181 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

    • Medicine

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.

    AMA #19: Deep dive on Zone 2 training, magnesium supplementation, and how to engage with your doctor

    AMA #19: Deep dive on Zone 2 training, magnesium supplementation, and how to engage with your doctor

    In this “Ask Me Anything” (AMA) episode, Peter and Bob take a deep dive into zone 2 training. They begin with a detailed definition of zone 2 and continue by discussing the importance of adding it to your exercise regimen. They talk about how to program zone 2 training, including intensity, frequency, and duration, and metrics for tracking improvement. Additionally, they provide a detailed overview of all things related to magnesium supplementation. The two conclude with insights about how to effectively engage with your doctor in the pursuit of getting your questions answered and considerations for finding a physician that’s right for you.
    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 #19 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.
    We discuss:
    Defining zone 2 exercise (3:30); The most effective ways to engage in zone 2 exercise (14:00); The process of training a deconditioned individual with zone 2: Dosage, frequency, and metrics to watch (19:45); Training for health vs. performance, and the importance dedicating training time solely to zone 2 (25:00); Why Peter does his zone 2 training in a fasted state (31:30); Improving mitochondrial density and function with zone 2 training (34:00); Metrics to monitor improving fitness levels from zone 2 training (36:30); Advice for choosing a bicycle for zone 2 exercise at home (42:30); Comparing the various equipment options for aerobic training: Rowing machine, treadmill, stairmaster, and more [48:15]; Back pain and exercise, and Peter’s stability issues as a consequence of previous surgeries (51:45); A deep dive into magnesium supplementation, and Peter’s personal protocol (55:30); Advice for engaging with and questioning your doctor (1:03:15); and More. Learn more: https://peterattiamd.com/

    Show notes page for this episode: https://peterattiamd.com/ama19

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    • 17 min
    Phil Maffetone: Optimizing health and performance through maximal aerobic function

    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

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    • 1 hr 22 min
    John Ioannidis, M.D., D.Sc.: Why most biomedical research is flawed, and how to improve it

    John Ioannidis, M.D., D.Sc.: Why most biomedical research is flawed, and how to improve it

    John Ioannidis is a physician, scientist, writer, and a Stanford University professor who studies scientific research itself, a process known as meta-research. In this episode, John discusses his staggering finding that the majority of published research is actually incorrect. Using nutritional epidemiology as the poster child for irreproducible findings, John describes at length the factors that play into these false positive results and offers numerous insights into how science can course correct. 
     
    We discuss:
    John’s background, and the synergy of mathematics, science, and medicine (2:40); Why most published research findings are false (10:00); The bending of data to reach ‘statistical significance,’ and the how bias impacts results (19:30); The problem of power: How over- and under-powered studies lead to false positives (26:00); Contrasting nutritional epidemiology with genetics research (31:00); How to improve nutritional epidemiology and get more answers on efficacy (38:45); How pre-existing beliefs impact science (52:30); The antidote to questionable research practices infected with bias and bad incentive structures (1:03:45); The different roles of public, private, and philanthropic sectors in funding high-risk research that asks the important questions (1:12:00); Case studies demonstrating the challenge of epidemiology and how even the best studies can have major flaws (1:21:30); Results of John’s study looking at the seroprevalence of SARS-CoV-2, and the resulting vitriol revealing the challenge of doing science in a hyper-politicized environment (1:31:00); John’s excitement about the future (1:47:45); and More. Learn more: https://peterattiamd.com/

    Show notes page for this episode: https://peterattiamd.com/JohnIoannidis 

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    • 1 hr 52 min
    Robert Abbott: The Bobby Knight story—a cautionary tale of unchecked anger, ego, and winning at all costs

    Robert Abbott: The Bobby Knight story—a cautionary tale of unchecked anger, ego, and winning at all costs

    Robert Abbott is a six-time Emmy award winner and the director of “The Last Days of Knight,” the behind-the-scenes documentary of legendary coach Bobby Knight, and the events that led to his termination from Indiana University. In this episode, Robert takes us through his investigative journey, which revealed cautionary tales of a winning at all costs environment—how pain often gets left in the wake of unchecked anger, ego, and perfectionism. Robert reflects on Knight’s legacy and extracts lessons in self-awareness and accountability that can be applied to ensure history doesn’t repeat itself.

    We discuss:
    Robert’s career covering sports and interesting athletes (2:30); Robert’s early impression of Bobby Knight’s controversial persona (10:15); The journalistic work that uniquely prepared Robert for his Bobby Knight story (13:30); The cost of excellence in sports—cautionary tales of ‘greatness at any cost’ (19:15); Knight’s coaching style, waning success in the 90s, and what put him on Robert’s radar (25:30); Three alarming accounts from a former player (Neil Reed) that launched Robert’s investigation into Bobby Knight (35:15); The “win-first” environment at Indiana that provided cover for Knight’s toxic behavior (44:45); Knight’s ego swells—a shift from team-first to “I” and “me” (53:00); How patience, honesty, and gaining trust with his sources paid off in his reporting on Bobby Knight (1:01:30); The vicious cycle and anger and shame, and why Bobby Knight is so interesting to Peter (1:08:00); Releasing the choking tape—Breaking open the Knight story, vindicating his earlier reporting, and the most powerful moment Robert has ever witnessed in his journalistic career (1:20:00); The bittersweet story of Neil Reed—triumph, PTSD, and breaking the cycle of pain (1:43:15); Examining Bobby Knight's legacy, and how society can avoid a repeat of similar devastating situations (1:57:30); Final thoughts on Bobby Knight and the pain left in his wake (2:08:00); and More. Learn more: https://peterattiamd.com/

    Show notes page for this episode: https://peterattiamd.com/RobertAbbott 

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    • 2 hrs 14 min
    AMA #18: Deep dive: sugar and sugar substitutes

    AMA #18: Deep dive: sugar and sugar substitutes

    In this “Ask Me Anything” (AMA) episode, Peter and Bob talk all about sugar and sugar substitutes and provide a way to think about sugar consumption. The conversation begins by defining the various forms of sugar, delineating between added sugar and naturally occurring sugar, and describing the important variables that determine the potential for metabolic damage from consumption. They then take a dive deep into three main categories of sugar substitutes—non-nutritive sweeteners, alcohol sugars, and leaving allulose, in a class by itself—including the safety profile of each, impact on blood sugar and insulin, side-effects, taste preferences, and more. 
    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 #18 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. 
    We discuss:
    Delineating the various forms of “sugar” (2:00); Added sugar vs. naturally occurring sugar (12:30); Important variables related to sugar consumption: Density, volume, and velocity (17:00); Alternatives to sugar: Non-nutritive sweeteners (22:30); Alternatives to sugar: Alcohol sugars (34:15); Alternatives to sugar: Allulose (39:00); Contextualizing risk when it comes to sugar substitutes (45:00); Why some people report feeling better when eliminating non-nutritive sweeteners from their diet (46:30); The impact of sweetness—Cephalic insulin response and the metabolic drive to eat more (49:45); and More. Learn more: https://peterattiamd.com/

    Show notes page for this episode: https://peterattiamd.com/ama18/ 

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    • 16 min
    Gerald Shulman, M.D., Ph.D.: A masterclass on insulin resistance—molecular mechanisms and clinical implications

    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 

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    • 2 hrs 8 min

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