212 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
    • 4.8 • 4.5K 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.

    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 hr 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 hr 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 hr 4 min
    Steve Austad, Ph.D.: The landscape of longevity science: making sense of caloric restriction, biomarkers of aging, and possible geroprotective molecules

    Steve Austad, Ph.D.: The landscape of longevity science: making sense of caloric restriction, biomarkers of aging, and possible geroprotective molecules

    Steve Austad is a distinguished professor of biology at the University of Alabama and director of one of the Nathan Shock Centers of Excellence in aging biology. Steve's current research seeks to understand the underlying causes of aging, specifically with a long-term goal of developing medical interventions that slow the age-related decay of human health. In this episode, Steve tells Peter about his unusual childhood and stints as a cab driver and lion tamer. He goes on to describe what led to his focus on studying aging and some of the major challenges and limitations of working with laboratory animals. Steve and Peter talk about the relationship between caloric restriction and lifespan, including some of the most important studies exploring this question. Additionally, they hypothesize what might explain the sex-related differences in longevity between men and women, explain the importance of finding longevity biomarkers, and discuss the most promising molecules as potential longevity agents.

    We discuss:

    Steve’s background and unusual childhood [2:30];
    Steve’s adventures driving a cab in New York City [9:00];
    How Steve drove to LA and accidentally became a lion tamer [13:30];
    How Steve’s early graduate school experiences led him to study longevity [23:00];
    The challenges and limitations of working with lab mice [30:45];
    The connection between caloric restriction and lifespan [43:00];
    Mice vs. rats and rodent aging experiments [51:15];
    The impact of dietary composition and the harm of sucrose: Comparing two caloric-restriction studies in monkeys [56:00];
    Challenges of studying animals due to major differences in the lab animal vs. wild animals [1:10:00];
    Human studies of calorie restriction [1:24:45];
    Better dietary protocols for humans: Alternatives to long-term caloric restriction [1:33:45];
    The protective effect of fasting [1:38:00];
    Reflecting on the sex differences in human lifespan, and why women have more neurodegenerative diseases [1:45:45];
    The importance of identifying longevity biomarkers and which ones show the potential to change the landscape of longevity research [2:03:30];
    Molecules showing the most promise as longevity agents [2:14:00]; and
    More. Learn more: https://peterattiamd.com/
    Show notes page for this episode: https://peterattiamd.com/SteveAustad
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    • 2 hr 26 min

Customer Reviews

4.8 out of 5
4.5K Ratings

4.5K Ratings

Nicholas book lover ,

Thank you.

Great podcast and beyond informative. As a health care worker I am thankful for people like Dr. Peter Attia and his ability and skill and craftsmanship to composing and producing this show. Words can do no justice to how this is truly educational to people everywhere. Knowledge is power, thank you for sharing. Please keep it going!

Schwke01 ,

Top Notch

I’ve never written a review on a podcast before, but felt compelled after listening intently to the interview with Lawrence Wright. What an enthralling three hour conversation. Thank you to Dr. Attia for sharing this with the world and for his work in advancing human health.

Ben Connelly ,

Some Episodes of The Drive Should be Required Listening

I have learned a lot listening to Peter Attia’s show. Some of the episodes are a bit technical, but I enjoy the challenge and learn something even when much of it goes over my head. I love expanding my mind and knowledge in new areas and this show has been perfect for learning more about the human body, health, longevity, and performance. Also, it’s fun and entertaining.

The vaccine episodes were very good. I was a small kid when the Wakefield stuff first came out so I did not know a lot about the origins of the anti-vax movement. I also thought the episodes with Jocko, Hugh Jackman, Richard Isaacson, Katherine Eban, Rhonda Patrick, and Jason Fung were very good. And so many others I’m forgetting.

The episodes with Dr. Matthew Walker should be required listening for every human being. I have trouble summarizing everything I learned in them to all the sleep-skeptics in my life.

Anyone interested in exercise, nutrition, fasting!, and the diseases of cancer, Alzheimer’s, heart disease, and diabetes, should listen to this podcast.

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