347 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
    • 4.7 • 6.5K 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.

    Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

    Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

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    Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease.
    We discuss:
    Julia’s training, the importance of liver health, and the challenges and innovations of hepatology [3:15]; The complex and crucial functionality of the liver, its four most essential functions, and more [8:45]; Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15]; How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45]; Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30]; The poisonous nature of ethanol to the liver [40:30]; Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15]; Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30]; Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15]; Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45]; Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45]; Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30]; Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30]; The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45]; Practical strategies for managing MAFLD [1:45:30]; The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45]; The potential of GLP-1 agonists for the treatment of MASLD [1:57:45]; How the four stages of liver disease have evolved [2:00:30]; Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15]; Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15]; Peter’s major takeaways [2:18:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 2 hr 25 min
    AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

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

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    In this “Ask Me Anything” (AMA) episode, Peter delves into the often misunderstood concept of inflammation. He first defines inflammation and differentiates between acute inflammation and chronic inflammation, the latter of which is linked to aging and a plethora of age-related diseases. Peter breaks down the intricate relationship between chronic inflammation, obesity, and metabolic health, and highlights the signs that might suggest someone may be suffering from chronic inflammation. From there, the conversation centers on actionable advice and practical steps one can take to manage and minimize chronic inflammation. He explores how diet plays a crucial role, including the potential benefits of elimination diets, and he examines the impact of lifestyle factors such as exercise, sleep, and stress management. Additionally, he discusses the relevance of food inflammatory tests and concludes by examining the potential benefits and drawbacks of drugs and supplements in managing inflammation.
    If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #59 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.
    We discuss:
    Defining inflammation (and the cultural impact of Napoleon Dynamite) [1:45]; Acute vs chronic inflammation [8:00]; The connection between chronic inflammation, aging, and age-related diseases [11:00]; The impact of inflammation on metabolic health [18:30]; Understanding and diagnosing chronic inflammation: blood tests and other approaches, and challenges with measurement [20:00]; Factors that contribute to low-level chronic inflammation [28:00]; Minimizing inflammation through diet [29:45]; The important role of fiber for gut health and inflammation [33:45]; A closer look at the impact of trans fats and saturated fats on overall health [34:45]; Why Peter prefers dietary fiber from food sources over supplements [38:30]; Debunking “superfoods”: emphasizing proven methods over marketing claims for reducing inflammation [39:00]; Is there any value in over-the-counter food inflammatory tests? [42:30]; Food elimination diets: how they work, symptoms and markers to watch, challenges and limitations [45:15]; Identifying dietary triggers for gut-related symptoms through low-FODMAP diets like the “carnivore diet” [51:15]; Dairy: the complex role of dairy on inflammation and individual responses [55:00]; Wheat: the complexities and conflicting evidence around wheat's inflammatory effects [57:45]; How exercise influences inflammation [1:02:00]; How sleep quality and duration impacts inflammation [1:07:00]; The potential impact of chronic psychological stressors on inflammation [1:13:00]; The impact of oral health on inflammation and overall well-being [1:15:00]; The role of medications in managing chronic inflammation [1:18:15]; Supplements: evaluating the efficacy of various anti-inflammatory supplements [1:22:15]; Parting thoughts and takeaways [1:27:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 24 min
    Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

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

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    In this special edition celebrating 300 episodes of The Drive, Peter discusses a variety of popular topics and health interventions and classifies them based on their level of evidence and relevance using the following categories: proven, promising, fuzzy, noise, and nonsense. Peter first delves into the topic of geroprotective molecules, covering rapamycin, metformin, NAD and its precursors, and resveratrol. Next, he explores the significance of metrics like VO2 max and muscle mass, as well as emerging concepts like blood flow restriction and stem cells. The conversation extends to nutrition, addressing questions surrounding long-term fasting, sugar consumption, sugar substitutes, and the contentious role of red meat in cancer. Peter not only provides his current stance on each topic—most of which have been covered in great detail in the previous 300 episodes—but also reflects on how his opinion may have evolved over the years.
    We discuss:
    Defining the categories of “proven, promising, fuzzy, noise, and nonsense” [3:15]; Rapamycin [9:30]; Metformin [17:00]; NAD and its precursors [24:30]; Resveratrol [32:45]; The importance of VO2 max, muscle mass, and muscular strength for lifespan [38:15]; Blood flow restriction (BFR) training [44:00]; Using stem cells to treat osteoarthritis or injury [51:30]; Fasting as a tool for longevity (and why Peter stopped his fasting protocol) [55:45]; The energy balance theory [1:06:30]; The idea that sugar is poison [1:12:00]; The idea that sugar substitutes are dangerous [1:22:15]; The debate on red meat and cancer [1:28:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 1 hr 40 min
    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

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    This is a special episode of The Drive with Peter’s friend and fellow car enthusiast Dax Shepard. In this podcast, which commemorates the 30th anniversary of the death of Brazilian Formula One legend Ayrton Senna, Dax sits down with Peter to better understand what made Senna so special and why Peter remains an enormous fan. This conversation focuses on Senna’s life, the circumstances of his death, and his lasting impact and legacy on the sport of F1.
    We discuss:
    Peter’s interest in motorsports began as a child [2:30]; The drama and dangers of F1 [6:00]; What made Senna special [13:00]; What Senna meant to Brazilians [24:00]; The cause of the fatal crash [28:15]; Why Peter is obsessed with Senna [40:30]; Being the best versus having the best record [43:30]; Senna’s unique driving style and incredible intuition about automotive engineering [46:30]; Back to the day of the dreadful race [53:00]; What Peter believes caused the crash [1:02:45]; Views on dying young, in the prime of life [1:13:00]; Senna lives on in his foundation and in safety changes adopted by F1 [1:21:00]; Statistics aren’t enough for fandom, and why people like who they do [1:24:15]; The biggest difference between F1 today and F1 in the 80s [1:28:30]; Senna’s driving superpower [1:30:30]; The fastest drivers currently in F1 [1:38:30]; Current F1 obsessions [1:45:00]; How hard it is to do what the top F1 drivers do [1:50:15]; Dax’s love of motorcycles and his AMG E63 station wagon [1:52:15]; Awesome Senna mementos from Etsy [2:01:15]; What makes specialists interesting, and Max’s devotion to F1 [2:10:15]; What Senna might have done if he had not died that day [2:14:00]; Michael Schumacher and Max Verstappen are also top F1 drivers [2:17:30]; Interlagos in Sao Paulo Brazil is always an incredible experience [2:18:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 2 hr 28 min
    Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

    Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

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    Luc van Loon is an internationally renowned expert in skeletal muscle metabolism. In this episode, Luc starts with an exploration of the roles of insulin and triglycerides in endurance exercise, highlighting their impact on skeletal muscle metabolism, and he offers profound insights into the significance of protein in this context. He elucidates how different protein types and forms influence muscle protein synthesis rates, exploring the nuances of protein absorption, digestibility, amino acid quality, and their implications for performance and recovery. Delving deeper, he differentiates between animal and plant protein sources, unraveling the distinctive properties of various protein types, from the differences between whey and casein to the emerging trends in collagen protein supplementation. Moreover, Luc dissects the intricate connections among physical activity, lean muscle mass, muscle protein synthesis induced by resistance training, and dietary protein.
    We discuss:
    Luc’s background and insights about fuel selection during exercise [3:30]; Fuel utilization during endurance exercise [9:30]; Fat metabolism, intramuscular lipids, and the nutritional dynamics of endurance sports [17:15]; The optimal window for replenishing intramuscular fat stores and glycogen post-exercise [25:15]; Luc’s interest in protein metabolism and exploration of amino acids' dual role as building blocks and signaling molecules in driving muscle protein synthesis [32:15]; How protein metabolism differs between sedentary individuals and those engaged in predominantly strength training or endurance training [38:45]; The basics of how proteins are digested and absorbed, and how muscle protein synthesis is measured [50:30]; How factors like food texture, cooking methods, and protein composition impact muscle protein synthesis, and the importance of protein distribution throughout the day [59:45]; Differences in whey and casein proteins, and the ability of ingested protein to stimulate muscle protein synthesis [1:03:30]; Dietary protein distribution and quantity for the maximization of muscle protein synthesis [1:09:00]; Muscle loss with age and inactivity and the importance of resistance exercise to maintain type II muscle fibers [1:17:15]; Differences between whey and casein proteins, and the importance of both quantity and quality of protein sources [1:28:30]; Optimizing muscle protein synthesis: exercise, timing of protein intake, protein quality, and more [1:37:00]; How to preserve muscle while trying to lose weight [1:46:00]; Anabolic resistance and overcoming it with physical activity [1:55:45]; Importance of protein intake and physical activity in hospitalized patients [2:06:30]; Reviewing the efficacy of collagen supplements [2:13:30]; Plant-based diets: how to ensure a balance of amino acids, and other considerations [2:20:30]; Future research: understanding protein metabolism in the brain [2:23:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 2 hr 30 min
    The impact of emotional health on longevity, self-audit strategies, improving well-being, and more | Paul Conti, M.D.

    The impact of emotional health on longevity, self-audit strategies, improving well-being, and more | Paul Conti, M.D.

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    Paul Conti is an author and practicing psychiatrist who specializes in helping people heal from trauma. In this episode, Paul returns to The Drive to delve into the intricate relationship between emotional health, healthspan, and lifespan. He first challenges common assumptions about the inevitable decline of emotional health with age, providing strategies for conducting a comprehensive audit of internal emotional health. He establishes a framework for the foundation of good emotional health: a balance between the generative drive, the assertive drive, and the pleasure drive. Paul also explores the nuanced dynamics of motivation, happiness, and satisfaction as it relates to material possessions, draws connections between physical and emotional well-being, confronts the impact of negative self-talk, and describes how making peace with our mortality can foster a sense of hope, purpose and well-being. Additionally, Paul offers many practical insights into initiating emotional health improvements and navigating the search for a suitable therapist.
    We discuss:
    The importance of prioritizing emotional health as we age [2:45]; The impact of emotional health on healthspan and how to foster a proactive approach to emotional well-being [7:00]; The discrepancy between outward success and inner fulfillment, and the importance of a healthy “generative drive” for genuine well-being [13:00]; A deeper dive into generative drive: impact on human behavior, resilience, purpose, and more [23:15]; Evaluating one’s inner self: introspection, self-awareness, challenging societal norms, and returning to the basics of physical and emotional well-being [29:00]; Self-auditing tools: introspection, curiosity, and exploring underlying reasons for unwanted behaviors [41:45]; Breaking free from destructive cycles by understanding the continuum of self-care and addictive behaviors and remaining curious [50:15]; Critical self talk: the malleability of one’s inner dialogue and the potential for transformative change with perseverance and self-compassion [1:00:15]; Slowing the anger response and gaining insights into the underlying triggers to achieve lasting change and self-understanding [1:13:45]; Foster gratitude and humility by achieving balance between the three drives—assertion, pleasure, and generative [1:20:45]; The conflict between intellectual understanding and emotional feelings, problematic comparison frameworks, and the importance of living in the present with intentionality [1:24:15]; How making peace with our mortality can foster a sense of hope, purpose and well-being [1:34:45]; Advice for finding a compatible therapist [1:43:45]; The key components of therapeutic progress [1:57:00]; The caricatures of four common patient phenotypes, and how to get through to them [2:05:30]; How Paul manages his own well-being and the emotional challenges that come with his line of work [2:15:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 2 hr 23 min

Customer Reviews

4.7 out of 5
6.5K Ratings

6.5K Ratings

Arob1 ,

Dr Julia W

Excellent episode. I appreciate the comprehensive information about enzymes etc. this podcast encourages me to work harder on my health

"Hey Joe" ,

Exceptional Life Advice

Podcast that I listen to over and over. Peter’s Podcasts will change your life.

kenpoengineer ,

Post Your Labwork Dr Attia

Post your Labwork report Dr Attia. No way your testosterone level is in the 400’s. You don’t even talk about your free testosterone level. Before continuing talking about Testosterone Replacement Therapy (TRT), you need to correct your understanding of it. Derek with More Plates More Dates can help you.

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