The Peter Attia Drive

By: Peter Attia MD
  • Summary

  • The Peter Attia Drive will feature guests and experts that will offer advice and insight to help you optimize performance, health, longevity, critical thinking, and life. It’s hosted by Stanford M.D., TED speaker, and longevity expert Dr. Peter Attia, founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City.
    Copyright © Peter Attia, MD
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Episodes
  • #333 ‒ Longevity roundtable — the science of aging, geroprotective molecules, lifestyle interventions, challenges in research, and more | Steven Austad, Matt Kaeberlein, Richard Miller
    Jan 27 2025

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    In this special episode of The Drive, Peter introduces a brand-new roundtable format. Joined by three renowned experts in longevity science—Steven Austad, Richard Miller, and Matt Kaeberlein—the group explores the rapidly evolving field of geroscience. Together, they dive deep into topics like the relationship between healthspan and lifespan, evaluating interventions like rapamycin and senolytics, the role of epigenetic changes in aging, and whether GLP-1 receptor agonists hold geroprotective potential. They also tackle major challenges in funding and public acceptance of longevity research including how geroprotective interventions might be tested in humans. Packed with nuanced debate, humor, and groundbreaking insights, this episode is a must-listen for anyone fascinated by the science of aging.

    We discuss:

    • The recent rise in public interest in longevity, misconceptions, and the link between healthspan and lifespan [3:45];
    • Redefining healthspan, the US healthcare paradox, and separating longevity science from commercial hype [12:30];
    • The need to redirect medical research from disease-specific models to aging-focused approaches [21:30];
    • Proactive healthcare: rethinking health, disease, and the role of aging [30:00];
    • Biologic age versus chronologic age, and the limitations and potential of epigenetic clocks [35:00];
    • The utility and drawbacks of the “hallmarks of aging” as a framework for research and funding [49:30];
    • The role of epigenetic changes in aging and the challenges of proving causality [56:45];
    • The translational challenges of moving aging research from preclinical studies to human applications [1:03:45];
    • Distinguishing between a biomarker of aging and aging rate indicators [1:17:15];
    • The difficulties of translating longevity research in mice to humans, and the difficulties of testing interventions in humans [1:21:15];
    • Exercise, aging, and healthspan: does exercise slow aging? [1:35:45];
    • Are GLP-1 receptor agonists geroprotective beyond caloric restriction effects? [1:41:00];
    • The role of senescent cells in aging, challenges with reproducibility in studies, and differing views on the value of current research approaches [1:46:15];
    • How funding challenges and leadership in NIH and other institutes impact the advancement of aging-related research [2:00:15];
    • Metformin: geroprotective potential, mechanisms, and unanswered questions [2:02:30];
    • Canagliflozin and rapamycin as geroprotective molecules: mechanisms, dosing strategies, and longevity potential [2:10:45];
    • Resveratrol and NAD precursors—a lack of evidence for anti-aging effects [2:22:45];
    • The potential of parabiosis and plasmapheresis to slow aging, the challenges in translating mouse studies to humans, and possible design for human studies [2:29:45]; and
    • More.

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    2 hrs and 42 mins
  • #332 - AMA #67: Microplastics, PFAS, and phthalates: understanding health risks and a framework for minimizing exposure and mitigating risk
    Jan 20 2025
    View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter In this “Ask Me Anything” (AMA) episode, Peter tackles a topic that's been dominating headlines and sparking widespread concern: microplastics and plastic-associated chemicals, including BPA, PFAS, and phthalates. Peter explores the science behind these substances including how and why they've become so prevalent, the extent of our exposure, and the potential risks to our health. Most importantly, he provides a practical framework for understanding microplastics and plastic-associated chemicals and minimizing exposure while distinguishing genuine risks from exaggerated concerns. 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 #67 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: The complexity of the topic of microplastics and associated chemicals [1:30];Definitions: microplastics, BPA, PM2.5, phthalates, and more [6:30];The reasons behind the increase in microplastics in our environment and the surge in interest in them [12:00];The various ways that humans are exposed to microplastics and nanoplastics [14:00];Volume of plastic consumed by humans, and how the body eliminates or absorbs microplastics [16:00];How microplastics accumulate in the body, the variability in tissue accumulation, and the challenges in studying their long-term health effects [21:30];Limitations of blood tests for microplastics, and the importance of reliable biomarkers for guiding behavior and interventions [26:30];The speculative health risks of microplastics, the limitations of current research, and the need for more robust studies [29:15];The challenges of measuring microplastics in human tissues, the need for better methodologies, and the importance of critically evaluating study relevance and claims [39:45];If it’s unclear whether microplastics actually cause harm, should we still be concerned about exposure? [42:15];Strategies to minimize microplastic exposure [45:00];The financial cost and effort involved in various microplastic exposure mitigation strategies [51:00];The role of airborne microplastics in total exposure and accumulation [1:03:00];Chemicals associated with plastics, their role as endocrine disruptors, and the challenges in linking exposure to specific health outcomes [1:04:00];BPAs: role in plastic production, and its potential developmental risks [1:05:45];BPA's potential health risks: pregnancy, fertility, obesity, and diabetes, and the socioeconomic confounders in the data [1:08:30];Regulatory limits on BPA exposure, and practical considerations for reducing exposure [1:12:45];The prevalence of BPA in modern products and how to identify it [1:17:15]; PFAS: chemical structure and purpose in products [1:18:30]; Why PFAS are considered endocrine disruptors [1:19:45];The main sources of PFAS exposure, and practical steps to reduce exposure [1:21:30];The potential health risks of PFAS exposure [1:24:00];Phthalates: role in making plastics flexible and presence in personal care products [1:24:45];Why phthalates are considered endocrine disruptors [1:25:15];The main sources of phthalate exposure, and how manufacturing practices are evolving to reduce exposure [1:26:45];Practical strategies to reduce exposure to phthalates in food, air, water, and personal care products [1:28:30];Navigating microplastics and associated chemicals: a framework for personalized risk reduction [1:29:30]; andMore. Connect With Peter on Twitter, Instagram, Facebook and YouTube
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    25 mins
  • #331 ‒ Optimizing endurance performance: metrics, nutrition, lactate, and more insights from elite performers | Olav Aleksander Bu (Pt. 2)
    Jan 13 2025

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    Olav Aleksander Bu is an internationally renowned sports scientist acclaimed for his coaching prowess with elite athletes spanning a diverse range of sports disciplines. In this episode, Olav returns to dive deeper into his groundbreaking work as an endurance coach, exercise scientist, engineer, and physiologist. The discussion explores his data-driven approach to coaching, unpacking key performance metrics like functional threshold power, VO2 max, and lactate threshold, while emphasizing the importance of consistent testing protocols. Olav shares insights on how training methodologies differ across sports, the impact of nutrition on endurance performance, and the evolving strategies for carbohydrate metabolism in fueling athletes for races. Olav concludes with a discussion on the use of artificial intelligence for optimizing training insights and performance.

    We discuss:

    • Olav’s unique, engineering-driven approach to endurance coaching [2:45];
    • Definitions and applications of key performance metrics: FTP, power, anaerobic threshold, and lactate threshold [4:45];
    • Lactate threshold: factors affecting lactate threshold, testing protocols, and how elite athletes' efficiency affects their performance and lactate profiles [14:15]
    • VO2 max: definition, testing, factors affecting its accuracy, and methods for optimizing oxygen utilization in elite athletes [22:15];
    • Testing VO2 max: common mistakes and key factors to consider—preparation, warm-up, timing, and more [34:00];
    • VO2 max testing continued: measuring instruments, testing protocols, and advanced insights gained from elite athletes [41:45];
    • The influence of supplements like beetroot concentrate and adaptogens on VO2 max and performance [49:45];
    • How respiratory quotient (RQ) reflects metabolic shifts during exercise, the challenges in measuring and interpreting RQ in elite athletes, and the physiological adaptations needed for prolonged endurance events [53:30];
    • Triathlon training: the challenge of maintaining elite performance across triathlon distances, metabolic efficiency, and swimming challenges [1:03:15];
    • How reducing drag in swimming could revolutionize performance and the role of biofeedback tools in optimizing efficiency across various endurance sports [1:07:00];
    • How endurance athletes prioritize effort regulation using RPE, heart rate, and power output, and the role of lactate in cardiac and athletic efficiency [1:20:00];
    • Lactate’s role as a fuel, buffering methods to combat lactic acidosis, and the variability in athlete response to bicarbonate supplementation [1:25:45];
    • The physiological mechanisms behind differences in performance between two elite athletes: lactate transport, cardiovascular efficiency, and compensatory systems [1:33:00];
    • Comparing interventions like acetaminophen to enhance performance in high-heat conditions versus natural adaptations to heat [1:37:15];
    • Advancements in nutrition science, changes in cyclist body composition, and the impact of fueling strategies on athletic performance and growth [1:39:30];
    • Optimizing endurance performance with utilization of carbohydrates, and the potential role of ketones [1:48:00];
    • Insights gained from elite performers in the 2020 and 2024 Olympics [1:58:30];
    • The use of artificial intelligence to optimizing training insights and performance [2:06:30]; and
    • More.

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    2 hrs and 16 mins

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