The discovery of antigen presentation, Steve’s first job, and why he knew he wanted to study cancer [19:30];
    Cancer treatment in the early 1970’s and Steve’s intuition to utilize lymphocytes [26:45];
    Cancer cells versus non-cancer cells, and why metastatic cancer is so deadly [31:45];
    The problem with chemotherapy and promise of immunotherapy [38:30];
    How the immune system works and why it seems to allow cancer to proliferate [43:15];
    Steve discovers how to use interleukin-2 to mediate cancer regression [52:00];
    The immunogenic nature of certain cancers and the role of mutations in cancer [1:03:45];
    The improbable story of how CAR T cell therapy was developed [1:16:30];
    The discovery of tumor infiltrating lymphocytes (TIL) and engineering of T cells to recognize specific antigens [1:28:00];
    Steve’s experience treating President Ronald Reagan’s colon cancer [1:36:00];
    Why Steve has turned down many tempting job offers to focus on his research at the National Cancer Institute [1:41:00];
    The role of checkpoint inhibitors in cancer therapy and the promise of adoptive cell therapy [1:43:00];
    Optimism for using immunotherapy to cure all cancers [1:48:00];
    The human side of cancer and the important lessons Peter learned from working with Steve [1:52:15]; and
    More Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/StevenRosenberg 
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    • 2 hrs 6 min
    AMA #27: The importance of muscle mass, strength, and cardiorespiratory fitness for longevity

    AMA #27: The importance of muscle mass, strength, and cardiorespiratory fitness for longevity

    In this “Ask Me Anything” (AMA) episode, Peter and Bob discuss the longevity benefits from greater cardiorespiratory fitness (CRF) and greater muscle mass and strength. Conversely, they dive deep into the literature showing a rapid increase in morbidity and mortality risk as fitness levels decline with age. They also try to tease out the relative contributions of CRF, muscle mass, and strength. Additionally, they discuss the impact of fasting on muscle mass, the potential tradeoffs to consider, and finish by discussing why it’s critical to maximize your fitness level.

    If you’re not a subscriber and 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 on our website at the AMA #27 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    VO2 max and its association with cardiorespiratory fitness [2:45];
    Changing mortality risk based on VO2 max and cardiorespiratory fitness [7:45];
    The profound impact of improving cardiorespiratory fitness [15:15];
    Muscle mass, function, and loss with aging: how it’s defined, measured, and the cutoff points for sarcopenia [25:00];
    Increasing mortality risk associated with declining muscle mass and strength [40:00];
    Muscle size vs. strength—which has the bigger impact on mortality risk? [58:00];
    Evaluating the cumulative impact of cardiorespiratory fitness and muscular strength on mortality risk when put together [1:03:30];
    Investigating the rising incidence in deaths from falls, and what role Alzheimer’s disease might play [1:09:00];
    The impact of fasting on muscle mass and the potential tradeoffs to consider [1:14:30];
    The critical importance of working to maintain muscle mass and strength as we age [1:20:30]; and
    More. Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/ama27/ 
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    • 18 min
    Matt Kaeberlein, Ph.D.: The biology of aging, rapamycin, and other interventions that target the aging process

    Matt Kaeberlein, Ph.D.: The biology of aging, rapamycin, and other interventions that target the aging process

    Matt Kaeberlein is globally recognized for his research on the biology of aging and is a previous guest on The Drive. In this episode, Matt defines aging, the relationship between aging, chronic inflammation, and the immune system, and talks extensively about the most exciting molecules for extending lifespan. He discusses the current state of the literature of testing rapamycin (and rapalogs) in animals and humans, including Matt’s Dog Aging Project, and provides insights into how we can improve future trials by conceptualizing risk, choosing better endpoints, and working with regulators to approve such trials. He also examines the connection between aging and periodontal disease, biomarkers of aging, and epigenetic clocks. Finally, they explore some of the biological pathways involved in aging, including mTOR and its complexes, sirtuins, NAD, and NAD precursors.

    We discuss:

    The various definitions of aging [3:25];
    The relationship between disease and the biology of aging [16:15];
    Potential for lifespan extension when targeting diseases compared to targeting biological aging [22:45];
    Rapamycin as a longevity agent and the challenges of targeting the biology of aging with molecules [32:45];
    Human studies using rapalogs for enhanced immune function [39:30];
    The role of inflammation in functional declines and diseases of aging [50:45];
    Study showing rapalogs may improve the immune response to a vaccine [56:15];
    Roadblocks to studying gero-protective molecules in humans [1:01:30];
    Potential benefits of rapamycin for age-related diseases—periodontal, reproductive function, and more [1:12:15];
    Debating the ideal length and frequency of rapamycin treatment for various indications like inflammation and longevity [1:21:30];
    Biomarkers of aging and epigenetic clocks [1:29:15];
    Prospects of a test that could calculate biological age [1:37:45];
    The Dog Aging Project testing rapamycin in pet dogs [1:42:30];
    The role of the mTOR complexes [1:58:30];
    mTor inhibitor called Torin2, mitochondrial disease and other potential pathways [2:09:45];
    Catalytic inhibitors, sirtuins, and NAD [2:19:15];
    NAD precursors: help or hype? [2:28:15]; and
    More.
    Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/MattKaeberlein2 
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    • 2 hrs 40 min
    Lawrence Wright: The 20th anniversary of the 9/11 attacks: reflections on how they happened, and lessons learned and not learned

    Lawrence Wright: The 20th anniversary of the 9/11 attacks: reflections on how they happened, and lessons learned and not learned

    Lawrence Wright is the author of The Looming Tower: Al-Qaeda and the Road to 9/11 which won the 2007 Pulitzer Prize for general nonfiction and was named one of Time's top 100 books of all time.  In this episode, released just before the 20th anniversary of the September 11th attacks, Lawrence and Peter discuss the book and the lasting impact of that day. Lawrence reflects on his personal experiences on that day and how he was first drawn into reporting on the attacks. Lawrence then discusses in detail the history that led up to 9/11 which is really composed of two parallel stories. The first story is of the growing discontent in Muslim countries, the roots of Islamic radicalism, and how two extremists, Osama bin Laden and Ayman al-Zawahiri, joined forces to create the global terrorist organization Al-Qaeda. The second story is about how interpersonal and institutional conflicts between the FBI and CIA led to a massive failure in intelligence and resulted in multiple missed opportunities to predict and prevent the attacks on September 11th, 2001. Finally, they reflect on what we should have learned from 9/11 and the future of terrorism.
     
    We discuss:
    Lawrence and Peter recount their personal experiences on September 11th, 2001 [3:30]; How 9/11 changed the US into a security state and affected a generation [9:45]; Lawrence’s early coverage of 9/11 and how he knew it was going to be “the story of our lifetime” [14:45]; Egyptian politics and the foundation of radical Islam [22:45]; Anwar Sadat’s presidency, assassination, and the birth of the radical Islamic movement [33:00]; Aftermath of the Sadat assassination, and establishment of Al-Qaeda in Afghanistan [50:15]; Osama bin Laden: Upbringing, involvement in the Soviet–Afghan War, and rise to celebrity status in Saudi Arabia [56:00]; How the Western intervention in Saudi Arabia impacted Arab nationalist’s hatred of America [1:15:30]; Theorizing on the role of the religion in holding back Islamic states from making progress towards democracy [1:20:30]; Bin Laden’s time in Sudan [1:32:30]; The CIA vs. the FBI: setting the stage for the failure of US intelligence [1:37:00]; The mistake by US intelligence of not taking the bombings of the US embassies and the USS Cole seriously [1:46:00]; Al-Qaeda in America: Losing the planners of the 9/11 attacks from our clutches and incompetence at the FBI and CIA [1:56:00]; Problematic policies in Europe, and a direct message warning of the 9/11 attacks [2:14:45]; The role of political infighting and personality conflicts that helped enable the 9/11 attacks and the lack of accountability [2:22:45]; What came of the 9/11 commission, the role of the Saudi government, and the trials of Ali Soufan [2:36:00]; Lessons from 9/11 and the future of terrorism [2:46:30]; and More.  
    Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/LawrenceWright 
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    • 3 hrs 1 min
    AMA #26: Continuous glucose monitors, zone 2 training, and a framework for interventions

    AMA #26: Continuous glucose monitors, zone 2 training, and a framework for interventions

    In this “Ask Me Anything” (AMA) episode, Peter and Bob answer numerous follow-up questions to recently discussed deep-dive topics such as the use of continuous glucose monitors and getting the most from zone 2 exercise. They also discuss the incredible feats of cyclists in the Tour de France through the lens of the amazing performance physiology required from these athletes. Additionally, Peter ties the conversation together by sharing his foundational framework when considering different interventions, even in the absence of data from a randomized controlled trial.

    If you’re not a subscriber and 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 on our website at the AMA #26 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    Peter’s foundational framework when considering different interventions [1:30];
    Applying Peter’s framework to the idea of using a CGM [8:00];
    Why certain fruits have a bigger impact on glucose, and the limitations of a CGM can tell you [16:00];
    Importance of paying attention to insulin, and the prospects of a continuous monitor for insulin levels [20:00];
    How exercise impacts glucose and peak glucose numbers to stay under [24:15];
    Impact of anxiety on stress on glucose, and why it’s important to calibrate your CGM [26:30];
    The five main tools for managing blood glucose numbers [33:45];
    Benefits of moving or exercising after a meal, and where ingested carbohydrates get can be stored [37:15];
    How to make decisions about an action or intervention in the absence of data from a rigorous, randomized controlled trial [40:30];
    The incredible athletic feats of Tour de France cyclists [48:30];
    Different modalities for doing zone 2 exercise: running, rowing, cycling, and more [1:00:15];
    Proxies for knowing your in zone 2 short of using a lactate monitor [1:07:30];
    Monitoring lactate for zone 2 exercise [1:10:00]; and
    More.
    Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/ama26/ 
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    • 19 min
    Esther Perel: The effects of trauma, the role of narratives in shaping our worldview, and why we need to accept uncomfortable emotions

    Esther Perel: The effects of trauma, the role of narratives in shaping our worldview, and why we need to accept uncomfortable emotions

    Esther Perel is a psychotherapist and New York Times bestselling author who is an expert on modern relationships. In this episode, Esther describes how being a child of parents who narrowly survived the Holocaust shaped and influenced her perspectives and ultimately led to her to a career in therapy. She discusses how the generational differences in parenting, among other things, led to the rise of individualism with a focus on happiness and self-esteem to the detriment of our relationships and sense of community. Ultimately, the conversation focuses on the value of our relationships with others for one’s sense of wellbeing, ability to deal with past trauma, resilience, and even our lifespan. She uses real world case studies to emphasize the therapeutic value of creating healthy relationships with others and oneself, explaining how our relationships with others can be a mirror into our own maladaptive behaviors. Esther explains how our self-narratives, which are often shaped by past trauma, may negatively impact our relationships with others and our emotional health, and emphasizes the value in trying to change them when warranted.
     

    We discuss:

    Esther’s background, adventures in hitchhiking, and how she ended up in the US [2:30]; The lasting effects of the Holocaust on Esther’s parents [8:45]; Grappling with a dark past and feeling alive again after trauma [16:45]; How Esther came to understand her parents in a new light [23:15]; Why Esther chose therapy as her career [30:00]; Using the concept of sexuality to understand society, culture, and people [40:00]; The significance of sexual revolutions, and the similarities of medical advancements and advancements in psychotherapy [50:15]; The impact of the rise of individualism and the focus on happiness and self-esteem [56:00]; Generational differences in parenting and changing role of fathers [1:09:15]; How our narratives affect our sense of wellbeing and relationships with others, and the challenge of changing them [1:17:15]; Generational effects of past trauma, and how relationship to others can be a mirror into your maladaptive behavior [1:30:30]; The role of willpower in one’s ability change their behavior and improve their relationships [1:40:00]; How your relationships impact longevity and the importance of being capable of sitting in uncomfortable emotions [1:43:45]; Esther’s definition of resilience and the dangers of believing everything you think or feel [1:50:00]; Questions about the human condition that Esther wants to explore [1:57:30]; and More.

    Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/EstherPerel 
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    • 2 hrs 4 min

Customer Reviews

5.0 out of 5
21 Ratings

21 Ratings

mehdiyac ,

The best of the best

If you are interested in health, longevity and topics related to medicine, this is the best podcast you can find!
Thank you Peter for this incredible ressource.

kunkien ,

One of the best podcast out there

Just stunning. Can't wait every week for the download. Everytime i am amazed by the storyes behind the people, the depth of the questions, the show notes . I could go on. A must listen.

George Kozma ,

Great Content

The scientific content of the PodCasts is just great and also the notes are very interesting to follow while listening to the content

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