154 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
    • 4.8, 3.7K 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.

    #118 - Lloyd Klickstein, M.D., Ph.D.: Rapamycin, mTOR inhibition, and the biology of aging

    #118 - Lloyd Klickstein, M.D., Ph.D.: Rapamycin, mTOR inhibition, and the biology of aging

    Lloyd Klickstein is the Chief Science Officer at resTORbio, a biopharmaceutical company that develops medications to target the biology of aging. In this episode, Lloyd discusses his company’s clinical application of rapamycin and its derivatives. He also elucidates details of his 2014 paper—a paper that greatly influenced Peter’s perspective of rapamycin in the context of longevity. Peter and Lloyd go on to discuss the dose-dependent effect of rapamycin on immune function and compare rapamycin, fasting, and caloric restriction.
     
    We discuss:
    His background and decision to leave academia for translational medicine [6:15]; Translational medicine—bridging the gap between basic science and clinical medicine [10:30]; What prompted Lloyd to focus on mTOR inhibition? [18:00]; Defining mTOR, TORC1, and TORC2, and the consequences of inhibiting them with rapamycin [21:30]; Dose-dependent impact of rapamycin on immune function, mTOR inhibition, and toxicity [42:15]; Lloyd’s 2014 experiment—mTOR inhibition improves immune function in the elderly [53:00]; Insights into autophagy, antigen presentation, and the pleiotropic benefits of a rapalog, and how it compares to fasting [1:13:00]; Lloyd’s 2018 experiment—TORC1 inhibition enhances immune function and reduces infections in the elderly [1:18:45]; Creation of resTORbio, subsequent studies, and takeaways about dosing, TORC2 inhibition, and tissue selectivity [1:29:00]; Comparing the longevity effect of rapamycin, fasting, and caloric restriction [1:40:00]; Excitement around RTB101—resTORbio’s mTOR inhibiting molecule [1:47:00]; Identifying rapalogs selective for TORC1 [1:56:15]; Treating depression with ketamine, an activator of mTOR [2:00:00]; Epigenetic clocks, rapalogs, and metformin [2:03:30]; and More. Learn more: https://peterattiamd.com/

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

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    • 2 hr 14 min
    #117 - Stanley Perlman, M.D., Ph.D.: Insights from a coronavirus expert on COVID-19

    #117 - Stanley Perlman, M.D., Ph.D.: Insights from a coronavirus expert on COVID-19

    In this episode, Stanley Perlman shares insights from his impressive career studying coronaviruses—both the common and more deadly ones, like MERS and SARS. In comparing preceding coronaviruses with SARS-CoV-2, Stanley discusses how other coronaviruses can aid our current understanding of, and be used to infer about, COVID-19. He also gives his thoughts on durable immunity, therapeutic strategies, and future outbreak preparedness.


     
    We discuss:
    His background and early work with coronaviruses [2:45]; The coronavirus family—various types, common traits, and scientific understanding [9:00]; The origin of viruses, animal to human transmission, R_0, immunity, and more [17:45]; Insights from the 2002 SARS outbreak [28:30]; Insights from the 2012 MERS outbreak [35:00]; Comparing SARS-CoV-2 to MERS, SARS, and other coronaviruses [42:00]; COVID-19 survivor potential for long-term damage [53:30]; Using the current pandemic for lessons on future preparedness [57:00]; Genetic drift and the potential for long-term immunity to COVID-19 [1:07:00]; Prevention and treatment strategies for COVID-19 and future diseases [1:22:30]; Alternative hypothesis to the origin of SARS-CoV-2 [1:32:30]; Determining durable immunity to COVID-19 and what a successful vaccine looks like  [1:34:30]; and More. Learn more: https://peterattiamd.com/

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

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    • 1 hr 43 min
    #116 - AMA with Dom D’Agostino, Ph.D., Part I of II: Ketogenic diet, exogenous ketones, and exercise

    #116 - AMA with Dom D’Agostino, Ph.D., Part I of II: Ketogenic diet, exogenous ketones, and exercise

    Back by very popular demand for a special AMA episode, ketosis expert Dom D’Agostino joins Bob Kaplan, Peter’s Head of Research, to address many lingering questions about the ketogenic diet, exogenous ketones, and exercise for overall health. Dom also shares valuable insights from his personal experience with training, supplements, intermittent fasting, and other nutritional strategies to optimize his own health and performance. 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 the website show notes page.
    We discuss:
    Dom’s recent and ongoing projects [3:00]; Benefits of a ketogenic diet for an otherwise healthy person [7:00]; Book recommendations to become more knowledgeable about a ketogenic diet [11:30]; Best devices for measuring ketones [13:45]; Genetic factors that influence how someone responds to the ketogenic diet [24:45]; Ketogenic diet for those with the APOE e4 allele [28:15]; Impact of long-term ketogenic diets on thyroid function [34:25]; Low-carb and ketogenic diets for appetite control and weight management [39:00]; Ketogenic diet and the microbiome [43:00]; Comparing monounsaturated fat versus saturated fat on the ketogenic diet [45:55]; Implications of long-term genetic and epigenetic adaptations to a ketogenic diet [47:45]; Why some people see a rise in LDL-C and LDL-P when on a ketogenic diet and what they can do about it [50:15]; Should someone with familial hypercholesterolemia consider a ketogenic diet? [55:00]; Exogenous ketones—benefits, therapeutic uses, and ketone supplements that Dom has tested [56:45]; Ketogenic protocols for management of traumatic brain injuries [1:06:00]; Comparing the benefits and therapeutic uses of various medium-chain fatty acids—caprylic acid (C8), capric acid (C10), MCT oil, and coconut oil [1:08:45]; Nootropics, caffeine, and other stimulants [1:16:15]; Supplemental use of testosterone, DHEA, and creatine for muscle growth and performance [1:23:45]; Impact of fasted-state training on strength and performance [1:30:15]; Stacking exogenous ketones with MCTs for optimal effectiveness [1:33:30]; BCAA supplements during a fast for muscle preservation [1:35:45]; What app is Dom using to track his macros? [1:42:00]; Getting enough micronutrients while on a ketogenic diet [1:47:15]; Ideal macros and getting enough protein for strength training in ketosis [1:48:15]; Pros, cons, and ideal macros of one meal a day [1:51:15]; Dom’s take on “carb backloading” [1:54:45]; Dom’s take on “carb up” days for ketogenic dieters [2:01:00]; Dom’s thoughts on the carnivore diet and the paleolithic ketogenic diet [2:05:30]; Advantages of the ketogenic diet for extreme endurance athletes [2:10:30]; Impact on strength, power, and performance during the adaptation period of the ketogenic diet [2:14:00]; Fasted-state elevation in growth hormone and its impact on training [2:17:45]; Is it possible to build muscle on a ketogenic diet? [2:23:30]; Why Dom took a year off from weight training [2:28:00]; What does Dom do for cardio exercise? [2:30:45]; Protocols for hard training recovery [2:33:15]; Dom’s personal approach to fasting, time-restricted eating, and sleep [2:35:45]; People, books, and other resources that shaped Dom’s training and nutrition [2:38:45]; and More. Learn more: https://peterattiamd.com/

    Show notes page for this episode: https://peterattiamd.com/domdagostinoama01

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    • 28 min
    #115 - David Watkins, Ph.D.: A masterclass in immunology, monoclonal antibodies, and vaccine strategies for COVID-19

    #115 - David Watkins, Ph.D.: A masterclass in immunology, monoclonal antibodies, and vaccine strategies for COVID-19

    In this episode, David Watkins, professor of pathology at George Washington University, shares how insights from his HIV and Zika virus research could apply to SARS-CoV-2 protection strategies. David introduces monoclonal antibodies as an intervention to prevent and treat COVID-19 infection, and also discusses how they could be used as a hedge to vaccine development. Additionally, David’s immunology tutorial explains the innate and adaptive immune systems and their differentiated responses to viral infection.
     
    We discuss:
    Background and current interest in immunology [4:30]; Immunology 101—The innate and adaptive immune system [10:15]; Defining antibodies, importance of neutralizing antibodies, and serology testing for COVID-19 [19:00]; B cells—How they fight viruses, create antibodies, and fit into the vaccine strategy [25:00]; T cells—Role in the adaptive immune system and ability to kill infected cells to prevent viral spread [36:15]; Valuable lessons from HIV applied to SARS-CoV-2 [51:00]; Lessons taken from the hepatitis C success story [1:01:30]; Monoclonal antibodies, vaccines, and the most promising strategies for preventing and treating COVID-19 infection [1:04:45]; COVID-19 vaccines in development [1:19:00]; How David’s work with Zika virus informs his thinking on SARS-CoV-2 [1:25:20]; Why a vaccine for COVID-19 doesn’t need to be perfect to be effective [1:27:45]; and More. Learn more: https://peterattiamd.com/

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

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    • 1 hr 37 min
    #114 - Eileen White, Ph.D.: Autophagy, fasting, and promising new cancer therapies

    #114 - Eileen White, Ph.D.: Autophagy, fasting, and promising new cancer therapies

    In this episode, Eileen White, Chief Scientific Officer at the Rutgers Cancer Institute, describes the fundamental role of autophagy in the maintenance of health and prevention of neurodegeneration, cancer, and other diseases. She also goes into detail about the paradoxical finding that autophagy may benefit an existing cancer cell and help it to survive—a discovery leading to new possibilities in cancer therapy. We also discuss fasting (and molecules that induce autophagy) and the critical need to decode the proper fasting “dose” in order to improve human health.

    We discuss:
     
    Eileen’s discovery that a specific oncogene blocks apoptosis [3:40]; Defining apoptosis and its role in cancer prevention [10:00]; How cancer cells use the autophagy pathway to survive [17:20]; Stressors that induce autophagy [29:15]; The importance of autophagy in the brain and liver [32:45]; The mechanisms that can trigger autophagy to support longevity [40:00]; Evidence for cancer treatment by blocking autophagy [42:30]; Types of cancer that are most autophagy-dependent [46:45]; The autophagy paradox [52:40]; Finding a molecular signal for autophagy [59:15]; Current knowledge gaps around fasting as a tool for longevity [1:13:00]; Rapamycin, metformin, and other molecules that may induce autophagy [1:22:15]; How to study fasting and exercise as longevity tools [1:32:50]; The Nobel Prize for autophagy research [1:36:45]; Eileen’s future areas of research [1:38:25]; A fasting strategy for Alzheimer’s Disease prevention[1:49:25]; Future study of metabolism and autophagy [1:51:30]; and More.  Learn more: https://peterattiamd.com/

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

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    • 1 hr 58 min
    #113: Normative errors—a conversation with my daughter about current events

    #113: Normative errors—a conversation with my daughter about current events

    In this episode, I sit down with my daughter to discuss the brutal death of George Floyd, and the aftermath we are watching unfold. Though I have no expertise in race relations, law enforcement, or police brutality, I do have some knowledge in the training of physicians, and it is that training of doctors that I’ve been thinking about lately as it may offer one small insight into this crisis. In this very short discussion, we speak about three types of errors in medicine (and medical training), how to distinguish between the two variants that are acceptable, and the one that is unacceptable. My question, ultimately, is if such a framework can be applied to law enforcement?  
    Learn more: https://peterattiamd.com/

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    • 22 min

Customer Reviews

4.8 out of 5
3.7K Ratings

3.7K Ratings

Slackerville3 ,

Medicine Deconstructed

Highly technical content presented on a level that can be understood by most amateur scientists with a little additional research. The balance of physicians and athletes as interview guests provides unique content and insights on every episode. A must listen for anyone who wanted to become a doctor, but never put in the time in school. Thanks Peter and crew.

dreardonUAKRON ,

Essential

Very integrated and wide ranged podcast. 10/10

atop a G ,

Conversation with your daughter

Dr Attia, after listening to your thoughtful articulate conversation with your daughter it is clear that you go beyond the medical...you care about the whole person. We need more people like you in this world!

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