Trang chủ kỹ năng Dr. Peter Attia on Longevity Drugs, Alzheimer’s Disease, and The 3 Most...

Dr. Peter Attia on Longevity Drugs, Alzheimer’s Disease, and The 3 Most Important Levers to Pull (#517) – The Blog of Author Tim Ferriss

Artist's rendering of Peter Attia

“Caloric restriction, dietary restriction, time restriction. You’ve probably heard me go on and on about my framework, the three levers. Always pull one, sometimes pull two, occasionally pull three, never pull none.”

— Peter Attia

Dr. Peter Attia (PeterAttiaMD.com) is a former ultra-endurance athlete (e.g., swimming races of 25 miles), a compulsive self-experimenter, and one of the most fascinating human beings I know. He is one of my go-to doctors for anything performance or longevity-related.

But here is his official bio to do him justice:

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (how long you live), while simultaneously improving healthspan (how well you live).

Peter trained for five years at the Johns Hopkins Hospital in general surgery, where he was the recipient of several prestigious awards, including Resident of the Year, and the author of a comprehensive review of general surgery. He also spent two years at NIH as a surgical oncology fellow at the National Cancer Institute where his research focused on immune-based therapies for melanoma. He has since been mentored by some of the most experienced and innovative lipidologists, endocrinologists, gynecologists, sleep physiologists, and longevity scientists in the United States and Canada.

Peter earned his M.D. from Stanford University and holds a B.Sc. in mechanical engineering and applied mathematics.

Peter also hosts The Drive, a weekly, deep-dive podcast focusing on maximizing longevity and all that goes into that, from physical to cognitive to emotional health. It features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. Subscribe on Apple Podcasts, Spotify, Overcast, or wherever you listen to podcasts.

Please enjoy!

Listen to the episode on Apple Podcasts, Spotify, Overcast, Stitcher, Castbox, Google Podcasts, or on your favorite podcast platform. You can also watch the interview on YouTube.

Brought to you by Athletic Greens all-in-one nutritional supplement, Oura smart ring wearable for personalized sleep and health insights, and Eight Sleep’s Pod Pro Cover sleeping solution for dynamic cooling and heating. More on all three below.

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This episode is brought to you by Athletic Greens. I get asked all the time, “If you could only use one supplement, what would it be?” My answer is usually Athletic Greens, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. I do my best with nutrient-dense meals, of course, but AG further covers my bases with vitamins, minerals, and whole-food-sourced micronutrients that support gut health and the immune system. 

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This episode is brought to you by Oura! Oura is the company behind the smart ring that delivers personalized sleep and health insights to help you optimize just about everything. I’ve been using it religiously for at least six months, and I was introduced to it by Dr. Peter Attia. It is the only wearable that I wear on a daily basis.

With advanced sensors, Oura packs state-of-the-art heart rate, heart-rate variability, temperature, activity, and sleep monitoring technology into a convenient, noninvasive ring. It weighs less than 6 grams and focuses on three key insights—sleep, readiness, and activity.

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This episode is brought to you by Eight Sleep! Eight Sleep’s Pod Pro Cover is the easiest and fastest way to sleep at the perfect temperature. It pairs dynamic cooling and heating with biometric tracking to offer the most advanced (and user-friendly) solution on the market. Simply add the Pod Pro Cover to your current mattress and start sleeping as cool as 55°F or as hot as 110°F. It also splits your bed in half, so your partner can choose a totally different temperature.

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What was your favorite quote or lesson from this episode? Please let me know in the comments.

SCROLL BELOW FOR LINKS AND SHOW NOTES…

Want to hear Peter’s last time on the show? Listen to this conversation in which we discuss Centenarian Olympics, goblet squats, dynamic neuromuscular stabilization, intra-abdominal pressure, egg boxing, tearing phone books in half, archery hunting, non-fixed personality traits, podcasting pointers, and much more.

SELECTED LINKS FROM THE EPISODE

  • Connect with Peter Attia:

Website | Twitter | Facebook | Instagram | YouTube

  • The Peter Attia Drive Podcast
  • Peter Attia, M.D. — Fasting, Metformin, Athletic Performance, and More | The Tim Ferriss Show #398
  • Dr. Peter Attia vs. Tim Ferriss | The Tim Ferriss Show #352
  • My Life Extension Pilgrimage to Easter Island | The Tim Ferriss Show #193
  • Dr. Peter Attia on Life-Extension, Drinking Jet Fuel, Ultra-Endurance, Human Foie Gras, and More | The Tim Ferriss Show #50
  • Liquid Biopsy: Using Tumor DNA in Blood to Aid Cancer Care | National Cancer Institute
  • The Future of Liquid Biopsy | Nature
  • FDA Approves First Liquid Biopsies That Test for Mutations in Multiple Genes | Lab Tests Online
  • Grail
  • Illumina Battles US, European Antitrust Enforcers on Grail Deal | WSJ
  • Rajpaul Attariwala, M.D., PH.D.: Cancer Screening with Full-Body MRI Scans and a Seminar on the Field of Radiology | The Drive #61
  • Cancer Types | National Cancer Institute
  • Only 12% of Americans Are Metabolically Healthy | Healthline
  • Core Stability | Physiopedia
  • Strength Training | Physiopedia
  • Aerobic Exercise | Physiopedia
  • Anaerobic Exercise | Physiopedia
  • 5 Anterior Pelvic Tilt Exercises | Healthline
  • Diaphragmatic Breathing Exercises & Techniques | Cleveland Clinic
  • A Beginner’s Guide to Dynamic Neuromuscular Stabilization (DNS) | Urban Wellness Clinic Blog
  • Dynamic Neuromuscular Stabilization | The Prague School
  • Postural Restoration Institute (PRI)
  • 11 Things to Know About Cerebral Palsy | CDC
  • Training Zones Explained | Active
  • How Proper Training Affects Lactate Threshold Heart Rate | TrainingPeaks
  • What is the Difference Between Endogenous Ketones and Exogenous Ketones? | Keto 101
  • Time-Restricted Eating: A Beginner’s Guide | Healthline
  • How to Exercise While Fasting | Mark’s Daily Apple
  • DEXA Scan (DXA): Bone Density Test, What Is It & How It’s Done | Cleveland Clinic
  • Oura Ring
  • “Most People Practicing Intermittent Fasting Think They’re Getting Leaner…” | Tim Ferriss, Twitter
  • My Nutritional Framework | Peter Attia
  • The Standard American Diet in 3 Simple Charts | Mother Jones
  • Calorie Restriction Society International Forum
  • 5 Proven Benefits of BCAAs (Branched-Chain Amino Acids) | Healthline
  • BioSteel
  • Psilocybin Narrowly Beat Lexapro in Small Depression Study | Drug Discovery and Development
  • ClinicalTrials.gov
  • Psilocybin for Depression? | Peter Attia
  • Studying Studies | Peter Attia
  • Welcome to Journal Club | Peter Attia
  • Testosterone Therapy Aids Type 2 Diabetes Remission | EndocrineWeb
  • Statistical Significance | Investopedia
  • Introduction to Power Analysis | UCLA
  • Randomization and Blinding (Masking) | Boston University School of Public Health
  • Factor Analysis of the Mystical Experience Questionnaire: A Study of Experiences Occasioned by the Hallucinogen Psilocybin | Journal for the Scientific Study of Religion
  • MDMA Reaches Next Step Toward Approval for Treatment | The New York Times
  • Rick Perry Calls on Texas to Study ‘Magic Mushrooms’ to Treat PTSD | People
  • What Is ApoB? | Pritkin Longevity Center
  • Thoughts Regarding LDL-P, ApoB, and Remnants | Cholesterol Code
  • The Straight Dope on Cholesterol | Peter Attia
  • Midi-chlorian | Wookieepedia
  • Atherosclerosis | American Heart Association
  • PCSK9 Inhibition: A Game Changer in Cholesterol Management | Mayo Clinic
  • Familial Hypercholesterolemia | National Organization for Rare Disorders
  • Can I Use Red Yeast Rice Instead of a Statin to Lower My Cholesterol? | Harvard Health
  • The Alzheimer’s-Cholesterol Connection | MedPage Today
  • A Two-Minute Primer on Mendelian Randomization | TARG Bristol
  • In Genetic Analysis, Statin-Induced LDL Decline Linked to New-Onset Diabetes | Cardiology Today
  • Tendies? Diamond Hands? Your Guide to the Lingo on WallStreetBets, the Reddit Forum Fueling GameStop’s Wild Rise | Marketwatch
  • What Is Rapamycin? | New Scientist
  • Rapamycin’s Secrets Unearthed | C&EN
  • Chris Sonnenday, M.D.: The History, Challenges, and Gift of Organ Transplantation | The Drive #155
  • Interventions Testing Program (ITP) | National Institute on Aging
  • Rapamycin Fed Late in Life Extends Lifespan in Genetically Heterogeneous Mice | Nature
  • Richard Miller, M.D., Ph.D.: The Gold Standard for Testing Longevity Drugs: The Interventions Testing Program | The Drive #148
  • Matt Kaeberlein, Ph.D.: Rapamycin and Dogs — Man’s Best Friends? — Living Longer, Healthier Lives and Turning Back the Clock on Aging and Age-Related Diseasess | The Drive #10
  • Aphthous Ulcer | DermNet NZ
  • Taylor Series | Wolfram MathWorld
  • mTOR Inhibition Improves Immune Function in the Elderly | Science Translational Medicine
  • Joan Mannick, M.D. & Nir Barzilai, M.D.: Rapamycin and Metformin—Longevity, Immune Enhancement, and COVID-19 | The Drive #123
  • Acarbose: Side Effects, Dosage, Uses, and More | Healthline
  • Giardia | Parasites | CDC
  • Canagliflozin | PubChem
  • Diabetes Research and Care Through the Ages | Diabetes Care
  • Diabetes Cases in Japan Top 10 Million for the First Time | Nippon.com
  • Health Benefits Attributed to 17α-Estradiol, a Lifespan-Extending Compound, Are Mediated through Estrogen Receptor α | eLife
  • Does 17α-Estradiol/Estrogen Extend Male Human Lifespan? | NearCyan
  • No One Eats the Nubbin | Muddling Through Medical School
  • Are Saunas Good For You? | Time
  • AMA #16: Exploring Hot and Cold Therapy | The Drive #132
  • Rhonda Patrick, Ph.D.: The Performance and Longevity Paradox of IGF-1, Ketogenic Diets and Genetics, the Health Benefits of Sauna, NAD+, and More | The Drive #02
  • Brain-Derived Neurotrophic Factor (BDNF) | FoundMyFitness
  • KICKR Smart Bike Trainer for Cyclists | Wahoo Fitness
  • Indoor Cycling & Cardio Fitness Equipment | Keiser
  • GLP-1 Receptor Agonists | Hormone Health Network
  • FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014 | FDA
  • Bad Science by Ben Goldacre
  • The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman by Timothy Ferriss
  • Obesity and Energetics Offerings | IU SPHB / UAB NORC
  • Tequila, Mezcal, and Sotol | Pinkie’s
  • “Most Likely to Secede” | Tim Ferriss, Instagram
  • “Decaffeinated Brands…” | Real Genius
  • Austin Original Since 2012 | Tommy Want Wingy
  • Cosmic Cafe
  • “Drunk as a Skunk.” | Sixteen Candles
  • “Tommy Want Wingy!” | Tommy Boy
  • AMA #19: Deep Dive on Zone 2 Training, Magnesium Supplementation, and How to Engage with Your Doctor | The Drive #145
  • Iñigo San Millán, Ph.D.: Mitochondria, Exercise, and Metabolic Health | The Drive #85

SHOW NOTES

  • What is a liquid biopsy, and why is Peter excited about this recent innovation? How does it work, what is it good at detecting, and why does Peter consider the bureaucratic red tape snagging its rollout a “tragedy?” [07:22]
  • The four pillars of exercise someone seeking to improve their metabolic health should understand. [19:38]
  • A few of the major causes for modern posture problems, and methods for remedying them. [22:06]
  • If Peter were Czar for a day, here’s how he’d train children to grow up into a more habitually active adulthood. [27:23]
  • What is zone two training, and what is it designed to do? [30:35]
  • Why a ketogenic diet won’t necessarily make you lose weight (nor will an all-Doritos or all-Twizzlers diet, for that matter). [32:43]
  • What Peter has learned about fasting since the last time we talked. [35:01]
  • The pros and cons of front-loading one’s meals when observing time-restricted feeding (aka intermittent fasting). [39:08]
  • The three levers of Peter’s nutritional framework: caloric restriction, dietary restriction, time restriction. “Always pull one, sometimes pull two, occasionally pull three, never pull none.” [43:16]
  • Does Peter recommend using branched-chain amino acids to mitigate muscle loss during a fast? [47:52]
  • Thoughts on a recent New England Journal paper comparing the effects of Lexapro to psilocybin in patients with depression, and how you can (and why you should) increase your scientific literacy to best understand the results of such papers. [49:47]
  • Why the research around MDMA as a treatment for patients with PTSD comes to clearer conclusions than the study comparing Lexapro and psilocybin. [1:10:30]
  • How is Peter’s thinking evolving around apoB and its relationship to cholesterol control in the body? [1:12:24]
  • Are there any benefits to low apoB outside of lowering cardiovascular risk? [1:24:27]
  • What is Mendelian randomization, how does it allow us to infer cause when an experiment is not done, and how was it used recently to understand the correlation between lower apoB and improved all-cause mortality? [1:26:05]
  • Is Peter more bearish or bullish on rapamycin since the last time we discussed it? As someone who’s not receiving an organ transplant, why has he been taking it for the past three years? [1:29:03]
  • Beyond potentially increasing lifespan, do we know if rapamycin can reverse aging-related impairments to our healthspan, such as hearing loss? [1:40:19]
  • What are some of the other pharmacological candidates for extending lifespan or healthspan that Peter currently finds interesting? How does someone bring potential candidates to the attention of the ITP? [1:44:42]
  • How the Age of COVID may have finally driven Peter (and his poor family with whom he’s been locked down) bananas. [1:53:16]
  • Why Peter has become bullish on the efficacy of saunas no matter how vigorously the Finns try to sway him otherwise. [1:55:24]
  • Peter’s preferred method of zone two training. [1:59:57]
  • Peter’s thoughts on semaglutide, the new drug treatment for chronic weight management that was just approved by the FDA. [2:00:39]
  • Peter’s resources and recommendations for people who want to further step up their scientific literacy, improve their ability to separate fact from fiction, and discern hype from reality. [2:09:17]
  • On the botanical origins of certain Central American spirits, and the only thing about Texas that Peter doesn’t like (so far). [2:11:38]
  • Decaffeinated brands, Tommy Want Wingy, and other parting thoughts. [2:14:20]
  • As promised, here’s the segment detailing everything you ever wanted to know about zone two training: aerobic efficiency, what happens on a chemical level, current research, minimum effective dose, and long-term adaptations and benefits. [2:16:50]

PEOPLE MENTIONED

The Tim Ferriss Show is one of the most popular podcasts in the world with more than 600 million downloads. It has been selected for “Best of Apple Podcasts” three times, it is often the #1 interview podcast across all of Apple Podcasts, and it’s been ranked #1 out of 400,000+ podcasts on many occasions. To listen to any of the past episodes for free, check out this page.

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